WorldWideScience

Sample records for providing risk reduction

  1. Randomized Comparison of Mobile and Web-Tools to Provide Dementia Risk Reduction Education: Use, Engagement and Participant Satisfaction.

    Science.gov (United States)

    O'Connor, Elodie; Farrow, Maree; Hatherly, Chris

    2014-01-01

    information-based website reported significantly higher scores on their ratings of the ease of navigation, F2,190=4.20, P=.02, than those using the mobile phone app and the interactive website. There were no significant differences between groups on ratings of ease of understanding the information, F2,188=0.27, P=.76. Most participants from each of the three intervention groups indicated that they intended to keep using the dementia risk reduction eHealth tool. Overall, results indicated that while participants across all three intervention groups reported a generally positive experience with the targeted dementia risk reduction tools, participants using the information-based website provided a more favorable evaluation across a range of areas than participants using the mobile phone app. Further research is required to investigate whether targeted dementia risk reduction tools, in the form of interactive websites and mobile apps, can be improved to provide benefits above those gained by providing static information alone.

  2. Risk reduction before surgery. The role of the primary care provider in preoperative smoking and alcohol cessation

    DEFF Research Database (Denmark)

    Tønnesen, Hanne; Faurschou, Pernille; Ralov, Helge

    2010-01-01

    Daily smokers and hazardous drinkers are high-risk patients, developing 2-4 times more complications after surgery. Preoperative smoking and alcohol cessation for four to eight weeks prior to surgery halves this complication rate. The patients' preoperative contact with the surgical departments m...... might be too brief for the hospital to initiate these programmes. Therefore, it was relevant to evaluate a new clinical practice which combined the general practitioner's (GP) referral to surgery with a referral to a smoking and alcohol intervention in the surgical pathway.......Daily smokers and hazardous drinkers are high-risk patients, developing 2-4 times more complications after surgery. Preoperative smoking and alcohol cessation for four to eight weeks prior to surgery halves this complication rate. The patients' preoperative contact with the surgical departments...

  3. Risk reduction before surgery. The role of the primary care provider in preoperative smoking and alcohol cessation

    DEFF Research Database (Denmark)

    Tønnesen, Hanne; Faurschou, Pernille; Ralov, Helge

    2010-01-01

    Daily smokers and hazardous drinkers are high-risk patients, developing 2-4 times more complications after surgery. Preoperative smoking and alcohol cessation for four to eight weeks prior to surgery halves this complication rate. The patients' preoperative contact with the surgical departments...... might be too brief for the hospital to initiate these programmes. Therefore, it was relevant to evaluate a new clinical practice which combined the general practitioner's (GP) referral to surgery with a referral to a smoking and alcohol intervention in the surgical pathway....

  4. A process to provide harmonised criteria for the selection of indicators for pesticide risk reduction within the framework of the sustainable use directive.

    Science.gov (United States)

    Calliera, Maura; Marchis, Alex; Bollmohr, Silke; Sacchettini, Gabriele; Lamastra, Lucrezia; Capri, Ettore

    2013-04-01

    In October 2009, the Council of the European Union adopted the Directive on Sustainable Use of Pesticides (EU 128/2009/EC). This directive establishes a framework to achieve the sustainable use of pesticides by reducing the risk and impacts of pesticide use on both human health and the environment, and promoting the use of integrated pest management and of alternative approaches or techniques. These risks thus need to be assessed using appropriate risk indicators. The OPERA Research Centre organised an expert working group and has had several consultations with stakeholders in order to identify a common way of thinking in evaluating and identifying the factors that should be considered in selecting each indicator. Harmonised criteria have been suggested to allow the selection of the most appropriate indicators, focusing on the use phase of pesticide, as requested by the sustainable use directive. The proposed methodology has led to a sharing of perspectives and knowledge between the experts involved, and some principles have been identified to help national regulatory institutions to estimate general trends in pesticide risk reduction. © 2012 Society of Chemical Industry.

  5. The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial

    Directory of Open Access Journals (Sweden)

    Leemrijse Chantal J

    2012-06-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the leading cause of death worldwide. Secondary prevention is essential, but participation rates for cardiac rehabilitation are low. Furthermore, current programmes do not accomplish that patients with CVD change their lifestyle in a way that their individual risk factors for recurrent events decrease, therefore more effective interventions are needed. In this study, the effectiveness of the Hartcoach-programme, a telephonic secondary prevention program focussing on self management, is studied. Methods/design A multicenter, randomised parallel-group study is being conducted. Participants are 400 patients with acute myocardial infarction (STEMI, NSTEMI, and patients with chronic or unstable angina pectoris (IAP. Patients are recruited through the participating hospitals and randomly assigned to the experimental group (Hartcoach-programme plus usual care or the control group (usual care. The Hartcoach-programme consists of a period of six months during which the coach contacts the patient every four to six weeks by telephone. Coaches train patients to take responsibility for the achievement and maintenance of the defined target levels for their particular individual modifiable risk factors. Target levels and treatment goals are agreed by the nurse and patient together. Data collection is blinded and occurs at baseline and after 26 weeks (post-intervention. Primary outcome is change in cardiovascular risk factors (cholesterol, body mass index, waist circumference, blood pressure, physical activity and diet. Secondary outcomes include chances in glucose, HbA1c, medication adherence, self-management and quality of life. Discussion This study evaluates the effects of the Hartcoach-programme on the reduction of individual risk factors of patients with CVDs. Patients who are not invited to follow a hospital based rehabilitation programme or patients who are unable to adhere to such a programme, may be

  6. 76 FR 40320 - Risk Reduction Program

    Science.gov (United States)

    2011-07-08

    ... Federal Railroad Administration 49 CFR Chapter II RIN 2130-AC11 Risk Reduction Program AGENCY: Federal... development of a regulation requiring certain railroads to develop a Risk Reduction Program (RRP). The Rail... reduction programs. Risk reduction is a comprehensive, system-oriented approach to safety that (1...

  7. RISK REDUCTION FOR MATERIAL ACCOUNTABILITY UPGRADES.

    Energy Technology Data Exchange (ETDEWEB)

    FISHBONE, L.G.; SISKIND, B.

    2005-05-16

    We present in this paper a method for evaluating explicitly the contribution of nuclear material accountability upgrades to risk reduction at nuclear facilities. The method yields the same types of values for conditional risk reduction that physical protection and material control upgrades yield. Thereby, potential material accountability upgrades can be evaluated for implementation in the same way that protection and control upgrades are evaluated.

  8. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    of postoperative intensive care admission. Even passive smoking is associated with increased risk at operation. Preoperative smoking intervention 6-8 weeks before surgery can reduce the complications risk significantly. Four weeks of abstinence from smoking seems to improve wound healing. An intensive, individual......Smoking is a well-known risk factor for perioperative complications. Smokers experience an increased incidence of respiratory complications during anaesthesia and an increased risk of postoperative cardiopulmonary complications, infections and impaired wound healing. Smokers have a greater risk...... approach to smoking intervention results in a significantly better postoperative outcome. Future research should focus upon the effect of a shorter period of preoperative smoking cessation. All smokers admitted for surgery should be informed of the increased risk, recommended preoperative smoking cessation...

  9. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    Smoking is a well-known risk factor for perioperative complications. Smokers experience an increased incidence of respiratory complications during anaesthesia and an increased risk of postoperative cardiopulmonary complications, infections and impaired wound healing. Smokers have a greater risk...... of postoperative intensive care admission. Even passive smoking is associated with increased risk at operation. Preoperative smoking intervention 6-8 weeks before surgery can reduce the complications risk significantly. Four weeks of abstinence from smoking seems to improve wound healing. An intensive, individual...... approach to smoking intervention results in a significantly better postoperative outcome. Future research should focus upon the effect of a shorter period of preoperative smoking cessation. All smokers admitted for surgery should be informed of the increased risk, recommended preoperative smoking cessation...

  10. Sound transit climate risk reduction project.

    Science.gov (United States)

    2013-09-01

    The Climate Risk Reduction Project assessed how climate change may affect Sound Transit commuter rail, light rail, and express bus : services. The project identified potential climate change impacts on agency operations, assets, and long-term plannin...

  11. RISK TRANSFER AND RISK REDUCTION OF ATHLETES

    Directory of Open Access Journals (Sweden)

    Željko Vojinović

    2011-09-01

    Full Text Available One of the indispensable factors in sports is insurance. The accidents influence not only the health, permanently or temporarily,they also influence the financial resources, more or less, depending on the recovery time of the injuries. Insurer in this case pay the agreed amount (the agreed compensation to the insured. Each participant in the sporting competition should have personal insurance. The reasons for the theme are to find ways to explain how athletes can reduce the risks they are exposed to in doing their activities, training and competition, and other moments in life. Every man has a need for certainty in the future, regardless of the category in which he works, the values and skills available. The only difference is in absolute values and everyone has his own need. Athletes ,those from less successful to the most successful ones, whose transfers or fees are in millions, all think about the future and of course how to save and invest funds that are earned. They can find a solution in insurance, as an institution that takes over their risks, taking care of the invested money and benefits of those stakes. When there is uncertainty in our lives we seek security and see it as a basic need. Insurers claim that insurance offers just that - the security of property and life

  12. Caries risk after interproximal enamel reduction.

    Science.gov (United States)

    Jarjoura, Karim; Gagnon, Genevieve; Nieberg, Lewis

    2006-07-01

    Air-rotor stripping (ARS) is a commonly used method to alleviate crowding in the permanent dentition. Its widespread acceptance, however, has been limited by the potential increase in caries risk of the abraded enamel surface. The aim of this study was to compare the susceptibility of ARS-treated enamel surfaces with intact surfaces in patients undergoing fixed orthodontic therapy. Forty patients treated with ARS were examined clinically and radiographically for caries 1 to 6 years after interproximal enamel reduction. All patients were seen by their dentists for prophylaxis at 6-month intervals during active orthodontic treatment and were exposed to fluoridated water and toothpaste. Topical fluoride agents or sealants were not applied on the abraded surface after any ARS session. Caries incidence was compared between ARS-treated and unaltered surfaces within subjects. The decayed, missing, filled tooth (DMFT) and surface (DMFS) scores were used to evaluate the subjects' overall caries risk. Totals of 376 test and 376 control surfaces were examined. The number of interproximal lesions detected was found to be low with no statistically significant difference detected between the groups (test = 3; control = 6; P = .33]. The DMFT and DMFS scores increased significantly during the study period, indicating that these patients were clearly at risk of tooth decay (P caries is not affected by ARS. Furthermore, our data show that the application of topical fluoride on the enamel surfaces immediately after ARS in patients exposed to fluoridated water and fluoride-containing toothpaste may not provide any additional benefit.

  13. [Substances considered addictive: prohibition, harm reduction and risk reduction].

    Science.gov (United States)

    Menéndez, Eduardo

    2012-01-01

    Latin America is currently the region with the highest rate of homicides worldwide, and a large part of the killings are linked to so-called organized crime, especially drug trafficking. The trafficking of drugs is a consequence of the illegality of certain substances which - at least presently - is based in and legitimated by biomedical criteria that turns the production, commercialization and often the consumption of certain substances considered addictive into "offenses against health." This text briefly analyzes the two policies formulated and implemented thus far in terms of prohibition and harm reduction, considering the failure of prohibitionism as well as the limitations of harm reduction proposals. The constant and multiple inconsistencies and contradictions of prohibitionism are noted, indicating the necessity of regarding cautiously repeated comments about its "failure." The text proposes the implementation of a policy of risk reduction that includes not only the behavior of individuals and groups, but also the structural dimension, both in economic-political and cultural terms.

  14. Women's experiences with isotretinoin risk reduction counseling.

    Science.gov (United States)

    Werner, Carly A; Papic, Melissa J; Ferris, Laura K; Lee, Jessica K; Borrero, Sonya; Prevost, Noel; Schwarz, Eleanor Bimla

    2014-04-01

    Isotretinoin, an effective anti-acne therapy, is a known teratogen that is strictly regulated through the iPLEDGE program. However, since this program has not significantly reduced rates of pregnancies exposed to isotretinoin, new strategies for reducing rates of isotretinoin-exposed pregnancies are needed. To explore women's experiences with counseling about isotretinoin risk reduction. Structured interviews were conducted between January and September 2012. Two independent coders performed content analysis using a grounded theory approach. The study participants were 16 women who had used isotretinoin to treat severe skin disease and who were recruited from a single urban community via flyers displayed on college campuses, at dermatology clinics, and at student health facilities. Perceptions of isotretinoin-associated risks and understanding of ways teratogenic risks can be avoided. Participants clearly understood that isotretinoin is teratogenic but had less understanding of contraceptive methods that effectively prevent pregnancy. Most described the counseling they received as anxiety provoking. Few were counseled about highly effective reversible contraceptives such as the subdermal implant or intrauterine contraception; most counseling focused on oral contraceptives. Women cited multiple influences on their contraceptive choices, including friends, family, physicians, the internet, and other media; however, some expressed concerns about the accuracy of these sources of information. For many, iPLEDGE was their first introduction to contraception. When presented with evidence-based information on the relative effectiveness of available contraceptives, participants expressed surprise that this was not part of the iPLEDGE materials. Since few clinicians provide women information on highly effective (ie, intrauterine or subdermal) contraceptives, the iPLEDGE program increases anxiety about isotretinoin more than it helps women feel protected from the teratogenic

  15. Pediatric health promotion through risk reduction.

    Science.gov (United States)

    Morris, N M

    1980-05-01

    The purpose of pediatric risk reduction is to both decrease the force of mortality acting in infancy and childhood and to promote the development of physically and emotionally comfortable adults. Due to the fact that much of the organism's capacity for optimal growth and development seems to be established during childhood, the ultimate potential of pediatric risk reduction is the improvement of the quality of life throughout its entire course. In discussing the concern of pediatric health promotion through risk reduction, attention is directed to the risks to children (mortality and morbidity risks), recommendations for pediatric risk reduction (family planning, prenatal care, care at birth, postnatal followup, and child health supervision), and children's life style and society. Risks may be divided into those affecting the child by their impact on the mother and those that affect the child directly. Maternal mortality represents a loss to any child in the family, as well as being the possible cause of an associated fetal or neonatal death. Infant mortality is largely due to conditions related to premature birth and congenital anomalies. True family planning is an essential measure for the reduction of pediatric risk. Possibly the most helpful approaches include the provision of sex education to adolescents and ensuring the availability of birth control devices. Research evidence shows that it is in the best interests of the child for parents to space pregnancies 2 or more years apart. Prenatal care needs to begin before conception occurs; both parents should be in optimal health. The need for education of parents who are having their 1st child cannot be overemphasized; much self-care and home care is both necessary and desirable.

  16. Child Participation and Disaster Risk Reduction

    Science.gov (United States)

    Lopez, Yany; Hayden, Jacqueline; Cologon, Kathy; Hadley, Fay

    2012-01-01

    It has been shown that child participation can have positive results in the rescue, relief and rehabilitation phases of a disaster. Currently child participation is achieving increased attention as a component of disaster risk reduction (DRR). This paper examines the ongoing dialogues on child participation and reviews pertinent literature…

  17. Risk Reduction Education: Voices from the Field

    Science.gov (United States)

    Lamorey, Suzanne

    2010-01-01

    Teens with disabilities need information about risk topics such as addiction, abuse, sex, and delinquency to make healthy choices as they participate in mainstream society. This article presents questionnaire-based information provided by special educators in secondary schools about their efforts, limitations, and needs in providing risk reduction…

  18. Ecosystem Approach To Flood Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    RK Kamble

    2013-12-01

    Full Text Available India is one of the ten worst disaster prone countries of the world. The country is prone to disasters due to number of factors; both natural and anthropogenic, including adverse geo-climatic conditions, topographical features, environmental degradation, population growth, urbanisation, industrlisation, non-scientific development practices etc. The factors either in original or by accelerating the intensity and frequency of disasters are responsible for heavy toll of human lives and disrupting the life support systems in the country. India has 40 million hectares of the flood-prone area, on an average, flood affect an area of around 7.5 million hectares per year. Knowledge of environmental systems and processes are key factors in the management of disasters, particularly the hydro-metrological ones. Management of flood risk and disaster is a multi-dimensional affair that calls for interdisciplinary approach. Ecosystem based disaster risk reduction builds on ecosystem management principles, strategies and tools in order to maximise ecosystem services for risk reduction. This perspective takes into account the integration of social and ecological systems, placing people at the centre of decision making. The present paper has been attempted to demonstrate how ecosystem-based approach can help in flood disaster risk reduction. International Journal of Environment, Volume-2, Issue-1, Sep-Nov 2013, Pages 70-82 DOI: http://dx.doi.org/10.3126/ije.v2i1.9209

  19. Provider-based Medicare risk contracting and subcontracting: opportunities and risks for provider sponsored organizations.

    Science.gov (United States)

    Levin, H A; Zenner, P A; Kipp, R A; Whitney, E L

    1997-01-01

    Provider sponsored organizations (PSOs) are increasingly acquiring the risk for the management of Medicare Risk patients by accepting capitation directly from the Health Care Financing Administration (HCFA) or through contracts with HMOs or other organizations contracting with HCFA. The Medicare population and the requirements that the federal administration has put into place with respect to risk contracting are unique and demand specific responses on the part of the PSO for a contract to be successful. The PSO is cautioned to understand the actuarial risk, the clinical uniqueness of the Medicare beneficiary, Medicare reimbursement regulatory requirements, utilization management needs, and necessary reporting before entering into a contractual arrangement. This article attempts to describe some of the more common issues a provider organization must consider.

  20. Semantic Mediation Tool for Risk Reduction Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This project focuses on providing an infrastructure to aid the building of ontologies from existing NASA applications, in a manner that leads to long-term risk...

  1. Waiting for Disasters: A Risk Reduction Assessment of Technological Disasters

    Science.gov (United States)

    Rovins, Jane; Winningham, Sam

    2010-05-01

    This session provides a risk reduction/mitigation assessment of natural hazards causation of technological disasters and possible solution. People use technology in an attempt to not only control their environment but nature itself in order to make them feel safe and productive. Most strategies for managing hazards followed a traditional planning model i.e. study the problem, identify and implement a solution, and move on to the next problem. This approach is often viewed as static model and risk reduction is more of an upward, positive, linear trend. However, technological disasters do not allow risk reduction action to neatly fit this upward, positive, linear trend with actual or potential threats to the environment and society. There are different types of technological disasters, including industrial accidents; pipeline ruptures; accidents at power, water and heat supply systems and other lines of communication; sudden collapse of buildings and mines; air crashes; shipwrecks; automobile and railway accidents to name a few. Natural factors can play an essential role in triggering or magnifying technological disasters. They can result from the direct destruction of given technical objects by a hazardous natural process such as the destruction of an atomic power plant or chemical plant due to an earthquake. Other examples would include the destruction of communications or infrastructure systems by heavy snowfalls, strong winds, avalanches. Events in the past ten years clearly demonstrate that natural disasters and the technological disasters that accompany them are not problems that can be solved in isolation and risk reduction can play an important part. Risk reduction was designed to head off the continuing rising financial and structural tolls from disasters. All Hazard Risk Reduction planning was supposed to include not only natural, but technological, and human-made disasters as well. The subsequent disaster risk reduction (DRR) indicators were to provide the

  2. The feasibility of integrating alcohol risk-reduction counseling into ...

    African Journals Online (AJOL)

    This pretest-posttest separate-sample study with intervention and comparison groups documented the abilities and willingness of trained voluntary counseling and testing (VCT) service providers to integrate alcohol screening and risk reduction counseling into their routine service delivery. Pre-test (n=1073) and post-test ...

  3. Mathematical modelling of risk reduction in reinsurance

    Science.gov (United States)

    Balashov, R. B.; Kryanev, A. V.; Sliva, D. E.

    2017-01-01

    The paper presents a mathematical model of efficient portfolio formation in the reinsurance markets. The presented approach provides the optimal ratio between the expected value of return and the risk of yield values below a certain level. The uncertainty in the return values is conditioned by use of expert evaluations and preliminary calculations, which result in expected return values and the corresponding risk levels. The proposed method allows for implementation of computationally simple schemes and algorithms for numerical calculation of the numerical structure of the efficient portfolios of reinsurance contracts of a given insurance company.

  4. Using alternative statistical formats for presenting risks and risk reductions.

    Science.gov (United States)

    Akl, Elie A; Oxman, Andrew D; Herrin, Jeph; Vist, Gunn E; Terrenato, Irene; Sperati, Francesca; Costiniuk, Cecilia; Blank, Diana; Schünemann, Holger

    2011-03-16

    The success of evidence-based practice depends on the clear and effective communication of statistical information. To evaluate the effects of using alternative statistical presentations of the same risks and risk reductions on understanding, perception, persuasiveness and behaviour of health professionals, policy makers, and consumers. We searched Ovid MEDLINE (1966 to October 2007), EMBASE (1980 to October 2007), PsycLIT (1887 to October 2007), and the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2007, Issue 3). We reviewed the reference lists of relevant articles, and contacted experts in the field. We included randomized and non-randomized controlled parallel and cross-over studies. We focused on four comparisons: a comparison of statistical presentations of a risk (eg frequencies versus probabilities) and three comparisons of statistical presentation of risk reduction: relative risk reduction (RRR) versus absolute risk reduction (ARR), RRR versus number needed to treat (NNT), and ARR versus NNT. Two authors independently selected studies for inclusion, extracted data, and assessed risk of bias. We contacted investigators to obtain missing information. We graded the quality of evidence for each outcome using the GRADE approach. We standardized the outcome effects using adjusted standardized mean difference (SMD). We included 35 studies reporting 83 comparisons. None of the studies involved policy makers. Participants (health professionals and consumers) understood natural frequencies better than probabilities (SMD 0.69 (95% confidence interval (CI) 0.45 to 0.93)). Compared with ARR, RRR had little or no difference in understanding (SMD 0.02 (95% CI -0.39 to 0.43)) but was perceived to be larger (SMD 0.41 (95% CI 0.03 to 0.79)) and more persuasive (SMD 0.66 (95% CI 0.51 to 0.81)). Compared with NNT, RRR was better understood (SMD 0.73 (95% CI 0.43 to 1.04)), was perceived to be larger (SMD 1.15 (95% CI 0.80 to 1.50)) and was more

  5. The Global Earthquake Model and Disaster Risk Reduction

    Science.gov (United States)

    Smolka, A. J.

    2015-12-01

    Advanced, reliable and transparent tools and data to assess earthquake risk are inaccessible to most, especially in less developed regions of the world while few, if any, globally accepted standards currently allow a meaningful comparison of risk between places. The Global Earthquake Model (GEM) is a collaborative effort that aims to provide models, datasets and state-of-the-art tools for transparent assessment of earthquake hazard and risk. As part of this goal, GEM and its global network of collaborators have developed the OpenQuake engine (an open-source software for hazard and risk calculations), the OpenQuake platform (a web-based portal making GEM's resources and datasets freely available to all potential users), and a suite of tools to support modelers and other experts in the development of hazard, exposure and vulnerability models. These resources are being used extensively across the world in hazard and risk assessment, from individual practitioners to local and national institutions, and in regional projects to inform disaster risk reduction. Practical examples for how GEM is bridging the gap between science and disaster risk reduction are: - Several countries including Switzerland, Turkey, Italy, Ecuador, Papua-New Guinea and Taiwan (with more to follow) are computing national seismic hazard using the OpenQuake-engine. In some cases these results are used for the definition of actions in building codes. - Technical support, tools and data for the development of hazard, exposure, vulnerability and risk models for regional projects in South America and Sub-Saharan Africa. - Going beyond physical risk, GEM's scorecard approach evaluates local resilience by bringing together neighborhood/community leaders and the risk reduction community as a basis for designing risk reduction programs at various levels of geography. Actual case studies are Lalitpur in the Kathmandu Valley in Nepal and Quito/Ecuador. In agreement with GEM's collaborative approach, all

  6. NASA's Orbital Space Plane Risk Reduction Strategy

    Science.gov (United States)

    Dumbacher, Dan

    2003-01-01

    This paper documents the transformation of NASA s Space Launch Initiative (SLI) Second Generation Reusable Launch Vehicle Program under the revised Integrated Space Transportation Plan, announced November 2002. Outlining the technology development approach followed by the original SLI, this paper gives insight into the current risk-reduction strategy that will enable confident development of the Nation s first orbital space plane (OSP). The OSP will perform an astronaut and contingency cargo transportation function, with an early crew rescue capability, thus enabling increased crew size and enhanced science operations aboard the International Space Station. The OSP design chosen for full-scale development will take advantage of the latest innovations American industry has to offer. The OSP Program identifies critical technologies that must be advanced to field a safe, reliable, affordable space transportation system for U.S. access to the Station and low-Earth orbit. OSP flight demonstrators will test crew safety features, validate autonomous operations, and mature thermal protection systems. Additional enabling technologies may be identified during the OSP design process as part of an overall risk-management strategy. The OSP Program uses a comprehensive and evolutionary systems acquisition approach, while applying appropriate lessons learned.

  7. Provider Opinions Regarding the Development of a Stigma-Reduction Intervention Tailored for Providers

    Science.gov (United States)

    Mittal, Dinesh; Corrigan, Patrick; Drummond, Karen L.; Porchia, Sylvia; Sullivan, Greer

    2016-01-01

    Interventions involving contact with a person who has recovered from mental illness are most effective at reducing stigma. This study sought input from health care providers to inform the design of a contact intervention intended to reduce provider stigma toward persons with serious mental illness. Using a purposive sampling strategy, data were…

  8. Long-Term International Space Station (ISS) Risk Reduction Activities

    Science.gov (United States)

    Fodroci, M. P.; Gafka, G. K.; Lutomski, M. G.; Maher, J. S.

    2012-01-01

    As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the initial ISS requirements and design were intended to provide the best practicable levels of safety, it is always possible to further reduce risk - given the determination, commitment, and resources to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS, and to reduce risk to all crewmembers. While years of work went into the development of ISS requirements, there are many things associated with risk reduction in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity Hazard Level- 4 [THL] materials, emergency procedures, emergency equipment, control of drag-throughs) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards) Due to the hard work and cooperation of many parties working together across the span of more than a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery for years

  9. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C. [Brower & Company, Andover, MA (United States); Bell, K. [Convergence Research, Seattle, WA (United States); Bernow, S.; Duckworth, M. [Tellus Inst., Boston, MA (United States); Spinney P. [Charles River Associates, Boston, MA (United States)

    1996-12-31

    This paper presents preliminary results of a study to evaluate the risk-reduction benefits of wind power for a case study utility system using decision analysis techniques. The costs and risks of two alternative decisions-whether to build a 400 MW gas-fired combined cycle plant or a 1600 MW wind plant in 2003-were compared through computer simulations as fuel prices, environmental regulatory costs, wind and conventional power plant availability, and load growth were allowed to vary. Three different market scenarios were examined: traditional regulation, a short-term power pool, and fixed-price contracts of varying duration. The study concludes that, from the perspective of ratepayers, wind energy provides a net levelized risk-reduction benefit of $3.4 to $7.8/MWh under traditional regulation, and less in the other scenarios. From the perspective of the utility plant owners, wind provides a significant risk benefit in the unregulated market scenarios but none in a regulated market. The methodology and findings should help inform utility resource planning and industry restructuring efforts. 2 figs., 3 tabs.

  10. Public Management and Disaster Risk Reduction: potential interdisciplinary contributions

    Directory of Open Access Journals (Sweden)

    Gerrit van der Waldt

    2009-04-01

    Full Text Available This article investigates the interdisciplinary nature of Disaster Risk Reduction as an emerging field of study. The development of this field of study is interpreted within the context of the evolution of Public Management as an academic discipline. The author argues that the philosophical and theoretical underpinnings of both Public Management and Disaster Risk Reduction share commonalities. Thus, the foundational and functional aspects of Public Management did, and should continue to, inform and enrich the study of Disaster Risk Reduction.

  11. Coastal community resilience in climate adaptation and risk reduction

    DEFF Research Database (Denmark)

    Thomsen, Mie; Sørensen, Carlo Sass

    the local municipalities to implement additional measures. For the fjord towns of Thyborøn (pop. 2100, located towards the North Sea by the Thyborøn Channel) and Løgstør (pop. 4000, located approximately 80 km east from the North Sea) flood hazard, vulnerability, and risk assessments and mapping...... are combined with community resilience studies to provide the corresponding municipalities with a more elaborate knowledge platform for climate adaptation and disaster risk reduction. Community resilience is investigated in four dimensions (information & communication, community competence, social capital...... and allow for better and more integrated solutions. The Løgstør community resilience is strong as the locals are knowledgeable about the flood risk, have good work relations with the municipality, and have detailed disaster preparedness plans. The plans are not flexible which may limit the community...

  12. Guidelines for contingency planning NASA (National Aeronautics and Space Administration) ADP security risk reduction decision studies

    Science.gov (United States)

    Tompkins, F. G.

    1984-01-01

    Guidance is presented to NASA Computer Security Officials for determining the acceptability or unacceptability of ADP security risks based on the technical, operational and economic feasibility of potential safeguards. The risk management process is reviewed as a specialized application of the systems approach to problem solving and information systems analysis and design. Reporting the results of the risk reduction analysis to management is considered. Report formats for the risk reduction study are provided.

  13. Adaptation of an HIV behavioural disinhibition risk reduction ...

    African Journals Online (AJOL)

    South Africa urgently needs HIV behavioural disinhibition risk reduction interventions for recently circumcised men for use in clinic and community settings. A theory-based HIV behavioural disinhibition risk reduction counselling intervention has recently been adapted for use in a South African traditional and medical ...

  14. A comparative study of European insurance schemes for extreme weather risks and incentives for risk reduction

    Science.gov (United States)

    de Ruiter, Marleen; Hudson, Paul; de Ruig, Lars; Kuik, Onno; Botzen, Wouter

    2017-04-01

    This paper provides an analysis of the insurance schemes that cover extreme weather events in twelve different EU countries and the risk reduction incentives offered by these schemes. Economic impacts of extreme weather events in many regions in Europe and elsewhere are on the rise due to climate change and increasing exposure as driven by urban development. In an attempt to manage impacts from extreme weather events, natural disaster insurance schemes can provide incentives for taking measures that limit weather-related risks. Insurance companies can influence public risk management policies and risk-reducing behaviour of policyholders by "rewarding behaviour that reduces risks and potential damages" (Botzen and Van den Bergh, 2008, p. 417). Examples of insurance market systems that directly or indirectly aim to incentivize risk reduction with varying degrees of success are: the U.S. National Flood Insurance Programme; the French Catastrophes Naturelles system; and the U.K. Flood Re program which requires certain levels of protection standards for properties to be insurable. In our analysis, we distinguish between four different disaster types (i.e. coastal and fluvial floods, droughts and storms) and three different sectors (i.e. residential, commercial and agriculture). The selected case studies also provide a wide coverage of different insurance market structures, including public, private and public-private insurance provision, and different methods of coping with extreme loss events, such as re-insurance, governmental aid and catastrophe bonds. The analysis of existing mechanisms for risk reduction incentives provides recommendations about incentivizing adaptive behaviour, in order to assist policy makers and other stakeholders in designing more effective insurance schemes for extreme weather risks.

  15. Hierarchical decision making for flood risk reduction

    DEFF Research Database (Denmark)

    Custer, Rocco; Nishijima, Kazuyoshi

    2013-01-01

    River flood events often cause large economic damages and casualties requiring stakeholders to manage flood risk. In flood prone areas, flood risk management can be achieved through a series hierarchically integrated protection structures, which together form a hierarchical flood protection system...

  16. Mission Risk Reduction Regulatory Change Management

    Science.gov (United States)

    Scroggins, Sharon

    2007-01-01

    NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated

  17. Climate change, uncertainty and investment in flood risk reduction

    NARCIS (Netherlands)

    Pol, van der T.D.

    2015-01-01

    Economic analysis of flood risk management strategies has become more complex due to climate change. This thesis investigates the impact of climate change on investment in flood risk reduction, and applies optimisation methods to support identification of optimal flood risk management strategies.

  18. Do flood risk perceptions provide useful insights for flood risk management? Findings from central Vietnam

    NARCIS (Netherlands)

    Bubeck, P.; Botzen, W.J.W.; Suu, L.T.T.; Aerts, J.C.J.H.

    2012-01-01

    Following the renewed attention for non-structural flood risk reduction measures implemented at the household level, there has been an increased interest in individual flood risk perceptions. The reason for this is the commonly-made assumption that flood risk perceptions drive the motivation of

  19. Interrelationships of risks faced by third party logistics service providers

    DEFF Research Database (Denmark)

    Govindan, Kannan; Chaudhuri, Atanu

    2016-01-01

    This paper analyses the interrelationships between risks faced by third party logistics service providers (3PLs) in relation to one of its customers using DEMATEL. Novel analysis of both within and between risk categories and generation of threshold value to prioritize risks generate useful...... insights. Results show that arms-length relationship between the customer and the 3PLs has strong influence on other risks and there is a need for collaborative relationships between 3PLs and its customers. Moreover, analysis indicates that the 3PLs need to improve internal processes related to quality...... management, flexibility of its operations and also geographical coverage of their services....

  20. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

    Energy Technology Data Exchange (ETDEWEB)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

  1. Hereditary Ovarian Cancer and Risk Reduction.

    Science.gov (United States)

    Andrews, Lesley; Mutch, David G

    2017-05-01

    Mutations in BRCA1 and BRCA2 account for hereditary breast and ovarian cancer syndrome in a majority of families and 14% of epithelial ovarian cancer cases. Despite next-generation sequencing, other identified genes (Lynch Syndrome, RAD51C, RAD51D, and BRIP1) account for only a small proportion of cases. The risk of ovarian cancer by age 70 is approximately 40% for BRCA1 and 18% for BRCA2. Most of these cancers are high-grade serous cancers that predominantly arise in the fimbriae of the fallopian tube. Ovarian screening does not improve outcomes, so women at high risk are recommended to undergo risk-reducing salpingo-oophorectomy around the age of 40, followed by hormone replacement therapy (HRT). Specimens should be carefully examined for occult malignancy. Mutation carriers may benefit from newly developed poly ADP ribose polymerase inhibitors. Genetic testing should only be performed after careful counseling, particularly if testing involves the testing of panels of genes that may identify unsuspected disease predisposition or confusing variants of uncertain significance. Copyright © 2017. Published by Elsevier Ltd.

  2. Disaster Risk Reduction in Agriculture through Geospatial (Big Data Processing

    Directory of Open Access Journals (Sweden)

    Tomáš Řezník

    2017-08-01

    Full Text Available Intensive farming on land represents an increased burden on the environment due to, among other reasons, the usage of agrochemicals. Precision farming can reduce the environmental burden by employing site specific crop management practices which implement advanced geospatial technologies for respecting soil heterogeneity. The objectives of this paper are to present the frontier approaches of geospatial (Big data processing based on satellite and sensor data which both aim at the prevention and mitigation phases of disaster risk reduction in agriculture. Three techniques are presented in order to demonstrate the possibilities of geospatial (Big data collection in agriculture: (1 farm machinery telemetry for providing data about machinery operations on fields through the developed MapLogAgri application; (2 agrometeorological observation in the form of a wireless sensor network together with the SensLog solution for storing, analysing, and publishing sensor data; and (3 remote sensing for monitoring field spatial variability and crop status by means of freely-available high resolution satellite imagery. The benefits of re-using the techniques in disaster risk reduction processes are discussed. The conducted tests demonstrated the transferability of agricultural techniques to crisis/emergency management domains.

  3. Public Management and Disaster Risk Reduction: potential interdisciplinary contributions

    OpenAIRE

    Gerrit van der Waldt

    2009-01-01

    This article investigates the interdisciplinary nature of Disaster Risk Reduction as an emerging field of study. The development of this field of study is interpreted within the context of the evolution of Public Management as an academic discipline. The author argues that the philosophical and theoretical underpinnings of both Public Management and Disaster Risk Reduction share commonalities. Thus, the foundational and functional aspects of Public Management did, and should continue to, info...

  4. Risk Reduction Technologies in General Practice and Social Work

    Directory of Open Access Journals (Sweden)

    Devin Rexvid

    2012-12-01

    Full Text Available General practitioners (GPs and social workers (SWs are professions whose professional autonomy and discretion have changed in the so-called risk and audit society. The aim of this article is to compare GPs’ and SWs’ responses to Evidence-Based and Organizational Risk Reduction Technologies (ERRT and ORRT. It is based on a content analysis of 54 peer-reviewed empirical articles. The results show that both professions held ambivalent positions towards ERRT. The response towards ORRT differed in that GPs were sceptical whilst SWs took a more pragmatic view. Furthermore the results suggest that SWs might experience professional benefits by adopting an adherent approach to the increased dissemination of risk reduction technologies (RRT. GPs, however, did not seem to experience such benefits. Keywords: Profession, risk, social worker, general practitioner, risk reduction technologies, evidence-based practice/medicine 

  5. Trialability, observability and risk reduction accelerating individual innovation adoption decisions.

    Science.gov (United States)

    Hayes, Kathryn J; Eljiz, Kathy; Dadich, Ann; Fitzgerald, Janna-Anneke; Sloan, Terry

    2015-01-01

    The purpose of this paper is to provide a retrospective analysis of computer simulation's role in accelerating individual innovation adoption decisions. The process innovation examined is Lean Systems Thinking, and the organizational context is the imaging department of an Australian public hospital. Intrinsic case study methods including observation, interviews with radiology and emergency personnel about scheduling procedures, mapping patient appointment processes and document analysis were used over three years and then complemented with retrospective interviews with key hospital staff. The multiple data sources and methods were combined in a pragmatic and reflexive manner to explore an extreme case that provides potential to act as an instructive template for effective change. Computer simulation of process change ideas offered by staff to improve patient-flow accelerated the adoption of the process changes, largely because animated computer simulation permitted experimentation (trialability), provided observable predictions of change results (observability) and minimized perceived risk. The difficulty of making accurate comparisons between time periods in a health care setting is acknowledged. This work has implications for policy, practice and theory, particularly for inducing the rapid diffusion of process innovations to address challenges facing health service organizations and national health systems. Originality/value - The research demonstrates the value of animated computer simulation in presenting the need for change, identifying options, and predicting change outcomes and is the first work to indicate the importance of trialability, observability and risk reduction in individual adoption decisions in health services.

  6. 75 FR 76345 - Risk Reduction Program

    Science.gov (United States)

    2010-12-08

    ... and benefits of implementing technologies, and (2) a 10-year implementation schedule prioritizing the..., including employee sleeping quarters provided by the railroad carrier. The increase of the number of... in a manner that maximizes benefits without imposing excessive, unjustified, or unnecessary costs...

  7. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Science.gov (United States)

    Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

    2008-01-01

    Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032

  8. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Directory of Open Access Journals (Sweden)

    Millson Peggy

    2008-06-01

    Full Text Available Abstract Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  9. 76 FR 41278 - Cargo Security Risk Reduction; Public Listening Sessions

    Science.gov (United States)

    2011-07-13

    ... SECURITY Coast Guard Cargo Security Risk Reduction; Public Listening Sessions AGENCY: Coast Guard, DHS... public and private sector stakeholders, across the Security Spectrum.\\1\\ \\1\\ The Security Spectrum... progress and development of a CDC Security National Strategy to reduce risks associated with the transport...

  10. Risk factors and risk reduction of breast and ovarian cancer

    NARCIS (Netherlands)

    C.T. Brekelmans (Cecile)

    2003-01-01

    textabstractPurpose of review: Breast and ovarian cancer remain a significant burden for women living in the Western world. This paper reviews the risk factors and current strategies to prevent these diseases. Recent findings: Established factors associated with the risk of breast cancer include

  11. Existential risks: exploring a robust risk reduction strategy.

    Science.gov (United States)

    Jebari, Karim

    2015-06-01

    A small but growing number of studies have aimed to understand, assess and reduce existential risks, or risks that threaten the continued existence of mankind. However, most attention has been focused on known and tangible risks. This paper proposes a heuristic for reducing the risk of black swan extinction events. These events are, as the name suggests, stochastic and unforeseen when they happen. Decision theory based on a fixed model of possible outcomes cannot properly deal with this kind of event. Neither can probabilistic risk analysis. This paper will argue that the approach that is referred to as engineering safety could be applied to reducing the risk from black swan extinction events. It will also propose a conceptual sketch of how such a strategy may be implemented: isolated, self-sufficient, and continuously manned underground refuges. Some characteristics of such refuges are also described, in particular the psychosocial aspects. Furthermore, it is argued that this implementation of the engineering safety strategy safety barriers would be effective and plausible and could reduce the risk of an extinction event in a wide range of possible (known and unknown) scenarios. Considering the staggering opportunity cost of an existential catastrophe, such strategies ought to be explored more vigorously.

  12. Insolvency and challenges of regulating providers that bear risk.

    Science.gov (United States)

    Brewster, L R; Jackson, L; Lesser, C S

    2000-02-01

    Risk contracting and capitation are two widely used financial mechanisms that give incentives to health care providers to control costs. Risk-bearing arrangements have failed in a number of communities, however. This has shaken local markets, disrupting consumers' access to health care services and triggering losses for physicians and hospitals. It also has raised questions about the adequacy of related regulatory oversight, which holds important implications for local and national policy makers. This Issue Brief provides case studies of failed risk-contracting arrangements in two of the 12 communities that the Center for Studying Health System Change (HSC) tracks intensively--Northern New Jersey and Orange County, Calif.--and examines implications for policy makers.

  13. Risk acceptance criterion for tanker oil spill risk reduction measures.

    Science.gov (United States)

    Psarros, George; Skjong, Rolf; Vanem, Erik

    2011-01-01

    This paper is aimed at investigating whether there is ample support for the view that the acceptance criterion for evaluating measures for prevention of oil spills from tankers should be based on cost-effectiveness considerations. One such criterion can be reflected by the Cost of Averting a Tonne of oil Spilt (CATS) whereas its target value is updated by elaborating the inherent uncertainties of oil spill costs and establishing a value for the criterion's assurance factor. To this end, a value of $80,000/t is proposed as a sensible CATS criterion and the proposed value for the assurance factor F=1.5 is supported by the retrieved Protection and Indemnity (P&I) Clubs' Annual Reports. It is envisaged that this criterion would allow the conversion of direct and indirect costs into a non-market value for the optimal allocation of resources between the various parties investing in shipping. A review of previous cost estimation models on oil spills is presented and a probability distribution (log-normal) is fitted on the available oil spill cost data, where it should be made abundantly clear that the mean value of the distribution is used for deriving the updated CATS criterion value. However, the difference between the initial and the updated CATS criterion in the percentiles of the distribution is small. It is found through the current analysis that results are partly lower than the predicted values from the published estimation models. The costs are also found to depend on the type of accident, which is in agreement with the results of previous studies. Other proposals on acceptance criteria are reviewed and it is asserted that the CATS criterion can be considered as the best candidate. Evidence is provided that the CATS approach is practical and meaningful by including examples of successful applications in actual risk assessments. Finally, it is suggested that the criterion may be refined subject to more readily available cost data and experience gained from future

  14. TRALI risk reduction: donor and component management strategies.

    Science.gov (United States)

    Eder, Anne F; Benjamin, Richard J

    2009-01-01

    Transfusion-related lung injury (TRALI) occurs in approximately 1 in 5,000 transfusions and may cause considerably more morbidity and mortality that is not recognized in clinical practice. Based on the current understanding of the etiology of TRALI, blood centers have implemented or are evaluating various donor and component management strategies in an effort to mitigate the risk of TRALI. Many cases of TRALI are likely caused by antibodies to leukocyte antigens (HLA or HNA) in blood components. Approximately 10 to 20% of female blood donors with a history of pregnancy and 1 to 5% of male blood donors harbor these antibodies. Alternatively, TRALI may be mediated by other bioactive lipids or substances that accumulate during storage and cause a reaction when transfused to susceptible patients. The complex interplay among various donor-, component-, and patient-related factors underlying TRALI guarantees that effective prevention will not be a single or simple intervention but rather will require a multifaceted approach. Perhaps, the most important risk reduction strategy is the effort to ensure appropriate use of blood products and eliminate unnecessary transfusions. Blood collection agencies, however, have more proximate control over donor selection and component management than transfusion practice. AABB has provided some guidance on deferring donors implicated in TRALI and minimizing the preparation of high plasma volume components from donors who have anti-leukocyte antibodies or are at increased risk of leukocyte alloimmunization. Blood centers have taken various approaches to mitigate the risk of TRALI, and the possible benefit and the inherent limitations of the current strategies will be reviewed.

  15. Risk reduction and the privatization option: First principles

    Energy Technology Data Exchange (ETDEWEB)

    Bjornstad, D.J.; Jones, D.W.; Russell, M. [Joint Inst. for Energy and Environment, Knoxville, TN (United States); Cummings, R.C.; Valdez, G. [Georgia State Univ., Atlanta, GA (United States); Duemmer, C.L. [Hull, Duemmer and Garland (United States)

    1997-06-25

    The Department of Energy`s Office of Environmental Restoration and Waste Management (EM) faces a challenging mission. To increase efficiency, EM is undertaking a number of highly innovative initiatives--two of which are of particular importance to the present study. One is the 2006 Plan, a planning and budgeting process that seeks to convert the clean-up program from a temporally and fiscally open-ended endeavor to a strictly bounded one, with firm commitments over a decade-long horizon. The second is a major overhauling of the management and contracting practices that define the relationship between the Department and the private sector, aimed at cost reduction by increasing firms` responsibilities and profit opportunities and reducing DOE`s direct participation in management practices and decisions. The goal of this paper is to provide an independent perspective on how EM should create new management practices to deal with private sector partners that are motivated by financial incentives. It seeks to ground this perspective in real world concerns--the background of the clean-up effort, the very difficult technical challenges it faces, the very real threats to environment, health and safety that have now been juxtaposed with financial drivers, and the constraints imposed by government`s unique business practices and public responsibilities. The approach is to raise issues through application of first principles. The paper is targeted at the EM policy officer who must implement the joint visions of the 2006 plan and privatization within the context of the tradeoff between terminal risk reduction and interim risk management.

  16. Religious narratives and their implications for disaster risk reduction.

    Science.gov (United States)

    McGeehan, Kathleen M; Baker, Charlene K

    2017-04-01

    The role of religious factors in the disaster experience has been under-investigated. This is despite evidence of their influence throughout the disaster cycle, including: the way in which the event is interpreted; how the community recovers; and the strategies implemented to reduce future risk. This qualitative study examined the role of faith in the disaster experience of four faith communities in the Hawaiian Islands of the United States. Twenty-six individuals from the Bahá'í, Buddhist, Church of Jesus Christ of Latter-day Saints (LDS), and United Methodist Church communities participated, including 10 faith leaders and 16 laypersons. The results suggest that religious narratives provide a framework for interpretation of, preparedness for, and responses to disasters. Preparedness varied widely across faith communities, with the LDS community reporting greater levels of preparedness than other communities. Recommendations include the development of collaborative efforts between disaster managers and faith leaders to increase preparedness within faith communities, which may facilitate community-wide disaster risk reduction. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  17. Capability for Integrated Systems Risk-Reduction Analysis

    Science.gov (United States)

    Mindock, J.; Lumpkins, S.; Shelhamer, M.

    2016-01-01

    NASA's Human Research Program (HRP) is working to increase the likelihoods of human health and performance success during long-duration missions, and subsequent crew long-term health. To achieve these goals, there is a need to develop an integrated understanding of how the complex human physiological-socio-technical mission system behaves in spaceflight. This understanding will allow HRP to provide cross-disciplinary spaceflight countermeasures while minimizing resources such as mass, power, and volume. This understanding will also allow development of tools to assess the state of and enhance the resilience of individual crewmembers, teams, and the integrated mission system. We will discuss a set of risk-reduction questions that has been identified to guide the systems approach necessary to meet these needs. In addition, a framework of factors influencing human health and performance in space, called the Contributing Factor Map (CFM), is being applied as the backbone for incorporating information addressing these questions from sources throughout HRP. Using the common language of the CFM, information from sources such as the Human System Risk Board summaries, Integrated Research Plan, and HRP-funded publications has been combined and visualized in ways that allow insight into cross-disciplinary interconnections in a systematic, standardized fashion. We will show examples of these visualizations. We will also discuss applications of the resulting analysis capability that can inform science portfolio decisions, such as areas in which cross-disciplinary solicitations or countermeasure development will potentially be fruitful.

  18. Effect of smoking reduction on lung cancer risk

    DEFF Research Database (Denmark)

    Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

    2005-01-01

    Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases.......Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

  19. Cholesterol Reduction in an ’At-Risk Population

    Science.gov (United States)

    1989-05-17

    cholesterol in ’our cream, etc. Frozen low rat yogurt , sherbet. blood stream. Luckily, it’s easy to buy dairv and ice milk are all much lower in tat...OI FILE COPY DISSERTATION c J CHOLESTEROL REDUCTION IN AN "AT-RISK" POPULATION DT IC."M "T E’T F.,E , FEB 0 11990nD Submitted by Jeffrey M. Johnston...UNITELEMENT NO. NO. NO IACCESSION NO. 11. TITLE (include Security Classification) (UNCLASSIFIED) ES CHOLESTEROL REDUCTION IN AN "AT-RISK" POPULATION 12

  20. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert S. Balch; Ron Broadhead

    2005-03-01

    Incomplete or sparse data such as geologic or formation characteristics introduce a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results when working with sparse data. State-of-the-art expert exploration tools, relying on a database, and computer maps generated by neural networks and user inputs, have been developed through the use of ''fuzzy'' logic, a mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk has been reduced with the use of these properly verified and validated ''Fuzzy Expert Exploration (FEE) Tools.'' Through the course of this project, FEE Tools and supporting software were developed for two producing formations in southeast New Mexico. Tools of this type can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In today's oil industry environment, many smaller exploration companies lack the resources of a pool of expert exploration personnel. Downsizing, volatile oil prices, and scarcity of domestic exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tools benefit a diverse group in the U.S., allowing a more efficient use of scarce funds, and potentially reducing dependence on foreign oil and providing lower product prices for consumers.

  1. Risk reduction by combining nature values with flood protection?

    Directory of Open Access Journals (Sweden)

    Van Loon-Steensma Jantsje M.

    2016-01-01

    Full Text Available In the Netherlands, the concept of a multifunctional dike has already often been implemented, and has been identified as a promising climate adaptation measure. In a multifunctional dike, functions like urban development, transport infrastructure, recreation, agriculture or nature are deliberately combined with its primary flood protection function. This means that the design must be based on the requirements and life span of all different functions, while in a monofunctional dike only the flood protection function is considered. By accommodating other functions, a multifunctional dike may easier fit into, or even contribute to the quality of the landscape. Moreover, these other functions may help in financing the flood protection works, but governance is more complicated. To avoid costly adjustments forthcoming from changed safety standards, incorporation of multiple functions can require a more “robust” flood defence than a monofunctional flood defence. A robust flood defence can withstand more extreme situations than required by the present safety standards, and has a substantially lower flooding probability. Therefore, a multifunctional dike may be attractive in view of the uncertainties regarding the effects of climate change and a changing world. Moreover, it will result in reduced flood risk. As part of the Dutch Delta programme, several explorative studies on multifunctional dikes were initiated. Most studies focused on urban areas, but also in the rural area interest emerged for multifunctional dikes, e.g. for the integration of salt marshes into the flood defences. Marshes provide valuable habitat for vegetation and invertebrate species, and are important for wading birds. Furthermore, under condition of abundant sediment availability they can keep pace with sea level rise. Explorative modelling results indicate that vegetated forelands affect wave heights, even under extreme conditions. However, the inclusion of a vegetated

  2. Quantitative Risk reduction estimation Tool For Control Systems, Suggested Approach and Research Needs

    Energy Technology Data Exchange (ETDEWEB)

    Miles McQueen; Wayne Boyer; Mark Flynn; Sam Alessi

    2006-03-01

    For the past year we have applied a variety of risk assessment technologies to evaluate the risk to critical infrastructure from cyber attacks on control systems. More recently, we identified the need for a stand alone control system risk reduction estimation tool to provide owners and operators of control systems with a more useable, reliable, and credible method for managing the risks from cyber attack. Risk is defined as the probability of a successful attack times the value of the resulting loss, typically measured in lives and dollars. Qualitative and ad hoc techniques for measuring risk do not provide sufficient support for cost benefit analyses associated with cyber security mitigation actions. To address the need for better quantitative risk reduction models we surveyed previous quantitative risk assessment research; evaluated currently available tools; developed new quantitative techniques [17] [18]; implemented a prototype analysis tool to demonstrate how such a tool might be used; used the prototype to test a variety of underlying risk calculational engines (e.g. attack tree, attack graph); and identified technical and research needs. We concluded that significant gaps still exist and difficult research problems remain for quantitatively assessing the risk to control system components and networks, but that a useable quantitative risk reduction estimation tool is not beyond reach.

  3. ASTARTE: Assessment Strategy and Risk Reduction for Tsunamis in Europe

    Science.gov (United States)

    Baptista, M. A.; Yalciner, A. C.; Canals, M.

    2014-12-01

    Tsunamis are low frequency but high impact natural disasters. In 2004, the Boxing Day tsunami killed hundreds of thousands of people from many nations along the coastlines of the Indian Ocean. Tsunami run-up exceeded 35 m. Seven years later, and in spite of some of the best warning technologies and levels of preparedness in the world, the Tohoku-Oki tsunami in Japan dramatically showed the limitations of scientific knowledge on tsunami sources, coastal impacts and mitigation measures. The experience from Japan raised serious questions on how to improve the resilience of coastal communities, to upgrade the performance of coastal defenses, to adopt a better risk management, and also on the strategies and priorities for the reconstruction of damaged coastal areas. Societal resilience requires the reinforcement of capabilities to manage and reduce risk at national and local scales.ASTARTE (Assessment STrategy And Risk for Tsunami in Europe), a 36-month FP7 project, aims to develop a comprehensive strategy to mitigate tsunami impact in this region. To achieve this goal, an interdisciplinary consortium has been assembled. It includes all CTWPs of NEAM and expert institutions across Europe and worldwide. ASTARTE will improve i) basic knowledge of tsunami generation and recurrence going beyond simple catalogues, with novel empirical data and new statistical analyses for assessing long-term recurrence and hazards of large events in sensitive areas of NEAM, ii) numerical techniques for tsunami simulation, with focus on real-time codes and novel statistical emulation approaches, and iii) methods for assessment of hazard, vulnerability, and risk. ASTARTE will also provide i) guidelines for tsunami Eurocodes, ii) better tools for forecast and warning for CTWPs and NTWCs, and iii) guidelines for decision makers to increase sustainability and resilience of coastal communities. In summary, ASTARTE will develop basic scientific and technical elements allowing for a significant

  4. Effect of smoking reduction on lung cancer risk

    DEFF Research Database (Denmark)

    Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

    2005-01-01

    Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

  5. Sexual risk reduction among Zambian couples | Jones | SAHARA-J ...

    African Journals Online (AJOL)

    Zambia has over 1 million HIV infections nationwide and an urban prevalence rate of 23%. This study compared the impact of male involvement in multiple and single session risk reduction interventions among inconsistent condom users in Zambia and the role of serostatus among HIV-seropositive and serodiscordant ...

  6. Local governance in disaster risk reduction in Cameroon

    Directory of Open Access Journals (Sweden)

    Buh-Wung Gaston

    2012-06-01

    Full Text Available At the 2005 World Conference on Disaster Risk Reduction held in Hyogo, Japan, 168 countries including Cameroon adopted the Hyogo Framework for Action, committing to take action to reduce human and socio-economic disaster losses. Geotechnology, Environmental Assessment and Disaster Risk Reduction was commissioned by the Global Network of Civil Society Organisations for Disaster Risk Reduction as the coordinating organisation in Cameroon to evaluate progress in implementation of the framework from the civil society perspective, particularly the role of local governance in disaster risk reduction (DRR. Seven regions of the country were identified for evaluation, where people have suffered losses from disasters during the last three decades. Three approaches were used: administration of questionnaires; consultations with local communities; and four case studies. It was found that there was significant scope for improvement on individual local governance indicators, and that effective progress depends on:1. level of achievement in the decentralisation process currently under way.2. adoption of a participatory approach to DRR.3. clear distribution of roles in the DRR process.4. adequate allocation of necessary financial and human resources.5. enhancement of capacity of local communities to prepare for and respond to all types of disasters.Creation of an independent body to carry out fundamental research, forecast new and emerging hazards and manage all disasters in the country will contribute greatly to moving things forward.

  7. Earthquake Risk Reduction to Istanbul Natural Gas Distribution Network

    Science.gov (United States)

    Zulfikar, Can; Kariptas, Cagatay; Biyikoglu, Hikmet; Ozarpa, Cevat

    2017-04-01

    Earthquake Risk Reduction to Istanbul Natural Gas Distribution Network Istanbul Natural Gas Distribution Corporation (IGDAS) is one of the end users of the Istanbul Earthquake Early Warning (EEW) signal. IGDAS, the primary natural gas provider in Istanbul, operates an extensive system 9,867km of gas lines with 750 district regulators and 474,000 service boxes. The natural gas comes to Istanbul city borders with 70bar in 30inch diameter steel pipeline. The gas pressure is reduced to 20bar in RMS stations and distributed to district regulators inside the city. 110 of 750 district regulators are instrumented with strong motion accelerometers in order to cut gas flow during an earthquake event in the case of ground motion parameters exceeds the certain threshold levels. Also, state of-the-art protection systems automatically cut natural gas flow when breaks in the gas pipelines are detected. IGDAS uses a sophisticated SCADA (supervisory control and data acquisition) system to monitor the state-of-health of its pipeline network. This system provides real-time information about quantities related to pipeline monitoring, including input-output pressure, drawing information, positions of station and RTU (remote terminal unit) gates, slum shut mechanism status at 750 district regulator sites. IGDAS Real-time Earthquake Risk Reduction algorithm follows 4 stages as below: 1) Real-time ground motion data transmitted from 110 IGDAS and 110 KOERI (Kandilli Observatory and Earthquake Research Institute) acceleration stations to the IGDAS Scada Center and KOERI data center. 2) During an earthquake event EEW information is sent from IGDAS Scada Center to the IGDAS stations. 3) Automatic Shut-Off is applied at IGDAS district regulators, and calculated parameters are sent from stations to the IGDAS Scada Center and KOERI. 4) Integrated building and gas pipeline damage maps are prepared immediately after the earthquake event. The today's technology allows to rapidly estimate the

  8. Changes in primary healthcare providers' attitudes and counseling behaviors related to dietary sodium reduction, DocStyles 2010 and 2015.

    Science.gov (United States)

    Quader, Zerleen S; Cogswell, Mary E; Fang, Jing; Coleman King, Sallyann M; Merritt, Robert K

    2017-01-01

    High blood pressure is a major risk factor for cardiovascular disease. The 2013 ACC/AHA Lifestyle Management Guideline recommends counseling pre-hypertensive and hypertensive patients to reduce sodium intake. Population sodium reduction efforts have been introduced in recent years, and dietary guidelines continued to emphasize sodium reduction in 2010 and 2015. The objective of this analysis was to determine changes in primary health care providers' sodium-reduction attitudes and counseling between 2010 and 2015. Primary care internists, family/general practitioners, and nurse practitioners answered questions about sodium-related attitudes and counseling behaviors in DocStyles, a repeated cross-sectional web-based survey in the United States. Differences in responses between years were examined. In 2015, the majority (78%) of participants (n = 1,251) agreed that most of their patients should reduce sodium intake, and reported advising hypertensive (85%), and chronic kidney disease patients (71%), but not diabetic patients (48%) and African-American patients (43%) to consume less salt. Since 2010, the proportion of participants agreeing their patients should reduce sodium intake decreased while the proportion advising patients with these characteristics to consume less salt increased and the prevalence of specific types of advice declined. Changes in behaviors between surveys remained significant after adjusting for provider and practice characteristics. More providers are advising patients to consume less salt in 2015 compared to 2010; however, fewer agree their patients should reduce intake and counseling is not universally applied across patient groups at risk for hypertension. Further efforts and educational resources may be required to enable patient counseling about sodium reduction strategies.

  9. Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    Suzanne Carlberg-Racich

    2016-04-01

    Full Text Available Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction—which removes judgment and operates at the patient’s stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38. A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen’s Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm

  10. Time-to-Compromise Model for Cyber Risk Reduction Estimation

    Energy Technology Data Exchange (ETDEWEB)

    Miles A. McQueen; Wayne F. Boyer; Mark A. Flynn; George A. Beitel

    2005-09-01

    We propose a new model for estimating the time to compromise a system component that is visible to an attacker. The model provides an estimate of the expected value of the time-to-compromise as a function of known and visible vulnerabilities, and attacker skill level. The time-to-compromise random process model is a composite of three subprocesses associated with attacker actions aimed at the exploitation of vulnerabilities. In a case study, the model was used to aid in a risk reduction estimate between a baseline Supervisory Control and Data Acquisition (SCADA) system and the baseline system enhanced through a specific set of control system security remedial actions. For our case study, the total number of system vulnerabilities was reduced by 86% but the dominant attack path was through a component where the number of vulnerabilities was reduced by only 42% and the time-to-compromise of that component was increased by only 13% to 30% depending on attacker skill level.

  11. Constructing a holistic approach to disaster risk reduction: the significance of focusing on vulnerability reduction.

    Science.gov (United States)

    Palliyaguru, Roshani; Amaratunga, Dilanthi; Baldry, David

    2014-01-01

    As a result of the increase in natural disaster losses, policy-makers, practitioners, and members of the research community around the world are seeking effective and efficient means of overcoming or minimising them. Although various theoretical constructs are beneficial to understanding the disaster phenomenon and the means of minimising losses, the disaster risk management process becomes less effective if theory and practice are set apart from one another. Consequently, this paper seeks to establish a relationship between two theoretical constructs, 'disaster risk reduction (DRR)' and 'vulnerability reduction', and to develop a holistic approach to DRR with particular reference to improving its applicability in practical settings. It is based on a literature review and on an overall understanding gained through two case studies of post-disaster infrastructure reconstruction projects in Sri Lanka and three expert interviews in Sri Lanka and the United Kingdom. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  12. Research and Evaluations of the Health Aspects of Disasters, Part IX: Risk-Reduction Framework.

    Science.gov (United States)

    Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P; Loretti, Alessandro

    2016-06-01

    A disaster is a failure of resilience to an event. Mitigating the risks that a hazard will progress into a destructive event, or increasing the resilience of a society-at-risk, requires careful analysis, planning, and execution. The Disaster Logic Model (DLM) is used to define the value (effects, costs, and outcome(s)), impacts, and benefits of interventions directed at risk reduction. A Risk-Reduction Framework, based on the DLM, details the processes involved in hazard mitigation and/or capacity-building interventions to augment the resilience of a community or to decrease the risk that a secondary event will develop. This Framework provides the structure to systematically undertake and evaluate risk-reduction interventions. It applies to all interventions aimed at hazard mitigation and/or increasing the absorbing, buffering, or response capacities of a community-at-risk for a primary or secondary event that could result in a disaster. The Framework utilizes the structure provided by the DLM and consists of 14 steps: (1) hazards and risks identification; (2) historical perspectives and predictions; (3) selection of hazard(s) to address; (4) selection of appropriate indicators; (5) identification of current resilience standards and benchmarks; (6) assessment of the current resilience status; (7) identification of resilience needs; (8) strategic planning; (9) selection of an appropriate intervention; (10) operational planning; (11) implementation; (12) assessments of outputs; (13) synthesis; and (14) feedback. Each of these steps is a transformation process that is described in detail. Emphasis is placed on the role of Coordination and Control during planning, implementation of risk-reduction/capacity building interventions, and evaluation. Birnbaum ML , Daily EK , O'Rourke AP , Loretti A . Research and evaluations of the health aspects of disasters, part IX: Risk-Reduction Framework. Prehosp Disaster Med. 2016;31(3):309-325.

  13. Risk Reduction with a Fuzzy Expert Exploration Tool

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, William W.; Broadhead, Ron; Mundorf, William R.

    2003-03-06

    A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, was developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs.

  14. Valuation of morbidity and mortality risk reductions. Does context matter?

    Science.gov (United States)

    Nielsen, Jytte Seested; Gyrd-Hansen, Dorte; Kjær, Trine

    2012-09-01

    The main research purpose of the present study was to test for any differences in the valuation of morbidity and mortality risk reductions across two contexts; traffic and health. A contingent valuation study on preferences for morbidity and mortality risk was carried out in Denmark in 2007. Respondents were randomised into two different arms: one arm in which the valuation took place in the context of health and another arm in which the context was traffic. In both contexts, the inferior health state was described by way of the standardized EQ-5D descriptive system. We obtained a total sample of 520 respondents from an online database. In the present study we found clear evidence of a context effect on expressed valuations of identical risk reductions. This was true irrespective of whether the adverse outcome in question was death or inferior health. This result suggests that interventions targeting risks of death or risks of ill health should not necessarily be valued equally across sectors. From a welfare economic perspective, the use of the same estimates across contexts - and especially across sectors - could be misleading and in worst case lead to inefficient resource allocations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Resilience and disaster risk reduction: an etymological journey

    OpenAIRE

    Alexander, D. E.

    2013-01-01

    This paper examines the development over historical time of the meaning and uses of the term resilience. The objective is to deepen our understanding of how the term came to be adopted in disaster risk reduction and resolve some of the conflicts and controversies that have arisen when it has been used. The paper traces the development of resilience through the sciences, humanities, and legal and political spheres. It considers how mechanics passed the word to ecology and psy...

  16. Providing access to risk prediction tools via the HL7 XML-formatted risk web service.

    Science.gov (United States)

    Chipman, Jonathan; Drohan, Brian; Blackford, Amanda; Parmigiani, Giovanni; Hughes, Kevin; Bosinoff, Phil

    2013-07-01

    Cancer risk prediction tools provide valuable information to clinicians but remain computationally challenging. Many clinics find that CaGene or HughesRiskApps fit their needs for easy- and ready-to-use software to obtain cancer risks; however, these resources may not fit all clinics' needs. The HughesRiskApps Group and BayesMendel Lab therefore developed a web service, called "Risk Service", which may be integrated into any client software to quickly obtain standardized and up-to-date risk predictions for BayesMendel tools (BRCAPRO, MMRpro, PancPRO, and MelaPRO), the Tyrer-Cuzick IBIS Breast Cancer Risk Evaluation Tool, and the Colorectal Cancer Risk Assessment Tool. Software clients that can convert their local structured data into the HL7 XML-formatted family and clinical patient history (Pedigree model) may integrate with the Risk Service. The Risk Service uses Apache Tomcat and Apache Axis2 technologies to provide an all Java web service. The software client sends HL7 XML information containing anonymized family and clinical history to a Dana-Farber Cancer Institute (DFCI) server, where it is parsed, interpreted, and processed by multiple risk tools. The Risk Service then formats the results into an HL7 style message and returns the risk predictions to the originating software client. Upon consent, users may allow DFCI to maintain the data for future research. The Risk Service implementation is exemplified through HughesRiskApps. The Risk Service broadens the availability of valuable, up-to-date cancer risk tools and allows clinics and researchers to integrate risk prediction tools into their own software interface designed for their needs. Each software package can collect risk data using its own interface, and display the results using its own interface, while using a central, up-to-date risk calculator. This allows users to choose from multiple interfaces while always getting the latest risk calculations. Consenting users contribute their data for future

  17. Reduction of excavation face collapse risk in tunnelling.

    Science.gov (United States)

    Ariani, Filippo; Baldasseroni, Alberto; Muller, Alessandro; Biffino, Marco; Matteucci, Alessandro

    2017-12-14

    Two large road tunnels, recently developed near Florence, showed instabilities of the excavation face which subsequently caused sixteen collapses. Due to the risk for workers' safety, the public authority for occupational health and safety (ASL) has monitored the failure rate and other background variables in order to assess the possible correlations between risk reductions, its own actions, and those of the various safety actors involved. To evaluate if the interventions carried out by the design team were able to reduce the risks of collapse and which of the ASL actions and/or which other factors were more effective in changing the attitudes of the parties involved, leading to a more expensive but safer project variant. After adoption of the second of two project variants, no more collapses were observed. No correlation was found between trend of ASL inspections and observed variation of collapse rate. Conversely, the adoption of strongly coercive measures and investigation reporting by local media coincided with periods of risk reduction, even if the low number of events does not allow for statistical evaluation. These findings appear to be coherent with the ratio of the cost of penalties related to health and safety infringements (thousands of euros) to the overall cost of the safer project variant (a hundred times greater).  The safer variant required 7% more labour but avoided forced interruptions caused by the collapses, allowing a 13% faster excavation rate.

  18. Risk Reduction in Terrorism Cases: Sentencing and the Post-Conviction Environment

    Directory of Open Access Journals (Sweden)

    Kelly Berkell

    2017-12-01

    Full Text Available This article explores existing underpinnings in the United States criminal justice system for post-conviction risk reduction measures in terrorism cases. The purpose of these measures is to reduce the risk of future criminality by those already convicted of violent extremist offenses, thereby protecting public safety while also benefiting individuals and communities. Specifically, integrating specialized risk and needs assessments into terrorism cases at sentencing and during the corrections process constitutes one possible risk reduction measure. When administered to individuals convicted of providing material support or other terrorism-related offenses, rigorous evaluations can supply courts with information significant for sentencing and, when appropriate, structuring individualized rehabilitation approaches. In addition to assessment tools, rehabilitation and reintegration programs constitute potential risk reduction measures. Risk reduction programs would supplement and enhance, not replace, existing correctional methods including incarceration and supervised release. The District of Minnesota federal court is pioneering a program of disengagement and deradicalization for terrorism defendants, and other courts likely will develop similar approaches. However, appropriate judicial bodies have yet to adopt proactive roles in developing national policy guidance in this area. This article aims to further the discussion of reducing recidivism risk in terrorism cases by clarifying the legal and technical issues that would require resolution as prerequisites for the consideration and potential development of post-conviction programming.

  19. Raloxifene hydrochloride for breast cancer risk reduction in postmenopausal women.

    Science.gov (United States)

    Provinciali, Nicoletta; Suen, Chen; Dunn, Barbara K; DeCensi, Andrea

    2016-09-12

    Raloxifene is an estrogen receptor modulator which competes with estrogens for binding to the estrogen receptor. Based on the results of the STAR (Study of Tamoxifen And Raloxifene) trial, raloxifene has been approved by the U.S. Food and Drug Administration for the reduction of breast cancer (BC) risk in postmenopausal women at increased risk. This analysis reviews the activity of raloxifene and the clinical trials for non-BC indications which led to investigate its use as BC preventive agent. We review the trial establishing its efficacy for BC prevention and the meta-analyses including different SERMs for BC prevention. Expert commentary: Compared with tamoxifen, raloxifene has shown a slightly lower efficacy in reducing BC risk and a better safety profile. Raloxifene also offers to postmenopausal women a benefit in terms of osteoporosis. Future research should investigate its use in premenopausal women and in association with other preventive agents.

  20. Education for disaster risk reduction : linking theory with practice in Ghana´s basic schools

    NARCIS (Netherlands)

    Apronti, Priscilla; Saito, Osamu; Otsuki, K.; Kranjac-Berisavljevic, Gordana

    2015-01-01

    Current understanding of disaster risk reduction (DRR) concurs that, when provided the right education, children have the potential to reduce their own vulnerability and the vulnerability of others in their community. What, then, comprises the right education for DRR? Research has established the

  1. Interleukin 1 genetic tests provide no support for reduction of preventive dental care.

    Science.gov (United States)

    Diehl, Scott R; Kuo, Fengshen; Hart, Thomas C

    2015-03-01

    It has been proposed that the PST and PerioPredict genetic tests that are based on polymorphisms in interleukin 1 (IL-1) genes identify a subset of patients who experience fewer tooth extractions if provided with 2 annual preventive visits. Economic analyses indicate rationing preventive care to only "high-risk" genotypes, smokers, patients with diabetes, or combinations of these risk factors would reduce the cost of dental care by $4.8 billion annually in the United States. Data presented in the study that claimed clinical utility for the PST and PerioPredict tests were obtained for reanalysis using logistic regression to assess whether the PST genetic test, smoking, diabetes, or number of preventive visits were risk factors for tooth extraction during a span of 16 years. Consistency of risk classification by the PST (version 1) and PerioPredict (version 2) genetic tests was evaluated in different ethnic groups from the 1000 Genomes database. Multivariate analyses revealed association of tooth extraction with diabetes (P preventive visits (P = .004), but no support for the PST genetic test (P = .96) nor indication that the benefit of 2 preventive visits was affected by this genetic test (P = .58). Classification of risk was highly inconsistent between the PST (version 1) and PerioPredict (version 2) genetic tests. Two annual preventive visits were supported as beneficial for all patients, and there was no evidence that the IL-1 PST genetic test has any effect on tooth extraction risk or influences the benefits of 2 annual preventive visits. Neither IL-1 PST nor PerioPredict genetic tests are useful for rationing preventive dental care. Further research is needed to identify genetic biomarkers with robust clinical validity and clinical utility to effectively personalize the practice of dentistry. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  2. Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

    NARCIS (Netherlands)

    Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

    2016-01-01

    The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

  3. [Risk reduction in cardiovascular diseases by physical activity].

    Science.gov (United States)

    Löllgen, H; Löllgen, D

    2012-01-01

    A sedentary lifestyle or physical inactivity is recognized as an important risk factor for cardiovascular diseases. Regular physical activity improves muscular function, cardiac function, and metabolic syndrome-related disorders. Leisure time physical activity reduces all-cause mortality by 22-34% and cardiovascular mortality by 27-35%. These data have been shown in many prospective cohort studies and published in four large meta-analyses with more than 800,000 participants (evidence IA). The risk reduction is somewhat more pronounced in the elderly and in women (IB). In addition to reduced mortality, physical activity also improves cardiopulmonary function and quality of life (IB). This also holds true for coronary artery disease, cardiac failure, and arterial hypertension with high-grade evidence (IA). Furthermore, evidence has been shown a risk reduction in stroke, development of cognitive dysfunction, and intermittent claudication. Training recommendations for physical activity have reached high-grade evidence (IA). Therefore, regular physical activity is one of the most important components of a healthy lifestyle. All physicians should ask their patients at all clinic and office visits about physical activity and recommend activity for prevention and therapy.

  4. Social resilience: the forgotten dimension of disaster risk reduction

    Directory of Open Access Journals (Sweden)

    Guy Sapirstein

    2006-04-01

    Full Text Available The current thinking in the Disaster Risk Reduction field emphasizes assessment and reduction of vulnerability and especially social vulnerability as an important factor in mitigating the effects of disasters. In the process of emphasizing vulnerability, the role and complexity of social resilience was somewhat lost and at times minimized. For example, Terry Cannon and his colleagues include resilience as a factor of social vulnerability in a report to United Kingdom Department for International Development (DFID (Cannon, Twigg and Rowell, 2002. The United Nations University, Institute for Environment and Human Security (UNU-EHS delineates “Social Vulnerability” and “Individual Vulnerability” as working areas, but does not mention Social or Individual Resilience (Bogardi, 2006.

  5. Valuing Drinking Water Risk Reductions Using the Contingent Valuation Method: A Methodological Study of Risks from THM and Giardia (1986)

    Science.gov (United States)

    This study develops contingent valuation methods for measuring the benefits of mortality and morbidity drinking water risk reductions. The major effort was devoted to developing and testing a survey instrument to value low-level risk reductions.

  6. Reduction of Systemic Risk by Means of Pigouvian Taxation.

    Directory of Open Access Journals (Sweden)

    Vinko Zlatić

    Full Text Available We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI are direct and certain, an overall positive effect on risk adjusted return on investments (ROIRA is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund.

  7. Reduction of Systemic Risk by Means of Pigouvian Taxation.

    Science.gov (United States)

    Zlatić, Vinko; Gabbi, Giampaolo; Abraham, Hrvoje

    2015-01-01

    We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI) are direct and certain, an overall positive effect on risk adjusted return on investments (ROIRA) is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund.

  8. JWST Pathfinder Telescope Risk Reduction Cryo Test Program

    Science.gov (United States)

    Matthews, Gary W.; Scorse, Thomas R.; Spina, John A.; Noel, Darin M.; Havey, Keith A., Jr.; Huguet, Jesse A.; Whitman, Tony L.; Wells, Conrad; Walker, Chanda B.; Lunt, Sharon; hide

    2015-01-01

    In 2014, the Optical Ground Support Equipment was integrated into the large cryo vacuum chamber at Johnson Space Center (JSC) and an initial Chamber Commissioning Test was completed. This insured that the support equipment was ready for the three Pathfinder telescope cryo tests. The Pathfinder telescope which consists of two primary mirror segment assemblies and the secondary mirror was delivered to JSC in February 2015 in support of this critical risk reduction test program prior to the flight hardware. This paper will detail the Chamber Commissioning and first optical test of the JWST Pathfinder telescope.

  9. Estimated Reduction in Cancer Risk due to PAH Exposures If Source Control Measures during the 2008 Beijing Olympics Were Sustained

    National Research Council Canada - National Science Library

    Yuling Jia; Dave Stone; Wentao Wang; Jill Schrlau; Shu Tao; Staci L. Massey Simonich

    2011-01-01

    Background: The 2008 Beijing Olympic Games provided a unique case study to investigate the effect of source control measures on the reduction in air pollution, and associated inhalation cancer risk, in a Chinese megacity. Objectives...

  10. The effectiveness of coral reefs for coastal hazard risk reduction and adaptation

    Science.gov (United States)

    Ferrario, Filippo; Beck, Michael W.; Storlazzi, Curt D.; Micheli, Fiorenza; Shepard, Christine C.; Airoldi, Laura

    2014-01-01

    The world’s coastal zones are experiencing rapid development and an increase in storms and flooding. These hazards put coastal communities at heightened risk, which may increase with habitat loss. Here we analyse globally the role and cost effectiveness of coral reefs in risk reduction. Meta-analyses reveal that coral reefs provide substantial protection against natural hazards by reducing wave energy by an average of 97%. Reef crests alone dissipate most of this energy (86%). There are 100 million or more people who may receive risk reduction benefits from reefs or bear hazard mitigation and adaptation costs if reefs are degraded. We show that coral reefs can provide comparable wave attenuation benefits to artificial defences such as breakwaters, and reef defences can be enhanced cost effectively. Reefs face growing threats yet there is opportunity to guide adaptation and hazard mitigation investments towards reef restoration to strengthen this first line of coastal defence.

  11. Smartphone Delivery of Mobile HIV Risk Reduction Education.

    Science.gov (United States)

    Phillips, Karran A; Epstein, David H; Mezghanni, Mustapha; Vahabzadeh, Massoud; Reamer, David; Agage, Daniel; Preston, Kenzie L

    2013-01-01

    We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability "as is" in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings.

  12. Resilience and disaster risk reduction: an etymological journey

    Science.gov (United States)

    Alexander, D. E.

    2013-11-01

    This paper examines the development over historical time of the meaning and uses of the term resilience. The objective is to deepen our understanding of how the term came to be adopted in disaster risk reduction and resolve some of the conflicts and controversies that have arisen when it has been used. The paper traces the development of resilience through the sciences, humanities, and legal and political spheres. It considers how mechanics passed the word to ecology and psychology, and how from there it was adopted by social research and sustainability science. As other authors have noted, as a concept, resilience involves some potentially serious conflicts or contradictions, for example between stability and dynamism, or between dynamic equilibrium (homeostasis) and evolution. Moreover, although the resilience concept works quite well within the confines of general systems theory, in situations in which a systems formulation inhibits rather than fosters explanation, a different interpretation of the term is warranted. This may be the case for disaster risk reduction, which involves transformation rather than preservation of the "state of the system". The article concludes that the modern conception of resilience derives benefit from a rich history of meanings and applications, but that it is dangerous - or at least potentially disappointing - to read to much into the term as a model and a paradigm.

  13. Smartphone Delivery of Mobile HIV Risk Reduction Education

    Directory of Open Access Journals (Sweden)

    Karran A. Phillips

    2013-01-01

    Full Text Available We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability “as is” in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P<0.05. Additionally, all of our video modules met our a priori criteria for feasibility: ≤20% of data were missing due to participant noncompliance and ≤20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings.

  14. A randomised controlled trial of providing personalised cardiovascular risk information to modify health behaviour.

    Science.gov (United States)

    Zullig, Leah L; Sanders, Linda L; Shaw, Ryan J; McCant, Felicia; Danus, Susanne; Bosworth, Hayden B

    2014-04-01

    We conducted a feasibility study of a web-based intervention, which provided personalized cardiovascular disease (CVD) risk information, behavioural risk reduction strategies and educational resources. Participants were block-randomized to the 3-month intervention (n = 47) or to usual care (n = 49). Participants in the intervention group were presented with their CVD risk based on the Framingham risk score, and in three subsequent online encounters could select two behavioural/lifestyle modules, giving them an opportunity to complete six modules over the course of the study. Because it was self-guided, participants had differing levels of engagement with intervention materials. Most intervention group participants (77%, n = 36) completed all modules. After 3 months there were no significant differences between the intervention and usual care groups for systolic blood pressure, body-mass index, CVD risk, smoking cessation or medication non-adherence. The study suggests that modest clinical improvements can be achieved by interventions that are entirely web-administered. However, web-based interventions do not replace the need for human interaction to communicate CVD risk and assist with decision-making.

  15. Landslide risk reduction strategies: an inventory for the Global South

    Science.gov (United States)

    Maes, Jan; Kervyn, Matthieu; Vranken, Liesbet; Dewitte, Olivier; Vanmaercke, Matthias; Mertens, Kewan; Jacobs, Liesbet; Poesen, Jean

    2015-04-01

    Landslides constitute a serious problem globally. Moreover, landslide impact remains underestimated especially in the Global South. It is precisely there where the largest impact is experienced. An overview of measures taken to reduce risk of landslides in the Global South is however still lacking. Because in many countries of the Global South disaster risk reduction (DRR) is at an emerging stage, it is crucial to monitor the ongoing efforts (e.g. discussions on the Post-2015 Framework for DRR). The first objective of this study is to make an inventory of techniques and strategies that are applied to reduce risk from landslides in tropical countries. The second objective is to investigate what are the main bottlenecks for implementation of DRR strategies. In order to achieve these objectives, a review of both scientific and grey literature was conducted, supplemented with expert knowledge. The compilation of recommended and implemented DRR measures from landslide-prone tropical countries is based on an adapted classification proposed by the SafeLand project. According to Vaciago (2013), landslide risk can be reduced by either reducing the hazard, the vulnerability, the number or value of elements at risk or by sharing the residual risk. In addition, these measures can be combined with education and/or awareness raising and are influenced by governance structures and cultural beliefs. Global landslide datasets have been used to identify landslide-prone countries, augmented with region-specific datasets. Countries located in the tropics were selected in order to include landslide-prone countries with a different Human Development Index (HDI) but with a similar climate. Preliminary results support the statement made by Anderson (2013) that although the importance of shifting from post-disaster emergency actions to pre-disaster mitigation is acknowledged, in practice this paradigm shift seems rather limited. It is expected that this is especially the case in countries

  16. Quantifying the risk-reduction potential of new Modified Risk Tobacco Products.

    Science.gov (United States)

    Martin, Florian; Vuillaume, Gregory; Baker, Gizelle; Sponsiello-Wang, Zheng; Ricci, Paolo F; Lüdicke, Frank; Weitkunat, Rolf

    2018-02-01

    Quantitative risk assessment of novel Modified Risk Tobacco Products (MRTP) must rest on indirect measurements that are indicative of disease development prior to epidemiological data becoming available. For this purpose, a Population Health Impact Model (PHIM) has been developed to estimate the reduction in the number of deaths from smoking-related diseases following the introduction of an MRTP. One key parameter of the model, the F-factor, describes the effective dose upon switching from cigarette smoking to using an MRTP. Biomarker data, collected in clinical studies, can be analyzed to estimate the effects of switching to an MRTP as compared to quitting smoking. Based on transparent assumptions, a link function is formulated that translates these effects into the F-factor. The concepts of 'lack of sufficiency' and 'necessity' are introduced, allowing for a parametrization of a family of link functions. These can be uniformly sampled, thus providing different 'scenarios' on how biomarker-based evidence can be translated into the F-factor to inform the PHIM. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Is it possible to make risk-reduction strategies socially sustainable?

    DEFF Research Database (Denmark)

    Korzen-Bohr, Sara Marie; Lassen, Jesper

    2007-01-01

    The public is involved in the assessment of different strategies for reducing food-related risks through perception studies that examine the social and cultural sustainability of these strategies. In this paper, we argue that this public involvement is based on the false assumption that ordinary...... people have an active perception of risk-reduction strategies. Thus, such studies run the risk of being futile or, in worst case, of providing a misleading image of public perception. We outline some theoretical and methodological issues that need to be addressed when members of the public are invited...

  18. Reduction of infectivity in chronic hepatitis B virus carriers among healthcare providers and pregnant women by antiviral therapy.

    Science.gov (United States)

    Gerlich, Wolfram H

    2014-01-01

    The main purpose of therapy for infectious diseases is restoration or protection of the patient's health, but suppression or elimination of infectious agents is also important. In two well-defined situations, reduction of potential infectivity may be the main reason for therapy in hepatitis B virus (HBV) carriers who do not suffer from significant disease: (1) healthcare providers who perform exposure-prone procedures to prevent transmission of HBV to individuals, and (2) pregnant women in the third trimester to prevent transmission to the fetus. This article describes the necessity to recognize highly viremic HBV-infected individuals in these situations, the methods to estimate the risk of transmission, and the therapeutic possibilities to prevent transmission. With today's methods of monitoring HBV DNA, it is possible to reliably estimate the risk of transmission. The drugs entecavir or tenofovir are able to suppress infectivity of HBV carriers to levels acceptable for healthcare providers performing exposure-prone procedures. According to the CDC, 'chronic HBV infection in itself should not preclude the practice or study of medicine, surgery, dentistry, or allied health professions.' Treatment of pregnant women with very high levels of HBV DNA prevents the transmission to the fetus and further if the newborn receives immediate active/passive immunization against HBV. © 2014 S. Karger AG, Basel.

  19. User Perceptions of a Dementia Risk Reduction Website and Its Promotion of Behavior Change

    Science.gov (United States)

    2013-01-01

    Background Several modifiable health and lifestyle factors are consistently associated with dementia risk and it is estimated that significantly fewer people would develop dementia if the incidence of risk factors could be reduced. Despite this, Australians’ awareness of the health and lifestyle factors associated with dementia risk is low. Within a national community education campaign, Alzheimer’s Australia developed a dementia risk reduction website providing information about modifiable risk or protective factors for dementia. Objective This study aimed to assess the usefulness of the website content in improving knowledge and enabling adoption of recommended strategies, and to examine what additional resources consumers need. Methods Visitors to the website over a 3 month period were invited to complete an online survey, which asked them to rate their knowledge of dementia risk reduction before and after visiting the site, how important monitoring their health related behavior was to them before and after visiting the site, their current behavior related to health and lifestyle factors associated with dementia risk, their intentions to change behavior, and the usefulness of potential additional resources to help them do so. Results For this study, 123 Australian adults responded to the survey. 44.7% (55/122) were aged over 60 and 82.1% (98/119) were female. Respondents’ ratings and comments indicated they generally found the content interesting, informative, and helpful to them. Respondents’ ratings of their knowledge about the links between health and lifestyle factors and dementia risk significantly increased after visiting the website (Pwebsite (Pwebsite visitors already had high levels of health motivation and healthy lifestyle behaviors. 55.6% (45/81) said that after visiting the website their intention to make lifestyle changes was strong. Only 27.1% (22/81) said their intention to visit their doctor to discuss dementia risk reduction was strong

  20. Risk Reduction with a Fuzzy Expert Exploration Tool

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, William W.; Broadhead, Ron; Sung, Andrew

    2000-10-24

    This project developed an Artificial Intelligence system that drew up on a wide variety of information in providing realistic estimates of risk. ''Fuzzy logic,'' a system of integrating large amounts of inexact, incomplete information with modern computational methods derived usable conclusions, were demonstrated as a cost-effective computational technology in many industrial applications.

  1. A school-based intervention for diabetes risk reduction.

    Science.gov (United States)

    Foster, Gary D; Linder, Barbara; Baranowski, Tom; Cooper, Dan M; Goldberg, Linn; Harrell, Joanne S; Kaufman, Francine; Marcus, Marsha D; Treviño, Roberto P; Hirst, Kathryn

    2010-07-29

    We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [+/- SD] age, 11.3 [+/- 0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. There was a decrease in the primary outcome--the combined prevalence of overweight and obesity--in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, percentage of students with waist circumference at or above the 90th percentile, fasting insulin levels (P=0.04 for all comparisons), and prevalence of obesity (P=0.05). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. Our comprehensive school-based program did not result in greater decreases in the combined prevalence of overweight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes. (Funded by the National Institutes of Health and the American Diabetes Association; ClinicalTrials.gov number, NCT00458029.)

  2. Providing food to treat adolescents at risk for cardiovascular disease.

    Science.gov (United States)

    de Ferranti, Sarah D; Milliren, Carly E; Denhoff, Erica Rose; Quinn, Nicolle; Osganian, Stavroula K; Feldman, Henry A; Ebbeling, Cara B; Ludwig, David S

    2015-10-01

    Diet modification is recommended to treat childhood cardiovascular (CV) risk factors; however, the optimal dietary strategy is unknown. In a randomized trial, the effect of a low-fat (LF) and a low-glycemic-load (LGL) reduced-calorie diet were examined in youth with overweight/obesity with CV risk factors. Using a novel intervention, we delivered LF or LGL meals and nutrition education to the home for 8 weeks (Intensive Phase), followed by 4 months Maintenance without food provision. Between-group differences in the change in insulin area under the curve (InsAUC) by oral glucose tolerance test and other risk factors were analyzed. Overall, participants (n = 27) showed substantial improvement during the Intensive Phase, including InsAUC (-59 ± 18.2 µU/ml × 120 min, P = 0.004), total cholesterol (-9.9 ± 3.6 mg/dl, P = 0.01), weight (-2.7 ± 0.5 kg, P risk factors that diminished without food delivery and did not differ based on dietary intervention. If scalable, food provision may represent an alternative nutrition treatment strategy. © 2015 The Obesity Society.

  3. Biodiesel from Specified Risk Material Tallow: An Appraisal of TSE Risks and their Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Baribeau, A.; Bradley, R.; Brown, P.; Goodwin, J.; Kihm, U.; Lotero, E.; O' Connor, D.; Schuppers, M.; Taylor, D.

    2007-03-15

    This document presents a systematic survey of current knowledge about the risk to human and animal health posed by the processing of tissues from animals potentially infected with transmissible spongiform encephalopathy (TSE, or 'prion disease') into biodiesel. It is organised into an introductory background section on TSE, followed by chapters treating the sequential stages of biodiesel production. The principal conclusions are: Animal tissue sources. The choice of geographic origin, based on published scientific evaluations of the risk of TSE to be present in a given country, can largely reduce or even eliminate the entry of contaminated tissue into the biodiesel feedstock. Further safeguards can be provided by selection of animal species not susceptible to TSE, and of tissues without any detectable infectivity even in susceptible species. None of these measures, however, would be applied to the biodiesel projects under consideration, which have the specific aim of using animals and tissues (including specified risk material, or SRM) considered to have sufficient potential risk to be unacceptable for use in food, feed, fertilisers, or pharmaceuticals (including biologicals and medical devices) and therefore are designated for other approved uses, or destruction. Tissue rendering to produce tallow. Experiments to test the survival of TSE infectivity in the products of rendering failed to detect any infectivity in the crude tallow fraction, even following processing methods that allowed survival of infectivity in the co-produced meat and bone meal fraction. It is therefore extremely unlikely that pure tallow originating from diseased animals would be infectious; however, lower grade tallow might contain infectious impurities. A requirement that tallow derived from SRM for use in biodiesel contain no detectable protein would reduce this possibility. Transesterification of tallow to biodiesel. Several steps in the manufacturing process have at least the

  4. The role of service learning in teaching and research for disaster-risk reduction

    Science.gov (United States)

    Suckale, J.; Saiyed, Z.; Alvisyahrin, T.; Hilley, G. E.; Muhari, A.; Zoback, M. L. C.; Truebe, S.

    2016-12-01

    An important motivation for natural-hazards research is to reduce threats posed by natural disasters to at-risk communities. Yet, we rarely teach students how research may be used to construct implementable solutions that reduce disaster risk. The goal of this contribution is to evaluate the potential of service learning to impart students with both the scientific background and the skills necessary to navigate real-world constraints of disaster risk reduction. We present results from a service-learning class taught at Stanford in the Winter quarter of 2016 in collaboration with the Indonesian Ministry of Marine Affairs and Fisheries and Syiah Kuala University, Banda Aceh. The main deliverable of the class was a final project in which students developed a specific idea of how to contribute to tsunami-risk reduction in Indonesia. A common critique of the service-learning approach posits that it may implicitly embed social and political perspectives within risk-reduction strategies that may be inappropriate within a particular culture. We attempted to avoid this problem using three strategies: First, we paired students from Stanford with students at Syiah Kuala University, Banda Aceh, to facilitate a close dialogue. Second, the Ministry of Marine Affairs and Fisheries provided a list of current risk-reduction strategies without requiring students to contribute to one specific project to minimally precondition project suggestions. Third, our community partners provided ongoing feedback on the scope and feasibility of the proposed projects and students were assessed based on their ability to integrate the feedback. Preliminary results from our class suggest significant promise for a service-learning approach to teaching disaster-risk reduction. There was substantial student interest in service learning, particularly among undergraduates. Pre-and post-assessment surveys showed that over 75% of students adjusted previous notions about disaster-risk reduction during the

  5. Psychological Resilience Provides No Independent Protection From Suicidal Risk.

    Science.gov (United States)

    Liu, Danica W Y; Fairweather-Schmidt, A Kate; Burns, Richard; Roberts, Rachel M; Anstey, Kaarin J

    2016-03-01

    Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28-32 years at the first time point and 32-36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

  6. Asset Management Planning – providing the evidence to support robust and risk-based investment decisions

    Directory of Open Access Journals (Sweden)

    Mitchell Chrissy

    2016-01-01

    Full Text Available Over the last decade the UK’s joint Flood and Coastal Erosion Risk Management Research and Development programme has been developing methods to support a move to a risk-based approach to flood defence asset management. Looking to ensure investment is less ‘find and fix’ and made to those assets where the biggest risk reduction can be made for the money available. In addition, providing the capability to articulate the benefits of investing in these assets quantitatively and transparently. This paper describes how the Asset Performance Tools (APT project [1] is delivering practical methods, prototype tools and supporting guidance which, together with related initiatives such as the Environment Agency’s Creating Asset Management Capacity (CAMC strategic programme [2] and the ‘State of the Nation’ (SoN [3] supportive datasets, will enable a risk-based, ‘predict and protect’ approach to asset management. A key advance is the ability to bring in local knowledge to make national generic datasets locally relevant. The paper also highlights existing outputs that can already be used to support a more proactive approach to asset management. It will summarise the ongoing work which will further develop and fine tune performance assessment and investment decision processes within an integrated conceptual framework aligned with ISO55000, deliverable via CAMC and whose concepts can be used by all risk management authorities.

  7. Alcohol risk reduction for fraternity and sorority members.

    Science.gov (United States)

    Harrington, N G; Brigham, N L; Clayton, R R

    1999-07-01

    The primary objective of this study is to evaluate the effectiveness of "Talking about Alcohol and Drugs... Among Greeks" (TAAD), a lifestyle risk reduction program that is research- and theory-based, protocol-driven, and targeted for fraternity and sorority members. One fraternity and two sororities on five campuses participated in the program. A total of 780 participants completed pre- and posttest questionnaires. Posttest data were collected 1 academic year after pretest data collection. Results indicate that the program decreased positive attitudes toward alcohol consumption among program participants, with participants in the true experimental condition indicating greater disagreement than control participants (F = 3.05, 2/701 df, p sororities might be better received than the current approach, which focuses on how individual attitudes, beliefs and behaviors lead to alcohol-related problems and alcoholism.

  8. METHODOLOGY OF SYSTEM APPROACHE TO SEISMIC RISK ASSESSMENT AND REDUCTION

    Directory of Open Access Journals (Sweden)

    A. D. Abakarov

    2016-01-01

    Full Text Available Abstract. Ensuring of urban areas seismic safety is a task which do not require delay. But it cannot be solved by separate parts. It is essential that all components of the seismic hazard must be grouped together in one problem based on the system approach. In the present paper is presented not only the main flowchart of systems approach to ensuring the territory seismic safety but also the flowcharts of components of each main unit. They cover the whole package of measures for a full assessment of territory seismic hazard, seismic risk and its reduction.The proposed methodology can be carried out for design and implementation of regional territory seismic safety programs. 

  9. Nation-building policies in Timor-Leste: disaster risk reduction, including climate change adaptation.

    Science.gov (United States)

    Mercer, Jessica; Kelman, Ilan; do Rosario, Francisco; de Deus de Jesus Lima, Abilio; da Silva, Augusto; Beloff, Anna-Maija; McClean, Alex

    2014-10-01

    Few studies have explored the relationships between nation-building, disaster risk reduction and climate change adaptation. Focusing on small island developing states, this paper examines nation-building in Timor-Leste, a small island developing state that recently achieved independence. Nation-building in Timor-Leste is explored in the context of disaster risk reduction, which necessarily includes climate change adaptation. The study presents a synopsis of Timor-Leste's history and its nation-building efforts as well as an overview of the state of knowledge of disaster risk reduction including climate change adaptation. It also offers an analysis of significant gaps and challenges in terms of vertical and horizontal governance, large donor presence, data availability and the integration of disaster risk reduction and climate change adaptation for nation-building in Timor-Leste. Relevant and applicable lessons are provided from other small island developing states to assist Timor-Leste in identifying its own trajectory out of underdevelopment while it builds on existing strengths. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  10. The Good, The Bad and The Ugly: Disaster Risk Reduction (DRR) Versus Disaster Risk Creation (DRC)

    Science.gov (United States)

    Lewis, James

    2012-01-01

    In understanding and trying to reduce the risk from disasters, connections are often articulated amongst poverty, vulnerability, risk, and disasters. These are welcome steps, but the approach taken in top-down international documents is rarely to articulate explicitly that vulnerability accrues from a wide variety of dynamic and long-term processes. Neglecting these processes—and failing to explore their links with poverty, risk, and disasters—tends to encourage disaster risk creation. This paper identifies seven examples of on-the-ground realities of long-term vulnerability within two clusters: Endangerment: 1 Environmental degradation. 2 Discrimination. 3 Displacement. Impoverishment: 4 Self-seeking public expenditure. 5 Denial of access to resources. 6 Corruption. 7 Siphoning of public money. Examples are presented as vignettes, many contemporary and many rooted in historical contexts, to demonstrate the extent to which “vulnerability drivers” emanate from greed, the misuse of political and commercial power, mismanagement and incompetence amongst other behaviours. Moving forward to the tackling of disaster risk creation, instead of simply seeking disaster risk reduction, requires detailed investigation into these contemporary and historical realities of the causes of vulnerability. That would support the integration of disaster risk reduction within the many wider contexts that foment and perpetuate vulnerability. PMID:22919564

  11. The Good, The Bad and The Ugly: Disaster Risk Reduction (DRR) Versus Disaster Risk Creation (DRC).

    Science.gov (United States)

    Lewis, James

    2012-06-21

    In understanding and trying to reduce the risk from disasters, connections are often articulated amongst poverty, vulnerability, risk, and disasters. These are welcome steps, but the approach taken in top-down international documents is rarely to articulate explicitly that vulnerability accrues from a wide variety of dynamic and long-term processes. Neglecting these processes-and failing to explore their links with poverty, risk, and disasters-tends to encourage disaster risk creation. This paper identifies seven examples of on-the-ground realities of long-term vulnerability within two clusters: Endangerment: 1 Environmental degradation. 2 Discrimination. 3 Displacement. Impoverishment: 4 Self-seeking public expenditure. 5 Denial of access to resources. 6 Corruption. 7 Siphoning of public money. Examples are presented as vignettes, many contemporary and many rooted in historical contexts, to demonstrate the extent to which "vulnerability drivers" emanate from greed, the misuse of political and commercial power, mismanagement and incompetence amongst other behaviours. Moving forward to the tackling of disaster risk creation, instead of simply seeking disaster risk reduction, requires detailed investigation into these contemporary and historical realities of the causes of vulnerability. That would support the integration of disaster risk reduction within the many wider contexts that foment and perpetuate vulnerability.

  12. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    William W. Weiss

    2001-05-17

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, is being developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices, and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tool will benefit a diverse group in the U.S., leading to a more efficient use of scarce funds and lower product prices for consumers. This second annual report contains a summary of progress to date, problems encountered, plans for the next quarter, and an assessment of the prospects for future progress. During the second year of the project, data acquisition of the Brushy Canyon Formation was completed with the compiling and analyzing of well logs, geophysical data, and production information needed to characterize production potential in the Delaware Basin. A majority of this data now resides in several online databases on our servers and is in proper form to be accessed by external

  13. Communicating risk using absolute risk reduction or prolongation of life formats

    DEFF Research Database (Denmark)

    Harmsen, Charlotte Gry; Kristiansen, Ivar Sønbø; Larsen, Pia Veldt

    2014-01-01

    BACKGROUND: It is important that patients are well-informed about risks and benefits of therapies to help them decide whether to accept medical therapy. Different numerical formats can be used in risk communication but It remains unclear how the different formats affect decisions made by real......-life patients. AIM: To compare the impact of using Prolongation Of Life (POL) and Absolute Risk Reduction (ARR) information formats to express effectiveness of cholesterol-lowering therapy on patients' redemptions of statin prescriptions, and on patients' confidence in their decision and satisfaction...... with the risk communication. DESIGN AND SETTING: Cluster-randomised clinical trial in general practices. Thirty-four Danish GPs from 23 practices participated in a primary care-based clinical trial concerning use of quantitative effectiveness formats for risk communication in health prevention consultations...

  14. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    William W. Weiss

    2000-12-31

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries, including medical diagnostics, have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized data base and computer maps generated by neural networks, is proposed for development through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This tool will be beneficial in many regions of the US, enabling risk reduction in oil and gas prospecting and decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the US as reserves are depleted. The proposed expert exploration tool will benefit a diverse group in the US, leading to a more efficient use of scarce funds and lower product prices for consumers. This third of ten semi-annual reports contains an account of the progress, problems encountered, plans for the next quarter, and an assessment of the prospects for future progress.

  15. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert Balch

    2004-04-08

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, is being developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices, and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tool will benefit a diverse group in the U.S., leading to a more efficient use of scarce funds, and possibly decreasing dependence on foreign oil and lower product prices for consumers. This fifth annual (and tenth of 12 semi-annual reports) contains a summary of progress to date, problems encountered, plans for the next year, and an assessment of the prospects for future progress. The emphasis during the March 2003 through March 2004 period was directed toward completion of the Brushy Canyon FEE Tool and to Silurian-Devonian geology, and development of rules for the Devonian fuzzy system, and on-line software.

  16. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert Balch

    2003-10-15

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, is being developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices, and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tool will benefit a diverse group in the U.S., leading to a more efficient use of scarce funds, and possibly decreasing dependence on foreign oil and lower product prices for consumers. This ninth of ten semi-annual reports contains a summary of progress to date, problems encountered, plans for the next year, and an assessment of the prospects for future progress. The emphasis during the March 2003 through September 2003 period was directed toward Silurian-Devonian geology, development of rules for the fuzzy system, and on-line software.

  17. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert Balch

    2003-04-15

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, is being developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices, and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The pool of experts is much reduced today. The FEE Tool will benefit a diverse group in the U.S., leading to a more efficient use of scarce funds, and possibly decreasing dependence on foreign oil and lower product prices for consumers. This fourth of five annual reports contains a summary of progress to date, problems encountered, plans for the next year, and an assessment of the prospects for future progress. The emphasis during the April 2002 through March 2003 period was directed toward Silurian-Devonian geology, development of rules for the fuzzy system, and on-line software.

  18. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    William W. Weiss

    2001-09-30

    Incomplete or sparse information on types of data such as geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results. A state-of-the-art exploration ''expert'' tool, relying on a computerized database and computer maps generated by neural networks, is being developed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk can be reduced with the use of a properly developed and validated ''Fuzzy Expert Exploration (FEE) Tool.'' This FEE Tool can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In the 1998-1999 oil industry environment, many smaller exploration companies lacked the resources of a pool of expert exploration personnel. Downsizing, low oil prices, and scarcity of exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. As a result, today's pool of experts is much reduced. The FEE Tool will benefit a diverse group in the U.S., leading to a more efficient use of scarce funds and lower product prices for consumers. This fifth of ten semi-annual reports contains a summary of progress to date, problems encountered, plans for the next year, and an assessment of the prospects for future progress. The emphasis during the May 2001 through September 2001 was directed toward development of rules for the fuzzy system.

  19. Analysis of sheep α-synuclein provides a molecular strategy for the reduction of fibrillation.

    Science.gov (United States)

    Bickle, Lungisa; Hopwood, John J; Karageorgos, Litsa

    2017-03-01

    Parkinson's disease (PD) presents with neuropathological inclusions called Lewy bodies, which are primarily composed of fibrillar α-synuclein. Recently, we characterized sheep with Gaucher disease and since GBA1 mutations represent the highest genetic risk factor for PD, we have investigated α-synuclein fibrillation in the sheep. Here we demonstrate that differences in six amino acid residues between sheep and human α-synuclein significantly alter in vitro fibril formation. Circular dichroism of recombinant human and sheep α-synuclein show that both proteins adopt the same secondary structure. Fibrils from human and sheep α-synuclein formed at pH7.0 or 4.5 were analyzed by Transmission Electron Microscopy (TEM). Unexpectedly, sheep α-synuclein form fibrils much less readily than human α-synuclein and this difference was more pronounced at the lysosomal pH of 4.5. Aggregation-propensity and intrinsic-solubility analysis revealed that sheep α-synuclein had lower aggregation-propensity and higher solubility. As a result of these observations, TEM was used to analyze fibrils formed at pH4.5 of various "sheep-like" human or "human-like" sheep mutant α-synucleins, together with their wild-type forms. Thioflavin T was used to monitor in situ α-synuclein fibril formation at pH7.0 and 4.5. Results show that "sheep-like" human α-synuclein has substantially lower fibril aggregation, and "human-like" sheep α-synuclein aggregates faster than wild-type forms, respectively. Seeding with WT human α-synuclein showed that "sheep-like" human α-synuclein could not be seeded, providing further evidence that sheep sequence is resistant to fibrillation. These findings provide new avenues to prevent/reduce fibrillation in PD, which may aid in the development of therapies. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Binomial Distribution Sample Confidence Intervals Estimation 7. Absolute Risk Reduction and ARR-like Expressions

    Directory of Open Access Journals (Sweden)

    Andrei ACHIMAŞ CADARIU

    2004-08-01

    Full Text Available Assessments of a controlled clinical trial suppose to interpret some key parameters as the controlled event rate, experimental event date, relative risk, absolute risk reduction, relative risk reduction, number needed to treat when the effect of the treatment are dichotomous variables. Defined as the difference in the event rate between treatment and control groups, the absolute risk reduction is the parameter that allowed computing the number needed to treat. The absolute risk reduction is compute when the experimental treatment reduces the risk for an undesirable outcome/event. In medical literature when the absolute risk reduction is report with its confidence intervals, the method used is the asymptotic one, even if it is well know that may be inadequate. The aim of this paper is to introduce and assess nine methods of computing confidence intervals for absolute risk reduction and absolute risk reduction – like function.Computer implementations of the methods use the PHP language. Methods comparison uses the experimental errors, the standard deviations, and the deviation relative to the imposed significance level for specified sample sizes. Six methods of computing confidence intervals for absolute risk reduction and absolute risk reduction-like functions were assessed using random binomial variables and random sample sizes.The experiments shows that the ADAC, and ADAC1 methods obtains the best overall performance of computing confidence intervals for absolute risk reduction.

  1. Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary.

    Science.gov (United States)

    Phibbs, Suzanne; Kenney, Christine; Severinsen, Christina; Mitchell, Jon; Hughes, Roger

    2016-12-14

    The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the "new" agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010-2011 earthquakes in Canterbury, New Zealand.

  2. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C.; Bell, K.; Spinney, P. [and others

    1997-05-01

    The question of uncertainty and risk in electric utility resource planning has received considerable attention in recent years. During the 1980s, many utilities suffered financial losses because of unexpectedly high plant construction costs and low growth in electricity demand. In addition, the introduction of competition to the electric industry is creating new risks for power companies. No longer will utilities be able to count on regulatory protections and a base of captive consumers to provide a stable market and adequate return on their investments. Alternative risk management strategies will have to be considered instead. One approach to managing risk is for a utility company to invest in diverse power sources such as wind power plants. Since wind plants consume no fuel, can be built in relatively small increments with short construction lead times, and generate no pollutants, it is often said that they offer significant protection from risks associated with conventional fossil-fuel power plants. So far there have been few efforts to quantify these benefits, however. The study compares the costs and risks of two competing resource options, a gas-fired combined cycle plant and a wind plant, both utility-owned, through decision analysis. The case study utility is Texas Utilities Electric, a very large investor-owned company serving an area with substantial, high-quality wind resources. The authors chose a specific moment in the future - the year 2003 - when the utility currently plans to build a large fossil-fueled power plant, and examined the implications for the utility`s expected revenues, costs, and profits if a wind plant were to be built instead.

  3. Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction

    Directory of Open Access Journals (Sweden)

    Dai Hongying

    2013-01-01

    Full Text Available Abstract Background Multifactor Dimensionality Reduction (MDR has been widely applied to detect gene-gene (GxG interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. Results We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. Conclusions The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi are proposed to detect multiple GxG interactions.

  4. Combining hazard, exposure and social vulnerability to provide lessons for flood risk management

    NARCIS (Netherlands)

    Koks, E.E.; Jongman, B.; Husby, T.G.; Botzen, W.J.W.

    2015-01-01

    Flood risk assessments provide inputs for the evaluation of flood risk management (FRM) strategies. Traditionally, such risk assessments provide estimates of loss of life and economic damage. However, the effect of policy measures aimed at reducing risk also depends on the capacity of households to

  5. Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.

    Science.gov (United States)

    Schmidt, Norman B; Raines, Amanda M; Allan, Nicholas P; Zvolensky, Michael J

    2016-02-01

    Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Ross, Stephanie L.; Jones, Lucile M.

    2013-01-01

    The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey (CGS), the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

  7. 41 CFR 102-80.55 - Are Federal agencies responsible for managing the execution of risk reduction projects?

    Science.gov (United States)

    2010-07-01

    ... responsible for managing the execution of risk reduction projects? 102-80.55 Section 102-80.55 Public... Management Risks and Risk Reduction Strategies § 102-80.55 Are Federal agencies responsible for managing the execution of risk reduction projects? Yes, Federal agencies must manage the execution of risk reduction...

  8. Sustainable development through a gendered lens: climate change adaptation and disaster risk reduction.

    Science.gov (United States)

    Lewis, Nancy D

    2016-03-01

    The UN General Assembly has just adopted the post 2015 Sustainable Development Agenda articulated in the 17 Sustainable Development Goals (SDGs). Achieving the SDGs will be furthered by the closer integration of the climate change adaptation (CCA) and disaster risk reduction (DRR) agendas. Gender provides us a valuable portal for considering this integration. Acknowledging that gender relaters to both women and men and that men and women experience climate variability and disasters differently, in this paper the role of women in both CCA and DRR is explored, shifting the focus from women as vulnerable victims to women as critical agents for change with respect to climate change mitigation and adaptation and reduction of disaster risks. Appropriately targeted interventions can also empower women and contribute to more just and inclusive sustainable development.

  9. Barriers to the dissemination of four harm reduction strategies: a survey of addiction treatment providers in Ontario

    Directory of Open Access Journals (Sweden)

    Cunningham John A

    2006-12-01

    Full Text Available Abstract A sample of service providers at addictions agencies' in Ontario were interviewed by telephone to assess attitudes toward, anticipated internal and external barriers to implementing, and expected benefits of four harm reduction strategies: needle exchange, moderate drinking goals, methadone treatment, and provision of free condoms to clients. Respondents were also asked to define harm reduction, list its most important elements, and describe what they find most troubling and most appealing about harm reduction. Attitudes toward harm reduction in general and the services provided at each agency were also assessed. Results indicated that the service providers surveyed had positive attitudes toward each of the four harm reduction strategies and harm reduction in general, and the majority of respondents were aware of the benefits associated with each strategy. Almost all of the agencies surveyed allowed for moderate drinking outcomes in the treatment of alcohol problems, and most agencies provided free condoms to clients. In terms of barriers, anticipated negative community reaction to needle exchange, methadone treatment, and free condoms was a major concern for the majority of respondents. Lack of staff, of funding, or anticipated staff resistance were also cited as potential barriers to introducing these strategies. In the case of methadone maintenance, the unavailability of a qualified physician was listed as the primary constraint. Implications for future efforts directed at encouraging the adoption of these strategies and suggestions for future research are discussed.

  10. Structure of active IspH enzyme from escherichia coli provides mechanistic insights into substrate reduction

    KAUST Repository

    Gräwert, Tobias

    2009-07-20

    The terminal step of the non-mevalonate pathway of terpene biosynthesis is catalyzed by IspH (see scheme). In the crystal structure of IspH from E. coli, a bound inorganic diphosphate ligand occupies the position of the diphosphate residue of the substrate. Together with mutation studies and theoretical calculations, these data support a mechanism which is analogous to the Birch reduction of allylic alcohols. © 2009 Wiley-VCH Verlag GmbH & Co. KGaA.

  11. Second malignant neoplasms: assessment and strategies for risk reduction.

    Science.gov (United States)

    Wood, Marie E; Vogel, Victor; Ng, Andrea; Foxhall, Lewis; Goodwin, Pamela; Travis, Lois B

    2012-10-20

    Improvements in early detection, supportive care, and treatment have resulted in an increasing number of cancer survivors, with a current 5-year relative survival rate for all cancers combined of approximately 66.1%. For some patients, these survival advances have been offset by the long-term late effects of cancer and its treatment, with second malignant neoplasms (SMNs) comprising one of the most potentially life-threatening sequelae. The number of patients with SMNs is growing, with new SMNs now representing about one in six of all cancers reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. SMNs reflect not only the late effects of therapy but also the influence of shared etiologic factors (in particular, tobacco and excessive alcohol intake), genetic susceptibility, environmental exposures, host effects, and combinations of factors, including gene-environment interactions. For selected SMNs, risk is also modified by age at exposure and attained age. SMNs can be categorized into three major groups according to the predominant etiologic factor(s): (1) treatment-related, (2) syndromic, and (3) those due to shared etiologic exposures, although the nonexclusivity of these groups should be underscored. Here we provide an overview of SMNs in survivors of adult-onset cancer, summarizing the current, albeit limited, clinical evidence with regard to screening and prevention, with a focus on the provision of guidance for health care providers. The growing number of patients with second (and higher-order) cancers mandates that we also further probe etiologic influences and genetic variants that heighten risk, and that we better define high-risk groups for targeted preventive and interventional clinical strategies.

  12. Evaluation of an HIV-risk reduction programme for first-year ...

    African Journals Online (AJOL)

    Evaluation of an HIV-risk reduction programme for first-year university students in South Africa. ... African Journal for Physical Activity and Health Sciences. Journal Home ... Results indicated that HIV-related knowledge; condom knowledge and risk perception were enhanced by the HIV- related risk reduction programme.

  13. LISA Technology Development and Risk Reduction at NASA

    Science.gov (United States)

    Stebbins, Robin T.

    2010-01-01

    The Laser Interferometer Space Antenna (LISA) is a joint ESA-NASA project to design, build and operate a space-based gravitational wave detector based on a laser interferometer. LISA relies on several technologies that are either new to spaceflight or must perform at levels not previously demonstrated in a spaceflight environment. The ESA-led LISA Pathfinder mission is the main effort to demonstrate LISA technology. NASA also supports complementary ground-based technology development and risk reduction activities. This presentation will report the status of NASA work on micronewton thrusters, the telescope, the optical pointing subsystem and mission formulation. More details on some of these topics will be given in posters. Other talks and posters will describe NASA-supported work on the laser subsystem, the phasemeter, and aspects of the interferometry. Two flight-qualified clusters of four colloid micronewton thrusters, each capable of thrust Levels between 5 and 30 microNewton with a resolution less than 0.l microNewton and a thrust noise less than 0.1 microNewton/vHz (0.001 to 4 Hz), have been integrated onto the LISA Pathfinder spacecraft. The complementary ground-based development focuses on lifetime demonstration. Laboratory verification of failure models and accelerated life tests are just getting started. LISA needs a 40 cm diameter, afocal telescope for beam expansion/reduction that maintains an optical pathlength stability of approximately 1 pm/vHz in an extremely stable thermal environment. A mechanical prototype of a silicon carbide primary-secondary structure has been fabricated for stability testing. Two optical assemblies must point at different distant spacecraft with nanoradian accuracy over approximately 1 degree annual variation in the angle between the distant spacecraft. A candidate piezo-inchworm actuator is being tested in a suitable testbed. In addition to technology development, NASA has carried out several studies in support of the

  14. Relationships among Trust in Messages, Risk Perception, and Risk Reduction Preferences Based upon Avian Influenza in Taiwan

    Directory of Open Access Journals (Sweden)

    Wen-Shan Hsu

    2012-08-01

    Full Text Available Improvements in communications technology enable consumers to receive information through diverse channels. In the case of avian influenza, information repeated by the mass media socially amplifies the consumer awareness of risks. Facing indeterminate risks, consumers may feel anxious and increase their risk perception. When consumers trust the information published by the media, their uncertainty toward avian influenza may decrease. Consumers might take some actions to reduce risk. Therefore, this study focuses on relationships among trust in messages, risk perception and risk reduction preferences. This study administered 525 random samples and consumer survey questionnaires in different city of Taiwan in 2007. Through statistical analysis, the results demonstrate: (1 the higher the trust consumers have in messages about avian influenza, the lower their risk perceptions are; (2 the higher the consumers’ risk perceptions are and, therefore, the higher their desired level of risk reductive, the more likely they are to accept risk reduction strategies; (3 consumer attributes such as age, education level, and marital status correlate with significant differences in risk perception and risk reduction preferences acceptance. Gender has significant differences only in risk reduction preferences and not in risk perception.

  15. From risk and harm reduction to decriminalizing abortion: The Uruguayan model for women's rights.

    Science.gov (United States)

    Briozzo, Leonel

    2016-08-01

    To describe public policies, social actions, particularly those of obstetricians/gynecologists, and changes in abortion-related legislation in the different historical periods between 1990 and 2015, and to analyze temporal correlations with a reduction in maternal mortality. The 1990-2015 period was divided into three different stages to permit evaluation of the legislation, health regulations, healthcare system, and professional practices related to the care provided in cases of unsafe abortion: 1990-2001, characterized by illegality and the healthcare system's denial of abortion; 2001-2012, when the model for reducing the risk and harm of unsafe abortions was developed; and 2012-2015, when abortion was finally decriminalized. Changes in public policies and expansion of the risk reduction model coincided with changes in the social perception of abortion and a decrease in maternal mortality and abortion rates, probably due to a set of public policies that led to the decriminalization of abortion in 2012. Changes in public policies and health actions such as the model for reducing the risk and harm of unsafe abortions coincided with a marked reduction in abortion-related maternal mortality. The challenges still to be faced include managing second trimester abortions, ensuring the creation of multidisciplinary teams, and offering postabortion contraception. Copyright © 2016. Published by Elsevier Ireland Ltd.

  16. Research and Evaluations of the Health Aspects of Disasters, Part VIII: Risk, Risk Reduction, Risk Management, and Capacity Building.

    Science.gov (United States)

    Birnbaum, Marvin L; Loretti, Alessandro; Daily, Elaine K; O'Rourke, Ann P

    2016-06-01

    There is a cascade of risks associated with a hazard evolving into a disaster that consists of the risk that: (1) a hazard will produce an event; (2) an event will cause structural damage; (3) structural damage will create functional damages and needs; (4) needs will create an emergency (require use of the local response capacity); and (5) the needs will overwhelm the local response capacity and result in a disaster (ie, the need for outside assistance). Each step along the continuum/cascade can be characterized by its probability of occurrence and the probability of possible consequences of its occurrence, and each risk is dependent upon the preceding occurrence in the progression from a hazard to a disaster. Risk-reduction measures are interventions (actions) that can be implemented to: (1) decrease the risk that a hazard will manifest as an event; (2) decrease the amounts of structural and functional damages that will result from the event; and/or (3) increase the ability to cope with the damage and respond to the needs that result from an event. Capacity building increases the level of resilience by augmenting the absorbing and/or buffering and/or response capacities of a community-at-risk. Risks for some hazards vary by the context in which they exist and by the Societal System(s) involved. Birnbaum ML , Loretti A , Daily EK , O'Rourke AP . Research and evaluations of the health aspects of disasters, part VIII: risk, risk reduction, risk management, and capacity building. Prehosp Disaster Med. 2016;31(3):300-308.

  17. The impact of the total tax rate reduction on public services provided in Romania

    Directory of Open Access Journals (Sweden)

    Adina TRANDAFIR

    2014-09-01

    Full Text Available Against the background of economic globalization, governments tend to take tax measures disadvantageous to society in order to increase the attractiveness of the business environment. A common measures for this purpose is the reduction in tax rate. According to the classical theory of tax competition such measure leads to under the provision of public goods. This article aims to show, through an econometric analysis, whether in Romania, in the period 2006-2013, reducing total tax rate had a negative impact on public services. For this, using linear regression technique, the article analysed the correlation between total tax rate and the variation in the share of the main public service spending in GDP.

  18. Reduction of earthquake risk in the united states: Bridging the gap between research and practice

    Science.gov (United States)

    Hays, W.W.

    1998-01-01

    Continuing efforts under the auspices of the National Earthquake Hazards Reduction Program are under way to improve earthquake risk assessment and risk management in earthquake-prone regions of Alaska, California, Nevada, Washington, Oregon, Arizona, Utah, Wyoming, and Idaho, the New Madrid and Wabash Valley seismic zones in the central United States, the southeastern and northeastern United States, Puerto Rico, Virgin Islands, Guam, and Hawaii. Geologists, geophysicists, seismologists, architects, engineers, urban planners, emergency managers, health care specialists, and policymakers are having to work at the margins of their disciplines to bridge the gap between research and practice and to provide a social, technical, administrative, political, legal, and economic basis for changing public policies and professional practices in communities where the earthquake risk is unacceptable. ?? 1998 IEEE.

  19. Self-monitoring of behaviour as a risk reduction strategy for persons living with HIV.

    Science.gov (United States)

    Lightfoot, M; Rotheram-Borus, M J; Comulada, S; Gundersen, G; Reddy, V

    2007-07-01

    To reduce the HIV-related transmission behaviours of persons living with HIV (PLH), a few efficacious interventions have been designed and evaluated. However, these interventions were delivered at relatively high cost, both in terms of time and resources. Given the challenges for health providers and community agencies in delivering these interventions, alternatives are needed. One possible intervention is allowing PLH to self-monitor their HIV transmission risk behaviour. Previous research suggests that self-monitoring of HIV-risk related behaviours may be a useful risk reduction strategy. This paper examines the impact of repeated risk assessments for behavioural self-monitoring as an intervention strategy for reducing sexual and substance use risk behaviours. A total of 365 PLH, recruited from community clinics, health management organizations, and health departments, completed self-assessments over time. Increased self-monitoring resulted in increases in protected sex with sexual partners of HIV-negative or unknown serostatus, and changes in attitudes conducive to reducing risk. Self-monitoring is a relatively low cost and easily implementable strategy for reducing the HIV-related transmission risk of PLH.

  20. A practical approach to assess depression risk and to guide risk reduction strategies in later life.

    Science.gov (United States)

    Almeida, Osvaldo P; Alfonso, Helman; Pirkis, Jane; Kerse, Ngaire; Sim, Moira; Flicker, Leon; Snowdon, John; Draper, Brian; Byrne, Gerard; Goldney, Robert; Lautenschlager, Nicola T; Stocks, Nigel; Scazufca, Marcia; Huisman, Martijn; Araya, Ricardo; Pfaff, Jon

    2011-03-01

    Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies. A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer. The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors. Our

  1. Ethical questions in landslide management and risk reduction in Norway

    Science.gov (United States)

    Taurisano, A.; Lyche, E.; Thakur, V.; Wiig, T.; Øvrelid, K.; Devoli, G.

    2012-04-01

    The loss of lives caused by landslides in Norway is smaller than in other countries due to the low population density in exposed areas. However, annual economic losses from damage to properties and infrastructures are vast. Yet nationally coordinated efforts to manage and reduce landslide and snow avalanche risk are a recent challenge, having started only in the last decade. Since 2009, this has been a task of the Norwegian Water Resources and Energy Directorate (NVE) under the Ministry of Petroleum and Energy. Ongoing work includes collection of landslide data, production of susceptibility and hazard maps, planning of mitigation measures along with monitoring and early warning systems, assistance to areal planning, providing expertise in emergencies and disseminating information to the public. These activities are realized in collaboration with the Norwegian Geological Survey (NGU), the Meteorological Institute, the Road and Railway authorities, universities and private consultant companies. As the total need for risk mitigating initiatives is by far larger than the annual budget, priority assessment is crucial. This brings about a number of ethical questions. 1. Susceptibility maps have been produced for the whole country and provide a first indication of areas with potential landslide or snow avalanche hazard, i.e. areas where special attention and expert assessments are needed before development. Areas where no potential hazard is shown can in practice be developed without further studies, which call for relatively conservative susceptibility maps. However, conservative maps are problematic as they too often increase both cost and duration of building projects beyond the reasonable. 2. Areas where hazard maps or risk mitigation initiatives will be funded are chosen by means of cost-benefits analyses which are often uncertain. How to estimate the benefits if the real probability for damage can only be judged on a very subjective level but not really calculated

  2. A text message intervention for alcohol risk reduction among community college students: TMAP.

    Science.gov (United States)

    Bock, Beth C; Barnett, Nancy P; Thind, Herpreet; Rosen, Rochelle; Walaska, Kristen; Traficante, Regina; Foster, Robert; Deutsch, Chris; Fava, Joseph L; Scott-Sheldon, Lori A J

    2016-12-01

    Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population. To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students. Heavy drinking adult CC students (N=60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up). Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD=1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up. The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy. Copyright © 2016. Published by Elsevier Ltd.

  3. Towards policy recommendations for future drought risk reduction

    NARCIS (Netherlands)

    Kampragou, E.; Assimacopoulos, D.; Stefano, De L.; Andreu, J.; Musolino, D.; Wolters, W.; Lanen, van H.A.J.; Rego, F.C.; Seidl, I.

    2015-01-01

    The paper presents a research framework for supporting drought management on the basis of drought risk identification, assessment and management. While risk identification involves the analysis of past and future drought on the basis of climate projections, the assessment of risk follows a

  4. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

    Science.gov (United States)

    Williams, Paul T; Thompson, Paul D

    2013-05-01

    To test whether equivalent energy expenditure by moderate-intensity (eg, walking) and vigorous-intensity exercise (eg, running) provides equivalent health benefits. We used the National Runners' (n=33 060) and Walkers' (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. Baseline expenditure (metabolic equivant hours per day [METh/d]) was compared with self-reported, physician-diagnosed incident hypertension, hypercholesterolemia, diabetes mellitus, and CHD during 6.2 years follow-up. Running significantly decreased the risks for incident hypertension by 4.2% (Pdiabetes mellitus by 12.1% (Phypertension; and (3) 43.5%, 44.1%, 47.7%, and 68.2% from running, and 34.1%, 44.2% and 23.6% from walking for diabetes mellitus (walking >5.4 METh/d excluded for too few cases). The risk reductions were not significantly different for running than walking for diabetes mellitus (P=0.94), hypertension (P=0.06), or CHD (P=0.26), and only marginally greater for walking than running for hypercholesterolemia (P=0.04). Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.

  5. Reduction of (Formazanate)boron Difluoride Provides Evidence for an N-Heterocyclic B(I) Carbenoid Intermediate

    NARCIS (Netherlands)

    Chang, Mu-Chieh; Otten, Edwin

    2015-01-01

    Despite the current interest in structure and reactivity of sub-valent main group compounds, neutral boron analogues of N-heterocyclic carbenes have been elusive due to their high reactivity. Here we provide evidence that 2-electron reduction of a (formazanate)BF2 precursor leads to NaF elimination

  6. Can I Count on Getting Better? Association between Math Anxiety and Poorer Understanding of Medical Risk Reductions.

    Science.gov (United States)

    Rolison, Jonathan J; Morsanyi, Kinga; O'Connor, Patrick A

    2016-10-01

    Lower numerical ability is associated with poorer understanding of health statistics, such as risk reductions of medical treatment. For many people, despite good numeracy skills, math provokes anxiety that impedes an ability to evaluate numerical information. Math-anxious individuals also report less confidence in their ability to perform math tasks. We hypothesized that, independent of objective numeracy, math anxiety would be associated with poorer responding and lower confidence when calculating risk reductions of medical treatments. Objective numeracy was assessed using an 11-item objective numeracy scale. A 13-item self-report scale was used to assess math anxiety. In experiment 1, participants were asked to interpret the baseline risk of disease and risk reductions associated with treatment options. Participants in experiment 2 were additionally provided a graphical display designed to facilitate the processing of math information and alleviate effects of math anxiety. Confidence ratings were provided on a 7-point scale. Individuals of higher objective numeracy were more likely to respond correctly to baseline risks and risk reductions associated with treatment options and were more confident in their interpretations. Individuals who scored high in math anxiety were instead less likely to correctly interpret the baseline risks and risk reductions and were less confident in their risk calculations as well as in their assessments of the effectiveness of treatment options. Math anxiety predicted confidence levels but not correct responding when controlling for objective numeracy. The graphical display was most effective in increasing confidence among math-anxious individuals. The findings suggest that math anxiety is associated with poorer medical risk interpretation but is more strongly related to confidence in interpretations. © The Author(s) 2015.

  7. Pure meat – public perceptions of risk reduction strategies in meat production

    DEFF Research Database (Denmark)

    Korzen, Sara Marie; Sandøe, Peter; Lassen, Jesper

    2011-01-01

    a bottom-up approach and included elements of meat quality, meat safety and risk reduction strategies. The study shows the dilemma risk reduction presents to members of the public. On the one hand, people want safe meat; on the other, the study showed that with the exception of hygiene practices, people...

  8. Reduction in predicted coronary heart disease risk after substantial weight reduction after bariatric surgery.

    Science.gov (United States)

    Vogel, Jody A; Franklin, Barry A; Zalesin, Kerstyn C; Trivax, Justin E; Krause, Kevin R; Chengelis, David L; McCullough, Peter A

    2007-01-15

    In recent years, bariatric surgery has become an increasingly used therapeutic option for morbid obesity. The effect of weight loss after bariatric surgery on the predicted risk of coronary heart disease (CHD) has not previously been studied. We evaluated baseline (preoperative) and follow-up (postoperative) body mass index, CHD risk factors, and Framingham risk scores (FRSs) for 109 consecutive patients with morbid obesity who lost weight after laparoscopic Roux-en-Y gastric bypass surgery. Charts were abstracted using a case-report form by a reviewer blinded to the FRS results. The study included 82 women (75%) and 27 men (25%) (mean age 46 +/- 10 years). Mean body mass index values at baseline and follow-up were 49 +/- 8 and 36 +/- 8 kg/m(2), respectively (p <0.0001). During an average follow-up of 17 months, diabetes, hypertension, and dyslipidemia resolved or improved after weight loss. Thus, the risks of CHD as predicted by FRS decreased by 39% in men and 25% in women. The predicted 10-year CHD risks at baseline and follow-up were 6 +/- 5% and 4 +/- 3%, respectively (p < or =0.0001). For those without CHD, men compared favorably with the age-matched general population, with a final 10-year risk of 5 +/- 4% versus an expected risk of 11 +/- 6% (p <0.0001). Likewise, women achieved a level below the age-adjusted expected 10-year risk of the general population, with a final risk of 3 +/- 3% versus 6 +/- 4% (p <0.0001). In conclusion, weight loss results in a significant decrease in FRS 10-year predicted CHD risk. Bariatric surgery decreases CHD risk to rates lower than the age- and gender-adjusted estimates for the general population. These data suggest substantial and sustained weight loss after bariatric surgery may be a powerful intervention to decrease future rates of myocardial infarction and death in the morbidly obese.

  9. Incentivising flood risk adaptation through ris based insurance premiums: trade-offs between affordability and risk reduction

    NARCIS (Netherlands)

    Hudson, P.G.M.B.; Botzen, W.J.W.; Feyen, L.; Aerts, J.C.J.H.

    2016-01-01

    The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

  10. Update on Risk Reduction Activities for a Liquid Advanced Booster for NASA's Space Launch System

    Science.gov (United States)

    Crocker, Andrew M.; Greene, William D.

    2017-01-01

    The stated goals of NASA's Research Announcement for the Space Launch System (SLS) Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) are to reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS and enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Dynetics, Inc. and Aerojet Rocketdyne (AR) formed a team to offer a wide-ranging set of risk reduction activities and full-scale, system-level demonstrations that support NASA's ABEDRR goals. During the ABEDRR effort, the Dynetics Team has modified flight-proven Apollo-Saturn F-1 engine components and subsystems to improve affordability and reliability (e.g., reduce parts counts, touch labor, or use lower cost manufacturing processes and materials). The team has built hardware to validate production costs and completed tests to demonstrate it can meet performance requirements. State-of-the-art manufacturing and processing techniques have been applied to the heritage F-1, resulting in a low recurring cost engine while retaining the benefits of Apollo-era experience. NASA test facilities have been used to perform low-cost risk-reduction engine testing. In early 2014, NASA and the Dynetics Team agreed to move additional large liquid oxygen/kerosene engine work under Dynetics' ABEDRR contract. Also led by AR, the objectives of this work are to demonstrate combustion stability and measure performance of a 500,000 lbf class Oxidizer-Rich Staged Combustion (ORSC) cycle main injector. A trade study was completed to investigate the feasibility, cost effectiveness, and technical maturity of a domestically-produced engine that could potentially both replace the RD-180 on Atlas V and satisfy NASA SLS payload-to-orbit requirements via an advanced booster application. Engine physical dimensions and performance parameters resulting from this study provide the system level requirements for the ORSC risk reduction test article

  11. Citizen science for hydrological risk reduction and resilience building

    NARCIS (Netherlands)

    Paul, Jonathan D.; Buytaert, Wouter; Allen, Simon; Ballesteros‐Cánovas, Juan A.; Bhusal, Jagat K.; Cieslik, Katarzyna; Clark, Julian; Dugar, Sumit; Hannah, David M.; Stoffel, M.; Dewulf, A.R.P.J.; Dhital, Megh R.; Liu, Wei; Nayaval, Janak Lal; Neupane, Bhanu; Schiller, Arnulf; Smith, P.J.; Supper, Robert

    2017-01-01

    In disaster risk management (DRM), an emerging shift has been noted from broad-scale, top-down assessments toward more participatory, community-based, bottom-up approaches. Arguably, nonscientist local stakeholders have always played an important role in knowledge risk management and resilience

  12. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    William W. Weiss

    2000-06-30

    Incomplete or sparse information on geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. Expert systems have been developed and used in several disciplines and industries, including medical diagnostics, with favorable results. A state-of-the-art exploration ''expert'' tool, relying on a computerized data base and computer maps generated by neural networks, is proposed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. This project will develop an Artificial Intelligence system that will draw upon a wide variety of information to provide realistic estimates of risk. ''Fuzzy logic,'' a system of integrating large amounts of inexact, incomplete information with modern computational methods to derive usable conclusions, has been demonstrated as a cost-effective computational technology in many industrial applications. During project year 1, 90% of geologic, geophysical, production and price data were assimilated for installation into the database. Logs provided geologic data consisting of formation tops of the Brushy Canyon, Lower Brushy Canyon, and Bone Springs zones of 700 wells used to construct regional cross sections. Regional structure and isopach maps were constructed using kriging to interpolate between the measured points. One of the structure derivative maps (azimuth of curvature) visually correlates with Brushy Canyon fields on the maximum change contours. Derivatives of the regional geophysical data also visually correlate with the location of the fields. The azimuth of maximum dip approximately locates fields on the maximum change contours. In a similar manner the second derivative in the x-direction of the gravity map visually correlates with the alignment of the known fields. The visual correlations strongly suggest that neural network architectures will be

  13. Risks and Crises for Healthcare Providers: The Impact of Cloud Computing

    Directory of Open Access Journals (Sweden)

    Ronald Glasberg

    2014-01-01

    Full Text Available We analyze risks and crises for healthcare providers and discuss the impact of cloud computing in such scenarios. The analysis is conducted in a holistic way, taking into account organizational and human aspects, clinical, IT-related, and utilities-related risks as well as incorporating the view of the overall risk management.

  14. Nonhormonal Management of Hot Flashes for Women on Risk Reduction Therapy

    Science.gov (United States)

    Sideras, Kostandinos; Loprinzi, Charles L.

    2014-01-01

    Hot flashes are very common in women in menopause and can have a detrimental effect on quality of life. Women on risk reduction therapy are particularly prone because treatments, such as tamoxifen, raloxifene, or oophorectomy, have the potential to exacerbate these symptoms. Hormonal treatments, despite the fact that they represent the most effective therapies, are not used for the treatment of hot flashes in these women because of concerns that they may increase the risk for breast cancer. As a result, several nonhormonal therapies have been tested in randomized placebo-controlled trials and shown to be effective, such as paroxetine, venlafaxine, desvenlafaxine, fluoxetine, citalopram, gabapentin, and pregabalin. In addition, several nonpharmacotogic therapies have been tested with various successes. An additional consideration is how some of those drugs, especially fluoxetine and paroxetine, interact with the metabolism of tamoxifen. This article discusses these issues, and provides some recommendations regarding use of nonhormonal therapies for treating hot flashes in women on risk reduction therapy, with an emphasis on pharmacogenomic considerations. PMID:20971841

  15. Institutional Venture Capital for the Space Industry: Providing Risk Capital for Space Companies that Provide Investor Returns

    Science.gov (United States)

    Moore, Roscoe M., III

    2002-01-01

    provided by an institution. Those institutions tend to be Banks, Pension Funds, Insurance Funds, Corporations, and other incorporated entities that are obligated to earn a return on their invested capital. These institutions invest in a venture capital firm for the sole purpose of getting their money back with a healthy profit - within a set period of time. The venture capital firm is responsible for investing in and managing companies whose risk and return are higher than other less risky classes of investment. The venture capital firm's primary skill is its ability to manage the high risk of its venture investments while maintaining the high return potential of its venture investments. to businesses for the purpose of providing the above-mentioned Institutions a substantial return on their invested capital. Institutional Venture Capital for the Space Industry cannot be provided to projects or companies whose philosophy or intention is not to increase shareholder equity value within a set time period. efficiently when tied up in companies that intend to spend billions of dollars before the first dollar of revenue is generated. If 2 billion dollars of venture capital is invested in the equity of a Space Company for a minority equity position, then that Space Company must build that minority shareholder's equity value to a minimum investment return of 4 to 8 billion dollars. There are not many start-up companies that are able to reach public market equity valuations in the tens of billions of dollars within reasonable time horizons. Foundations, Manufacturers, and Strategic Investors can invest in projects that cannot realistically provide a substantial return on their equity to their investors within a reasonable period (5-7 years) of time. Venture Capitalists have to make money. Venture capitalists have made money on Satellite Television, Satellite Radio, Fixed Satellite Services, and other businesses. Venture capitalists have not made money on stand

  16. Expansion of the National Salt Reduction Initiative: A Mathematical Model of Benefits and Risks of Population-Level Sodium Reduction.

    Science.gov (United States)

    Choi, Sung Eun; Brandeau, Margaret L; Basu, Sanjay

    2016-01-01

    The National Salt Reduction Initiative, in which food producers agree to lower sodium to levels deemed feasible for different foods, is expected to significantly reduce sodium intake if expanded to a large sector of food manufacturers. Given recent data on the relationship between sodium intake, hypertension, and associated cardiovascular disease at a population level, we sought to examine risks and benefits of the program. To estimate the impact of further expanding the initiative on hypertension, myocardial infarction (MI) and stroke incidence, and related mortality, given food consumption patterns across the United States, we developed and validated a stochastic microsimulation model of hypertension, MI, and stroke morbidity and mortality, using data from food producers on sodium reduction among foods, linked to 24-hour dietary recalls, blood pressure, and cardiovascular histories from the National Health and Nutrition Examination Survey. Expansion of the initiative to ensure all restaurants and manufacturers reach agreed-upon sodium targets would be expected to avert from 0.9 to 3.0 MIs (a 1.6%-5.4% reduction) and 0.5 to 2.8 strokes (a 1.1%-6.2% reduction) per 10,000 Americans per year over the next decade, after incorporating consumption patterns and variations in the effect of sodium reduction on blood pressure among different demographic groups. Even high levels of consumer addition of table salt or substitution among food categories would be unlikely to neutralize this benefit. However, if recent epidemiological associations between very low sodium and increased mortality are causal, then older women may be at risk of increased mortality from excessively low sodium intake. An expanded National Salt Reduction Initiative is likely to significantly reduce hypertension and hypertension-related cardiovascular morbidity but may be accompanied by potential risks to older women. © The Author(s) 2015.

  17. Reductive stress in young healthy individuals at risk of Alzheimer disease.

    Science.gov (United States)

    Badía, Mari-Carmen; Giraldo, Esther; Dasí, Francisco; Alonso, Dolores; Lainez, Jose M; Lloret, Ana; Viña, Jose

    2013-10-01

    Oxidative stress is a hallmark of Alzheimer disease (AD) but this has not been studied in young healthy persons at risk of the disease. Carrying an Apo ε4 allele is the major genetic risk factor for AD. We have observed that lymphocytes from young, healthy persons carrying at least one Apo ε4 allele suffer from reductive rather than oxidative stress, i.e., lower oxidized glutathione and P-p38 levels and higher expression of enzymes involved in antioxidant defense, such as glutamylcysteinyl ligase and glutathione peroxidase. In contrast, in the full-blown disease, the situation is reversed and oxidative stress occurs, probably because of the exhaustion of the antioxidant mechanisms just mentioned. These results provide insights into the early events of the progression of the disease that may allow us to find biomarkers of AD at its very early stages. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Risk Reduction for Use of Complex Devices in Space Projects

    Science.gov (United States)

    Berg, Melanie; Poivey, Christian; Friendlich, Mark; Petrick, Dave; LaBel, Kenneth; Stansberry, Scott

    2007-01-01

    We present guidel!nes to reduce risk to an acceptable level when using complex devices in space applications. Application to Virtex 4 Field Programmable Gate Array (FPGA) on Express Logistic Carrier (ELC) project is presented.

  19. Risk reduction in a changing insurance climate: examples from the US and UK

    Science.gov (United States)

    Horn, Diane; McShane, Michael

    2015-04-01

    Coastal cities face a range of increasingly severe challenges as sea level rises, and adaptation to future flood risk will require more than structural defences. Many cities will not be able to rely solely on engineering structures for protection and will need to develop a suite of policy responses to increase their resilience to impacts of rising sea level. Insurance can be used as a risk-sharing mechanism to encourage adaptation to sea level rise, using pricing or restrictions on availability of cover to discourage new development in flood risk areas or to encourage the uptake of flood resilience measures. We draw on flood insurance policy lessons learned from the United States and the United Kingdom to propose risk-sharing among private insurers/reinsurers, government, and policyholders to alleviate major issues of the current programs, while still maintaining a holistic approach to managing flood risk. The UK and the US are almost polar opposites in the way flood insurance is implemented. Flood insurance in the US is fully public and in the UK fully private; however, in both countries the participants feel that the established system is unsustainable. In the US, flood coverage is excluded from property policies provided by private insurers, and is only available through the National Flood Insurance Program (NFIP), with the federal government acting as insurer of last resort. Flood risk reduction has been part of the NFIP remit since the introduction of the program in 1968. Following massive payments for flood claims related primarily to Hurricanes Katrina and Sandy, the NFIP is approximately 26 billion in debt, prompting calls to bring private insurance back into the flood insurance business. Two major Congressional modifications to the NFIP in 2012 and 2014 have pushed the contradictory goals of fully risk-based, yet affordable premiums. The private market has not been significantly involved in a risk-bearing role, but that is changing as private insurers

  20. Harnessing farmers' knowledge and perceptions for health-risk reduction in wastewater-irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, Pay; Seidu, Razak

    2009-01-01

    This chapter addresses the importance of understanding farmers' knowledge and perceptions on health-risk and risk-reduction measures for the development of mutually acceptable risk-management strategies. Drawing on studies from different countries, the chapter shows that it is not realistic to ex...

  1. Harnessing Farmers' knowledge and perceptions for health-risk reduction in wastewater-irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernhard; Drechsel, Pay; Seidu, Razak

    2010-01-01

    This chapter addresses the importance of understanding farmers’ knowledge and perceptions on health-risk and risk-reduction measures for the development of mutually acceptable risk-management strategies. Drawing on studies from different countries, the chapter shows that it is not realistic to ex...

  2. Earthquake risk reduction in the United States: An assessment of selected user needs and recommendations for the National Earthquake Hazards Reduction Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    This Assessment was conducted to improve the National Earthquake Hazards Reduction Program (NEHRP) by providing NEHRP agencies with information that supports their user-oriented setting of crosscutting priorities in the NEHRP strategic planning process. The primary objective of this Assessment was to take a ``snapshot`` evaluation of the needs of selected users throughout the major program elements of NEHRP. Secondary objectives were to conduct an assessment of the knowledge that exists (or is being developed by NEHRP) to support earthquake risk reduction, and to begin a process of evaluating how NEHRP is meeting user needs. An identification of NEHRP`s strengths also resulted from the effort, since those strengths demonstrate successful methods that may be useful to NEHRP in the future. These strengths are identified in the text, and many of them represent important achievements since the Earthquake Hazards Reduction Act was passed in 1977.

  3. Osteoporosis: Implications for Risk Reduction in the College Setting.

    Science.gov (United States)

    Leslie, Maryann; St. Pierre, Richard W.

    1999-01-01

    Examines risk factors for osteoporosis that are especially relevant to the college health setting, focusing on bone development, inadequate calcium and vitamin D intake, cigarette smoking and alcohol use, steroid use and high protein diets, and physical inactivity and excessive exercise. Also presents intervention strategies for college health…

  4. Atrial Fibrillation In Heart Failure: New Directions In Diagnosis, Risk Assessment And Risk Reduction.

    Science.gov (United States)

    Till, Richard J A; Cowie, Martin R

    2014-01-01

    Heart failure and atrial fibrillation are common conditions which frequently co-exist. In patients with established systolic and diastolic dysfunction, atrial fibrillation increases the risk of stroke, mortality and reduces quality of life. Recent advances in implantable device technology have improved the detection of atrial fibrillation and reduced the time to intervention. Rate control remains the mainstay of treatment to improve symptoms in patients with heart failure. Currently evidence does not suggest that the routing use of a rhythm control strategy is beneficial, other than improving symptoms in patients resistant to or intolerant of rate control medications. Atrial fibrillation ablation in heart failure is safe and may be effective in maintaining sinus rhythm. Patients with AF and heart failure have more severe strokes and require longer hospital admissions. Warfarin has traditionally been the drug of choice to reduce the risk of stroke in patients with AF and heart failure, although it use is no longer recommended in patients with heart failure and sinus rhythm. Newer oral anticoagulants offer improved stroke prevention in patients with heart failure albeit at a higher drug cost. Alternative methods of stroke reduction such as left atrial appendage occlusion are emerging, although evidence for their benefit in patients with heart failure has not yet been published.

  5. The social value of mortality risk reduction: VSL versus the social welfare function approach.

    Science.gov (United States)

    Adler, Matthew D; Hammitt, James K; Treich, Nicolas

    2014-05-01

    We examine how different welfarist frameworks evaluate the social value of mortality risk reduction. These frameworks include classical, distributively unweighted cost-benefit analysis--i.e., the "value per statistical life" (VSL) approach-and various social welfare functions (SWFs). The SWFs are either utilitarian or prioritarian, applied to policy choice under risk in either an "ex post" or "ex ante" manner. We examine the conditions on individual utility and on the SWF under which these frameworks display sensitivity to wealth and to baseline risk. Moreover, we discuss whether these frameworks satisfy related properties that have received some attention in the literature, namely equal value of risk reduction, preference for risk equity, and catastrophe aversion. We show that the particular manner in which VSL ranks risk-reduction measures is not necessarily shared by other welfarist frameworks. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Using a relative health indicator (RHI) metric to estimate health risk reductions in drinking water.

    Science.gov (United States)

    Alfredo, Katherine A; Seidel, Chad; Ghosh, Amlan; Roberson, J Alan

    2017-03-01

    When a new drinking water regulation is being developed, the USEPA conducts a health risk reduction and cost analysis to, in part, estimate quantifiable and non-quantifiable cost and benefits of the various regulatory alternatives. Numerous methodologies are available for cumulative risk assessment ranging from primarily qualitative to primarily quantitative. This research developed a summary metric of relative cumulative health impacts resulting from drinking water, the relative health indicator (RHI). An intermediate level of quantification and modeling was chosen, one which retains the concept of an aggregated metric of public health impact and hence allows for comparisons to be made across "cups of water," but avoids the need for development and use of complex models that are beyond the existing state of the science. Using the USEPA Six-Year Review data and available national occurrence surveys of drinking water contaminants, the metric is used to test risk reduction as it pertains to the implementation of the arsenic and uranium maximum contaminant levels and quantify "meaningful" risk reduction. Uranium represented the threshold risk reduction against which national non-compliance risk reduction was compared for arsenic, nitrate, and radium. Arsenic non-compliance is most significant and efforts focused on bringing those non-compliant utilities into compliance with the 10 μg/L maximum contaminant level would meet the threshold for meaningful risk reduction.

  7. Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives.

    Science.gov (United States)

    Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J

    2016-04-01

    Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.

  8. United States-Chile binational exchange for volcanic risk reduction, 2015—Activities and benefits

    Science.gov (United States)

    Pierson, Thomas C.; Mangan, Margaret T.; Lara Pulgar, Luis E.; Ramos Amigo, Álvaro

    2017-07-25

    In 2015, representatives from the United States and Chile exchanged visits to discuss and share their expertise and experiences dealing with volcano hazards. Communities in both countries are at risk from various volcano hazards. Risks to lives and property posed by these hazards are a function not only of the type and size of future eruptions but also of distances from volcanoes, structural integrity of volcanic edifices, landscape changes imposed by recent past eruptions, exposure of people and resources to harm, and any mitigative measures taken (or not taken) to reduce risk. Thus, effective risk-reduction efforts require the knowledge and consideration of many factors, and firsthand experience with past volcano crises provides a tremendous advantage for this work. However, most scientists monitoring volcanoes and most officials delegated with the responsibility for emergency response and management in volcanic areas have little or no firsthand experience with eruptions or volcano hazards. The reality is that eruptions are infrequent in most regions, and individual volcanoes may have dormant periods lasting hundreds to thousands of years. Knowledge may be lacking about how to best plan for and manage future volcanic crises, and much can be learned from the sharing of insights and experiences among counterpart specialists who have had direct, recent, or different experiences in dealing with restless volcanoes and threatened populations. The sharing of information and best practices can help all volcano scientists and officials to better prepare for future eruptions or noneruptive volcano hazards, such as large volcanic mudflows (lahars), which could affect their communities.

  9. JV Task 104 - Risk Reduction Using Innovative Vacuum-Enhanced Plume Controls

    Energy Technology Data Exchange (ETDEWEB)

    Jaroslav Solc; Barry Botnen

    2009-03-01

    The Energy & Environmental Research Center (EERC) conducted remediation of hydrocarbon-contaminated soils and groundwater at the Vining Oil site in Carrington, North Dakota. The primary technological synergies included (1) contaminant recovery using simultaneous operation of multiphase recovery and high-vacuum soil vapor extraction (SVE) and (2) vacuum-controlled air and ozone sparging on the periphery of an induced hydraulic and pneumatic depression. Final risk reduction steps included design and retrofit for the municipal well. The successful remediation effort resulted in the reduction of long-term health risks associated with rate-limited contaminant release within the capture zone for the municipal well and allowed for its reintegration into the water supply system. Contaminant recovery for the remediation period of September 2006 to June 2008 totaled over 12,653 lb (5,740 kg) of hydrocarbons, an equivalent to 2022 gallons (7653 l) of product. Integration of the air-sparging subsystem operated simultaneously with multiphase extraction and SVE systems resulted in accelerated volatile organic contaminant transport from the saturated zone and increased contaminants of concern recovery. Delivery of over 7.7 million ft{sup 3} of oxygen (219.8 thousand m{sup 3}) into the contaminated aquifer would translate into in situ biodegradation of 2007 kg (4424 lb) of benzene and provide for long term stimulation of the natural attenuation process.

  10. The Effect of Risk Reduction Intervention on Earthquake Disaster Preparedness of the Elderly People

    Directory of Open Access Journals (Sweden)

    Kian Nourozi

    2016-01-01

    Conclusion: Preparedness programs for disaster risk reduction has a positive effect on the elders’ preparedness. Thus, similar multimodal preparedness programs should be used more frequently for this vulnerable community citizens.

  11. Low-cost risk reduction strategy for small workplaces: how can we spread good practices?

    Science.gov (United States)

    Kogi, K

    2006-01-01

    Recent advances in health risk reduction approaches are examined based on inter-country networking experiences. A noteworthy progress is the wider application of low-cost improvements to risk reduction particularly in small enterprises and agriculture in both industrially developing and developed countries. This is helped by the readiness of managers and workers to implement these improvements despite many constraints. Typical improvements include mobile racks, simple workstation changes, screening hazards, better welfare facilities and teamwork arrangements. In view of the complex circumstances of work-related health risks, it is important to know whether a low-cost strategy can advance risk reduction practices effectively and what support measures are necessary. It is confirmed that the strategy can overcome related constraints through its advantages. Main advantages lie in (a) the facilitation of improved practices in multiple technical areas, (b) the strengthening of realistic stepwise risk reduction, and (c) the enhanced multiplier effects through training of local trainers. Action-oriented risk assessment tools, such as action checklists and low-cost improvement guides, can encourage risk-reducing measures adjusted to each local situation. It is suggested to spread the low-cost risk reduction strategy for improving small workplaces in diversified settings with the support of these locally tailored tools.

  12. Procurement risk management practices and supply chain performance among mobile phone service providers in Kenya

    Directory of Open Access Journals (Sweden)

    Emily Adhiambo Okonjo

    2016-02-01

    Full Text Available The aim of this study was to establish the relationship between procurement risk management practices and supply chain performance among mobile phone service providers in Kenya. The study specifically set out to establish the extent to which mobile phone service providers have implemented procurement risk management practices and to determine the relationship between procurement risk management practices and supply chain performance. The study adopted a descriptive study design by collecting data from the four (4 mobile telecommunication companies in Kenya using a self-administered questionnaire. Means, standard deviation, and regression analysis were used to analyze the data collected. The study established that most of the mobile phone service providers in Kenya had implemented procurement risk management practices. It was also clear that there was a very significant relationship between procurement risk management practices and supply chain performance.

  13. Brief communication: Sendai framework for disaster risk reduction – success or warning sign for Paris?

    Directory of Open Access Journals (Sweden)

    J. Mysiak

    2016-09-01

    Full Text Available In March 2015, a new international blueprint for disaster risk reduction (DRR was adopted in Sendai, Japan, at the end of the Third UN World Conference on Disaster Risk Reduction (WCDRR, 14–18 March 2015. We review and discuss the agreed commitments and targets, as well as the negotiation leading the Sendai Framework for DRR (SFDRR and discuss briefly its implication for the later UN-led negotiations on sustainable development goals and climate change.

  14. Human Resources (HR) as a strategic business partner: value creation and risk reduction capacity

    OpenAIRE

    Mitsakis, FV

    2014-01-01

    The competitive forces firms face today, and will continue to face in the future, demand organizational excellence through which HR departments could make a real contribution to the business through their value-added and risk reduction capacity, while been accepted as\\ud equal strategic business partners in organizations. The article discusses HR department’s capability of being seen as an integrated value-driven business function, while it also demonstrates its risk reduction capacity, both ...

  15. Risk reduction strategies in laparoscopic donor nephrectomy: A comparative study

    Directory of Open Access Journals (Sweden)

    T Manohar

    2006-01-01

    Full Text Available OBJECTIVES: As the advancements, modifications and standardization of laparoscopy are taking place, there is a need for the reduction in morbidity associated with laparoscopic live donor nephrectomy. This study was performed to determine and reconfirm the advantages of laparoscopic donor nephrectomy over its open counterpart. MATERIALS AND METHODS: Two hundred open live donor nephrectomy (ODN cases were compared to 264 cases of laparoscopic live donor nephrectomy (LDN. Pretransplant functional and radiological evaluation was done routinely by excretory urogram and renal arteriography. In case of vascular variations, CT angiography was preferred. Open cases were done by conventional method and laparoscopic group underwent certain technical and surgical modifications, including meticulous planning for the port placement. Operative time, analgesia requirement, start of the orals, hospital stay, blood loss, late allograft function, incidence of rejection, complications and technical problems were analyzed. RESULTS: Operative time was 135.8 ± 43 and 165 ± 44.4 min ( P < 0.0001, requirement of analgesia was 60.5 ± 40 and 320 ± 120 mg ( P < 0.0001, hospital stay was 4 ± 0.04 and 5.7 ± 2.03 days ( P < 0.0001, warm ischemia time was 6.1 ± 2.0 and 4.1 ± 0.80 min ( P < 0.0001 and time taken for the serum creatinine to stabilize in the recipient was 4.1 ± 1.6 and 4.32 ± 1.40 days ( P =0.06 for LDN and ODN groups respectively. There was a significant reduction in the blood loss in LDN group ( P =0.0005. Overall complications were 6.81 and 14.5% and ureteric injury was seen in 0.37 and 1% in LDN and ODN respectively. CONCLUSION: Laparoscopic live donor nephrectomy can now be performed with low morbidity and mortality to both donors and recipients and is proving to be the preferred operation to open donor nephrectomy. Our continued innovations in technical modifications have made this novel operation successful.

  16. Structuring Cooperative Nuclear RIsk Reduction Initiatives with China.

    Energy Technology Data Exchange (ETDEWEB)

    Brandt, Larry [Stanford Univ., CA (United States); Reinhardt, Jason Christian [Stanford Univ., CA (United States); Hecker, Siegfried [Stanford Univ., CA (United States)

    2017-03-01

    The Stanford Center for International Security and Cooperation engaged several Chinese nuclear organizations in cooperative research that focused on responses to radiological and nuclear terrorism. The objective was to identify joint research initiatives to reduce the global dangers of such threats and to pursue initial technical collaborations in several high priority areas. Initiatives were identified in three primary research areas: 1) detection and interdiction of smuggled nuclear materials; 2) nuclear forensics; and 3) radiological (“dirty bomb”) threats and countermeasures. Initial work emphasized the application of systems and risk analysis tools, which proved effective in structuring the collaborations. The extensive engagements between national security nuclear experts in China and the U.S. during the research strengthened professional relationships between these important communities.

  17. The congressional viewpoint: Deficit reduction and risk legislation

    Energy Technology Data Exchange (ETDEWEB)

    Chakoff, H.E.

    1995-12-31

    This presentation will provide a current congressional status of legislation related to low-level waste and DOE cleanup. Key legislation discussed will include S. 755 for Privatization of the Uranium Enrichment Corporation and the markup of H.R. 1020, the Nuclear Waste Legislation. In addition, the session will include a discussion of legislation related to the approval of the Texas compact.

  18. Effects of a late-life suicide risk--assessment training on multidisciplinary healthcare providers.

    Science.gov (United States)

    Huh, Joung T; Weaver, Christopher M; Martin, Jennifer L; Caskey, Nicholas H; O'Riley, Alisa; Kramer, Betty Josea

    2012-04-01

    Older adults are among the highest at risk for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental health care, but providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of healthcare providers who may see older adults in their care settings. One hundred thirty-two participants from two Veterans Affairs Medical Centers participated in a 6.5-hour-long workshop in the assessment and management of suicide risk in older adults. Participants were asked to complete pre- and postworkshop case notes and report on subjective changes in knowledge, attitudes, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists from a variety of care settings, including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, home, and community. After the workshop, participants demonstrated improvement in the overall quality of case notes (P = .001), greater ability to recognize important conceptual suicide risk categories (P = .003), and reported heightened awareness of the importance of late-life suicide. The results suggest that educational training may have beneficial effect on the ability of multidisciplinary care providers to identify and manage suicide risk in elderly adults. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  19. Army Health Promotion, Risk Reduction, Suicide Prevention: Report 2010

    Science.gov (United States)

    2010-07-01

    medico -legal, law enforcement and program/service systems. Data sharing and retrieval were hampered by lack of integrated methodology, disjointed...page 115)  HP/RR/SP databases are not integrated across the medico -legal, law enforcement and program/service systems and as a result do not provide...and “Spectrum of Care.”114 Following this categorization, the list of AFC programs/services was reduced to 130 (eliminating duplications, errors in

  20. Social media in disaster risk reduction and crisis management.

    Science.gov (United States)

    Alexander, David E

    2014-09-01

    This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

  1. JCL Roundtable: Gender differences in risk reduction with lifestyle changes.

    Science.gov (United States)

    Brown, W Virgil; Bays, Harold E; La Forge, Ralph; Sikand, Geeta

    2015-01-01

    The first efforts to uncover the causes of cardiovascular disease focused on the behavioral, now called lifestyle habits of populations. Diet, exercise, and smoking were recognized as important issues with strong relationships in community-based observational studies such as the Seven Countries study, the Framingham Heart Study, and the Western Electric Study in Chicago. The first meaningful intervention in the United States was the dietary recommendations made by the American Heart Association in 1963 and the Surgeon General's Report on Smoking and Health in 1964. The American public listened and a very large change occurred in food consumption data and cigarette smoking over the next decade. These changes were mainly focused on men because the incidence of myocardial infarction was much higher in middle aged and older men than women. As smoking prevalence has decreased in men and increased in women and the population has aged, the differences in major vascular events have virtually disappeared. Women still enjoy a longer period of low rates but eventually the incidence rates approach those of men. As we constantly attempt to demonstrate ways of reducing risk by improved lifestyle it behooves us to re-evaluate the potential differences in gender response and adjust our expectations accordingly as clinicians. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. Comparative effectiveness of personalized lifestyle management strategies for cardiovascular disease risk reduction

    NARCIS (Netherlands)

    P. Chu (Paula); A. Pandya; J.A. Salomon (Joshua A); S.J. Goldie (Sue J); Hunink, M.G.M. (M.G. Myriam)

    2015-01-01

    textabstractBackground-Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year

  4. Farmers Prone to Drought Risk: Why Some Farmers Undertake Farm-Level Risk-Reduction Measures While Others Not?

    Science.gov (United States)

    Gebrehiwot, Tagel; van der Veen, Anne

    2015-03-01

    This research investigates farmers' cognitive perceptions of risk and the behavioral intentions to undertake farm-level risk-reduction measures. It has been observed that people who are susceptible to natural hazards often fail to act, or do very little, to protect their assets or lives. To answer the question of why some people show adaptive behavior while others do not, a socio-psychological model of precautionary adaptation based on protection motivation theory and trans-theoretical stage model has been applied for the first time to areas of drought risk in the developing countries cultural context. The applicability of the integrated model is explored by means of a representative sample survey of smallholder farmers in northern Ethiopia. The result of the study showed that there is a statistically significant association between farmer's behavioral intention to undertake farm-level risk-reduction measures and the main important protection motivation model variables. High perceived vulnerability, severity of consequences, self-efficacy, and response efficacy lead to higher levels of behavioral intentions to undertake farm-level risk-reduction measures. For farmers in the action stage, self-efficacy and response efficacy were the main motivators of behavioral intention. For farmers in the contemplative stage, self-efficacy and cost appear to be the main motivators for them to act upon risk reduction, while perceived severity of consequences and cost of response actions were found to be important for farmers in the pre-contemplative stage.

  5. Moderate alcohol consumption and cardiovascular risk reduction: open issues

    Directory of Open Access Journals (Sweden)

    Simona Costanzo

    2006-06-01

    Full Text Available

    Background: The inverse relationship between low to moderate alcohol consumption and several favorable health outcomes has been well established in many epidemiological studies and meta-analyses. However, several questions still remain controversial.

    Aims: To discuss a number of open questions relating to the healthy effect of a moderate intake of alcohol (especially wine on cardiovascular disease and total mortality. This will be based on findings from the literature, with a particular emphasis on meta-analyses.

    Results and Conclusion: The role of different alcoholic beverages, age and sex, confounding, former drinkers and study design has been discussed. Whether wine is better than beer or spirits, though suggestive, remains to be established. Cardiovascular morbidity and total mortality is significantly reduced both in men and women who are regular drinkers of low amounts of alcohol; however, the predicted protection in women disappears at lower doses than in men. The primary protection of alcohol decreases after adjustment for known variables, thus confirming the importance of confounding in assessing drinking effects, but it remains significant and of undoubted public health value. As the cardiovascular protection by moderate alcohol consumption might have been unduly overestimated by inclusion in control groups of former drinkers, we compared studies that used as a reference group the category of no alcohol intake and/or formally excluded former drinkers with studies which did not: the protection was indeed somewhat lower in the former than in the latter studies, but was still statistically significant. We conclude that the dose-response relationship between alcohol intake and cardiovascular risk or total mortality, consistently described by J-shaped curves, can be reasonably attributed to a combination of both real beneficial (at lower doses and harmful (at higher doses

  6. Past-Forwarding Ancient Calamities. Pathways for Making Archaeology Relevant in Disaster Risk Reduction Research

    Directory of Open Access Journals (Sweden)

    Felix Riede

    2017-10-01

    Full Text Available Despite the alleged mastery of humans over nature, contemporary societies are acutely vulnerable to natural hazards. In interaction with vulnerable communities, these transform into catastrophes. In a deep historical perspective, human communities of many different kinds have been affected by numerous kinds of natural disasters that may provide useful data for scenario-based risk reduction measures vis-à-vis future calamities. The low frequency of high magnitude hazards necessitates a deep time perspective for understanding both the natural and human dimensions of such events in an evidence-based manner. This paper focusses on the eruption of the Laacher See volcano in western Germany about 13,000 years ago as an example of such a rare, but potentially highly devastating event. It merges Lee Clarke’s sociological argument for also thinking about such very rare events in disaster planning and David Staley’s notion of thinking historically about the future in order to ‘past-forward’ such information on past constellations of vulnerability and resilience. ‘Past-forwarding’ is here intended to signal the use of such deep historical information in concerns for contemporary and future resilience. This paper outlines two pathways for making archaeological information on past extreme environmental events relevant in disaster risk reduction: First, the combination of information from the geosciences and the humanities holds the potential to transform ancient hazards from matters of fact to matters of concern and, hence, to more effectively raise awareness of the issues concerned. Second, in addition to information on past calamities feeding into preparatory scenarios, I argue that the well-established outreach channels available to the humanities (museums, in particular provide powerful platforms for communication to multiple publics.

  7. Evaluating the effectiveness of risk-reduction strategies for consumer chemical products.

    Science.gov (United States)

    Riley, D M; Fischhoff, B; Small, M J; Fischbeck, P

    2001-04-01

    Communication about risks offers a voluntary approach to reducing exposure to pollutants. Its adequacy depends on its impact on behavior. Estimating those impacts first requires characterizing current activities and their associated risk levels, and then predicting the effectiveness of risk-reduction strategies. Characterizing the risks from chemical consumer products requires knowledge of both the physical and the behavioral processes that influence exposures. This article presents an integrated approach that combines consumer interviews, users' beliefs and behaviors, and quantitative exposure modeling. This model was demonstrated in the context of consumer exposure to a methylene chloride-based paint stripper, showing how it could be used to evaluate current levels of risk and predict the effectiveness of proposed voluntary risk-reduction strategies.

  8. Obesity and Cardiovascular Diseases in a High-Risk Population: Evidence-Based Approach to CHD Risk Reduction.

    Science.gov (United States)

    Kwagyan, John; Retta, Tamrat M; Ketete, Muluemebet; Bettencourt, Cristina N; Maqbool, Abid R; Xu, Shichen; Randall, Otelio S

    2015-01-01

    Obesity is becoming a worldwide public health problem and it is expected to worsen as its prevalence is increasing in children and adolescents. This report examined the distribution of major cardiovascular disease (CVD) risk factors and the effect of life-style changes on coronary heart disease (CHD) risk prediction in a high risk obese African Americans. We examined the baseline distribution of CVD risk factors in 515 obese African Americans, with mean BMI of 42.9 ± 6.8 kg/m2, and prospectively the effect of a 6-month low-salt, low-fat diet and aerobic-exercise intervention program on risk reduction. Prevalence of hypertension, dyslipidemia, and diabetes mellitus were 57%, 27% and 24% respectively. Metabolic syndrome was present in 36% and 39% met two features of the syndrome. The 10-year risk prediction for developing CHD ranged from 4% to 17% for women and 6% to 29% for men. After 6 months of life-style changes, many of the risk factors improved, and the CHD risk scores decreased from 6% to 4% in the women and 16% to 13% in the men. The high prevalence and increasing incidence of obesity and associated cardiovascular risk emphasizes the need to focus on obesity reduction in this high risk population.

  9. An Overview of Propulsion Concept Studies and Risk Reduction Activities for Robotic Lunar Landers

    Science.gov (United States)

    Trinh, Huu P.; Story, George; Burnside, Chris; Kudlach, Al

    2010-01-01

    In support of designing robotic lunar lander concepts, the propulsion team at NASA Marshall Space Flight Center (MSFC) and the Johns Hopkins University Applied Physics Laboratory (APL), with participation from industry, conducted a series of trade studies on propulsion concepts with an emphasis on light-weight, advanced technology components. The results suggest a high-pressure propulsion system may offer some benefits in weight savings and system packaging. As part of the propulsion system, a solid rocket motor was selected to provide a large impulse to reduce the spacecraft s velocity prior to the lunar descent. In parallel to this study effort, the team also began technology risk reduction testing on a high thrust-to-weight descent thruster and a high-pressure regulator. A series of hot-fire tests was completed on the descent thruster in vacuum conditions at NASA White Sands Test Facility (WSTF) in New Mexico in 2009. Preparations for a hot-fire test series on the attitude control thruster at WSTF and for pressure regulator testing are now underway. This paper will provide an overview of the concept trade study results along with insight into the risk mitigation activities conducted to date.

  10. Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia.

    Science.gov (United States)

    Wilkins-Haug, Louise; Celi, Ann; Thomas, Ann; Frolkis, Joseph; Seely, Ellen W

    2015-06-01

    To assess health care providers' knowledge regarding pregnancy outcome as a risk factor for cardiovascular disease and evaluate the variables associated with their responses to questions about routine surveillance for cardiovascular disease. A voluntary, anonymous survey of internal medicine and obstetric and gynecologic health care providers at an academic institution. Responses to a case-based and direct inquiry questionnaire were evaluated. The overall response rate was 65% (173/265). When assessing cardiovascular risk, gynecologists compared with internists significantly more often requested a pregnancy history (44/49 [90%] compared with 56/75 [75%], P=.039) and more often attached importance to a history of preeclampsia (35/48 [73%] compared with 41/75 [55%], P=.028). When a history of preeclampsia was obtained, internists more often obtained a fasting glucose test (25/52 [48%] compared with 9/43 [20.9%], P=.009). A minority of health care providers recognized the importance of fetal growth restriction. Both health care provider groups demonstrated similar knowledge of general cardiovascular risk factors, screening tools, and interventions. Higher general cardiovascular knowledge was significantly associated with identification of pregnancy complications as cardiovascular risk factors (P=.001). When assessing cardiovascular risk, internists were less likely than gynecologists to include a pregnancy history. However, once identified as at risk for cardiovascular disease, gynecologists were less likely than internists to obtain appropriate testing. Education concerning the link between certain pregnancy complications and future cardiovascular disease is needed. Areas of opportunity for education in both medical specialties are identified.

  11. Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction.

    Science.gov (United States)

    Chu, Paula; Pandya, Ankur; Salomon, Joshua A; Goldie, Sue J; Hunink, M G Myriam

    2016-03-29

    Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

    Science.gov (United States)

    Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

    2015-02-12

    Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the

  13. Perceptions of farmers on health risks and risk reduction measures in wastewater-irrigated urban vegetable farming in Ghana

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, Pay; Konradsen, Flemming

    2008-01-01

    , authorities and the general public, especially if they had some incentives. These findings demonstrate the need to involve farmers as early as possible in intervention projects especially in informal farming practices, like urban agriculture, where restrictions are difficult to implement. This will ensure......Most irrigation water used in urban vegetable farming in Ghana is contaminated with untreated wastewater. This poses health risks to farmers and consumers. As part of a study to explore options for health risk reduction, this paper summarizes farmers' perceptions on health risks and possible risk...

  14. Disaster Risk Reduction through Innovative Uses of Crowd Sourcing (Invited)

    Science.gov (United States)

    Berger, J.; Greene, M.

    2010-12-01

    Crowd sourcing can be described as a method of distributed problem-solving. It takes advantage of the power of the crowd, which can in some cases be a community of experts and in other cases the collective insight of a broader range of contributors with varying degrees of domain knowledge. The term crowd sourcing was first used by Jeff Howe in a June 2006 Wired magazine article “The Rise of Crowdsourcing,” and is a combination of the terms “crowd” and “outsourcing.” Some commonly known examples of crowd sourcing, in its broadest sense, include Wikepedia, distributed participatory design projects, and consumer websites such as Yelp and Angie’s List. The popularity and success of early large-scale crowd sourcing activities is made possible through leveraging Web 2.0 technologies that allow for mass participation from distributed individuals. The Earthquake Engineering Research Institute (EERI) in Oakland, California recently participated in two crowd sourcing projects. One was initiated and coordinated by EERI, while in the second case EERI was invited to contribute once the crowd sourcing activity was underway. In both projects there was: 1) the determination of a problem or set of tasks that could benefit immediately from the engagement of an informed volunteer group of professionals; 2) a segmenting of the problem into discrete pieces that could be completed in a short period of time (from ten minutes to four hours); 3) a call to action, where an interested community was made aware of the project; and 4) the collection, aggregation, vetting and ultimately distribution of the results in a relatively short period of time. The first EERI crowd sourcing example was the use of practicing engineers and engineering students in California to help estimate the number of pre-1980 concrete buildings in the high seismic risk counties in the state. This building type is known to perform poorly in earthquakes, and state officials were interested in understanding

  15. POTENTIAL HEALTH RISK REDUCTION ARISING FROM REDUCED MERCURY EMISSIONS FROM COAL FIRED POWER PLANTS.

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, T. M.; Lipfert, F. W.; Morris, S. C.; Moskowitz, P. D.

    2001-09-01

    The U.S. Environmental Protection Agency (EPA) has announced plans to regulate mercury (Hg) emissions from coal-fired power plants. EPA has not prepared a quantitative assessment of the reduction in risk that could be achieved through reduction in coal plant emissions of Hg. To address this issue, Brookhaven National Laboratory (BNL) with support from the U.S. Department of Energy Office of Fossil Energy (DOE FE) prepared a quantitative assessment of the reduction in human health risk that could be achieved through reduction in coal plant emissions of Hg. The primary pathway for Hg exposure is through consumption of fish. The most susceptible population to Hg exposure is the fetus. Therefore the risk assessment focused on consumption of fish by women of child-bearing age. Dose response factors were generated from studies on loss of cognitive abilities (language skills, motor skills, etc.) by young children whose mothers consumed large amounts of fish with high Hg levels. Population risks were estimated for the general population in three regions of the country, (the Midwest, Northeast, and Southeast) that were identified by EPA as being heavily impacted by coal emissions. Three scenarios for reducing Hg emissions from coal plants were considered: (1) A base case using current conditions; (2) A 50% reduction; and, (3) A 90% reduction. These reductions in emissions were assumed to translate linearly into a reduction in fish Hg levels of 8.6% and 15.5%, respectively. Population risk estimates were also calculated for two subsistence fisher populations. These groups of people consume substantially more fish than the general public and, depending on location, the fish may contain higher Hg levels than average. Risk estimates for these groups were calculated for the three Hg levels used for the general population analyses. Analysis shows that the general population risks for exposure of the fetus to Hg are small. Estimated risks under current conditions (i.e., no

  16. Generating tsunami risk knowledge at community level as a base for planning and implementation of risk reduction strategies

    Directory of Open Access Journals (Sweden)

    S. Wegscheider

    2011-02-01

    Full Text Available More than 4 million Indonesians live in tsunami-prone areas along the southern and western coasts of Sumatra, Java and Bali. Although a Tsunami Early Warning Center in Jakarta now exists, installed after the devastating 2004 tsunami, it is essential to develop tsunami risk knowledge within the exposed communities as a basis for tsunami disaster management. These communities need to implement risk reduction strategies to mitigate potential consequences.

    The major aims of this paper are to present a risk assessment methodology which (1 identifies areas of high tsunami risk in terms of potential loss of life, (2 bridges the gaps between research and practical application, and (3 can be implemented at community level. High risk areas have a great need for action to improve people's response capabilities towards a disaster, thus reducing the risk. The methodology developed here is based on a GIS approach and combines hazard probability, hazard intensity, population density and people's response capability to assess the risk.

    Within the framework of the GITEWS (German-Indonesian Tsunami Early Warning System project, the methodology was applied to three pilot areas, one of which is southern Bali. Bali's tourism is concentrated for a great part in the communities of Kuta, Legian and Seminyak. Here alone, about 20 000 people live in high and very high tsunami risk areas. The development of risk reduction strategies is therefore of significant interest. A risk map produced for the study area in Bali can be used for local planning activities and the development of risk reduction strategies.

  17. Evaluation of severe accident risks and the potential for risk reduction: Surry Power Station, Unit 1: Draft report for comment

    Energy Technology Data Exchange (ETDEWEB)

    Benjamin, A.S.; Boyd, G.J.; Kunsman, D.M.; Murfin, W.B.; Williams, D.C.

    1987-02-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a particular pressurized water reactor with a subatmospheric containment (Surry, Unit 1). Emphasis was placed on determining the magnitude and character of the uncertainties, rather than focusing on a point estimate. The risk-reduction potential of a set of proposed safety option backfits was also studied, and their costs and benefits were also evaluated. It was found that the risks from internal events are generally lower than previously evaluated in the Reactor Safety Study (RSS). However, certain unresolved issues (such as direct containment heating) caused the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. None of the postulated safety options appears to be cost effective for the Surry power plant. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150.

  18. Preliminary Investigation of Workplace-Provided Compressed Mindfulness-Based Stress Reduction with Pediatric Medical Social Workers.

    Science.gov (United States)

    Trowbridge, Kelly; Mische Lawson, Lisa; Andrews, Stephanie; Pecora, Jodi; Boyd, Sabra

    2017-11-01

    Mindfulness practices, including mindfulness meditation, show promise for decreasing stress among health care providers. This exploratory study investigates the feasibility of a two-day compressed mindfulness-based stress reduction (cMBSR) course provided in the hospital workplace with pediatric health care social workers. The standard course of Jon Kabat-Zinn's MBSR requires a participant commitment to eight weeks of instruction consisting of one 2.5-hour-per-week class, a single day retreat, and 45 minutes of practice for six of seven days each week. Commitments to family, work, caregiving, education, and so on, as well as limitations such as distance, may prevent health care providers from participating in a standard MBSR course. Using t tests, researchers measured the effect of cMBSR on (a) positive and negative experiences in pediatric social work, (b) perceived stress, (c) mindfulness, and (d) caring self-efficacy (as a component of patient- and family-centered care). Results included significant differences between the pre- and post-intervention outcome variables on the Professional Quality of Life Secondary Traumatic Stress subscale, the Mindful Attention and Awareness Scale, and the Caring Efficacy Scale. Findings found adequate evidence for the feasibility of cMBSR design and for a need of a more rigorous study of the effects of the cMBSR intervention. © 2017 National Association of Social Workers.

  19. Impact of psychosocial risk factors on prenatal care delivery: a national provider survey.

    Science.gov (United States)

    Krans, Elizabeth E; Moloci, Nicholas M; Housey, Michelle T; Davis, Matthew M

    2014-12-01

    To evaluate providers' perspectives regarding the delivery of prenatal care to women with psychosocial risk factors. A random, national sample of 2,095 prenatal care providers (853 obstetricians and gynecologists (Ob/Gyns), 270 family medicine (FM) physicians and 972 midwives) completed a mailed survey. We measured respondents' practice and referral patterns regarding six psychosocial risk factors: adolescence (age ≤19), unstable housing, lack of paternal involvement and social support, late prenatal care (>13 weeks gestation), domestic violence and drug or alcohol use. Chi square and logistic regression analyses assessed the association between prenatal care provider characteristics and prenatal care utilization patterns. Approximately 60 % of Ob/Gyns, 48.4 % of midwives and 32.2 % of FM physicians referred patients with psychosocial risk factors to clinicians outside of their practice. In all three specialties, providers were more likely to increase prenatal care visits with alternative clinicians (social workers, nurses, psychologists/psychiatrists) compared to themselves for all six psychosocial risk factors. Drug or alcohol use and intimate partner violence were the risk factors that most often prompted an increase in utilization. In multivariate analyses, Ob/Gyns who recently completed clinical training were significantly more likely to increase prenatal care utilization with either themselves (OR 2.15; 95 % CI 1.14-4.05) or an alternative clinician (2.27; 1.00-4.67) for women with high psychosocial risk pregnancies. Prenatal care providers frequently involve alternative clinicians such as social workers, nurses and psychologists or psychiatrists in the delivery of prenatal care to women with psychosocial risk factors.

  20. A brief individualized computer-delivered sexual risk reduction intervention increases HIV/AIDS preventive behavior.

    Science.gov (United States)

    Kiene, Susan M; Barta, William D

    2006-09-01

    One objective of translational science is to identify elements of human immunodeficiency virus (HIV) risk-reduction interventions that have been shown to be effective and find new ways of delivering these interventions to the community to ensure that they reach the widest possible audience of at-risk individuals. The current study reports the development and evaluation of a computer-delivered, theory-based, individually tailored HIV risk-reduction intervention. This study evaluated the effectiveness of a custom computerized HIV/AIDS risk reduction intervention at increasing HIV/AIDS preventive behaviors in a randomized trial with 157 college students. The intervention content and delivery were based on the Information-Motivation-Behavioral Skills Model of Health Behavior Change and used Motivational Interviewing techniques. Participants completed a baseline assessment of HIV prevention information, motivation, behavioral skills and behavior, attended two brief computer-delivered intervention sessions, and completed a follow-up assessment. As compared to the control group (a nutrition education tutorial), participants who interacted with the computer-delivered HIV/AIDS risk reduction intervention exhibited a significant increase in risk reduction behavior. Specifically, participants reported a greater frequency of keeping condoms available and displayed greater condom-related knowledge at a four-week follow-up session; among sexually active participants, there was a significant increase in self-reported condom use. Delivery of brief individually tailored HIV/AIDS risk reduction interventions via computer may be an effective HIV/AIDS prevention approach for adolescents. More research is needed to further support the effectiveness of this type of intervention and determine the generalizability of these findings to economically and educationally disadvantaged adolescents.

  1. Ecohydrology of agroecosystems: probabilistic description of yield reduction risk under limited water availability

    Science.gov (United States)

    Vico, Giulia; Porporato, Amilcare

    2013-04-01

    Supplemental irrigation represents one of the main strategies to mitigate the effects of climate variability and stabilize yields. Irrigated agriculture currently provides 40% of food production and its relevance is expected to further increase in the near future, in face of the projected alterations of rainfall patterns and increase in food, fiber, and biofuel demand. Because of the significant investments and water requirements involved in irrigation, strategic choices are needed to preserve productivity and profitability, while maintaining a sustainable water management - a nontrivial task given the unpredictability of the rainfall forcing. To facilitate decision making under uncertainty, a widely applicable probabilistic framework is proposed. The occurrence of rainfall events and irrigation applications are linked probabilistically to crop development during the growing season and yields at harvest. Based on these linkages, the probability density function of yields and corresponding probability density function of required irrigation volumes, as well as the probability density function of yields under the most common case of limited water availability are obtained analytically, as a function of irrigation strategy, climate, soil and crop parameters. The full probabilistic description of the frequency of occurrence of yields and water requirements is a crucial tool for decision making under uncertainty, e.g., via expected utility analysis. Furthermore, the knowledge of the probability density function of yield allows us to quantify the yield reduction hydrologic risk. Two risk indices are defined and quantified: the long-term risk index, suitable for long-term irrigation strategy assessment and investment planning, and the real-time risk index, providing a rigorous probabilistic quantification of the emergence of drought conditions during a single growing season in an agricultural setting. Our approach employs relatively few parameters and is thus easily and

  2. Laypersons' understanding of relative risk reductions: Randomised cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kristiansen Ivar S

    2008-07-01

    Full Text Available Abstract Background Despite increasing recognition of the importance of involving patients in decisions on preventive healthcare interventions, little is known about how well patients understand and utilise information provided on the relative benefits from these interventions. The aim of this study was to explore whether lay people can discriminate between preventive interventions when effectiveness is presented in terms of relative risk reduction (RRR, and whether such discrimination is influenced by presentation of baseline risk. Methods The study was a randomised cross-sectional interview survey of a representative sample (n = 1,519 of lay people with mean age 59 (range 40–98 years in Denmark. In addition to demographic information, respondents were asked to consider a hypothetical drug treatment to prevent heart attack. Its effectiveness was randomly presented as RRR of 10, 20, 30, 40, 50 or 60 percent, and half of the respondents were presented with quantitative information on the baseline risk of heart attack. The respondents had also been asked whether they were diagnosed with hypercholesterolemia or had experienced a heart attack. Results In total, 873 (58% of the respondents consented to the hypothetical treatment. While 49% accepted the treatment when RRR = 10%, the acceptance rate was 58–60% for RRR>10. There was no significant difference in acceptance rates across respondents irrespective of whether they had been presented with quantitative information on baseline risk or not. Conclusion In this study, lay people's decisions about therapy were only slightly influenced by the magnitude of the effect when it was presented in terms of RRR. The results may indicate that lay people have difficulties in discriminating between levels of effectiveness when they are presented in terms of RRR.

  3. The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes

    OpenAIRE

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

    2014-01-01

    Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, control...

  4. [Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

    Science.gov (United States)

    Hainer, V; Kunesová, M; Parízková, J; Stunkard, A

    1997-06-12

    An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity

  5. Data poverty: A global evaluation for 2009 to 2013 - implications for sustainable development and disaster risk reduction

    Science.gov (United States)

    Leidig, Mathias; Teeuw, Richard M.; Gibson, Andrew D.

    2016-08-01

    The article presents a time series (2009-2013) analysis for a new version of the ;Digital Divide; concept that developed in the 1990s. Digital information technologies, such as the Internet, mobile phones and social media, provide vast amounts of data for decision-making and resource management. The Data Poverty Index (DPI) provides an open-source means of annually evaluating global access to data and information. The DPI can be used to monitor aspects of data and information availability at global and national levels, with potential application at local (district) levels. Access to data and information is a major factor in disaster risk reduction, increased resilience to disaster and improved adaptation to climate change. In that context, the DPI could be a useful tool for monitoring the Sustainable Development Goals of the Sendai Framework for Disaster Risk Reduction (2015-2030). The effects of severe data poverty, particularly limited access to geoinformatic data, free software and online training materials, are discussed in the context of sustainable development and disaster risk reduction. Unlike many other indices, the DPI is underpinned by datasets that are consistently provided annually for almost all the countries of the world and can be downloaded without restriction or cost.

  6. First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

    Science.gov (United States)

    Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

    2017-01-01

    There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Study on integrating disaster risk reduction in Indonesian municipal spatial planning

    Science.gov (United States)

    Rachmawati, T. A.

    2017-06-01

    Indonesia has experienced many major natural disasters. As result, the Spatial Planning Law number 26/2007 and the Disaster Management Law number 24/2007 were enacted. Spatial Planning Law number 26/2007 requires local governments to revise their municipal spatial plans. This paper aims to investigate the obstacles to revising the municipal spatial plans in response to disaster risk reduction and analyze the application of disaster risk reduction by municipalities in relation to the municipal spatial plan. For these purposes, questionnaires were distributed to 106 municipalities (52 responses were obtained) and document analysis was conducted on eight revised municipal spatial plans. The questionnaires, interviews, and document analysis revealed two obstacles to revising the municipal spatial plan (stakeholders with differing interests and a lack of spatial data) and that the eight plans had varying levels of application in disaster risk reduction as a result of the differences in support from government and non-government agencies.

  8. From LEO, to the Moon and then Mars: Developing a Global Strategy for Exploration Risk Reduction

    Science.gov (United States)

    Laurini, Kathleen C.; Hufenbach, Bernard

    2009-01-01

    Most nations currently involved in human spaceflight, or with such ambitions, believe that space exploration will capture the imagination of our youth resulting in future engineers and scientists, advance technologies which will improve life on earth, increase the knowledge of our solar system, and strengthen bonds and relationships across the globe. The Global Exploration Strategy, published in 2007 by 14 space agencies, eloquently makes this case and presents a vision for space exploration. It argues that in order for space exploration to be sustainable, nations must work together to address the challenges and share the burden of costs. This paper will examine Mars mission scenarios developed by NASA, ESA and other agencies and show resulting conclusions regarding key challenges, needed technologies and associated mission risks. It will discuss the importance of using the International Space Station as a platform for exploration risk reduction and how the global exploration community will develop lunar exploration elements and architectures that enable the long term goal of human missions to Mars. The International Space Station (ISS) is a critical first step both from a technology and capability demonstration point of view, but also from a partnership point of view. There is much work that can be done in low earth orbit for exploration risk reduction. As the current "outpost at the edge of the frontier", the ISS is a place where we can demonstrate certain technologies and capabilities that will substantially reduce the risk of deploying an outpost on the lunar surface and Mars mission scenarios. The ISS partnership is strong and has fulfilled mission needs. Likewise, the partnerships we build on the moon will provide a strong foundation for establishing partnerships for the human Mars missions. On the moon, we build a permanently manned outpost and deploy technologies and capabilities to allow humans to stay for long periods of time. The moon is interesting from

  9. Health-risk behaviors among high school athletes and preventive services provided during sports physicals.

    Science.gov (United States)

    Johnson, Karen E; McRee, Annie-Laurie

    2015-01-01

    Preparticipation examinations (PPEs), or sports physicals, present opportunities for health care providers to identify and discuss common adolescent health-risk behaviors. We sought to examine the prevalence of health-risk behaviors among high school athletes and the proportion of providers who address these behaviors during PPEs. For this descriptive study we used data from two statewide surveys: a survey of adolescents (n = 46,492) and a survey of nurse practitioners and physicians (n = 561). The most prevalent risk behaviors reported by student athletes were low levels of physical activity (70%), bullying perpetration (41%), and alcohol use (41%). Most providers (≥75%) addressed many common risk behaviors during PPEs but fewer addressed bullying, violence, and prescription drug use. Topics discussed differed by provider type and patient population. Many providers addressed critical threats to adolescent health during PPEs, but findings suggest potential disconnects between topics addressed during PPEs and behaviors of athletes. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  10. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Benjamin Ansa

    2015-12-01

    Full Text Available A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs. Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%, lack of physical activity (48.7%, and a high fat diet (63.2% are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5% agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9% believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M2 (p = 0.06; nearly all of the women (99.2% answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05. These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.

  11. Copper increases reductive dehalogenation of haloacetamides by zero-valent iron in drinking water: Reduction efficiency and integrated toxicity risk.

    Science.gov (United States)

    Chu, Wenhai; Li, Xin; Bond, Tom; Gao, Naiyun; Bin, Xu; Wang, Qiongfang; Ding, Shunke

    2016-12-15

    The haloacetamides (HAcAms), an emerging class of nitrogen-containing disinfection byproducts (N-DBPs), are highly cytotoxic and genotoxic, and typically occur in treated drinking waters at low μg/L concentrations. Since many drinking distribution and storage systems contain unlined cast iron and copper pipes, reactions of HAcAms with zero-valent iron (ZVI) and metallic copper (Cu) may play a role in determining their fate. Moreover, ZVI and/or Cu are potentially effective HAcAm treatment technologies in drinking water supply and storage systems. This study reports that ZVI alone reduces trichloroacetamide (TCAcAm) to sequentially form dichloroacetamide (DCAcAm) and then monochloroacetamide (MCAcAm), whereas Cu alone does not impact HAcAm concentrations. The addition of Cu to ZVI significantly improved the removal of HAcAms, relative to ZVI alone. TCAcAm and their reduction products (DCAcAm and MCAcAm) were all decreased to below detection limits at a molar ratio of ZVI/Cu of 1:1 after 24 h reaction (ZVI/TCAcAm = 0.18 M/5.30 μM). TCAcAm reduction increased with the decreasing pH from 8.0 to 5.0, but values from an integrated toxic risk assessment were minimised at pH 7.0, due to limited removal MCAcAm under weak acid conditions (pH = 5.0 and 6.0). Higher temperatures (40 °C) promoted the reductive dehalogenation of HAcAms. Bromine was preferentially removed over chlorine, thus brominated HAcAms were more easily reduced than chlorinated HAcAms by ZVI/Cu. Although tribromoacetamide was more easily reduced than TCAcAm during ZVI/Cu reduction, treatment of tribromoacetamide resulted in a higher integrated toxicity risk than TCAcAm, due to the formation of monobromoacetamide (MBAcAm). Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. 76 FR 44301 - Information Collection; Homeowner Risk Reduction Behaviors Concerning Wildfire Risks and Climate...

    Science.gov (United States)

    2011-07-25

    ... Behaviors Concerning Wildfire Risks and Climate Change Impacts. The information will be collected from... INFORMATION: Title: Understanding the Threats of Wildfire & Climate Change: Risk Mitigation Behaviors of... risk, and climate change. The objective of this study is to help decisionmakers better understand the...

  13. Exploring Perceived Risk and Risk Reduction Strategies in the Pursuit of Higher Education Abroad

    Science.gov (United States)

    Lam, Jason M. S.; Tong, David Yoon Kin; Ariffin, Ahmad Azmi M.

    2017-01-01

    While past studies have merely focused on perceived risks that influence how students select the destination of international education best suited to their needs, research on perceived risk regarding post-purchase behavior remains limited. This study attempts to extend and redefine the perceived risk paradigm by uncovering the underlying elements…

  14. A framework for assessing risk reduction due to DNAPL mass removal from low permeability soils

    Energy Technology Data Exchange (ETDEWEB)

    Freeze, R.A. [R. Allan Freeze Engineering, Inc., White Rock, British Columbia (Canada); McWhorter, D.B. [Colorado State Univ., Fort Collins, CO (United States)

    1996-08-01

    Many emerging remediation technologies are designed to remove contaminant mass from source zones at DNAPL sites in response to regulatory requirements. There is often concern in the regulated community as to whether mass removal actually reduces risk, or whether the small risk reductions achieved warrant the large costs incurred. This paper sets out a framework for quantifying the degree to which risk is reduced as mass is removed from shallow, saturated, low-permeability, dual-porosity, DNAPL source zones. Risk is defined in terms of meeting an alternate concentration level (ACL) at a compliance well in an aquifer underlying the source zone. The ACL is back-calculated from a carcinogenic health-risk characterization at a downstream water-supply well. Source-zone mass-removal efficiencies are heavily dependent on the distribution of mass between media (fractures, matrix) and phases (dissolved, sorbed, free product). Due to the uncertainties in currently-available technology performance data, the scope of the paper is limited to developing a framework for generic technologies rather than making risk-reduction calculations for specific technologies. Despite the qualitative nature of the exercise, results imply that very high mass-removal efficiencies are required to achieve significant long-term risk reduction with technology, applications of finite duration. 17 refs., 7 figs., 6 tabs.

  15. Gemitis : an integrated and participative risk reduction strategy for the sustainable development of cities

    Science.gov (United States)

    Masure, P.

    2003-04-01

    The GEMITIS method has been implemented since 1995 into a global and integrated Risk Reduction Strategy for improving the seismic risk-assessment effectiveness in urban areas, including the generation of crisis scenarios and mid- to long term- seismic impact assessment. GEMITIS required us to provide more precise definitions of notions in common use by natural-hazard specialists, such as elements at risk and vulnerability. Until then, only the physical and human elements had been considered, and analysis of their vulnerability referred to their fragility in the face of aggression by nature. We have completed this approach by also characterizing the social and cultural vulnerability of a city and its inhabitants, and, with a wider scope, the functional vulnerability of the "urban system". This functional vulnerability depends upon the relations between the system elements (weak links in chains, functional relays, and defense systems) and upon the city's relations with the outside world (interdependence). Though well developed in methods for evaluating industrial risk (fault-tree analysis, event-tree analysis, multiple defense barriers, etc.), this aspect had until now been ignored by the "hard-science" specialists working on natural hazards. Based on the implementation of an Urban System Exposure methodology, we were able to identify specific human, institutional, or functional vulnerability factors for each urban system, which until had been very little discussed by risk-analysis and civil-protection specialists. In addition, we have defined the new concept of "main stakes" of the urban system, ranked by order of social value (or collective utility). Obviously, vital or strategic issues must be better resistant or protected against natural hazards than issues of secondary importance. The ranking of exposed elements of a city in terms of "main stakes" provides a very useful guide for adapting vulnerability studies and for orienting preventive actions. For this

  16. Assessment of Disaster Risk Reduction and Climate Change Adaptation policy integration in Zambia

    Science.gov (United States)

    Pilli-Sihvola, K.; Väätäinen-Chimpuku, S.

    2015-12-01

    Integration of Disaster Risk Management (DRM) and Climate Change Adaptation (CCA) policies, their implementation measures and the contribution of these to development has been gaining attention recently. Due to the shared objectives of CCA and particularly Disaster Risk Reduction (DRR), a component of DRM, their integration provides many benefits. At the implementation level, DRR and CCA are usually integrated. Policy integration, however, is often lacking. This study presents a novel analysis of the policy integration of DRR and CCA by 1) suggesting a definition for their integration at a general and further at horizontal and vertical levels, 2) using an analysis framework for policy integration cycle, which separates the policy formulation and implementation processes, and 3) applying these to a case study in Zambia. Moreover, the study identifies the key gaps in the integration process, obtains an understanding of identified key factors for creating an enabling environment for the integration, and provides recommendations for further progress. The study is based on a document analysis of the relevant DRM, climate change (CC), agriculture, forestry, water management and meteorology policy documents and Acts, and 21 semi-structured interviews with key stakeholders. Horizontal integration has occurred both ways, as the revised DRM policy draft has incorporated CCA, and the new CC policy draft has incorporated DRR. This is not necessarily an optimal strategy and unless carefully implemented, it may create pressure on institutional structures and duplication of efforts in the implementation. Much less vertical integration takes place, and where it does, no guidance on how potential goal conflicts with sectorial and development objectives ought to be handled. The objectives of the instruments show convergence. At the programme stage, the measures are fully integrated as they can be classified as robust CCA measures, providing benefits in the current and future

  17. Abstinence and teenagers: prevention counseling practices of health care providers serving high-risk patients in the United States.

    Science.gov (United States)

    Harper, Cynthia C; Henderson, Jillian T; Schalet, Amy; Becker, Davida; Stratton, Laura; Raine, Tina R

    2010-06-01

    Abstinence-only education has had little demonstrable impact on teenagers' sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers' reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention. In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted. A semistructured interview guide was used to ask clinicians about adolescent pregnancy, HIV and STD prevention counseling, and when they include abstinence. Thematic content analysis was used to examine the content of the counseling and the techniques used in different situations. Providers reported offering comprehensive counseling, presenting abstinence as a choice for teenagers, along with information about contraceptives and condoms. Several providers mentioned that with young, sexually inexperienced teenagers, they discuss delaying sexual activity and suggest other ways to be affectionate, while giving information on condoms. Providers explained how they assess whether teenagers feel ready to be sexually active and try to impart skills for healthy relationships. Some described abstinence as giving teenagers a way to opt out of unwanted sexual activity. Many support abstinence if that is the patient's desire, but routinely dispense condoms and contraceptives. Overall, providers did not give abstinence counseling as a rigid categorical concept in their preventive practices, but as a health tool to give agency to teenagers within a harm reduction framework. Their approach may be informative for adolescent policies and programs in the future.

  18. Child Care Providers' Competence and Confidence in Referring Children at Risk for Developmental Delays

    Science.gov (United States)

    Branson, Diane; Bingham, Ann

    2017-01-01

    Despite the benefits of early intervention for children, the majority of children with developmental delays are not identified prior to the age of 5 years. Child care providers could aid in recognition of children at risk for developmental delays; however, there is little research on this topic. This article reports on a qualitative research study…

  19. Providing a Supportive Alternative Education Environment for At-Risk Students

    Science.gov (United States)

    McGee, John J.; Lin, Fan-Yu

    2017-01-01

    Many factors cause student disengagement from school that subsequently result in high dropout rates. Alternative education (AE) programs provide a different pathway for at-risk youths who do not meet the goals, standards, and requirements of traditional educational settings. However, educational agencies have vastly different interpretations…

  20. Development and Refinement of a Targeted Sexual Risk Reduction Intervention for Women With a History of Childhood Sexual Abuse.

    Science.gov (United States)

    Senn, Theresa E; Braksmajer, Amy; Hutchins, Heidi; Carey, Michael P

    2017-11-01

    Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. First, initial quantitative work revealed that the intervention should address how maladaptive thoughts related to traumatic sexualization, trust, powerlessness, and guilt/shame (traumagenic dynamics constructs) influence current sexual behavior. Second, qualitative interviews with 10 women who reported a history of CSA (M age = 34 years; 90% African American) as well as current sexual risk behavior provided support for targeting maladaptive thoughts associated with these traumagenic dynamics constructs. Third, based on the qualitative and quantitative results, we developed a 5-session, group-delivered intervention to address the maladaptive thoughts that occurred as a result of CSA, as well as the cognitive-behavioral determinants of sexual risk behavior. This intervention drew heavily on cognitive behavioral techniques to address cognitions associated with CSA and the links between these cognitions and current sexual risk behavior. Techniques from trauma-based therapies, as well as motivational techniques, were also incorporated into the intervention. Finally, we refined the intervention with 24 women (M age = 33 years; 79% African American), and assessed feasibility and acceptability. These women reported high levels of satisfaction with the intervention. The resultant intervention is currently being evaluated in a small, randomized controlled trial.

  1. A comparison of mantle versus involved-field radiotherapy for Hodgkin's lymphoma: reduction in normal tissue dose and second cancer risk

    Directory of Open Access Journals (Sweden)

    Xu Tony

    2007-03-01

    Full Text Available Abstract Background Hodgkin's lymphoma (HL survivors who undergo radiotherapy experience increased risks of second cancers (SC and cardiac sequelae. To reduce such risks, extended-field radiotherapy (RT for HL has largely been replaced by involved field radiotherapy (IFRT. While it has generally been assumed that IFRT will reduce SC risks, there are few data that quantify the reduction in dose to normal tissues associated with modern RT practice for patients with mediastinal HL, and no estimates of the expected reduction in SC risk. Methods Organ-specific dose-volume histograms (DVH were generated for 41 patients receiving 35 Gy mantle RT, 35 Gy IFRT, or 20 Gy IFRT, and integrated organ mean doses were compared for the three protocols. Organ-specific SC risk estimates were estimated using a dosimetric risk-modeling approach, analyzing DVH data with quantitative, mechanistic models of radiation-induced cancer. Results Dose reductions resulted in corresponding reductions in predicted excess relative risks (ERR for SC induction. Moving from 35 Gy mantle RT to 35 Gy IFRT reduces predicted ERR for female breast and lung cancer by approximately 65%, and for male lung cancer by approximately 35%; moving from 35 Gy IFRT to 20 Gy IFRT reduces predicted ERRs approximately 40% more. The median reduction in integral dose to the whole heart with the transition to 35 Gy IFRT was 35%, with a smaller (2% reduction in dose to proximal coronary arteries. There was no significant reduction in thyroid dose. Conclusion The significant decreases estimated for radiation-induced SC risks associated with modern IFRT provide strong support for the use of IFRT to reduce the late effects of treatment. The approach employed here can provide new insight into the risks associated with contemporary IFRT for HL, and may facilitate the counseling of patients regarding the risks associated with this treatment.

  2. Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders.

    Science.gov (United States)

    Yoon, Jin-Ha; Kim, Sung-Kyung; Choi, Ho-June; Choi, Soo-In; Cha, So-Youn; Koh, Sang-Baek; Kang, Hee-Taik; Ahn, Song Vogue

    2013-01-01

    This study evaluated the relation between adiponectin and atherosclerosis in both genders, and investigated whether adiponectin provides useful additional information for assessing the risk of atherosclerosis. We measured serum adiponectin levels and other cardiovascular risk factors in 1033 subjects (454 men, 579 women) from the Korean Genomic Rural Cohort study. Carotid intima-media-thickness (CIMT) was used as measure of atherosclerosis. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated using multiple logistic regression, and receiver operating characteristic curves (ROC), the category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated. After adjustment for conventional cardiovascular risk factors, such as age, waist circumference, smoking history, low-density and high-density lipoprotein cholesterol, triglycerides, systolic blood pressure and insulin resistance, the ORs (95%CI) of the third tertile adiponectin group were 0.42 (0.25-0.72) in men and 0.47 (0.29-0.75) in women. The area under the curve (AUC) on the ROC analysis increased significantly by 0.025 in men and 0.022 in women when adiponectin was added to the logistic model of conventional cardiovascular risk factors (AUC in men: 0.655 to 0.680, p = 0.038; AUC in women: 0.654 to 0.676, p = 0.041). The NRI was 0.32 (95%CI: 0.13-0.50, pgenders, and these relationships were independent of conventional cardiovascular risk factors. Furthermore, adiponectin provided additional information to conventional cardiovascular risk factors regarding the risk of atherosclerosis.

  3. Use of the event tree to assess the risk reduction obtained from rockfall protection devices

    Directory of Open Access Journals (Sweden)

    D. Peila

    2008-12-01

    Full Text Available The paper presents and discusses a procedure for the evaluation of the collective risk that can affect a road subjected to rockfalls, with and without protection measures, by means of the event tree analysis. This tool is useful to show designers whether the rockfall protection structures are located in the correct positions, whether they are the correct technological choice and what level of reduction of risk can be obtained. Different design options can therefore be compared on the same bases.

  4. Disaster Risk Reduction in the Built Environment in\\ud Sri Lanka- An overview

    OpenAIRE

    Ginige, Kanchana; Amaratunga, Dilanthi; Haigh, Richard

    2013-01-01

    Natural disasters have long-term implications on sustainable development. They mainly destroy\\ud the built environment thereby hindering economic and social development, and causing\\ud environment degradation. Reducing the risk of natural disasters within the built environment is\\ud therefore critical for ensuring sustainable development. The paper in this context, aims to\\ud assess the current state of disaster risk reduction in the built environment in Sri Lanka.\\ud Empirical data was colle...

  5. Meeting the Needs of USGS's Science Application for Risk Reduction Group through Evaluation Research

    Science.gov (United States)

    Ritchie, L.; Campbell, N. M.; Vickery, J.; Madera, A.

    2016-12-01

    The U.S. Geological Survey's (USGS) Science Application for Risk Reduction (SAFRR) group aims to support innovative collaborations in hazard science by uniting a broad range of stakeholders to produce and disseminate knowledge in ways that are useful for decision-making in hazard mitigation, planning, and preparedness. Since 2013, an evaluation team at the Natural Hazards Center (NHC) has worked closely with the SAFRR group to assess these collaborations and communication efforts. In contributing to the nexus between academia and practice, or "pracademia," we use evaluation research to provide the USGS with useful feedback for crafting relevant information for practitioners and decision-makers. This presentation will highlight how the NHC team has varied our methodological and information design approaches according to the needs of each project, which in turn assist the SAFRR group in meeting the needs of practitioners and decision-makers. As the foci of our evaluation activities with SAFRR have evolved, so have our efforts to ensure that our work appropriately matches the information needs of each scenario project. We draw upon multiple projects, including evaluation work on the SAFRR Tsunami Scenario, "The First Sue Nami" tsunami awareness messaging, and their most recent project concerning a hypothetical M7 earthquake on the Hayward fault in the Bay Area (HayWired scenario). We have utilized various qualitative and quantitative methodologies—including telephone interviews, focus groups, online surveys, nonparticipant observation, and in-person survey distribution. The findings generated from these series of evaluations highlight the ways in which evaluation research can be used by researchers and academics to more appropriately address the needs of practitioners. Moreover, they contribute to knowledge enhancement surrounding disaster preparedness and risk communication, and, more generally, the limited body of knowledge about evaluation-focused disaster

  6. Reduction of risk level as one of the main challenges of development in covered karst regions

    Directory of Open Access Journals (Sweden)

    Makhnatov Stanislav A.

    2013-01-01

    Full Text Available The paper describes the experience of application of the residual karst risk concept, and presents coefficients of karst risk level reduction for planning constructional karst-protection. Practical experience of design for karstified territories of Nizhny Novgorod region demonstrates that special research of the interaction between constructions and foundations is required. Numerous accidents can serve vivid examples proving the need. I2n this situation it is important to approach the issue of safety in a proper way, taking into account probable economic, environmental and social damage. The problem can be solved by introduction of the karst risk level parameter, which permits to take into consideration constructional characteristics of objects (design philosophy, service life, as well as conditions and mechanisms of interaction between the foundation and the construction (sinkholes, local subsidence, karst-suffosion deformations, etc.. The importance of risk reduction is highlighted by current Russian Federal laws. Depending on karst risk level adequate karst-protection should be performed. For building projects, reduction of karst risk to a permissible level (conventionally equal to 1 is one of the most important research challenges of the karstified territories development, and its solution permits to plan appropriate karst protection measures.

  7. Education for Disaster Risk Reduction (DRR: Linking Theory with Practice in Ghana’s Basic Schools

    Directory of Open Access Journals (Sweden)

    Priscilla T. Apronti

    2015-07-01

    Full Text Available Current understanding of disaster risk reduction (DRR concurs that, when provided the right education, children have the potential to reduce their own vulnerability and the vulnerability of others in their community. What, then, comprises the right education for DRR? Research has established the need for disaster education to address the causes and effects, prevention and response, and management and recovery from disaster events. The educational process must include diverse and practical techniques that reinforce disaster knowledge and builds a culture of safety and resilience amongst students. Drawing on syllabus content analysis and field research in two rural communities in semi-arid Northern Ghana, this study explored the presence and nature of DRR within the syllabi of the basic school system. By comparing the result of the content analysis with results from interviews and questionnaires completed by teachers and students, significant gaps were identified between the disaster pedagogy outlined in the syllabi (theory and that which occurs in the classroom (practice. It was realized that while the theory outlines active and innovative techniques for teaching, learning, and evaluating DRR lessons, various challenges hinder the practical application of these techniques in the classroom. The study concludes that a lack of teacher training and professional development, and inadequate teaching and learning materials, generally account for these results. A new and consolidated effort is required from all stakeholders to train teachers and to provide the appropriate learning materials to improve on the current DRR education.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  9. Estimated Reduction in Cancer Risk due to PAH Exposures If Source Control Measures during the 2008 Beijing Olympics Were Sustained

    Science.gov (United States)

    Jia, Yuling; Stone, Dave; Wang, Wentao; Schrlau, Jill; Tao, Shu; Massey Simonich, Staci L.

    2011-01-01

    Background The 2008 Beijing Olympic Games provided a unique case study to investigate the effect of source control measures on the reduction in air pollution, and associated inhalation cancer risk, in a Chinese megacity. Objectives We measured 17 carcinogenic polycyclic aromatic hydrocarbons (PAHs) and estimated the lifetime excess inhalation cancer risk during different periods of the Beijing Olympic Games, to assess the effectiveness of source control measures in reducing PAH-induced inhalation cancer risks. Methods PAH concentrations were measured in samples of particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) collected during the Beijing Olympic Games, and the associated inhalation cancer risks were estimated using a point-estimate approach based on relative potency factors. Results We estimated the number of lifetime excess cancer cases due to exposure to the 17 carcinogenic PAHs [12 priority pollutant PAHs and five high-molecular-weight (302 Da) PAHs (MW 302 PAHs)] to range from 6.5 to 518 per million people for the source control period concentrations and from 12.2 to 964 per million people for the nonsource control period concentrations. This would correspond to a 46% reduction in estimated inhalation cancer risk due to source control measures, if these measures were sustained over time. Benzo[b]fluoranthene, dibenz[a,h]anthracene, benzo[a]pyrene, and dibenzo[a,l]pyrene were the most carcinogenic PAH species evaluated. Total excess inhalation cancer risk would be underestimated by 23% if we did not include the five MW 302 PAHs in the risk calculation. Conclusions Source control measures, such as those imposed during the 2008 Beijing Olympics, can significantly reduce the inhalation cancer risk associated with PAH exposure in Chinese megacities similar to Beijing. MW 302 PAHs are a significant contributor to the estimated overall inhalation cancer risk. PMID:21632310

  10. Evaluation of an Alcohol Risk Reduction Program (PRIME for Life) in Young Swedish Military Conscripts

    Science.gov (United States)

    Hallgren, Mats A.; Kallmen, Hakan; Leifman, Hakan; Sjolund, Torbjorn; Andreasson, Sven

    2009-01-01

    Purpose: The purpose of this paper is to evaluate the effectiveness of the PRIME for Life risk reduction program in reducing alcohol consumption and improving knowledge and attitudes towards alcohol use in male Swedish military conscripts, aged 18 to 22 years. Design/methodology/approach: A quasi-experimental design was used in which 1,371…

  11. Valuing Mortality Risk Reductions for Environmental Policy: A White Paper (1999)

    Science.gov (United States)

    This white paper addresses current and recent U.S. EPA practices regarding the valuation of mortality risk reductions, focusing especially on empirical estimates of the “value of a statistical life” (VSL) from stated preference and hedonic wage studies.

  12. Community-Managed Disaster Risk Reduction : Investing in Resilience. A report prepared for Cordaid

    NARCIS (Netherlands)

    Gordon, A.N.

    2012-01-01

    Cordaid has been supporting community-managed disaster risk reduction (CMDRR) and drought cycle management (DCM) in the Horn of Africa for eight years. Many evaluations have pointed to successful outcomes but quantitative data are scarce. The aim of this study was to verify the extent to which

  13. Risk reduction in road and rail LPG transportation by passive fire protection

    NARCIS (Netherlands)

    Paltrinieri, N.; Landucci, G.; Molag, M.; Bonvicini, S.; Spadoni, G.; Cozzani, V.

    2009-01-01

    The potential reduction of risk in LPG (Liquefied Petroleum Gas) road transport due to the adoption of passive fire protections was investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements

  14. Ready for the Storm: Education for Disaster Risk Reduction and Climate Change Adaptation and Mitigation

    Science.gov (United States)

    Kagawa, Fumiyo; Selby, David

    2012-01-01

    Incidences of disaster and climate change impacts are rising globally. Disaster risk reduction and climate change education are two educational responses to present and anticipated increases in the severity and frequency of hazards. They share significant complementarities and potential synergies, the latter as yet largely unexploited. Three…

  15. Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction

    DEFF Research Database (Denmark)

    Crabtree, Andrew

    2013-01-01

    to symptoms of depression. It argues that mental health issues should be fully integrated into Disaster Risk Reduction plans and policies, which are likely to be included in the Post-2015 Millennium Development Goals. In addition to supporting mental health interventions, the paper suggests that deep socio...

  16. Risk reduction in road and rail LPG transportation bij passive fire protection

    NARCIS (Netherlands)

    Molag e.a., M. (Menso)

    2009-01-01

    The potential reduction of risk in LPG (Liquified Petroleum Gas) road transport due to the adoption of passive fire protectionswas investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements

  17. The Differential Effects of Social Media Sites for Promoting Cancer Risk Reduction.

    Science.gov (United States)

    Lauckner, Carolyn; Whitten, Pamela

    2016-09-01

    Social media are potentially valuable tools for disseminating cancer education messages, but the differential effects of various sites on persuasive outcomes are unknown. In an effort to inform future health promotion, this research tested the effects of Facebook, YouTube, Twitter, and blogs for delivering a cancer risk reduction message. Using an experimental design, participants were randomly placed in several conditions that delivered the same message but with different forms of social media. Effects on comprehension and attitudes were examined, as they are important variables in the behavior change process. YouTube led to higher comprehension and stronger attitudes toward cancer risk reduction than Twitter, but there were no differences between other sites. Additionally, YouTube led to stronger attitudes toward cancer risk reduction as compared to Facebook, but not any other sites. These results demonstrate that, even if the message is kept constant, the form of social media used to deliver content can have an effect on persuasive outcomes. More research is needed to determine the mechanisms behind the differences found, however. Altogether, this line of research is valuable for any individuals seeking to use social media for health promotion purposes and could have direct implications for the development of cancer risk reduction campaigns.

  18. Risk factors for anterior disc displacement with reduction and intermittent locking in adolescents.

    NARCIS (Netherlands)

    Kalaykova, S.I.; Lobbezoo, F.; Naeije, M.

    2011-01-01

    AIMS: To test the hypothesis that oral parafunctions and symptomatic temporomandibulair joint (TMJ) hypermobility are risk factors in adolescents for both anterior disc displacement with reduction (ADDR) and intermittent locking. METHODS: Participants were two hundred sixty 12- to 16-year-old

  19. Risk factors for anterior disc displacement with reduction and intermittent locking in adolescents

    NARCIS (Netherlands)

    Kalaykova, S.I.; Lobbezoo, F.; Naeije, M.

    2011-01-01

    ims: To test the hypothesis that oral parafunctions and symptomatic temporomandibulair joint (TMJ) hypermobility are risk factors in adolescents for both anterior disc displacement with reduction (ADDR) and intermittent locking. Methods: Participants were two hundred sixty 12- to 16-year-old

  20. College Women and Personal Goals: Cognitive Dimensions that Differentiate Risk-Reduction Sexual Decisions

    Science.gov (United States)

    Moore, Nelwyn B.; Davidson, J. Kenneth, Sr.

    2006-01-01

    As the twenty-first century begins, a high level of participation in premarital sexual intercourse by college women is well-documented. But, in the research exploring risk-reduction sexual behaviors, the relationship of cognitive abilities to responsible sexual behavior has been under-researched. Anonymous questionnaires were administered to 626…

  1. Social Media Use and Sexual Risk Reduction Behavior Among Minority Youth: Seeking Safe Sex Information.

    Science.gov (United States)

    Stevens, Robin; Gilliard-Matthews, Stacia; Dunaev, Jamie; Todhunter-Reid, Abigail; Brawner, Bridgette; Stewart, Jennifer

    Sexual health is an important area of study-particularly for minority youth and youth living in disadvantaged neighborhoods. The purpose of the research was to examine the sources of sexual health information associated with youth adopting sexual risk reduction behaviors. Data collection took place in a small city in the Northeastern United States using cross-sectional behavioral surveys and modified venue-based sampling. Participants included 249 African American and Latino youth aged 13-24. Participants reported their sources of information about contraception and human immunodeficiency virus/sexually transmitted disease, such as TV/movies, parents, social media; their intentions to have sex; and condom and contraception use during their last sexual activity. Social media use, past pregnancy experience, past sexual history, age, and gender were also measured. Standard tests of bivariate association (chi-square and F tests) were used to examine initial associations between sexual risk reduction behavior and exposure to sexual risk reduction information on social media. Logistic regression models were used to test multivariate relationships between information sources and sexual risk reduction behavior. Youth who were exposed to sexual health messages on social media were 2.69 times (p information sources were not significantly associated with contractive use or condom use at last intercourse. Youth sexual behavior is increasingly informed by social media messages. Health practitioners should utilize social media as an important health promotion tool.

  2. Reducing hazard vulnerability: towards a common approach between disaster risk reduction and climate adaptation.

    Science.gov (United States)

    Thomalla, Frank; Downing, Tom; Spanger-Siegfried, Erika; Han, Guoyi; Rockström, Johan

    2006-03-01

    Over the past few decades, four distinct and largely independent research and policy communities--disaster risk reduction, climate change adaptation, environmental management and poverty reduction--have been actively engaged in reducing socio-economic vulnerability to natural hazards. However, despite the significant efforts of these communities, the vulnerability of many individuals and communities to natural hazards continues to increase considerably. In particular, it is hydro-meteorological hazards that affect an increasing number of people and cause increasingly large economic losses. Arising from the realisation that these four communities have been largely working in isolation and enjoyed only limited success in reducing vulnerability, there is an emerging perceived need to strengthen significantly collaboration and to facilitate learning and information exchange between them. This article examines key communalities and differences between the climate change adaptation and disaster risk reduction communities, and proposes three exercises that would help to structure a multi-community dialogue and learning process.

  3. Quantitative Cyber Risk Reduction Estimation Methodology for a Small Scada Control System

    Energy Technology Data Exchange (ETDEWEB)

    Miles A. McQueen; Wayne F. Boyer; Mark A. Flynn; George A. Beitel

    2006-01-01

    We propose a new methodology for obtaining a quick quantitative measurement of the risk reduction achieved when a control system is modified with the intent to improve cyber security defense against external attackers. The proposed methodology employs a directed graph called a compromise graph, where the nodes represent stages of a potential attack and the edges represent the expected time-to-compromise for differing attacker skill levels. Time-to-compromise is modeled as a function of known vulnerabilities and attacker skill level. The methodology was used to calculate risk reduction estimates for a specific SCADA system and for a specific set of control system security remedial actions. Despite an 86% reduction in the total number of vulnerabilities, the estimated time-to-compromise was increased only by about 3 to 30% depending on target and attacker skill level.

  4. What if Dutch investors started worrying about flood risk? Implications for disaster risk reduction

    NARCIS (Netherlands)

    Husby, T.G.; Mechler, R.; Jongman, B.

    2016-01-01

    Increasingly, roles and responsibilities of the public sector in flood risk management are receiving attention in research and policy. Part of the debate suggests that allocating risk to the private sector increases efficiency as it promotes individual adaptation, thereby reducing the impact if a

  5. Data management and GIS in the Center for Disaster Management and Risk Reduction Technology (CEDIM: from integrated spatial data to the mapping of risk

    Directory of Open Access Journals (Sweden)

    P. Köhler

    2006-01-01

    Full Text Available The project 'Risk Map Germany' of the Center for Disaster Management and Risk Reduction Technology (CEDIM aims at the examination of existing and the development of new approaches for integrated risk assessment as well as the realisation of risk analyses for selected threats and regions. Hazard, vulnerability and risk maps display the results and provide valuable information for planning, insurances, emergency management, science and the public. This article describes the development of the basic information infrastructure for CEDIM and the 'Risk Map Germany' providing components for the networking of participating institutions, for common data management, data dissemination and publication. While a web based project platform offers information and communication facilities for all the project members and also the presentation of CEDIM to the public, an integrated data base is prepared as foundation for cross-discipline but common risk assessment. It is made available by the spatial data service 'CEDIM Data Center' which allows the project members to inform themselves about the characteristics of existing data and its applicability for their specific tasks by exploring GIS functionalities. Suitable data can be downloaded and further processed in their own work environment. The components' alignment with the principles of Spatial Data Infrastructures is required to accomplish the suppositions for long-term availability and accessibility of data, information and services.

  6. Provider perceptions on HIV risk and prevention services within permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony

    2017-10-01

    Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH. The purpose of this study was to investigate how PSH providers approach HIV prevention and the challenges they perceive surrounding HIV prevention in PSH. Results serve as a critical first step toward addressing the acceptability and feasibility of providing HIV/STI prevention services to PSH residents. As part of a longitudinal mixed methods study examining HIV risk and prevention behavior among homeless unaccompanied adults moving into PSH in Los Angeles, we conducted eleven focus groups with a total of 60 frontline staff across 10 PSH agencies. Thirty-three percent of focus group participants were African American, 32% were Hispanic, and 55% were women. Results suggest that provider awareness and knowledge of PrEP is very limited, and provision of formal HIV prevention programing for residents is perceived as challenging. Informal, ad hoc conversations with residents about sexual risk and HIV prevention do occur when providers have rapport with clients and perceive risk. There are significant gaps in HIV prevention services through PSH but also opportunities to enhance providers' efforts to promote the health of residents through prevention.

  7. Provider Perspectives on the Implementation of Psychosocial Risk Screening in Pediatric Cancer.

    Science.gov (United States)

    Kazak, Anne E; Barakat, Lamia P; Askins, Martha A; McCafferty, Maureen; Lattomus, Alyssa; Ruppe, Nicole; Deatrick, Janet

    2017-07-01

     Psychosocial risk screening is an important initial step in delivering evidence-based care. This qualitative descriptive study identified how multidisciplinary pediatric oncology health-care providers perceive psychosocial risk screening to identify factors in uptake and implementation.  A script guided digitally recorded (transcribed) interviews regarding psychosocial screening and challenges to facilitators of screening. Participants were 15 multidisciplinary staff (physicians, nurses, social workers, psychologists, physician assistant) at nine sites, three using the Psychosocial Assessment Tool© for research and six for clinical care. Constant comparative analysis was used to analyze the independently coded interviews.  Thematic content analysis identified an overarching theme - Screening is important because it facilitates clinical care - and four subthemes: Optimizing Psychosocial Care, Implementing Screening, Engaging Families, and Utilizing Clinical Pathways.  Findings support the importance of integrating psychosocial risk screening into clinical care and offer strategies for implementation of screening across a range of settings.

  8. Update on Risk Reduction Activities for a Liquid Advanced Booster for NASA's Space Launch System

    Science.gov (United States)

    Crocker, Andy; Greene, William D.

    2017-01-01

    Goals of NASA's Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) are to: (1) Reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS. (2) Enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. SLS Block 1 vehicle is being designed to carry 70 mT to LEO: (1) Uses two five-segment solid rocket boosters (SRBs) similar to the boosters that helped power the space shuttle to orbit. Evolved 130 mT payload class rocket requires an advanced booster with more thrust than any existing U.S. liquid-or solid-fueled boosters

  9. An interdisciplinary approach to volcanic risk reduction under conditions of uncertainty: a case study of Tristan da Cunha

    Science.gov (United States)

    Hicks, A.; Barclay, J.; Simmons, P.; Loughlin, S.

    2014-07-01

    The uncertainty brought about by intermittent volcanic activity is fairly common at volcanoes worldwide. While better knowledge of any one volcano's behavioural characteristics has the potential to reduce this uncertainty, the subsequent reduction of risk from volcanic threats is only realised if that knowledge is pertinent to stakeholders and effectively communicated to inform good decision making. Success requires integration of methods, skills and expertise across disciplinary boundaries. This research project develops and trials a novel interdisciplinary approach to volcanic risk reduction on the remote volcanic island of Tristan da Cunha (South Atlantic). For the first time, volcanological techniques, probabilistic decision support and social scientific methods were integrated in a single study. New data were produced that (1) established no spatio-temporal pattern to recent volcanic activity; (2) quantified the high degree of scientific uncertainty around future eruptive scenarios; (3) analysed the physical vulnerability of the community as a consequence of their geographical isolation and exposure to volcanic hazards; (4) evaluated social and cultural influences on vulnerability and resilience; and (5) evaluated the effectiveness of a scenario planning approach, both as a method for integrating the different strands of the research and as a way of enabling on-island decision makers to take ownership of risk identification and management, and capacity building within their community. The paper provides empirical evidence of the value of an innovative interdisciplinary framework for reducing volcanic risk. It also provides evidence for the strength that comes from integrating social and physical sciences with the development of effective, tailored engagement and communication strategies in volcanic risk reduction.

  10. Providing earplugs to young adults at risk encourages protective behaviour in music venues.

    Science.gov (United States)

    Beach, Elizabeth Francis; Nielsen, Lillian; Gilliver, Megan

    2016-06-01

    For some young people, nightclubs and other music venues are a major source of noise exposure, arising from a combination of very high noise levels; relatively long attendance duration; and frequent, sustained participation over several years. Responsibility for hearing protection is largely left to individuals, many of whom choose not to wear earplugs. In order to encourage earplug use in these settings, a new approach is needed. The aim of the study was to examine whether presentation of hearing health information would result in increased use of earplugs, or whether provision of earplugs alone would be sufficient to change behaviour. A total of 51 regular patrons of music venues were allocated to either a low-information (lo-info) or high-information (hi-info) group. Both groups completed a survey about their current noise exposure, earplug usage and perceived risk of hearing damage. Both groups were also provided with one-size-fits-all filtered music earplugs. The hi-info group was also provided with audio-visual and written information about the risks of excessive noise exposure. After 4 weeks, and again after an additional 12 weeks, participants were asked about their recent earplug usage, intention to use earplugs in the future, and perceived risk of hearing damage. The results showed that after 4 weeks, the hi-info group's perceived personal risk of hearing damage was significantly higher than that of the lo-info group. After 16 weeks, these differences were no longer evident; however, at both 4 and 16 weeks, both the lo- and hi-info groups were using the earplugs equally often; and both groups intended to use earplugs significantly more often in the future. This suggests that the information was unnecessary to motivate behavioural change. Rather, the simple act of providing access to earplugs appears to have effectively encouraged young at-risk adults to increase their earplug use. © The Author(s) 2015.

  11. Interrater reliability of Violence Risk Appraisal Guide scores provided in Canadian criminal proceedings.

    Science.gov (United States)

    Edens, John F; Penson, Brittany N; Ruchensky, Jared R; Cox, Jennifer; Smith, Shannon Toney

    2016-12-01

    Published research suggests that most violence risk assessment tools have relatively high levels of interrater reliability, but recent evidence of inconsistent scores among forensic examiners in adversarial settings raises concerns about the "field reliability" of such measures. This study specifically examined the reliability of Violence Risk Appraisal Guide (VRAG) scores in Canadian criminal cases identified in the legal database, LexisNexis. Over 250 reported cases were located that made mention of the VRAG, with 42 of these cases containing 2 or more scores that could be submitted to interrater reliability analyses. Overall, scores were skewed toward higher risk categories. The intraclass correlation (ICCA1) was .66, with pairs of forensic examiners placing defendants into the same VRAG risk "bin" in 68% of the cases. For categorical risk statements (i.e., low, moderate, high), examiners provided converging assessment results in most instances (86%). In terms of potential predictors of rater disagreement, there was no evidence for adversarial allegiance in our sample. Rater disagreement in the scoring of 1 VRAG item (Psychopathy Checklist-Revised; Hare, 2003), however, strongly predicted rater disagreement in the scoring of the VRAG (r = .58). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Risk of hospital admission for COPD following smoking cessation and reduction

    DEFF Research Database (Denmark)

    Godtfredsen, N S; Vestbo, J; Osler, M

    2002-01-01

    by at least 50% between the two initial examinations without quitting and smokers who stopped smoking during this time were compared with continuous heavy smokers using a Cox proportional hazards model. RESULTS: During the follow up period 1,260 subjects (741 men and 519 women) were admitted to hospital...... for COPD. After multivariate adjustment, quitting smoking was associated with a significant reduction in the risk of hospital admission. The relative hazard (HR) was 0.57 (95% confidence interval (CI) 0.33 to 0.99). Those who reduced smoking did not show a significantly lower risk of hospitalisation than......BACKGROUND: Little is known about the effects of changes in smoking habits on the subsequent risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between smoking cessation and reduction and admission to hospital for COPD in a general...

  13. Grasping the hydra: the need for a holistic and systematic approach to disaster risk reduction

    Directory of Open Access Journals (Sweden)

    Per Becker

    2009-04-01

    Full Text Available This article stresses the significance of recognising interdependencies between factors determining disaster risk in any attempts to integrate disaster risk reduction in international development cooperation. It bases its arguments on the case studies of four past projects in Sri Lanka and Tajikistan, which are scrutinised using a theoretical framework based on systems approaches. It appears that the results of ignoring interdependencies may (1cause sub-optimisation problems where the desired outcome is not reached as the factor focused on and/or the desired outcome are dependent on other factors, and (2 make it difficult or impossible to monitor and evaluate the actual effects of international development cooperation projects in disaster risk reduction.

  14. Twitter as a Potential Disaster Risk Reduction Tool. Part I: Introduction, Terminology, Research and Operational Applications.

    Science.gov (United States)

    Cooper, Guy Paul; Yeager, Violet; Burkle, Frederick M; Subbarao, Italo

    2015-06-29

    Twitter, a popular communications platform, is identified as contributing to improved mortality and morbidity outcomes resulting from the 2013 Hattiesburg, Mississippi EF-4 Tornado. This study describes the methodology by which Twitter was investigated as a potential disaster risk reduction and management tool at the community level and the process by which the at-risk population was identified from the broader Twitter user population. By understanding how various factors contribute to the superspreading of messages, one can better optimize Twitter as an essential communications and risk reduction tool. This study introduces Parts II, III and IV which further define the technological and scientific knowledge base necessary for developing future competency base curriculum and content for Twitter assisted disaster management education and training at the community level.

  15. Hydrological modelling in a drinking water catchment area as a means of evaluating pathogen risk reduction

    Science.gov (United States)

    Bergion, Viktor; Sokolova, Ekaterina; Åström, Johan; Lindhe, Andreas; Sörén, Kaisa; Rosén, Lars

    2017-01-01

    Waterborne outbreaks of gastrointestinal diseases are of great concern to drinking water producers and can give rise to substantial costs to the society. The World Health Organisation promotes an approach where the emphasis is on mitigating risks close to the contamination source. In order to handle microbial risks efficiently, there is a need for systematic risk management. In this paper we present a framework for microbial risk management of drinking water systems. The framework incorporates cost-benefit analysis as a decision support method. The hydrological Soil and Water Assessment Tool (SWAT) model, which was set up for the Stäket catchment area in Sweden, was used to simulate the effects of four different mitigation measures on microbial concentrations. The modelling results showed that the two mitigation measures that resulted in a significant (p < 0.05) reduction of Cryptosporidium spp. and Escherichia coli concentrations were a vegetative filter strip linked to cropland and improved treatment (by one Log10 unit) at the wastewater treatment plants. The mitigation measure with a vegetative filter strip linked to grazing areas resulted in a significant reduction of Cryptosporidium spp., but not of E. coli concentrations. The mitigation measure with enhancing the removal efficiency of all on-site wastewater treatment systems (total removal of 2 Log10 units) did not achieve any significant reduction of E. coli or Cryptosporidium spp. concentrations. The SWAT model was useful when characterising the effect of different mitigation measures on microbial concentrations. Hydrological modelling implemented within an appropriate risk management framework is a key decision support element as it identifies the most efficient alternative for microbial risk reduction.

  16. Evidence-based disease management: its role in cardiovascular risk reduction.

    Science.gov (United States)

    Fanning, Etta L

    2004-01-01

    Cardiovascular disease remains the most pressing healthcare problem in the United States. Traditional risk factors--hypertension, obesity, and diabetes-are still unresolved issues; and new risk factors--pre-diabetes, insulin resistance, and pediatric and adolescent diabetes-have emerged. There is an urgent need to identify the risk factors for cardiovascular disease, and address risk reduction with disease management and treatment for each factor, based on qualitative and quantitative approaches for developing the evidence base for public health action. The objectives of this paper are to review (i) the burden of cardiovascular illness-morbidity, mortality, and cost; (ii) risk factors and the emerging epidemic of adolescent obesity; (iii) the challenges of attaining target endpoints; and (iv) the attributes of a successful programmatic healthcare initiative for potential impact on cardiovascular care and, eventually, public health.

  17. Deconstructing anti-harm-reduction metaphors; mortality risk from falls and other traumatic injuries compared to smokeless tobacco use

    Directory of Open Access Journals (Sweden)

    Bergen Paul

    2006-04-01

    Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.

  18. Tsunami mitigation and preparedness activities in California: Chapter L in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Wilson, Rick; Miller, Kevin H.

    2013-01-01

    Scenario planning and final results associated with the U.S. Geological Survey Science Application for Risk Reduction (SAFRR) tsunami project are providing great benefits to the ongoing tsunami risk-reduction efforts of the California Tsunami Preparedness and Hazard Mitigation Program. This program, led by the California Governor’s Office of Emergency Services and the California Geological Survey, works with coastal communities to improve tsunami preparedness and mitigation at the local level through various efforts, such as improving tsunami hazard analysis, establishing consistent evacuation communications and planning, and leveraging national risk-reduction efforts associated with the National Tsunami Hazard Mitigation Program. The recent 2010 Chilean and 2011 Tohoku tsunamis did not cause notable inundation of dry land in California, but dozens of harbors sustained damages totaling nearly $100 million (Wilson and others, 2012a). Estimates associated with the SAFRR distant tsunami scenario suggest socioeconomic and environmental losses could be even larger. Information gathered from these events and the SAFRR scenario is guiding the development and implementation of new strategies for emergency response, maritime planning, and land-use planning, including a reassessment of the tsunami threat along the California coast;

  19. Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

    Full Text Available BACKGROUND: This study evaluated the relation between adiponectin and atherosclerosis in both genders, and investigated whether adiponectin provides useful additional information for assessing the risk of atherosclerosis. METHODS: We measured serum adiponectin levels and other cardiovascular risk factors in 1033 subjects (454 men, 579 women from the Korean Genomic Rural Cohort study. Carotid intima-media-thickness (CIMT was used as measure of atherosclerosis. Odds ratios (ORs with 95% confidence intervals (95% CI were calculated using multiple logistic regression, and receiver operating characteristic curves (ROC, the category-free net reclassification improvement (NRI and integrated discrimination improvement (IDI were calculated. RESULTS: After adjustment for conventional cardiovascular risk factors, such as age, waist circumference, smoking history, low-density and high-density lipoprotein cholesterol, triglycerides, systolic blood pressure and insulin resistance, the ORs (95%CI of the third tertile adiponectin group were 0.42 (0.25-0.72 in men and 0.47 (0.29-0.75 in women. The area under the curve (AUC on the ROC analysis increased significantly by 0.025 in men and 0.022 in women when adiponectin was added to the logistic model of conventional cardiovascular risk factors (AUC in men: 0.655 to 0.680, p = 0.038; AUC in women: 0.654 to 0.676, p = 0.041. The NRI was 0.32 (95%CI: 0.13-0.50, p<0.001, and the IDI was 0.03 (95%CI: 0.01-0.04, p<0.001 for men. For women, the category-free NRI was 0.18 (95%CI: 0.02-0.34, p = 0.031 and the IDI was 0.003 (95%CI: -0.002-0.008, p = 0.189. CONCLUSION: Adiponectin and atherosclerosis were significantly related in both genders, and these relationships were independent of conventional cardiovascular risk factors. Furthermore, adiponectin provided additional information to conventional cardiovascular risk factors regarding the risk of atherosclerosis.

  20. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    Science.gov (United States)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  1. A CONCEPTUAL DISASTER RISK REDUCTION FRAMEWORK FOR HEALTH AND SAFETY HAZARDS IN THE CONSTRUCTION INDUSTRY

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    Amir S. GOHARDANI

    2013-06-01

    Full Text Available The health and safety hazard status of construction workers is constantly challenged by the projects in the built environment. In this article, various aspects of health and safety hazards for construction workers have been reviewed and investigated through a disaster risk reduction prism. This approach has further led to the perception of glancing at the construction sector as an ongoing disaster zone and equally provides a new management perspective. From this perspective, the occurrence of a disaster within the construction sector corresponds to the temporary or permanent ill-health or death of a construction worker. Geographical location is one of the factors that play an important role in addressing the health and safety hazards for construction workers. In addition to the location, geographical considerations equally encapsulate regional, cultural, governmental and work ethical effects. These effects may potentially contribute to disparities in the construction sector. With an increasing level of understanding for health and safety hazards in the construction domain, more efficient prevention measures can be taken in order to enable a disaster management cycle, capable of responding to the rigorous demands of the construction sector.

  2. Natural hazards and risk reduction in Hawai'i: Chapter 10 in Characteristics of Hawaiian volcanoes

    Science.gov (United States)

    Kauahikaua, James P.; Tilling, Robert I.; Poland, Michael P.; Takahashi, T. Jane; Landowski, Claire M.

    2014-01-01

    Significant progress has been made over the past century in understanding, characterizing, and communicating the societal risks posed by volcanic, earthquake, and tsunami hazards in Hawai‘i. The work of the Hawaiian Volcano Observatory (HVO), with a century-long commitment to serving the public with credible hazards information, contributed substantially to this global progress. Thomas A. Jaggar, Jr., HVO’s founder, advocated that a scientific approach to understanding these hazards would result in strategies to mitigate their damaging effects. The resultant hazard-reduction methods range from prediction of eruptions and tsunamis, thereby providing early warnings for timely evacuation (if needed), to diversion of lava flows away from high-value infrastructure, such as hospitals. In addition to long-term volcano monitoring and multifaceted studies to better understand eruptive and seismic phenomena, HVO has continually and effectively communicated—through its publications, Web site, and public education/outreach programs—hazards information to emergency-management authorities, news media, and the public.

  3. Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception.

    Science.gov (United States)

    Huang, Hui-Ya; Huang, Xiao-Zhong; Han, Yi-Jiang; Zhu, Li-Bin; Huang, Kai-Yu; Lin, Jing; Li, Zhong-Rong

    2017-05-01

    Intestinal necrosis is the most serious complication of intussusception. The risk factors associated with intestinal necrosis in pediatric patients with intussusception have not been well characterized. This study aimed to investigate the risk factors associated with intestinal necrosis in pediatric patients with failed non-surgical reduction for intussusception. Hospitalized patients who failed the air-enema reduction for intussusception in the outpatient department and subsequently underwent surgery were retrospectively reviewed. All cases were categorized into two groups: intestinal necrosis group and non-intestinal necrosis group based on the surgical findings. Demographic and clinical features including the findings from the surgery were recorded and analyzed. Factors associated with intestinal necrosis were analyzed using univariate and multivariate unconditional logistic regression analyses. A total of 728 cases were included. Among them, 171 had intestinal necrosis at the time of surgery. The group with intestinal necrosis had a longer duration of symptom or length of illness (P = 0.000), and younger (P = 0.000) than the non-intestinal necrosis group. Complex/compound type of intussusceptions is more likely to have intestinal necrosis. Multivariate analysis showed that the presence of grossly bloody stool (OR = 2.12; 95% CI 1.19-3.76, P = 0.010) and duration of symptom (OR = 1.07; 95% CI 1.06-1.08, P = 0.000) were independent risk factors for intestinal necrosis in patients hospitalized for surgical reduction for intussusceptions. At time of admission, the presence of bloody stools and duration of symptom are the important risk factors for developing intestinal necrosis for those patients who failed non-surgical reduction. The length of illness has the highest sensitivity and specificity to correlate with intestinal necrosis. This finding may suggest that we should take the intussusception cases that have the longer duration of

  4. Promoting flood risk reduction: The role of insurance in Germany and England

    Science.gov (United States)

    Surminski, Swenja; Thieken, Annegret H.

    2017-10-01

    Improving society's ability to prepare for, respond to and recover from flooding requires integrated, anticipatory flood risk management (FRM). However, most countries still focus their efforts on responding to flooding events if and when they occur rather than addressing their current and future vulnerability to flooding. Flood insurance is one mechanism that could promote a more ex ante approach to risk by supporting risk reduction activities. This paper uses an adapted version of Easton's System Theory to investigate the role of insurance for FRM in Germany and England. We introduce an anticipatory FRM framework, which allows flood insurance to be considered as part of a broader policy field. We analyze if and how flood insurance can catalyze a change toward a more anticipatory approach to FRM. In particular we consider insurance's role in influencing five key components of anticipatory FRM: risk knowledge, prevention through better planning, property-level protection measures, structural protection and preparedness (for response). We find that in both countries FRM is still a reactive, event-driven process, while anticipatory FRM remains underdeveloped. Collaboration between insurers and FRM decision-makers has already been successful, for example in improving risk knowledge and awareness, while in other areas insurance acts as a disincentive for more risk reduction action. In both countries there is evidence that insurance can play a significant role in encouraging anticipatory FRM, but this remains underutilized. Effective collaboration between insurers and government should not be seen as a cost, but as an investment to secure future insurability through flood resilience.

  5. A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women.

    Science.gov (United States)

    Stewart, Jennifer M; Rogers, Christopher K; Bellinger, Dawn; Thompson, Keitra

    2016-07-01

    HIV/AIDS has a devastating impact on African Americans, particularly women and young adults. We sought to characterize risks, barriers, and content and delivery needs for a faith-based intervention to reduce HIV risk among African American women ages 18 to 25. In a convergent parallel mixed methods study, we conducted four focus groups (n = 38) and surveyed 71 young adult women. Data were collected across four African American churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting, and financial burdens into faith-based HIV risk-reduction interventions. Incorporating additional social context-related factors into HIV risk-reduction interventions for young African American women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings. © The Author(s) 2016.

  6. Development of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction Scale

    Directory of Open Access Journals (Sweden)

    Sarang Kim

    2014-06-01

    Full Text Available Background and Aims: It is not yet understood how attitudes concerning dementia risk may affect motivation to change health behaviours and lifestyle. This study was designed to develop a reliable and valid theory-based measure to understand beliefs underpinning the lifestyle and health behavioural changes needed for dementia risk reduction. Methods: 617 participants aged ≥50 years completed a theory-based questionnaire, namely, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR scale. The MCLHB-DRR consists of 53 items, reflecting seven subscales of the Health Belief Model. Results: Confirmatory factor analysis was performed and revealed that a seven-factor solution with 27 items fitted the data (comparative fit index = 0.920, root-mean-square error of approximation = 0.047 better than the original 53 items. Internal reliability (α = 0.608-0.864 and test-retest reliability (α = 0.552-0.776 were moderate to high. Measurement of invariance across gender and age was also demonstrated. Conclusions: These results propose that the MCLHB-DRR is a useful tool in assessing the beliefs and attitudes of males and females aged ≥50 years towards dementia risk reduction. This measure can be used in the development and evaluation of interventions aimed at dementia prevention.

  7. HIV RISK REDUCTION INTERVENTIONS AMONG SUBSTANCE-ABUSING REPRODUCTIVE-AGE WOMEN: A SYSTEMATIC REVIEW

    Science.gov (United States)

    Weissman, Jessica; Kanamori, Mariano; Dévieux, Jessy G.; Trepka, Mary Jo; De La Rosa, Mario

    2017-01-01

    HIV/AIDS is one of the leading causes of death among reproductive-age women throughout the world, and substance abuse plays a major role in HIV infection. We conducted a systematic review, in accordance with the 2015 Preferred Items for Reporting Systematic Reviews and Meta-analysis tool, to assess HIV risk-reduction intervention studies among reproductive-age women who abuse substances. We initially identified 6,506 articles during our search and, after screening titles and abstracts, examining articles in greater detail, and finally excluding those rated methodologically weak, a total of 10 studies were included in this review. Studies that incorporated behavioral skills training into the intervention and were based on theoretical model(s) were the most effective in general at decreasing sex and drug risk behaviors. Additional HIV risk-reduction intervention research with improved methodological designs is warranted to determine the most efficacious HIV risk-reduction intervention for reproductive-age women who abuse substances. PMID:28467160

  8. Risk classification priorities in an emergency unit and outcomes of the service provided

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    Rafael Silva Marconato

    2017-12-01

    Full Text Available ABSTRACT Objective: to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method: observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge based on the information recorded in the emergency bulletin. Results: the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion: the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.

  9. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction

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    Cochrane Thomas

    2012-11-01

    Full Text Available Abstract Background The global burden of the major vascular diseases is projected to rise and to remain the dominant non-communicable disease cluster well into the twenty first century. The Department of Health in England has developed the NHS Health Check service as a policy initiative to reduce population vascular disease risk. The aims of this study were to monitor population changes in cardiovascular disease (CVD risk factors over the first year of the new service and to assess the value of tailored lifestyle support, including motivational interview with ongoing support and referral to other services. Methods Randomised trial comparing NHS Health Check service only with NHS Health Check service plus additional lifestyle support in Stoke on Trent, England. Thirty eight general practices and 601 (365 usual care, 236 additional lifestyle support patients were recruited and randomised independently between September 2009 and February 2010. Changes in population CVD risk between baseline and one year follow-up were compared, using intention-to-treat analysis. The primary outcome was the Framingham 10 year CVD risk score. Secondary outcomes included individual modifiable risk measures and prevalence of individual risk categories. Additional lifestyle support included referral to a lifestyle coach and free sessions as needed for: weight management, physical activity, cook and eat and positive thinking. Results Average population CVD risk decreased from 32.9% to 29.4% (p Conclusions The NHS Health Check service in Stoke on Trent resulted in significant reduction in estimated population CVD risk. There was no evidence of further benefit of the additional lifestyle support services in terms of absolute CVD risk reduction.

  10. Risk prediction and risk reduction in patients with manifest arterial disease

    NARCIS (Netherlands)

    Goessens, B.M.B.; Goessens, B.M.B.

    2006-01-01

    Risicovoorspelling en risicoverlaging bij patienten met manifest vaatlijden Engelstalig abstract The number of patients with clinical manifest arterial disease is increasing because of the aging of the population. Patients with manifest arterial disease have an increased risk of a new vascular event

  11. A practical approach to assess depression risk and to guide risk reduction strategies in later life

    NARCIS (Netherlands)

    Almeida, O.P.; Alfonso, H.; Pirkis, J; Kerse, N.; Sim, M.; Flicker, L.; Snowdon, J.; Draper, B.; Byrne, G.; Goldney, R.; Lautenschlager, N.T.; Stocks, N.; Scazufca, M.; Huisman, M.; Araya, R.; Pfaff, J.

    2011-01-01

    Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors

  12. Barriers to Knowledge Translation Regarding the Use of Probiotics as a Risk-Reduction Strategy for Necrotizing Enterocolitis.

    Science.gov (United States)

    Anderson, Sharon

    2016-08-01

    Increasingly, evidence supports enteral probiotics are an important risk-reduction strategy for necrotizing enterocolitis (NEC) among very low birth-weight and extremely low birth-weight preterm infants. Yet, the majority of providers remain reluctant to implement practice changes. The aim of this study was to better understand the discrepancy between the available evidence and clinical practice regarding the use of probiotics and other NEC prevention strategies in New Jersey. Using an exploratory descriptive design, a multimodal interprofessional survey was developed and executed to elicit intensive care nursery provider knowledge, views, and current practice. Although the sample size was small (N = 29), approximately one-half of respondents familiar with the literature rated the quality of the evidence regarding probiotics as "above average" to "excellent." These respondents were "very likely" to "extremely likely" to recommend probiotics as an NEC prevention strategy; however, none actually prescribed this intervention. The most important reason respondents did not prescribe probiotics was the focus on providing exclusive maternal and donor breast milk feedings. Other confounding factors included provision of oral colostrum care, standardized feeding protocols, and withholding feedings during blood transfusion. Study results suggested that some providers (primarily nurses) were not familiar with probiotic literature, which may contribute to deficits in knowledge translation to practice. Areas for future study include identifying improved mechanisms for knowledge dissemination, recognizing and addressing barriers and facilitators to knowledge translation, and understanding how probiotics fit and/or contrast with other NEC risk-reduction strategies in the research and clinical settings.

  13. The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes.

    Science.gov (United States)

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

    2014-12-01

    Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2,564 grade 10 students and their parents in the Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention that should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs.

  14. The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes

    Science.gov (United States)

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

    2014-01-01

    Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2564 grade 10 students and their parents in The Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention which should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs. PMID:25490732

  15. A model program: neonatal nurse practitioners providing community health care for high-risk infants.

    Science.gov (United States)

    Vasquez, Elias Provencio; Pitts, Kathleen; Mejia, Nilson Enrique

    2008-01-01

    Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long-term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high-risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary-- and tertiary--level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.

  16. RAPID EXPOSURE ASSESSMENT OF NATIONWIDE RIVER FLOOD FOR DISASTER RISK REDUCTION

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    Y. Kwak

    2016-06-01

    Full Text Available considerably increased. For flood disaster risk reduction, it is important to identify and characterize flood area, locations (particularly lowland along rivers, and durations. For this purpose, flood mapping and monitoring are an imperative process and the fundamental part of risk management as well as emergency response. Our ultimate goal is to detect flood inundation areas over a nationwide scale despite limitations of optical and multispectral images, and to estimate flood risk in terms of affected people. We propose a methodological possibility to be used as a standard approach for nationwide rapid flood exposure assessment with the use of the multi-temporal Moderate Resolution Imaging Spectrometer (MODIS, a big contributor to progress in near-real-time flood mapping. The preliminary results in Bangladesh show that a propensity of flood risk change strongly depends on the temporal and spatial dynamics of exposure such as distributed population.

  17. Integrating climate change adaptation into disaster risk reduction in urban contexts: perceptions and practice.

    Science.gov (United States)

    Rivera, Claudia

    2014-01-15

    This paper analyses the perceptions of disaster risk reduction (DRR) practitioners concerning the on-going integration of climate change adaptation (CCA) into their practices in urban contexts in Nicaragua. Understanding their perceptions is important as this will provide information on how this integration can be improved. Exploring the perceptions of practitioners in Nicaragua is important as the country has a long history of disasters, and practitioners have been developing the current DRR planning framework for more than a decade. The analysis is based on semi-structured interviews designed to collect information about practitioners' understanding of: (a) CCA, (b) the current level of integration of CCA into DRR and urban planning, (c) the opportunities and constraints of this integration, and (d) the potential to adapt cities to climate change. The results revealed that practitioners' perception is that the integration of CCA into their practice is at an early stage, and that they need to improve their understanding of CCA in terms of a development issue. Three main constraints on improved integration were identified: (a) a recognized lack of understanding of CCA, (b) insufficient guidance on how to integrate it, and (c) the limited opportunities to integrate it into urban planning due to a lack of instruments and capacity in this field. Three opportunities were also identified: (a) practitioners' awareness of the need to integrate CCA into their practices, (b) the robust structure of the DRR planning framework in the country, which provides a suitable channel for facilitating integration, and (c) the fact that CCA is receiving more attention and financial and technical support from the international community.

  18. Breast cancer risk reduction options: awareness, discussion, and use among women from four ethnic groups.

    Science.gov (United States)

    Kaplan, Celia Patricia; Haas, Jennifer S; Pérez-Stable, Eliseo J; Gregorich, Steven E; Somkin, Carol; Des Jarlais, Genevieve; Kerlikowske, Karla

    2006-01-01

    With recent advances in breast cancer risk reduction practices, it is increasingly important to assess both the breadth of and disparities in use across different racial/ethnic groups. We conducted telephone interviews with 1,700 women ages 40 to 74, from four racial/ethnic groups, without prior history of breast cancer, who received mammograms at one of five mammography facilities in San Francisco. Main outcomes measured included recognition of tamoxifen, raloxifene, genetic testing, and prophylactic surgery. Global indicators (recognition of any therapy, discussion of breast cancer risk) were developed from original outcome measures and analyzed using logistic regression. Multivariate analyses indicate that race/ethnicity and interview language affected recognition of therapies and discussion of risk. White women were more likely than all other women to recognize any therapy and more likely than Asian-Americans to discuss risk. Women at high risk, who had a prior abnormal mammogram, who perceived themselves to be at high risk, or who were exposed to breast health information were more likely to discuss risk. Women are aware of preventive therapies, although discussion and use is limited. Interventions to increase use of therapies should focus on those at high risk. (Cancer Epidemiol Biomarkers Prev 2006;15(1):162-6).

  19. Relationship among Food-Safety Knowledge, Beliefs, and Risk-Reduction Behavior in University Students in Japan

    Science.gov (United States)

    Takeda, Sayaka; Akamatsu, Rie; Horiguchi, Itsuko; Marui, Eiji

    2011-01-01

    Objective: To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. Design: Cross-sectional research using a questionnaire that included food-safety knowledge, perceptions, risk-reduction behavior, stages for the selection of safer food based on the Transtheoretical Model, and…

  20. Disaster Risk Reduction and Climate Change Adaptation—A Sustainable Development Systems Perspective

    Directory of Open Access Journals (Sweden)

    Tom R. Burns

    2017-02-01

    Full Text Available This article considers the concepts of sustainability and sustainable development in relation to disaster risk reduction and climate change adaptation. We conceptualize sustainability from a social systemic perspective, that is, from a perspective that encompasses the multiple functionalities of a social system and their interrelationships in particular environmental contexts. The systems perspective is applied in our consideration and analysis of disaster risk reduction (DRR, climate change adaptation (CCA, and sustainable development (SD. Section “Sustainability and Sustainable Development” introduces briefly sustainability and sustainable development, followed by a brief presentation of the theory of complex social systems (Section “Social System Model”. The theory conceptualizes interdependent subsystems, their multiple functionalities, and the agential and systemic responses to internal and external stressors on a social system. Section “Case Studies of Response to Stressors” considers disaster risk reduction (DRR and climate change adaptation (CCA, emerging in response to one or more systemic stressors. It illustrates these with disaster risk reduction in the cases of food and chemical security regulation in the EU. CCA is illustrated by initiatives and developments on the island of Gotland, Sweden and in the Gothenburg Metropolitan area, which go beyond a limited CCA perspective, taking into account long-term sustainability issues. Section “Sustainable Development as a Societal Development System” discusses the limitations of DRR and CCA, not only their technical limitations but economic, socio-cultural, and political limitations, as informed from a sustainability perspective. It is argued that DRRs are only partial subsystems and must be considered and assessed in the context of a more encompassing systemic perspective. Part of the discussion is focused on the distinction between sustainable and non-sustainable DRRs and

  1. Exploring disaster risk reduction and climate change adaptation from a gender perspective. Insights from Ladakh, India

    OpenAIRE

    Le Masson, Virginie

    2013-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Both Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) aim at reducing the vulnerabilities and enhancing the capacities of men and women when facing natural hazards and climate change. Despite conceptual bridges existing between both sectors, the literature suggests a lack of practical integration of objectives and approaches in the design and implementation of climate change-...

  2. Ethical Responsibility of Governance for Integrating Disaster Risk Reduction with Development

    Science.gov (United States)

    Parkash Gupta, Surya

    2015-04-01

    The development in the public as well as the private sectors is controlled and regulated, directly or indirectly by the governments at federal, provincial and local levels. If this development goes haphazard and unplanned, without due considerations to environmental constraints and potential hazards; it is likely to cause disasters or may get affected by disasters. Therefore, it becomes an ethical responsibility of the people involved in governance sector to integrate disaster risk reduction with development in their administrative territories through enforcement of appropriate policies, guidelines and regulatory mechanisms. Such mechanisms should address the social, scientific, economic, environmental, and legal requirements that play significant role in planning, implementation of developmental activities as well as disaster management. The paper focuses on defining the ethical responsibilities for the governance sector for integrating disaster risk reduction with development. It highlights the ethical issues with examples from two case studies, one from the Uttarakhand state and the other Odhisa state in India. The case studies illustrates how does it make a difference in disaster risk reduction if the governments own or do not own ethical responsibilities. The paper considers two major disaster events, flash floods in Uttarakhand state and Cyclone Phailin in Odhisa state, that happened during the year 2013. The study points out that it makes a great difference in terms of consequences and response to disasters when ethical responsibilities are owned by the governance sector. The papers attempts to define these ethical responsibilities for integrating disaster risk reduction with development so that the governments can be held accountable for their acts or non-actions.

  3. HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months.

    Science.gov (United States)

    Jemmott, John B; Jemmott, Loretta S; O'Leary, Ann; Ngwane, Zolani; Lewis, David A; Bellamy, Scarlett L; Icard, Larry D; Carty, Craig; Heeren, G Anita; Tyler, Joanne C; Makiwane, Monde B; Teitelman, Anne

    2015-06-01

    Little research has tested HIV/sexually transmitted infection (STI) risk-reduction interventions' effects on early adolescents as they age into middle and late adolescence. This study tested whether intervention-induced reductions in unprotected intercourse during a 12-month period endured over a 54-month period and whether the intervention reduced the prevalence of STIs, which increase risk for HIV. Grade 6 learners (mean age = 12.4 years) participated in a 12-month trial in Eastern Cape Province, South Africa, in which 9 matched pairs of schools were randomly selected and within pairs randomized to a theory-based HIV/STI risk-reduction intervention or an attention-control intervention. They completed 42- and 54-month postintervention measures of unprotected intercourse (the primary outcome), other sexual behaviors, theoretical constructs, and, at 42- and 54-month follow-up only, biologically confirmed curable STIs (chlamydial infection, gonorrhea, and trichomoniasis) and herpes simplex virus 2. The HIV/STI risk-reduction intervention reduced unprotected intercourse averaged over the entire follow-up period (OR = 0.42, 95% CI [0.22, 0.84]), an effect not significantly reduced at 42- and 54-month follow-up compared with 3-, 6-, and 12-month follow-ups. The intervention caused positive changes on theoretical constructs averaged over the 5 follow-ups, although most effects weakened at long-term follow-up. Although the intervention's main effect on STIs was nonsignificant, an Intervention Condition × Time interaction revealed that it significantly reduced curable STIs at 42-month follow-up in adolescents who reported sexual experience. These results suggest that theory-based behavioral interventions with early adolescents can have long-lived effects in the context of a generalized severe HIV epidemic. (c) 2015 APA, all rights reserved).

  4. Participatory three dimensional mapping for the preparation of landslide disaster risk reduction program

    Science.gov (United States)

    Kusratmoko, Eko; Wibowo, Adi; Cholid, Sofyan; Pin, Tjiong Giok

    2017-07-01

    This paper presents the results of applications of participatory three dimensional mapping (P3DM) method for fqcilitating the people of Cibanteng' village to compile a landslide disaster risk reduction program. Physical factors, as high rainfall, topography, geology and land use, and coupled with the condition of demographic and social-economic factors, make up the Cibanteng region highly susceptible to landslides. During the years 2013-2014 has happened 2 times landslides which caused economic losses, as a result of damage to homes and farmland. Participatory mapping is one part of the activities of community-based disaster risk reduction (CBDRR)), because of the involvement of local communities is a prerequisite for sustainable disaster risk reduction. In this activity, participatory mapping method are done in two ways, namely participatory two-dimensional mapping (P2DM) with a focus on mapping of disaster areas and participatory three-dimensional mapping (P3DM) with a focus on the entire territory of the village. Based on the results P3DM, the ability of the communities in understanding the village environment spatially well-tested and honed, so as to facilitate the preparation of the CBDRR programs. Furthermore, the P3DM method can be applied to another disaster areas, due to it becomes a medium of effective dialogue between all levels of involved communities.

  5. Social Participation and Disaster Risk Reduction Behaviors in Tsunami Prone Areas.

    Directory of Open Access Journals (Sweden)

    Nopphol Witvorapong

    Full Text Available This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1 following disaster-related news closely, (2 preparing emergency kits and/or having a family emergency plan, and (3 having an intention to migrate and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation.

  6. Social Participation and Disaster Risk Reduction Behaviors in Tsunami Prone Areas.

    Science.gov (United States)

    Witvorapong, Nopphol; Muttarak, Raya; Pothisiri, Wiraporn

    2015-01-01

    This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1) following disaster-related news closely, (2) preparing emergency kits and/or having a family emergency plan, and (3) having an intention to migrate) and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation.

  7. Takotsubo Cardiomyopathy: A Long Term Follow-up Shows Benefit with Risk Factor Reduction

    Directory of Open Access Journals (Sweden)

    Koroush Khalighi

    2015-11-01

    Full Text Available Only sparse data was available on long-term of Takotusbo Cardiomyopathy (TC. Previous studies suggested prognosis is not necessarily benign. We report the long-term follow-up of 12 TC patients actively managed with risk factor reduction. Retrospective analysis of all patients diagnosed with TC at our hospital between 1998 and 2010. We identified 12 patients with TC among 1651 cases of emergent left heart catheterization over 12 years. Mean follow-up time was 8.3 ± 3.6 years. All were female, 87% had hypertension, 25% had history of Coronary Artery Disease (CAD, 67% had hyperlipidemia, 44% had some preceding emotional trauma, and 44% had some physical/physiological stress. Previous studies have shown that over 50% of TC patients experience future cardiac events, and 10% have a recurrence of TC. Patients were prescribed therapeutic lifestyle changes (TLC and guideline directed medical therapy (GDMT for aggressive risk factor reduction. TLC included diet, exercise, and cardiac rehabilitation. GDMT often included aspirin, beta-blockers, ACE-inhibitors, and statins. Follow-up echocardiograms showed recovery and maintenance of the ejection fraction. There was no cardiac mortality and no recurrences of TC. Aggressive risk factor reduction with TLC and GDMT may be effective in improving the long term outcomes of patients with TC.

  8. Disaster risk reduction education in Indonesia: challenges and recommendations for scaling up

    Science.gov (United States)

    Amri, Avianto; Bird, Deanne K.; Ronan, Kevin; Haynes, Katharine; Towers, Briony

    2017-04-01

    This article investigates the implementation of disaster risk reduction education for children in Indonesia. In the last decade, education programmes related to this subject have been promoted as capable of reducing disaster losses and increasing resilience, based on several studies that have identified positive outcomes. Therefore, it is critical to evaluate and address any potential challenges that might impede their success. The article uses a case study in Jakarta, a rapidly growing megacity that is highly prone to disasters and natural hazards, especially floods and fires, to explore the scaling up and sustainability of disaster risk reduction in Indonesian schools. Based on previous studies, a new approach was developed for evaluating the implementation of education programmes related to these subjects. This study captured the perspectives of children, school personnel, and non-governmental organisations on the challenges of scaling up the implementation of disaster risk reduction education in schools. The study revealed seven key issues and suggests several policy recommendations to move forward. These key issues may also be apparent in many other developing and developed countries, and the suggested recommendations may well be applicable beyond Indonesia.

  9. Developmental windows of breast cancer risk provide opportunities for targeted chemoprevention

    Science.gov (United States)

    Martinson, Holly A.; Lyons, Traci R.; Giles, Erin D.; Borges, Virginia F.; Schedin, Pepper

    2014-01-01

    The magnitude of the breast cancer problem implores researchers to aggressively investigate prevention strategies. However, several barriers currently reduce the feasibility of breast cancer prevention. These barriers include the inability to accurately predict future breast cancer diagnosis at the individual level, the need for improved understanding of when to implement interventions, uncertainty with respect to optimal duration of treatment, and negative side effects associated with currently approved chemoprevention therapies. None-the-less, the unique biology of the mammary gland, with its postnatal development and conditional terminal differentiation, may permit the resolution of many of these barriers. Specifically, lifecycle-specific windows of breast cancer risk have been identified that may be amenable to risk-reducing strategies. Here, we argue for prevention research focused on two of these lifecycle windows of risk: postpartum mammary gland involution and peri-menopause. We provide evidence that these windows are highly amenable to targeted, limited duration treatments. Such approaches could result in the prevention of postpartum and postmenopausal breast cancers, correspondingly. PMID:23664839

  10. Hand contamination of anesthesia providers is an important risk factor for intraoperative bacterial transmission.

    Science.gov (United States)

    Loftus, Randy W; Muffly, Matthew K; Brown, Jeremiah R; Beach, Michael L; Koff, Matthew D; Corwin, Howard L; Surgenor, Stephen D; Kirkland, Kathryn B; Yeager, Mark P

    2011-01-01

    We have recently shown that intraoperative bacterial transmission to patient IV stopcock sets is associated with increased patient mortality. In this study, we hypothesized that bacterial contamination of anesthesia provider hands before patient contact is a risk factor for direct intraoperative bacterial transmission. Dartmouth-Hitchcock Medical Center is a tertiary care and level 1 trauma center with 400 inpatient beds and 28 operating suites. The first and second operative cases in each of 92 operating rooms were randomly selected for analysis. Eighty-two paired samples were analyzed. Ten pairs of cases were excluded because of broken or missing sampling protocol and lost samples. We identified cases of intraoperative bacterial transmission to the patient IV stopcock set and the anesthesia environment (adjustable pressure-limiting valve and agent dial) in each operating room pair by using a previously validated protocol. We then used biotype analysis to compare these transmitted organisms to those organisms isolated from the hands of anesthesia providers obtained before the start of each case. Provider-origin transmission was defined as potential pathogens isolated in the patient stopcock set or environment that had an identical biotype to the same organism isolated from hands of providers. We also assessed the efficacy of the current intraoperative cleaning protocol by evaluating isolated potential pathogens identified at the start of case 2. Poor intraoperative cleaning was defined as 1 or more potential pathogens found in the anesthesia environment at the start of case 2 that were not there at the beginning of case 1. We collected clinical and epidemiological data on all the cases to identify risk factors for contamination. One hundred sixty-four cases (82 case pairs) were studied. We identified intraoperative bacterial transmission to the IV stopcock set in 11.5 % (19/164) of cases, 47% (9/19) of which were of provider origin. We identified intraoperative

  11. Risk management in providing specialized care for people living with AIDS.

    Science.gov (United States)

    Leadebal, Oriana Deyze Correia Paiva; Medeiros, Leidyanny Barbosa de; Morais, Kalline Silva de; Nascimento, João Agnaldo do; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida

    2016-01-01

    Analyzing the provision of actions related to managing clinical risk in managing specialized care for people living with AIDS. A cross-sectional study carried out in a reference outpatient clinic in Paraíba, with a sample of 150 adults with AIDS. Data were collected through primary and secondary sources using a structured questionnaire, analyzed using descriptive statistics, multiple correspondence analysis and logistic regression model to determine the association between "providing care" and "clinical risk." Actions with satisfactory provision express a biological care focus; the dimensions that most contributed to a satisfactory assessment of care provision were "clinical and laboratory evaluations" and "prevention and self-care incentivization"; 45.3% of participants were categorized into high clinical risk, 34% into average clinical risk, and 20.7% into low clinical risk; a positive association between providing care and clinical risk was found. The need to use risk classification technologies to direct the planning of local care provision became evident considering its requirements, and thus qualifying the care provided in these areas. Analisar a oferta de ações relacionadas ao manejo de risco clínico na gestão do cuidado especializado a pessoas vivendo com aids. Estudo transversal realizado em ambulatório de referência na Paraíba, com amostra de 150 adultos com aids. Os dados foram coletados por meio de fontes primárias e secundárias utilizando-se de formulário estruturado, e analisados através de estatística descritiva, análise de correspondência múltipla e modelo de regressão logística para averiguar a associação entre "oferta" e "risco clínico". As ações de oferta satisfatória expressam foco biologicista do cuidado; as dimensões que mais contribuíram para o julgamento satisfatório da oferta foram "avaliação clínica e laboratorial" e "prevenção e estímulo ao autocuidado"; 45,3% dos participantes foram categorizados em risco

  12. Improving access to comprehensive injury risk assessment and risk factor reduction in older adult populations.

    Science.gov (United States)

    Pressley, Joyce C; Barlow, Barbara; Quitel, Lodze; Jafri, Aisha

    2007-04-01

    Preventing injuries in older populations (aged 50-86 years) is more complex than in younger populations because of frailty, comorbidities, polypharmacy, and physical and cognitive functional limitations. To improve accessibility and delivery of comprehensive, focused injury prevention, we developed a model incorporating applicable features of our national children's program with additional elements to address challenges of older populations. The older adult injury prevention model addresses gaps in prevention by improving access to risk factor screening, safety devices, education, counseling, medical care, and referrals.

  13. Alcoholism Risk Reduction in France: A Modernised Approach Related to Alcohol Misuse Disorders

    Directory of Open Access Journals (Sweden)

    Georges Brousse

    2014-11-01

    Full Text Available During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption.

  14. Reading and Writing as Risk-Reduction: The School's Role in Preventing Teenage Pregnancies.

    Science.gov (United States)

    Pittman, Karen J.

    1989-01-01

    Schools can reduce teenage pregnancy by providing specific sex education, counseling, and health services, and by improving schooling for high risk students. Emphasizes early childhood education and alternative programs for pregnant adolescents and adolescent parents. (FMW)

  15. Sheltering risks: Implementation of harm reduction in homeless shelters during an overdose emergency.

    Science.gov (United States)

    Wallace, Bruce; Barber, Katrina; Pauly, Bernadette Bernie

    2017-12-28

    The current opioid overdose crisis in North America is heightening awareness of the need for and the challenges of implementing harm reduction, notably within complex and diverse settings such as homeless shelters. In this paper, we explore the implementation of harm reduction in homeless shelters during an emerging overdose emergency. The objective of this qualitative study was to identify and understand micro-environment level factors within emergency shelters responding to homelessness and substance use, and the macro-level influences that produce and sustain structural vulnerabilities. We conducted eight focus groups with a total of 49 participants during an emerging overdose emergency. These included shelter residents (n = 23), shelter staff (n = 13), and harm reduction workers (n = 13). The findings illustrate the challenges of implementing an overdose response when substance use is prohibited onsite, without an expectation of abstinence, and where harm reduction services are limited to the distribution of supplies. In this context, harm reduction is partially implemented and incomplete. Shelters can be a site of risks and trauma for residents and staff due to experiencing, witnessing, and responding to overdoses. The current overdose crisis heightens the challenges of implementing harm reduction, particularly within complex and diverse settings such as homeless shelters. When harm reduction is limited to the distribution of supplies such as clean equipment and naloxone, important principles of engagement and the development of trust necessary to the provision of services are overlooked with negative implications for service users. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Pre-Launch GOES-R Risk Reduction Activities for the Geostationary Lightning Mapper

    Science.gov (United States)

    Goodman, S. J.; Blakeslee, R. J.; Boccippio, D. J.; Christian, H. J.; Koshak, W. J.; Petersen, W. A.

    2005-01-01

    The GOES-R Geostationary Lightning Mapper (GLM) is a new instrument planned for GOES-R that will greatly improve storm hazard nowcasting and increase warning lead time day and night. Daytime detection of lightning is a particularly significant technological advance given the fact that the solar illuminated cloud-top signal can exceed the intensity of the lightning signal by a factor of one hundred. Our approach is detailed across three broad themes which include: Data Processing Algorithm Readiness, Forecast Applications, and Radiance Data Mining. These themes address how the data will be processed and distributed, and the algorithms and models for developing, producing, and using the data products. These pre-launch risk reduction activities will accelerate the operational and research use of the GLM data once GOES-R begins on-orbit operations. The GLM will provide unprecedented capabilities for tracking thunderstorms and earlier warning of impending severe and hazardous weather threats. By providing direct information on lightning initiation, propagation, extent, and rate, the GLM will also capture the updraft dynamics and life cycle of convective storms, as well as internal ice precipitation processes. The GLM provides information directly from the heart of the thunderstorm as opposed to cloud-top only. Nowcasting applications enabled by the GLM data will expedite the warning and response time of emergency management systems, improve the dispatch of electric power utility repair crews, and improve airline routing around thunderstorms thereby improving safety and efficiency, saving fuel and reducing delays. The use of GLM data will assist the Bureau of Land Management (BLM) and the Forest Service in quickly detecting lightning ground strikes that have a high probability of causing fires. Finally, GLM data will help assess the role of thunderstorms and deep convection in global climate, and will improve regional air quality and global chemistry/climate modeling

  17. EXAMINATION OF COMPACT LAYOUT CITY MEASURE THAT CONSIDERS CHANGE OF TRAVEL BEHAVIOR BE FORE AND AFTER RELOCATION AND THE INFLUENCE OF PROVIDING INFO RMATION FOR CAR USE REDUCTION

    Science.gov (United States)

    Nakamichi, Kumiko; Murao, Toshimichi; Yoshiura, Keiko; Taniguchi, Mamoru

    In recent years, numerous municipalities have anno unced plans for promoting compact city. However, even if the citizens that have car dependent lifestyle move from suburbs to city center, not all of them simply abandon that kind of lifestyle. An objective of this study is to clarify the effect of the compact layout city for reduction of environmental load by tr ansportation. The effect is analyzed considering the change condition of travel behavior before and after relocation and the influence of providing information for car use reduction by using research data conduc ted in the satelite cities in metropolitan area. It was clarified that providing information continuously and making an effort for car use reduction produce the desirable effect of CO2 reduction.

  18. Geothermal Risk Reduction via Geothermal/Solar Hybrid Power Plants. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Wendt, Daniel [Idaho National Lab. (INL), Idaho Falls, ID (United States); Mines, Greg [Idaho National Lab. (INL), Idaho Falls, ID (United States); Turchi, Craig [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zhu, Guangdong [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-11-01

    There are numerous technical merits associated with a renewable geothermal-solar hybrid plant concept. The performance of air-cooled binary plants is lowest when ambient temperatures are high due to the decrease in air-cooled binary plant performance that occurs when the working fluid condensing temperature, and consequently the turbine exhaust pressure, increases. Electrical power demand is generally at peak levels during periods of elevated ambient temperature and it is therefore especially important to utilities to be able to provide electrical power during these periods. The time periods in which air-cooled binary geothermal power plant performance is lowest generally correspond to periods of high solar insolation. Use of solar heat to increase air-cooled geothermal power plant performance during these periods can improve the correlation between power plant output and utility load curves. While solar energy is a renewable energy source with long term performance that can be accurately characterized, on shorter time scales of hours or days it can be highly intermittent. Concentrating solar power (CSP), aka solar-thermal, plants often incorporate thermal energy storage to ensure continued operation during cloud events or after sunset. Hybridization with a geothermal power plant can eliminate the need for thermal storage due to the constant availability of geothermal heat. In addition to the elimination of the requirement for solar thermal storage, the ability of a geothermal/solar-thermal hybrid plant to share a common power block can reduce capital costs relative to separate, stand-alone geothermal and solar-thermal power plant installations. The common occurrence of long-term geothermal resource productivity decline provides additional motivation to consider the use of hybrid power plants in geothermal power production. Geothermal resource productivity decline is a source of significant risk in geothermal power generation. Many, if not all, geothermal resources

  19. Mainstreaming risk reduction in urban planning and housing: a challenge for international aid organisations.

    Science.gov (United States)

    Wamsler, Christine

    2006-06-01

    The effects of 'natural' disasters in cities can be worse than in other environments, with poor and marginalised urban communities in the developing world being most at risk. To avoid post-disaster destruction and the forced eviction of these communities, proactive and preventive urban planning, including housing, is required. This paper examines current perceptions and practices within international aid organisations regarding the existing and potential roles of urban planning as a tool for reducing disaster risk. It reveals that urban planning confronts many of the generic challenges to mainstreaming risk reduction in development planning. However, it faces additional barriers. The main reasons for the identified lack of integration of urban planning and risk reduction are, first, the marginal position of both fields within international aid organisations, and second, an incompatibility between the respective professional disciplines. To achieve better integration, a conceptual shift from conventional to non-traditional urban planning is proposed. This paper suggests related operative measures and initiatives to achieve this change.

  20. Age-Related Effects of Bariatric Surgery on Early Atherosclerosis and Cardiovascular Risk Reduction.

    Science.gov (United States)

    Jonker, Frederik H W; van Houten, Vera A A; Wijngaarden, Leontine H; Klaassen, René A; de Smet, André A E A; Niezen, André; Schelfhout, Lodewijk J D M; Bruning, Tobias A; van der Harst, Erwin

    2017-10-17

    Carotid intima-media thickness (CIMT) is increasingly used as a prognostic indicator for early atherosclerosis and the development of cardiovascular disease. The objective of this study is to assess the exact effects of bariatric surgery on CIMT reduction in different age groups. CIMT was measured just proximal to the bifurcation of the carotid artery in 166 patients with mean body mass index of 43.4 kg/m2 before and at 6 and 12 months after bariatric surgery. Preoperative CIMT and Framingham Risk Score (FRS) were compared to measurements at 6 and 12 months, postoperatively. Impact of age on CIMT change and cardiovascular risk reduction was analyzed. Median follow-up was 12 months; 12% were lost to follow-up. Mean CIMT values at 12 months after bariatric surgery were significantly lower compared to baseline (0.619 vs. 0.587 mm, p = 0.005 in women and 0.675 vs. 0.622 mm, p = 0.037 in men, respectively), and these effects were statistically significant in all age groups. The mean reduction of CIMT for patients bariatric surgery, FRS had decreased with 52% in patients Bariatric surgery resulted in a significant CIMT decrease in patients with morbid obesity in all evaluated age categories. These beneficial effects of bariatric surgery were more pronounced in younger patients, while cardiovascular risk reduction by bariatric surgery appeared inferior in patients of 50 years and older.

  1. Reduction of Radiation Risk to Interventional Cardiologists and Patients during Angiography and Coronary Angioplasty

    Directory of Open Access Journals (Sweden)

    Mohsen Mohammadi

    2017-06-01

    Full Text Available Radiation risk allied to invasive cardiology is relatively high, and protecting both patients and cardiologists is necessary. The aim of this review is to discuss how to better protect patients and cardiologists against radiation exposure. We performed a global search on PubMed, Science Direct, and Scopus databases via keywords of “interventional cardiologist”, “patient”, “radiation”, and “exposure” and then performed an overview of the main strategies for risk reduction among interventional cardiologists and exposed patients. The 1st line for protection is awareness of both radiation risk factors and exposure doses and how to manage and minimize exposure levels. In conclusion, radiation-attenuating techniques can effectively reduce occupational/treatment radiation exposure to both operators and patients in cardiology interventions.

  2. Indigenous Institutions and Their Role in Disaster Risk Reduction and Resilience: Evidence from the 2009 Tsunami in American Samoa

    Directory of Open Access Journals (Sweden)

    Andrew Rumbach

    2014-03-01

    Full Text Available Indigineity has emerged as an important area of focus for research and policy making on disaster risk reduction (DRR and resilience. Most research on indigeneity and DRR centers on indigenous knowledge and its integration with western scientific understandings of hazards and risk. Through a detailed case study of the 2009 tsunami in American Samoa, we argue that indigenous institutions also play a critical role in disaster risk reduction and resilience. Based on original data from semistructured interviews, village planning meetings, and focus group discussions, we describe how the indigenous institutions of fa'a Samoa, or the culture of Samoa, operated in a time of crisis by: (1 structuring emergency decision making and authority; (2 assigning roles and responsibilities during crises; (3 building effective lines of communication between villages and outside actors; (4 providing a system of accountability for vulnerable people; and (5 acting as gatekeepers to villages and mobilizing social groups to act. We then suggest some ways that indigenous institutions could be better leveraged to help create more resilient communities.

  3. The efficacy of a programme of landslide risk reduction in areas of unplanned housing in the Eastern Caribbean.

    Science.gov (United States)

    Anderson, Malcolm G; Holcombe, Elizabeth; Esquivel, Maricarmen; Toro, Joaquin; Ghesquiere, Francis

    2010-04-01

    Poor countries are disproportionately affected by the cost of disasters. Yet there is evidence of the benefits of seeking to mitigate the impact of a disaster, compared with the costs incurred in 'making good' after a major event has occurred. This article reviews a programme of landslide risk reduction in unplanned communities in the Eastern Caribbean. The construction of appropriate surface water management measures, based on the application of scientific and engineering principles, has been demonstrated to reduce the hazard from rainfall-triggered landslides. Adopting a community-based approach additionally delivers social and environmental benefits relating to employment generation, improvements in the environmental conditions within the community, and improvements slope management practices. The sustained implementation of the community-based projects has provided the necessary evidence-base for these practices to influence Government policy and practice, and gain recognition from regional development agencies. The strategic and incremental uptake of the community-based methodology is demonstrated to be an effective means for delivering physical landslide risk reduction measures in the most 'at risk' areas of unplanned housing.

  4. Use of calcium channel blockers in cardiovascular risk reduction: issues in Latin America.

    Science.gov (United States)

    Alcocer, Luis; Bendersky, Mario; Acosta, Julio; Urina-Triana, Miguel

    2010-01-01

    Cardiovascular disease (CVD) is a continuum that begins with the presence of several risk factors for CVD, including smoking, hypertension, obesity, diabetes mellitus, and high levels of cholesterol, and if unaddressed can result in premature death, ischemic heart disease, stroke, congestive heart failure, and end-stage renal disease. Hypertension is associated with a significant increase in cardiovascular (CV) morbidity and mortality, raising the risk of stroke, myocardial infarction, heart failure, kidney disease, and peripheral arterial disease. In Latin America, the prevalence of hypertension and other CV risk factors has become similar to that seen in more developed countries, increasing the proportion of the population at high risk for CVD and congestive heart failure; however, it is hypertension that is a key driving force behind CV risk in Latin America. Despite the existence of a wide range of antihypertensive agents, BP control and reductions in CV risk remain poor in Latin America and in Hispanics living in the US. Ethnic differences in treatment rates and disease awareness have been well documented. Studies have shown that calcium channel blockers (CCBs; calcium channel antagonists) are at least as effective in reducing BP and improving the CV risk profile as other classes of antihypertensive agents when administered as monotherapy. CCBs have also been shown to be effective when administered as part of combination therapy in both low- and high-risk hypertensive patients, suggesting that CCBs can easily be combined with other antihypertensive classes in order to achieve BP control and CV risk reduction. In patients with hypertension, coronary artery disease, and high cholesterol, CCBs have been associated with beneficial effects on a range of other aspects of the CV continuum, including the vasculature, coronary calcification, and progression of atherosclerosis. CCBs have also been shown to preserve renal function. Unlike diuretics and beta

  5. Update on the role of candesartan in the optimal management of hypertension and cardiovascular risk reduction

    Directory of Open Access Journals (Sweden)

    Ikechi G Okpechi

    2010-05-01

    Full Text Available Ikechi G Okpechi, Brian L RaynerDepartment of Medicine, Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Observatory, Cape Town 7925, South AfricaAbstract: Hypertension is the most prevalent cardiovascular disease of adults and is a major risk factor for cardiovascular (CV and cerebrovascular morbidity and mortality worldwide. Treatment of hypertension leads to reduction of CV morbidity and mortality through blood pressure reduction. The role of renin–angiotensin–aldosterone system (RAAS in the pathophysiology of hypertension is mainly through generation of potent vasoconstrictor angiotensin II, stimulation of aldosterone secretion, and increase in sympathetic activation. Angiotensin II receptor blockers such as candesartan, a long-acting agent, alter this system by blocking the activation of angiotensin I receptors. Several important clinical trials have tested the efficacy of candesartan with placebo, antihypertensive agents, or other agents that block the RAAS for the control of hypertension and reduction of key CV risk factors such as microalbuminuria, heart failure, retinopathy, and carotid intima medial thickness. Candesartan has been shown to be a welltolerated and effective antihypertensive agent with positive metabolic characteristics and additional benefits on CV and cerebrovascular outcomes. The aim of this review is to discuss the pharmacology, efficacy, and safety of candesartan, with an overview of key hypertension and CV studies involving candesartan.Keywords: ACE inhibitor, ARB, blood pressure, treatment, heart

  6. Closed reduction of slipped capital femoral epiphysis: high-risk factor for avascular necrosis.

    Science.gov (United States)

    Kitano, Toshio; Nakagawa, Keisuke; Wada, Mayuko; Moriyama, Michiko

    2015-07-01

    How should we treat acute/unstable slipped capital femoral epiphysis (SCFE) without the development of avascular necrosis (AVN)? To answer this question, we investigated the risk factors of AVN development after SCFE. Seventy-six hips of 64 patients were classified using two kinds of classification systems, Loder's classification based on instability and the conventional classification based on the duration of symptom, because both classifications are related to AVN development. Of 21 unstable SCFEs, seven hips developed AVN. Of 35 hips defined as acute or acute on chronic, nine hips developed AVN. Two stable SCFEs of Loder's classification developed AVN, one was acute and the other was acute on chronic. No hips of chronic SCFE developed AVN. The factor that had influenced AVN development was only closed reduction, whether purposefully or inadvertently, in an acute or unstable SCFE. On the basis of the findings of this study, one should not embark on any modality of closed reduction for an unstable or acute form of SCFE, as there is a high risk for occurrence of AVN. For the same reason, a traction table should not be used for SCFE fixation, so as to avoid an inadvertent reduction or force that can lead to AVN.

  7. Mechanisms of Partner Violence Reduction in a Group HIV-Risk Intervention for Hispanic Women.

    Science.gov (United States)

    McCabe, Brian E; Gonzalez-Guarda, Rosa M; Peragallo, Nilda P; Mitrani, Victoria B

    2016-08-01

    The objective of this study was to test whether partner communication about HIV and/or alcohol intoxication mediated reductions in intimate partner violence (IPV) in SEPA (Salud [health], Educación [education], Promoción [promotion], y [and] Autocuidado [self-care]), a culturally specific, theoretically based group HIV-risk reduction intervention for Hispanic women. SEPA had five sessions covering sexually transmitted infection (STI)/HIV prevention, partner communication, condom negotiation and use, and IPV. SEPA reduced IPV and alcohol intoxication, and improved partner communication compared with controls in a randomized trial with adult U.S. Hispanic women (SEPA, n = 274; delayed intervention control, n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Parallel process latent growth curve models indicated that partner communication about HIV mediated the reduction in male-to-female IPV in SEPA, B = -0.78, SE = 0.14, p< .001, but alcohol intoxication did not, B = -0.15, SE = 0.19, p = .431. Male-to-female IPV mediated the intervention effect on female-to-male IPV, B = -1.21, SE = 0.24, p< .001. Skills building strategies originally designed to enhance women's communication with their partners about sexual risk behaviors also worked to reduce male-to-female IPV, which in turn reduced female-to-male IPV. These strategies could be integrated into other types of health promotion interventions. © The Author(s) 2015.

  8. Vertebral fracture risk reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors.

    Science.gov (United States)

    Roux, Christian; Reginster, Jean-Yves; Fechtenbaum, Jacques; Kolta, Sami; Sawicki, Andrzej; Tulassay, Zsolt; Luisetto, Giovanni; Padrino, José-Maria; Doyle, David; Prince, Richard; Fardellone, Patrice; Sorensen, Ole Helmer; Meunier, Pierre Jean

    2006-04-01

    Strontium ranelate (2 g/day) was studied in 5082 postmenopausal women. A reduction in incident vertebral fracture risk by 40% was shown after 3 years. This effect was independent of age, initial BMD, and prevalent vertebral fractures. Strontium ranelate is an orally active treatment able to decrease the risk of vertebral and hip fractures in osteoporotic postmenopausal women. The aim of this study was to assess the efficacy of strontium ranelate according to the main determinants of vertebral fracture risk: age, baseline BMD, prevalent fractures, family history of osteoporosis, baseline BMI, and addiction to smoking. We pooled data of two large multinational randomized double-blind studies with a population of 5082 (2536 receiving strontium ranelate 2 g/day and 2546 receiving a placebo), 74 years of age on average, and a 3-year follow-up. An intention-to-treat principle was used, as well as a Cox model for comparison and relative risks. The treatment decreased the risk of both vertebral (relative risk [RR] = 0.60 [0.53-0.69] p or = 80 years. The RR of vertebral fracture was 0.28 (0.07-0.99) in osteopenic and 0.61 (0.53-0.70) in osteoporotic women, and baseline BMD was not a determinant of efficacy. The incidence of vertebral fractures in the placebo group increased with the number of prevalent vertebral fractures, but this was not a determinant of the effect of strontium ranelate. In 2605 patients, the risk of experiencing a first vertebral fracture was reduced by 48% (p < 0.001). The risk of experiencing a second vertebral fracture was reduced by 45% (p < 0.001; 1100 patients). Moreover, the risk of experiencing more than two vertebral fractures was reduced by 33% (p < 0.001; 1365 patients). Family history of osteoporosis, baseline BMI, and addiction to smoking were not determinants of efficacy. This study shows that a 3-year treatment with strontium ranelate leads to antivertebral fracture efficacy in postmenopausal women independently of baseline osteoporotic

  9. Comparing the risk identification and management behaviors between oral health providers for patients with diabetes.

    Science.gov (United States)

    Efurd, Mitzi G; Bray, Kimberly Krust; Mitchell, Tanya Villalpando; Williams, Karen

    2012-01-01

    Evidence supporting the link between periodontal disease and systemic disease continues to grow. To date, little is known about how dental professionals incorporate this information into managing diabetic patients. This study examines the risk identification and practice behaviors regarding diabetic patients among dentists, hygienists and specialists. Responses were received from 383 currently practicing oral health professionals in Arkansas. The electronic survey consisted of 35 open and closed-ended or Likert-type items. Principal components factor analysis using varimax rotation was used to explore underlying dimensions of the questionnaire in order to provide a more parsimonious view of the outcomes. Logistic models were fitted to determine best practice outcome as a function of knowledge and professional and social norms. Neither knowledge about diabetes (pdental hygienist. Results indicate oral health professionals in Arkansas need to improve the treatment and management of patients with diabetes and periodontal disease.

  10. A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Lorraine [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Cox, Jennifer [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Morgia, Marita [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Atyeo, John [Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Lamoury, Gillian [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia)

    2015-09-15

    The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time. A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch). There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm{sup 3} (4–118) and CT2ch: median 16 cm{sup 3}, (2–99), (P = 0.01), but no significant volume reduction thereafter. Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

  11. Clinical utility of rosuvastatin and other statins for cardiovascular risk reduction among the elderly

    Directory of Open Access Journals (Sweden)

    Sydney B Long

    2010-12-01

    Full Text Available Sydney B Long, Michael J Blaha, Roger S Blumenthal, Erin D MichosJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USAAbstract: Age is one of the strongest predictors of cardiovascular disease (CVD risk. Treatment with statins can significantly reduce CVD events and mortality in both primary and secondary prevention. Yet despite the high CVD risk among the elderly, there is underutilization of statins in this population (ie, the treatment-risk paradox. Few studies have investigated the use of statins in the elderly, particularly for primary prevention and, as a result, guidelines for treating the elderly are limited. This is likely due to: uncertainties of risk assessment in older individuals where the predictive value of individual risk factors is decreased; the need to balance the benefits of primary prevention with the risks of polypharmacy, health care costs, and adverse medication effects in a population with decreased life expectancy; the complexity of treating patients with many other comorbidities; and increasingly difficult social and economic concerns. As life expectancy increases and the total elderly population grows, these issues become increasingly important. JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin is the largest primary prevention statin trial to date and enrolled a substantial number of elderly adults. Among the 5695 JUPITER participants ≥70 years of age, the absolute CVD risk reduction associated with rosuvastatin was actually greater than for younger participants. The implications of this JUPITER subanalysis and the broader role of statins among older adults is the subject of this review.Keywords: JUPITER, rosuvastatin, elderly, risk

  12. Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate

    DEFF Research Database (Denmark)

    Bruyere, Olivier; Roux, Christian; Detilleux, Johann

    2007-01-01

    Of Peripheral OSteoporosis study were evaluated. OUTCOME MEASURES: The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based...... on written documentation. RESULTS: After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1-5%) and 2% (1-4%) reduction in risk of a new vertebral fracture, respectively. The 3-yr...... changes in femoral neck and total proximal femur BMD explained 76% and 74%, respectively, of the reduction in vertebral fractures observed during the treatment. Three-year changes in spine BMD were not statistically associated with the incidence of new vertebral fracture (P = 0.10). No significant...

  13. Effectiveness of Methadone in Reduction of High Risk Behaviors in Clients of MMT Center

    Directory of Open Access Journals (Sweden)

    F Ehsani

    2010-09-01

    Full Text Available Introduction: Addiction as a social, health problem with its specific complications threatens societies. High risk behaviors such as violence, self mutilation, tattooing, shared injections and unprotected sex behaviors are some of the problems in addicts that need to be treated. One of these treatments is methadone therapy. The purpose of this study was to evaluate effectiveness of methadone in prevention or reduction of high risk behaviors in clients of a MMT center of Shaheed Sadoughi University of medical sciences of Yazd. Methods: This study was done on 93 clients of a MMT center.Questionnaire for this study included items from MAP and questions about some other risky behaviors. This questionnaire was completed at onset of treatment and 6 months after. Data was analyzed with SPSS software program Results: 89.2% of participants were married and 10.8% were single. 63.5% of them were in the20-40 years age group. Most commonly abused substances were heroin and opium. Before onset of treatment, 37.6% of participants had history of imprisonment, 35.5% had shared injections, 32.3%had had unprotected sex, 22.6%had tattooing and 5.4%had mutilated their own selves. Only 36.6% didn’t have any high risk behavior. These behaviors were more common in heroin users and in the20-40 years age group. After onset of treatment and during 6 month of MMT, 86% of clients didn’t have any risky behavior. Only 14%of them continued to have unsafe sex behaviors Conclusion: Addiction can cause high risk behaviors. Data in this paper suggests that young age, heroin use, low education level and no or inadequate information about addictive substances and their consequences are effective and important factors that cause high risk behaviors. Treatment of addicts with methadone maintenance therapy plays an important role in reduction of risky behaviors. Development of appropriate and more MMT centers are recommended.

  14. Canagliflozin provides greater attainment of both HbA1c and body weight reduction versus sitagliptin in patients with type 2 diabetes.

    Science.gov (United States)

    Schernthaner, Guntram; Lavalle-González, Fernando J; Davidson, Jaime A; Jodon, Holly; Vijapurkar, Ujjwala; Qiu, Rong; Canovatchel, William

    2016-11-01

    To evaluate the proportion of patients with type 2 diabetes mellitus (T2DM) achieving reductions in both glycated hemoglobin (HbA1c) and body weight with canagliflozin, a sodium glucose co-transporter 2 inhibitor, versus sitagliptin over 52 weeks. Data were pooled from two, randomized, Phase 3 studies of canagliflozin 100 and 300 mg versus sitagliptin 100 mg as add-on to metformin, and canagliflozin 300 mg versus sitagliptin 100 mg as add-on to metformin plus sulfonylurea (N = 1856). The composite end points of change from baseline in both HbA1c body weight body weight reduction ≥5% at Week 52 were evaluated. Safety was assessed based on adverse event reports. Canagliflozin provided reductions in HbA1c and body weight over 52 weeks versus sitagliptin. A greater proportion of patients had both HbA1c and body weight reductions with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (67.7%, 72.6%, and 44.1%, respectively). Among patients with HbA1c and body weight reductions, more patients achieved the composite end point of HbA1c body weight reduction ≥5% with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (18.9%, 18.3%, and 5.7%, respectively). Canagliflozin was generally well tolerated. A greater proportion of patients with T2DM achieved reductions in both HbA1c and body weight, and more patients with HbA1c and body weight reductions achieved HbA1c body weight reduction ≥5% with canagliflozin versus sitagliptin over 52 weeks. www.ClinicalTrials.gov identifiers are NCT01106677; NCT01137812.

  15. Dental health assessed after interproximal enamel reduction: caries risk in posterior teeth.

    Science.gov (United States)

    Zachrisson, Björn U; Minster, Line; Ogaard, Bjørn; Birkhed, Dowen

    2011-01-01

    We investigated whether careful interdental enamel reduction (using extrafine diamond disks with air cooling, followed by contouring with triangular diamond burs and polishing) leads to increased caries risk in premolars and first molars. Our subjects were 43 consecutive patients from 19 to 71 years of age who had received mesiodistal enamel reduction of anterior and posterior teeth 4 to 6 years previously. Dental caries were assessed on standardized bite-wing radiographs according to a 5-grade scale and with a fine-tip explorer catch. The incidence of interproximal caries was compared between reproximated and unground contralateral surfaces in the same patient. Patients were asked about their toothbrushing habits, use of dental floss and toothpicks, and regular fluoride supplementation after the orthodontic appliances were removed. The overall clinical impression generally showed healthy dentitions with excellent occlusion. Only 7 (2.5%) new caries lesions (all grade 1) were found among 278 reproximated mesial or distal surfaces, in 3 patients. Among 84 contralateral unground reference tooth surfaces, 2 lesions (2.4%) were seen. On nonpaired premolars and molars that had not been ground, 23 surfaces had to be referred for caries treatment (grade 3 or occlusal caries). Eleven of these occurred in 1 patient. None of the 43 patients reported increased sensitivity to temperature variations. Interdental enamel reduction with this protocol did not result in increased caries risk in posterior teeth. We found no evidence that proper mesiodistal enamel reduction within recognized limits and in appropriate situations will cause harm to the teeth and supporting structures. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  16. Preventive potential of body mass reduction to lower cardiovascular risk: the Italian Progetto CUORE study.

    Science.gov (United States)

    Panico, Salvatore; Palmieri, Luigi; Donfrancesco, Chiara; Vanuzzo, Diego; Chiodini, Paolo; Cesana, Giancarlo; Ferrario, Marco; Mattiello, Amalia; Pilotto, Lorenza; Sega, Roberto; Giampaoli, Simona; Stamler, Jeremiah

    2008-07-01

    To estimate effects of weight change on incidence of major cardiovascular events in the Italian population-based Progetto CUORE. Prospective observation in 12 Italian population-based cohorts on etiology of cardiovascular disease. Twenty-thousand six-hundred-forty-seven men and women aged 35-69 years without previous CVD, examined at baseline between 1984 and 1993 and followed for median time 8.5 years, with validated first cardiovascular events. Standardised anthropometric variables, lifestyle and biochemical risk factors for CVD; major cardiovascular events as end-points. Linear regression between BMI and major CVD risk factors was combined with Cox coefficients from a prediction model of CVD, CHD and stroke using major risk factors as dependent variables. Estimated cardiovascular risk reductions with BMI lowered by 1 to 3 U were: for men 3.8% to 10.9% for all cardiovascular events, 4.2% to 12.1% for CHD, and 2.3% to 6.9% for stroke; for women 2.8% to 8.1% for all cardiovascular events, 3.4% to 9.8% for CHD, and 2.1% to 6.2% for stroke. Body weight level influences cardiovascular disease risk in the Italian population.

  17. SAFRR (Science Application for Risk Reduction) Tsunami Scenario--Executive Summary and Introduction: Chapter A in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Ross, Stephanie L.; Jones, Lucile M.; Miller, Kevin H.; Porter, Keith A.; Wein, Anne; Wilson, Rick I.; Bahng, Bohyun; Barberopoulou, Aggeliki; Borrero, Jose C.; Brosnan, Deborah M.; Bwarie, John T.; Geist, Eric L.; Johnson, Laurie A.; Kirby, Stephen H.; Knight, William R.; Long, Kate; Lynett, Patrick; Mortensen, Carl E.; Nicolsky, Dmitry J.; Perry, Suzanne C.; Plumlee, Geoffrey S.; Real, Charles R.; Ryan, Kenneth; Suleimani, Elena; Thio, Hong Kie; Titov, Vasily V.; Whitmore, Paul M.; Wood, Nathan J.

    2013-01-01

    The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey, the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

  18. Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis.

    Science.gov (United States)

    Terrier, Alexandre; Latypova, Adeliya; Guillemin, Maika; Parvex, Valérie; Guyen, Olivier

    2017-03-01

    Constrained devices, standard implants with large heads, and dual mobility systems have become popular options to manage instability after total hip arthroplasty (THA). Clinical results with these options have shown variable success rates and significant higher rates of aseptic loosening and mechanical failures with constrained implants. Literature suggests potential advantages of dual mobility, however little is known about its biomechanics. We present a comparative biomechanical study of a standard implant, a constrained implant, and a dual mobility system. A finite element analysis was developed to assess and compare these acetabular options with regard to the range of motion (ROM) to impingement, the angle of dislocation, the resistive torque, the volume of polyethylene (PE) with a stress above 80% of the elastic limit, and the interfacial cup/bone stress. Dual mobility implants provided the greatest ROM to impingement and allowed delaying subluxation and dislocation when compared to standard and constrained implants. Dual mobility also demonstrated the lowest resistive torque at subluxation while the constrained implant provided the greatest one. The lowest critical PE volume was observed with the dual mobility implant, and the highest stress at the interfaces was observed with the constrained implant. This study highlights the biomechanical advantages of dual mobility systems over constrained and standard implants, and is supported by the clinical results reported. Therefore, the use of dual mobility systems in situations at risk for instability should be advocated and constrained implants should be restricted to salvage situations.

  19. Automixer: equipment for the reduction of risks associated with inadequate oxygen supply

    Directory of Open Access Journals (Sweden)

    Jesús A. López

    2014-03-01

    Full Text Available In this paper, the AUTOMIXER, a medical support equipment for the reduction of risks associated with the inadequate supply of oxygen, is presented. The equipment automatically regulates the Inspired Oxygen Fraction (FIO2 concentration, which is supplied to the patient according to user parameters, measures of oxygen saturation and patient's status. The AUTOMIXER is based on a fuzzy control system, which was implemented in a microcontroller using a LookUp Table. The operation of the device was validated using simulated data and actual patients. The results show that the AUTOMIXER is an important tool for decreasing the incidence of pathologies related to unsuitable handling (excess or lack of oxygen.

  20. Short and long term efficiencies of debris risk reduction measures: Application to a European LEO mission

    Science.gov (United States)

    Lang, T.; Kervarc, R.; Bertrand, S.; Carle, P.; Donath, T.; Destefanis, R.; Grassi, L.; Tiboldo, F.; Schäfer, F.; Kempf, S.; Gelhaus, J.

    2015-01-01

    Recent numerical studies indicate that the low Earth orbit (LEO) debris environment has reached a point such that even if no further space launches were conducted, the Earth satellite population would remain relatively constant for only the next 50 years or so. Beyond that, the debris population would begin to increase noticeably, due to the production of collisional debris (Liou and Johnson, 2008). Measures to be enforced play thus a major role to preserve an acceptable space mission risk and ensure sustainable space activities. The identification of such measures and the quantification of their efficiency over time for LEO missions is of prime concern in the decision-making process, as it has been investigated for the last few decades by the Inter-Agency Space Debris Coordination Committee (IADC). This paper addresses the final results of a generic methodology and the characteristics of a tool developed to assess the efficiency of the risk reduction measures identified for the Sentinel-1 (S1) mission. This work is performed as part of the 34-month P2-ROTECT project (Prediction, Protection & Reduction of OrbiTal Exposure to Collision Threats), funded by the European Union within the Seventh Framework Programme. Three ways of risk reduction have been investigated, both in short and long-term, namely: better satellite protection, better conjunction prediction, and cleaner environment. According to our assumptions, the S1 mission vulnerability evaluations in the long term (from 2093 to 2100) show that full compliance to the mitigation measures leads to a situation twice safer than that induced by an active debris removal of 5 objects per year in a MASTER2009 Business-As-Usual context. Because these measures have visible risk reduction effects in the long term, complementary measures with short response time are also studied. In the short term (from 2013 to 2020), a better prediction of the conjunctions is more efficient than protecting the satellite S1 itself. By

  1. A reduction in body mass index lowers risk for bilateral slipped capital femoral epiphysis.

    Science.gov (United States)

    Nasreddine, Adam Y; Heyworth, Benton E; Zurakowski, David; Kocher, Mininder S

    2013-07-01

    Slipped capital femoral epiphysis (SCFE) is occurring in greater numbers, at increasingly younger ages, and more frequently bilaterally (BL-SCFE). Obesity is one risk factor for SCFE. However, it is unclear whether postoperative decreases or increases in body mass index (BMI) alter the risk of subsequent contralateral SCFE. We therefore determined whether (1) BMI percentile was a risk factor for BL-SCFE; and (2) postoperative increases and/or decreases in BMI percentile influenced the risk for BL-SCFE. We retrospectively reviewed the records of 502 patients surgically treated for SCFE and identified 138 (27%) with BL-SCFE and 364 (73%) with unilateral SCFE (UL-SCFE); 173 patients, 60 (35%) with BL-SCFE and 113 (65%) with UL-SCFE met our inclusion criteria. Risk factors included sex, age, slip stability, slip chronicity, slip angle, and obesity. Percentile BMI was recorded at the time of first SCFE surgery, at the time of last followup for patients undergoing UL-SCFE, and at the time of second SCFE surgery for patients undergoing BL-SCFE. Sex, age, slip stability, and slip angle were not associated with BL-SCFE. Postoperative obesity (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.2-9.7) and acute slip chronicity (OR, 2.9; 95% CI, 1.3-6.7) had higher risks for sequential BL-SCFE. Obese patients who became nonobese postoperatively had a decreased risk of sequential BL-SCFE compared with those who remained obese (OR, 0.16; 95% CI, 1.2-116.5). Only postoperative obesity and an acute slip were risk factors for sequential BL-SCFE. BMI reduction to lower than the 95% percentile after SCFE surgery was associated with lower risk for BL-SCFE development. The data suggest early supervised therapeutic weight management programs for patients treated for UL-SCFE are important to reduce risk of subsequent SCFE. Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

  2. Workshop: Economic Valuation of Mortality Risk Reduction: Assessing the State of the Art for Policy Applications (2002)

    Science.gov (United States)

    This two-day workshop, co-sponsored by EPA's National Center for Environmental Economics and National Center for Environmental Research, was dedicated to exploring methods for valuing mortality risk reductions. There were six sessions held in total.

  3. 76 FR 26682 - Study on Protection of Certain Railroad Risk Reduction Data From Discovery or Use in Litigation

    Science.gov (United States)

    2011-05-09

    ... accidents) to withhold from discovery or admission into evidence in a Federal or State court proceeding for...-highway grade crossing accidents, and railroad employee injuries. If the risk reduction information that...

  4. Mujeres felices por ser saludables: a breast cancer risk reduction program for Latino women.

    Science.gov (United States)

    Fitzgibbon, Marian L; Gapstur, Susan M; Knight, Sara J

    2003-05-01

    Breast cancer is the most commonly diagnosed cancer and the most common cause of cancer mortality among Latino women. Several behavioral factors such as early detection and dietary practices could help decrease morbidity and mortality associated with breast cancer in this population. Unfortunately, there are few data regarding the efficacy of health-related interventions for young Latino women. Mujeres Felices por ser Saludables is a randomized intervention project designed to assess breast cancer risk reduction behavior among Latino women ages 20-40 years. The primary objectives of the project were to determine whether an 8-month integrated dietary/breast health intervention could lead to a greater reduction in dietary fat, increase in dietary fiber, increase in the frequency and proficiency of breast self examination (BSE), and reduction in anxiety related to BSE compared to controls. Herein we describe the overall design of the project and present baseline characteristics of the 256 randomized women. Our results suggest that the average daily intake of dietary fat (percentage of total energy) was slightly below 30% (percentage of total energy) among the women randomized. While over half of these women reported that they practice BSE, and few reported anxiety related to BSE, less than 27% of women were proficient in the recommended BSE technique. There are few data on the dietary and breast health behaviors of young low-acculturated Latino women. This study documents the feasibility of recruiting, randomizing, and obtaining both baseline dietary and breast health data on this unique and underserved population.

  5. Treatment of osteoporosis and reduction in risk of invasive breast cancer in postmenopausal women with raloxifene

    Science.gov (United States)

    Ko, Seung Sang; Jordan, V Craig

    2011-01-01

    Introduction Raloxifene, a non-steroidal selective estrogen receptor modulator (SERM), offers a new dimension for the treatment and prevention of osteoporosis and risk reduction of invasive breast cancer in postmenopausal populations at high risk. Both osteoporosis and breast cancer are important public health issues for postmenopausal women. It is well known that estrogen and estrogen receptors play an important role in the pathogenesis of both diseases. Initially, hormone replacement therapy (HRT) was used for the purpose of preventing and treating postmenopausal osteoporosis. However, HRT significantly contributed to an increase in breast cancer risk. The SERM, raloxifene, is used for the prevention and for the treatment of post-menopausal osteoporosis and reducing the risk of invasive breast cancer in postmenopausal women. Areas covered This article reviews the emerging evidence of the efficacy of raloxifene in postmenopausal women, summarizes the results and places in perspective their therapeutic uses for women having either a high risk of osteoporosis or breast cancer. Emerging clinical evidence suggests bisphosphonates, currently used as drugs for the treatment of osteoporosis, may also reduce breast cancer risk. The status of other SERMs and bisphosphonates are included for completeness. A Medline search of raloxifene, osteoporosis, breast cancer and SERMs was used to derive a database of 355 references. Expert opinion Readers will understand the value of raloxifene to prevent osteoporosis and breast cancer in postmenopausal women. Although most women do not require pharmacotherapy for menopausal symptoms, many are severely affected by osteoporosis or breast cancer at and beyond menopause and, for such women, pharmacologic intervention is important if they are to retain an acceptable quality of life. It is reasonable to use raloxifene or bisphosphonate as an appropriate drug that targets symptom-free postmenopausal women for treatment and prevention of

  6. Assessing social vulnerability to drought in South Africa: Policy implication for drought risk reduction

    Directory of Open Access Journals (Sweden)

    Fumiso Muyambo

    2017-01-01

    Full Text Available The aim of this article was to assess and identify social vulnerability of communal farmers to drought in the O.R. Tambo district in the Eastern Cape province of South Africa using a survey data and social vulnerability index (SoVI. Eleven social vulnerability indicators were identified using Bogardi, Birkman and Cardona conceptual framework. The result found that an SoVI estimated for O.R. Tambo district was very high with a Likert scale of 5 for cultural values and practices, security or safety, social networks, social dependence, preparedness strategies and psychological stress attributed for the high value of social vulnerability to drought. Indigenous knowledge and education had an SoVI value of 2, which was of low vulnerability, contributing positively to resilience to drought. The study also found that government involvement in drought risk reduction is limited; as a result, the study recommends that a national, provincial and district municipalities policy on drought risk reduction and mitigation should be developed.

  7. The Effect of Risk Reduction Intervention on Earthquake Disaster Preparedness of the Elderly People

    Directory of Open Access Journals (Sweden)

    Kian Nourozi

    2016-01-01

    Full Text Available Background: Because of vulnerability of the elders in disasters, preparedness of this group is very important in reducing the damages caused by the earthquake. Therefore, the present study designed and conducted with the purpose of developing interventions to increase earthquake preparedness and risk reduction in the elderly people living in Hadishahr Jolfa City, Iran. Materials and Methods: This study was a quasi-experimental study with pretest, posttest design and a control group. Fifty community dwelling elderly people were selected through simple random sampling method from 2 health centers and randomly allocated to intervention and control groups. Intervention program consisted of educational sessions with slideshows, group discussions, and sending reminder materials to their addresses a week later. The data were collected using the researcher developed preparedness questionnaire consisting of 58 items with 4 subscales (communication, environmental, during and after earthquake period. Inferential analyses of data, including analysis of covariance was done by SPSS version 16. Results: The findings showed that scores in all subscales of earthquake preparedness (communication, environment, during and after earthquake significantly increased after educational intervention (P<0.05. Conclusion: Preparedness programs for disaster risk reduction has a positive effect on the elders’ preparedness. Thus, similar multimodal preparedness programs should be used more frequently for this vulnerable community citizens.

  8. We4DRR: A brand new European network for women in Disaster Risk Reduction

    Science.gov (United States)

    Papathoma-Koehle, Maria; Keiler, Margreth; Promper, Catrin; Patek, Maria

    2017-04-01

    Natural hazards often intensify societal inequalities having disproportionate impact on some population groups including women. On the other hand, women working in the field of natural hazards, either on site as emergency workers or in research, policy and administration as scientists, experts and managers have to deal with a number of challenges. However, gender issues are often neglected and women networks related to natural hazards in Europe but also worldwide are scarce. We present here "We4DRR: Women exchange for Disaster Risk Reduction", a new women's network focusing on gender issues in the field of disaster risk reduction but also on women working in the field. The network was initiated and organised by the Austrian Federal Ministry of Agriculture, Forestry, Environment and Water Management (BMLFUW) and the University of Natural Resources and Life Sciences Vienna (BOKU) and was launched in Austria in March 2016. Its aims include collecting data on gender issues and DRR, empowerment of women, mentoring of young female professionals, and increasing the visibility of gender-specific aspects in DRR.

  9. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

    Directory of Open Access Journals (Sweden)

    A. Gero

    2011-01-01

    Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

  10. Scientific Opinion on the risk to plant health posed by Daktulosphaira vitifoliae (Fitch) in the EU territory, with the identification and evaluation of risk reduction options

    National Research Council Canada - National Science Library

    2014-01-01

    ... (an aphid species commonly known as phylloxera), in the European Union, identified risk reduction options and evaluated the effectiveness of the phytosanitary measures listed in Council Directive 2000/29/EC...

  11. Advances in earthquake and tsunami sciences and disaster risk reduction since the 2004 Indian ocean tsunami

    Science.gov (United States)

    Satake, Kenji

    2014-12-01

    The December 2004 Indian Ocean tsunami was the worst tsunami disaster in the world's history with more than 200,000 casualties. This disaster was attributed to giant size (magnitude M ~ 9, source length >1000 km) of the earthquake, lacks of expectation of such an earthquake, tsunami warning system, knowledge and preparedness for tsunamis in the Indian Ocean countries. In the last ten years, seismology and tsunami sciences as well as tsunami disaster risk reduction have significantly developed. Progress in seismology includes implementation of earthquake early warning, real-time estimation of earthquake source parameters and tsunami potential, paleoseismological studies on past earthquakes and tsunamis, studies of probable maximum size, recurrence variability, and long-term forecast of large earthquakes in subduction zones. Progress in tsunami science includes accurate modeling of tsunami source such as contribution of horizontal components or "tsunami earthquakes", development of new types of offshore and deep ocean tsunami observation systems such as GPS buoys or bottom pressure gauges, deployments of DART gauges in the Pacific and other oceans, improvements in tsunami propagation modeling, and real-time inversion or data assimilation for the tsunami warning. These developments have been utilized for tsunami disaster reduction in the forms of tsunami early warning systems, tsunami hazard maps, and probabilistic tsunami hazard assessments. Some of the above scientific developments helped to reveal the source characteristics of the 2011 Tohoku earthquake, which caused devastating tsunami damage in Japan and Fukushima Dai-ichi Nuclear Power Station accident. Toward tsunami disaster risk reduction, interdisciplinary and trans-disciplinary approaches are needed for scientists with other stakeholders.

  12. Providing web-based mental health services to at-risk women

    Directory of Open Access Journals (Sweden)

    Kenny Meghan

    2011-08-01

    Full Text Available Abstract Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7, adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15. Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post

  13. Providing web-based mental health services to at-risk women.

    Science.gov (United States)

    Lipman, Ellen L; Kenny, Meghan; Marziali, Elsa

    2011-08-19

    We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show

  14. Smoking duration alone provides stronger risk estimates of chronic obstructive pulmonary disease than pack-years.

    Science.gov (United States)

    Bhatt, Surya P; Kim, Young-Il; Harrington, Kathy F; Hokanson, John E; Lutz, Sharon M; Cho, Michael H; DeMeo, Dawn L; Wells, James M; Make, Barry J; Rennard, Stephen I; Washko, George R; Foreman, Marilyn G; Tashkin, Donald P; Wise, Robert A; Dransfield, Mark T; Bailey, William C

    2018-01-11

    Cigarette smoking is the strongest risk factor for COPD. Smoking burden is frequently measured in pack-years, but the relative contribution of cigarettes smoked per day versus duration towards the development of structural lung disease, airflow obstruction and functional outcomes is not known. We analysed cross-sectional data from a large multicentre cohort (COPDGene) of current and former smokers. Primary outcome was airflow obstruction (FEV 1 /FVC); secondary outcomes included five additional measures of disease: FEV 1 , CT emphysema, CT gas trapping, functional capacity (6 min walk distance, 6MWD) and respiratory morbidity (St George's Respiratory Questionnaire, SGRQ). Generalised linear models were estimated to compare the relative contribution of each smoking variable with the outcomes, after adjustment for age, race, sex, body mass index, CT scanner, centre, age of smoking onset and current smoking status. We also estimated adjusted means of each outcome by categories of pack-years and combined groups of categorised smoking duration and cigarettes/day, and estimated linear trends of adjusted means for each outcome by categorised cigarettes/day, smoking duration and pack-years. 10 187 subjects were included. For FEV 1 /FVC, standardised beta coefficient for smoking duration was greater than for cigarettes/day and pack-years (P<0.001). After categorisation, there was a linear increase in adjusted means FEV 1 /FVC with increase in pack-years (regression coefficient β=-0.023±SE0.003; P=0.003) and duration over all ranges of smoking cigarettes/day (β=-0.041±0.004; P<0.001) but a relatively flat slope for cigarettes/day across all ranges of smoking duration (β=-0.009±0.0.009; P=0.34). Strength of association of duration was similarly greater than pack-years for emphysema, gas trapping, FEV 1 , 6MWD and SGRQ. Smoking duration alone provides stronger risk estimates of COPD than the composite index of pack-years. Post-results; NCT00608764. © Article author

  15. Program for Volcanic Risk Reduction in the Americas: Translation of Science into Policy and Practice

    Science.gov (United States)

    Mangan, Margaret; Pierson, Thomas; Wilkinson, Stuart; Westby, Elizabeth; Driedger, Carolyn; Ewert, John

    2016-04-01

    In 2013, the United States Geological Survey (USGS) and the U.S. Agency for International Development/Office of Foreign Disaster Assistance (USAID/OFDA) inaugurated Volcanic Risk Reduction in the Americas, a program that brings together binational delegations of scientists, civil authorities, and emergency response managers to discuss the challenges of integrating volcano science into crisis response and risk reduction practices. During reciprocal visits, delegations tour areas impacted by volcanic unrest and/or eruption, meet with affected communities, and exchange insights and best practices. The 2013 exchange focused on hazards at Mount Rainier (Washington, USA) and Nevado del Ruiz (Caldas/Tolima, Colombia). Both of these volcanoes are highly susceptible to large volcanic mudflows (lahars). The Colombia-USA exchange allowed participants to share insights on lahar warning systems, self-evacuation planning, and effective education programs for at-risk communities. [See Driedger and Ewert (2015) Abstract 76171 presented at 2015 Fall AGU, San Francisco, Calif., Dec 14-18]. The second exchange, in 2015, took place between the USA and Chile, focusing on the Long Valley volcanic region (California, USA) and Chaitén volcano (Lagos, Chile) - both are centers of rhyolite volcanism. The high viscosity of rhyolite magma can cause explosive eruptions with widespread destruction. The rare but catastrophic "super eruptions" of the world have largely been the result of rhyolite volcanism. Chaitén produced the world's first explosive rhyolite eruption in the age of modern volcano monitoring in 2008-2009. Rhyolite eruptions of similar scale and style have occurred frequently in the Long Valley volcanic region, most recently about 600 years ago. The explosivity and relative rarity of rhyolite eruptions create unique challenges to risk reduction efforts. The recent Chaitén eruption was unexpected - little was known of Chaitén's eruptive history, and because of this, monitoring

  16. Are decreases in drug use risk associated with reductions in HIV sex risk behaviors among adults in an urban hospital primary care setting?

    Directory of Open Access Journals (Sweden)

    Angela Wangari Walter, PhD, MPH, MSW

    2016-12-01

    Full Text Available Drug use is associated with increased sexual risk behaviors. We examined whether decreases in drug use risk are associated with reduction in HIV-related sex risk behaviors among adults. Data was from a cohort of participants (n = 574 identified by drug use screening in a randomized trial of brief intervention for drug use in an urban primary care setting. Inverse probability of treatment weighted (IPTW logistic regression models were used to examine the relationship between decreases in drug use risk and sex-related HIV risk behavior reduction from study entry to six months. Weights were derived from propensity score modeling of decreases in drug use risk as a function of potential confounders. Thirty seven percent of the study participants (213/574 reported a decrease in drug use risk, and 7% (33/505 reported decreased sex-related HIV risk behavior at the six-month follow-up point. We did not detect a difference in reduction of risky sexual behaviors for those who decreased drug use risk (unadjusted: OR 1.32, 95% CI 0.65–2.70; adjusted OR [AOR] 1.12, 95% CI 0.54–2.36. Adults who screened positive for high drug use risk had greater odds of reducing sex risk behavior in unadjusted analyses OR 3.71, 95% CI 1.81–7.60; but the results were not significant after adjusting for confounding AOR 2.50, 95% CI 0.85–7.30. In this primary care population, reductions in HIV sex risk behaviors have complex etiologies and reductions in drug use risk do not appear to be an independent predictor of them.

  17. Are decreases in drug use risk associated with reductions in HIV sex risk behaviors among adults in an urban hospital primary care setting?

    Science.gov (United States)

    Walter, Angela Wangari; Cheng, Debbie M; Lloyd-Travaglini, Christine A; Samet, Jeffrey H; Bernstein, Judith; Saitz, Richard

    2016-12-01

    Drug use is associated with increased sexual risk behaviors. We examined whether decreases in drug use risk are associated with reduction in HIV-related sex risk behaviors among adults. Data was from a cohort of participants (n = 574) identified by drug use screening in a randomized trial of brief intervention for drug use in an urban primary care setting. Inverse probability of treatment weighted (IPTW) logistic regression models were used to examine the relationship between decreases in drug use risk and sex-related HIV risk behavior reduction from study entry to six months. Weights were derived from propensity score modeling of decreases in drug use risk as a function of potential confounders. Thirty seven percent of the study participants (213/574) reported a decrease in drug use risk, and 7% (33/505) reported decreased sex-related HIV risk behavior at the six-month follow-up point. We did not detect a difference in reduction of risky sexual behaviors for those who decreased drug use risk (unadjusted: OR 1.32, 95% CI 0.65-2.70; adjusted OR [AOR] 1.12, 95% CI 0.54-2.36). Adults who screened positive for high drug use risk had greater odds of reducing sex risk behavior in unadjusted analyses OR 3.71, 95% CI 1.81-7.60; but the results were not significant after adjusting for confounding AOR 2.50, 95% CI 0.85-7.30). In this primary care population, reductions in HIV sex risk behaviors have complex etiologies and reductions in drug use risk do not appear to be an independent predictor of them.

  18. Feasibility and acceptability of a bar-based sexual risk reduction ...

    African Journals Online (AJOL)

    A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons.

  19. Effect of a sudden infant death syndrome risk reduction education program on risk factor compliance and information sources in primarily black urban communities.

    Science.gov (United States)

    Rasinski, Kenneth A; Kuby, Alma; Bzdusek, Stefanie A; Silvestri, Jean M; Weese-Mayer, Debra E

    2003-04-01

    In the US, a higher incidence of sudden infant death syndrome (SIDS) and a slower decline in the incidence of SIDS has been found among blacks when compared with white infants. The continued racial disparity in SIDS is thought to be attributable to lack of compliance with SIDS risk reduction recommendations. To better understand the disparities in SIDS risk reduction behaviors, we sought to study compliance and information sources related to SIDS among primarily black communities in a city with a high SIDS incidence rate before and after a targeted educational campaign. Pre- and post-SIDS Risk Reduction Education Program telephone surveys were performed in targeted Chicago communities with at least 86% blacks. Data collection for Survey 1 was from September 22 to November 4, 1999. Data collection for Survey 2 was from November 17, 2001, to January 12, 2002, 24 months after the aggressive implementation of a comprehensive, ethnically sensitive risk reduction program. Survey 1 analyzed data from 480 mothers with an infant <12 months of age (327 black, 66 white, and 87 Hispanic) and Survey 2 had 472 mothers (305 black, 77 white, and 90 Hispanic). The incidence of nighttime prone sleeping at Survey 1 was 25% among black respondents, 17% in whites, and 12% in Hispanics and decreased (but not significantly) among all groups by Survey 2. Overall, in Survey 2 compared with Survey 1, fewer mothers reported putting their infants on an adult bed, sofa, or cot both during the day and at night, with the biggest change seen in black mothers for daytime naps. Despite the same educational initiative, blacks increased the use of pillows, stuffed toys, and soft bedding in the sleep environment as compared with whites. More mothers in Survey 2 than in Survey 1 said that they noticed their infants sleeping on their back during the newborn hospitalization. Significantly more black and white mothers in Survey 2 compared with Survey 1 reported that a doctor or nurse had told them what

  20. Impact of the new Sendai framework for disaster risk reduction on Paris flood prevention program

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    Thepot Regis

    2016-01-01

    Full Text Available The greater Paris region faces a significant risk of flooding due to potential spill-over from the Seine and the Marne. Because the last major flood occurred in 1910, the event has faded in the collective memory. Consequently, the population and the public authorities have difficulty imagining that such a catastrophe might repeat itself. In parallel, widespread urban expansion into flood zones has considerably aggravated the foreseeable damage if an event of a comparable intensity were to hit the region.In response to this situation, the EPTB Seine Grands Lacs – a public territorial basin establishment– decided to take action to reduce this risk.It began by commissioning a study from the OECD on flood risk prevention in the Seine Basin. This study was presented in January 2014 and highlighted the considerable risk of flooding in or near Paris, which could, affect a total of nearly 5 million people, cause up to €30 billion in direct damage and affect up to 400.000 jobs. It also put forward 14 recommendations that are being implemented by the public authorities, at either the national, basin or local level.The EPTB launched in partnership with the government a second initiative for which it steers and coordinates a coherent, balanced, relevant and gradual programme of 78 flood prevention actions. As a new post-2015 framework for disaster risk reduction was adopted in Sendai in March 2015 taking in account lessons learned during the 2005-2015 period, gaps identified and future challenges, this paper addresses the question of the impact of this new international framework on the implementation of the flood prevention of Paris region. One of the main points developed is the necessity to increase public awareness, to enhance disaster preparedness for effective response and to “build back better” in recovery rehabilitation and reconstruction.

  1. Bridging Income Generation with Group Integrated Care for cardiovascular risk reduction: Rationale and design of the BIGPIC study.

    Science.gov (United States)

    Vedanthan, Rajesh; Kamano, Jemima H; Lee, Hana; Andama, Benjamin; Bloomfield, Gerald S; DeLong, Allison K; Edelman, David; Finkelstein, Eric A; Hogan, Joseph W; Horowitz, Carol R; Manyara, Simon; Menya, Diana; Naanyu, Violet; Pastakia, Sonak D; Valente, Thomas W; Wanyonyi, Cleophas C; Fuster, Valentin

    2017-06-01

    Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with >80% of CVD deaths occurring in low and middle income countries (LMICs). Diabetes mellitus and pre-diabetes are risk factors for CVD, and CVD is the major cause of morbidity and mortality among individuals with DM. There is a critical period now during which reducing CVD risk among individuals with diabetes and pre-diabetes may have a major impact. Cost-effective, culturally appropriate, and context-specific approaches are required. Two promising strategies to improve health outcomes are group medical visits and microfinance. This study tests whether group medical visits integrated into microfinance groups are effective and cost-effective in reducing CVD risk among individuals with diabetes or at increased risk for diabetes in western Kenya. An initial phase of qualitative inquiry will assess contextual factors, facilitators, and barriers that may impact integration of group medical visits and microfinance for CVD risk reduction. Subsequently, we will conduct a four-arm cluster randomized trial comparing: (1) usual clinical care, (2) usual clinical care plus microfinance groups only, (3) group medical visits only, and (4) group medical visits integrated into microfinance groups. The primary outcome measure will be 1-year change in systolic blood pressure, and a key secondary outcome measure is 1-year change in overall CVD risk as measured by the QRISK2 score. We will conduct mediation analysis to evaluate the influence of changes in social network characteristics on intervention outcomes, as well as moderation analysis to evaluate the influence of baseline social network characteristics on effectiveness of the interventions. Cost-effectiveness analysis will be conducted in terms of cost per unit change in systolic blood pressure, percent change in CVD risk score, and per disability-adjusted life year saved. This study will provide evidence regarding effectiveness and cost

  2. When Are Qualitative Testing Results Sufficient To Predict a Reduction in Illnesses in a Microbiological Food Safety Risk Assessment?

    Science.gov (United States)

    Ebel, Eric D; Williams, Michael S

    2015-08-01

    Process models that include the myriad pathways that pathogen-contaminated food may traverse before consumption and the dose-response function to relate exposure to likelihood of illness may represent a "gold standard" for quantitative microbial risk assessment. Nevertheless, simplifications that rely on measuring the change in contamination occurrence of a raw food at the end of production may provide reasonable approximations of the effects measured by a process model. In this study, we parameterized three process models representing different product-pathogen pairs (i.e., chicken-Salmonella, chicken-Campylobacter, and beef-E. coli O157:H7) to compare with predictions based on qualitative testing of the raw product before consideration of mixing, partitioning, growth, attenuation, or dose-response processes. The results reveal that reductions in prevalence generated from qualitative testing of raw finished product usually underestimate the reduction in likelihood of illness for a population of consumers. Qualitative microbial testing results depend on the test's limit of detection. The negative bias is greater for limits of detection that are closer to the center of the contamination distribution and becomes less as the limit of detection is moved further into the right tail of the distribution. Nevertheless, a positive bias can result when the limit of detection refers to very high contamination levels. Changes in these high levels translate to larger consumed doses for which the slope of the dose-response function is smaller compared with the larger slope associated with smaller doses. Consequently, in these cases, a proportional reduction in prevalence of contamination results in a less than proportional reduction in probability of illness. The magnitudes of the biases are generally less for nonscalar (versus scalar) adjustments to the distribution.

  3. Reduction in cardiometabolic disease risk following gastric bypass surgery among Hispanic adults.

    Science.gov (United States)

    De La Cruz-Muñoz, Nestor; Lopez-Mitnik, Gabriela; Arheart, Kristopher L; Livingstone, Alan S; Miller, Tracie L; Lipshultz, Steven E; Messiah, Sarah E

    2013-08-01

    The increasing prevalence of US morbid obesity is associated with serious health consequences and high medical costs, particularly among ethnic minority groups. Little information is available on the long-term weight and chronic disease risk reduction effectiveness of bariatric surgery among Hispanics. A retrospective medical chart analysis of 633 Hispanic adults (76% female, mean age at surgery 41.3 years) from Central and South America and the Caribbean who underwent gastric bypass surgery from 2002 to 2010 was conducted. A presurgery and 1-year postsurgery comparative means analysis of weight, body mass index (BMI), and cardiometabolic disease risk factors [systolic (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TGs) was performed. Mean weight (127-109 kg) and BMI (46.4-39.9 kg/m(2)) significantly decreased and all cardiometabolic disease risk factors improved from before to 1 year after surgery. Males were significantly more likely than females to show postsurgery improvement in weight (-21.7 kg versus -16.9 kg, P<0.0001), HbA1c (-1.1% versus -0.7%, P=0.02), HDL (3.2 mg/dL versus -0.6 mg/dL, P=0.04), and TGs (-97.2 mg/dL versus -54.5 mg/dL, P=0.006) versus females. Conversely, women were significantly more likely than men to have postsurgery improvements in LDL (-24.5 mg/dL versus -12.7 mg/dL, P=0.04). Gastric bypass surgery results in significant weight loss and cardiometabolic disease risk reduction among Hispanic adults 1 year after surgery. These improvements vary by gender. Gastric bypass surgery is an effective treatment option for weight loss and chronic disease risk improvements in Hispanic adults who are not Mexican American.

  4. Disaster risk reduction policies and regulations in Aceh after the 2004 Indian Ocean Tsunami

    Science.gov (United States)

    Syamsidik; Rusydy, I.; Arief, S.; Munadi, K.; Melianda, E.

    2017-02-01

    The 2004 Indian Ocean Tsunami that struck most of coastal cities in Aceh has motivated a numerous changes in the world of disaster risk reduction including to the policies and regulations at local level in Aceh. This paper is aimed at elaborating the changes of policies and regulations in Aceh captured and monitored during 12-year of the tsunami recovery process. A set of questionnaires were distributed to about 245 respondents in Aceh to represent government officials at 6 districts in Aceh. The districts were severely damaged due to the 2004 tsunami. Four aspects were investigated during this research, namely tsunami evacuation mechanism and infrastructures, disaster risk map, disaster data accessibility, perceptions on tsunami risks, and development of tsunami early warning at local level in Aceh. This research found that the spatial planning in several districts in Aceh have adopted tsunami mitigation although they were only significant in terms of land-use planning within several hundreds meter from the coastline. Perceptions of the government officials toward all investigated aspects were relatively good. One concern was found at coordination among disaster stakeholders in Aceh.

  5. Combining Co-Benefits and Stakeholders Perceptions into Green Infrastructure Selection for Flood Risk Reduction

    Directory of Open Access Journals (Sweden)

    Alida Alves

    2018-02-01

    Full Text Available An important increase in flood risk levels is expected in future decades in many areas around the globe. In addition, the traditional approaches for flood management offer options with low sustainability. As a response, the use of non-traditional drainage measures, also called green infrastructures, has been increasingly suggested in the last years. One important reason for their increasing popularity has been the co-benefits that they offer to the environment. The development of an efficient planning for sustainable urban drainage systems is a complex process that needs the involvement of multiple stakeholders. Moreover, the measures to be adopted should be evaluated considering their potential to achieve multiple benefits related to human well-being, rather than just to flood risk management. In this work, we propose a framework for the selection of green infrastructures on the basis of a co-benefits analysis. The aim is to include the achievement of co-benefits and human well-being into decision-making for flood management, considering the stakeholders’ perceptions to define the most important benefits to be enhanced. The application of the framework presented here to a case study in Ayutthaya, Thailand, shows the importance of including different stakeholder’s opinions. In addition, it shows that decision makers should consider locally defined co-benefits as well as flood risk reduction when defining which green infrastructures to apply.

  6. Coordination of International Risk-Reduction Investigations by the Multilateral Human Research Panel for Exploration

    Science.gov (United States)

    Charles, John B.; Bogomolov, Valery V.

    2015-01-01

    Effective use of the unique capabilities of the International Space Station (ISS) for risk reduction on future deep space missions involves preliminary work in analog environments to identify and evaluate the most promising techniques, interventions and treatments. This entails a consolidated multinational approach to biomedical research both on ISS and in ground analogs. The Multilateral Human Research Panel for Exploration (MHRPE) was chartered by the five ISS partners to recommend the best combination of partner investigations on ISS for risk reduction in the relatively short time available for ISS utilization. MHRPE will also make recommendations to funding agencies for appropriate preparatory analog work. In 2011, NASA's Human Research Program (HRP) and the Institute of Biomedical Problems (IBMP) of the Russian Academy of Science, acting for MHRPE, developed a joint US-Russian biomedical program for the 2015 one-year ISS mission (1YM) of American and Russian crewmembers. This was to evaluate the possibilities for multilateral research on ISS. An overlapping list of 16 HRP, 9 IBMP, 3 Japanese, 3 European and 1 Canadian investigations were selected to address risk-reduction goals in 7 categories: Functional Performance, Behavioral Health, Visual Impairment, Metabolism, Physical Capacity, Microbial and Human Factors. MHRPE intends to build on this bilateral foundation to recommend more fully-integrated multilateral investigations on future ISS missions commencing after the 1YM. MHRPE has also endorsed an on-going program of coordinated research on 6-month, one-year and 6-week missions ISS expeditions that is now under consideration by ISS managers. Preparatory work for these missions will require coordinated and collaborative campaigns especially in the psychological and psychosocial areas using analog isolation facilities in Houston, Köln and Moscow, and possibly elsewhere. The multilateral Human Analogs research working group (HANA) is the focal point of those

  7. Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

    Directory of Open Access Journals (Sweden)

    Jessica J. Skradski, PharmD

    2012-01-01

    Full Text Available Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization’s outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM, lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC and the Medication Possession Ratio (MPR. Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01. The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01. The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence pre enrollment versus post enrollment (+10%, P=0.086. The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable

  8. Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

    Directory of Open Access Journals (Sweden)

    Mallory C. McKenzie

    2012-01-01

    Full Text Available Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM, lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC and the Medication Possession Ratio (MPR. Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01. The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01. The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence pre enrollment versus post enrollment (+10%, P=0.086. The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for

  9. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

    Directory of Open Access Journals (Sweden)

    Monica Zolezzi

    2017-02-01

    Full Text Available Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorst achieved similar knowledge scores, less than half (n = 38, 47% were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32% were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3. Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as major by nursing students. Future integration of interprofessional educational (IPE activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  10. Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers

    Science.gov (United States)

    Galligan, Catherine; Quinn, Margaret

    2017-01-01

    In the United States, home health care (HHC) is a rapidly growing industry and home infusion therapy is a rapidly growing market. HHC can present substantial occupational safety and health (OSH) risks. This article summarizes major OSH risks relevant to home infusion therapy by illustrating them through real-life scenarios collected systematically using qualitative research methods by the National Institute for Occupational Safety and Health-funded research projects at the University of Massachusetts Lowell. The need for home infusion therapy will continue to grow in the future, and safety interventions to prevent or minimize OSH risks are essential. PMID:28683000

  11. Achieving continuous improvement in reductions in foodborne listeriosis: A risk-based approach

    DEFF Research Database (Denmark)

    Gram, Lone

    2005-01-01

    Listeria monocytogenes is a foodborne pathogen that can cause listeriosis, a severe disease that can lead to septicemia, meningitis, and spontaneous abortion. Ongoing efforts are needed to further reduce the incidence of listeriosis, due to its high mortality rate. The focus of this report...... or retard the growth of L. monocytogenes; and (5) using postpackaging treatments to destroy L. monocytogenes on products. Science-based education and risk communication strategies aimed at susceptible populations and focused on high-risk foods should be delivered through health care providers or other...

  12. Wildfire risk reduction in the United States: Leadership staff perceptions of local fire department roles and responsibilities

    Science.gov (United States)

    Rachel S. Madsen; Hylton J. G. Haynes; Sarah M. McCaffrey

    2018-01-01

    As wildland fires have had increasing negative impacts on a range of human values, in many parts of the United States (U.S.) and around the world, collaborative risk reduction efforts among agencies, homeowners, and fire departments are needed to improve wildfire safety and mitigate risk. Using interview data from 46 senior officers from local fire departments around...

  13. Testing an optimized community-based HIV risk reduction and antiretroviral adherence intervention for HIV-infected injection drug users

    Science.gov (United States)

    Copenhaver, Michael M.; Lee, I-Ching; Margolin, Arthur; Bruce, Robert D.; Altice, Frederick L.

    2011-01-01

    We conducted a preliminary study of the 4 session Community-Friendly Health Recovery Program for HIV-infected drug users (CHRP+) which was adapted from a 12 session evidence-based risk reduction and antiretroviral adherence intervention. Improvements were found in the behavioral skills required to properly adhere to HIV medication regimens. Enhancements were found in all measured aspects of sex-risk reduction outcomes including HIV knowledge, motivation to reduce sex-risk behavior, behavioral skills related to engaging in reduced sexual risk, and reduced risk behavior. Improvements in drug use outcomes included enhancements in risk reduction skills as well as reduced heroin and cocaine use. Intervention effects also showed durability from Post-intervention to the Follow-up assessment point. Females responded particularly well in terms of improvements in risk reduction skills and risk behavior. This study suggests that an evidence-based behavioral intervention may be successfully adapted for use in community-based clinical settings where HIV-infected drug users can be more efficiently reached. PMID:21302180

  14. Balancing absolute and relative risk reduction in tobacco control policy: the example of antenatal smoking in Victoria, Australia.

    Science.gov (United States)

    Grills, Nathan; Bolam, Bruce; Piers, Leonard Sunil

    2010-08-01

    This descriptive epidemiological analysis aims to explore the benefits, risks and policy balance between a whole-of-population and high-risk reduction approach to reducing antenatal smoking prevalence. Using Victorian hospital antenatal statistics the rate-ratio for smoking in each hypothesised high prevalence group was calculated and combined with the absolute number of births in each high-risk group. The effect on smoking prevalence of whole-of-population reductions and high-risk group reductions was then modelled. In Victoria, there were higher rates of antenatal smoking among single [RR = 4.67 (3.46-4.42)], teenage women [RR (95%CI) = 3.26 (3.00-3.54)] of indigenous ethnicity [RR = 4.39 (3.94, 4.88)] with low income [RR = 4.67 (4.17-5.22)] and low education attainment [RR = 3.89 (3.47-4.36)] who lived in less accessible areas [RR = 2.14 (1.92-2.39)]. However, as each of these high-risk groups represents a relatively small proportion of mothers, most antenatal smokers are aged 25-34, educated, city-based, non-Indigenous and non-impoverished. The majority of Victorian women who smoke in pregnancy do not belong to traditional high-risk groups. Absolute reductions in smoking prevalence in high-risk groups can potentially be achieved by whole-of-population prevalence reductions, despite a potential continuance in high relative risk among these groups. Conversely, an exclusive focus on smoking reduction in high-risk groups may fail to reduce the whole-of-population antenatal smoking prevalence.

  15. Extension of the survival dimensionality reduction algorithm to detect epistasis in competing risks models (SDR-CR).

    Science.gov (United States)

    Beretta, Lorenzo; Santaniello, Alessandro

    2013-02-01

    The discovery and the description of the genetic background of common human diseases is hampered by their complexity and dynamic behavior. Appropriate bioinformatic tools are needed to account all the facets of complex diseases and to this end we recently described the survival dimensionality reduction (SDR) algorithm in the effort to model gene-gene interactions in the context of survival analysis. When one event precludes the occurrence of another event under investigation in the 'competing risk model', survival algorithms require particular adjustment to avoid the risk of reporting wrong or biased conclusions. The SDR algorithm was modified to incorporate the cumulative incidence function as well as an adapted version of the Brier score for mutually exclusive outcomes, to better search for epistatic models in the competing risk setting. The applicability of the new SDR algorithm (SDR-CR) was evaluated using synthetic lifetime epistatic datasets with competing risks and on a dataset of scleroderma patients. The SDR-CR algorithms retains a satisfactory power to detect the causative variants in simulated datasets under different scenarios of sample size and degrees of type I or type II censoring. In the real-world dataset, SDR-CR was capable of detecting a significant interaction between the IL-1α C-889T and the IL-1β C-511T single-nucleotide polymorphisms to predict the occurrence of restrictive lung disease vs. isolated pulmonary hypertension. We provide an useful extension of the SDR algorithm to analyze epistatic interactions in the competing risk settings that may be of use to unveil the genetic background of complex human diseases. http://sourceforge.net/projects/sdrproject/files/. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. PROVIDING AGRICULTURAL RISKS IN THE REPUBLIC OF MOLDOVA: TRENDS, PROBLEMS AND OPPORTUNITIES

    Directory of Open Access Journals (Sweden)

    Iulia CAPRIAN

    2015-01-01

    Full Text Available In this paper, the author presents results of scientific researches on the problems which farmers of the Republic of Moldova are facing in the field of risk management and insurance. In conclusion, the author formulates recommendations on farm managers’ opportunities to benefit from subsidized insurance, but also some recommendations resulting from the research of the experience of other countries from the European Union aimed to ensure the entrepreneurial risks in agricultural entities.

  17. On the use of a risk ladder: Linking public perception of risks associated with indoor air with cognitive elements and attitudes toward risk reduction

    Science.gov (United States)

    Moschandreas, D. J.; Chang, P. E.

    In recent years a number of building managers have invested small amounts of money to measure indoor air quality in offices and other non-industrial buildings. Their objective is to reduce the number of occupant complaints, and not necessarily to reduce the risk associated with such complaints. Clearly, reduction of the risk would require greater investment of funds and effort. This paper focuses on individuals and the amount of money they are willing to invest in order to reduce risks associated with indoor air pollution in their home. Psychologists assert that lay judgement of risks are influenced by cognitive biases and attitudes. This study investigates the possibility that cognitive elements and general attitudes influence not only the perceived risk associated with exposures to indoor air pollutants, but also the willingness of individuals to invest in order to reduce the risk. A three-stage study was performed to determine some of the factors that influence public decisions to control the quality of the air inside their home. The study is focused on the design of a risk ladder, and the survey of 400 randomly selected individuals in the Chicago metropolitan area. The survey was designed to determine if demographics, smoking, education, or income influence the desire of individuals to invest in order to reduce indoor air pollution. The following conclusions were reached: (i) public awareness of indoor air pollution is high; (ii) media campaigns on indoor air pollution affect the determination of the specific pollutant the public perceives as important, but do not influence the public's desire to invest larger amounts of money to reduce risks from exposures to air pollutants in the residential environment; (iii) the public is not willing to spend large amounts of money to reduce indoor residential air pollution; (iv) education does not affect the level of awareness regarding indoor air pollution, but it increases the willingness to invest in an effort to reduce

  18. Reduction of Perceived Social Distance as an Explanation for Media's Influence on Personal Risk Perceptions: A Test of the Risk Convergence Model

    Science.gov (United States)

    So, Jiyeon; Nabi, Robin

    2013-01-01

    The risk convergence model proposes reduction of perceived social distance to a mediated personality as a mechanism through which the mass media can influence audiences' personal risk perceptions. As an initial test of the model, this study examined whether 5 audience variables known to facilitate media effects on personal risk…

  19. Concurrent administration of sexual assault prevention and risk reduction programming: outcomes for women.

    Science.gov (United States)

    Gidycz, Christine A; Orchowski, Lindsay M; Probst, Danielle R; Edwards, Katie M; Murphy, Megan; Tansill, Erin

    2015-06-01

    The present study describes the 4- and 7-month postintervention outcomes of a sexual assault risk reduction program for women, which was part of an evaluation that included a prevention program for men. Relative to the control group, participants evidenced more relational sexual assertiveness and self-protective behavior, and were more likely to indicate that they utilized active verbal and physical self-defense strategies. Whether or not women experienced subsequent victimization did not differ between groups. Relative to control group women who were victimized, program participants who were victimized between the 4- and 7-month follow-up blamed the perpetrator more and evidenced less self-blame. © The Author(s) 2015.

  20. Fighting Testing ACAT/FRRP: Automatic Collision Avoidance Technology/Fighter Risk Reduction Project

    Science.gov (United States)

    Skoog, Mark A.

    2009-01-01

    This slide presentation reviews the work of the Flight testing Automatic Collision Avoidance Technology/Fighter Risk Reduction Project (ACAT/FRRP). The goal of this project is to develop common modular architecture for all aircraft, and to enable the transition of technology from research to production as soon as possible to begin to reduce the rate of mishaps. The automated Ground Collision Avoidance System (GCAS) system is designed to prevent collision with the ground, by avionics that project the future trajectory over digital terrain, and request an evasion maneuver at the last instance. The flight controls are capable of automatically performing a recovery. The collision avoidance is described in the presentation. Also included in the presentation is a description of the flight test.

  1. NOAA's Joint Polar Satellite System's Proving Ground and Risk Reduction Program - Bringing New Capabilities to Operations!

    Science.gov (United States)

    Sjoberg, B.

    2015-12-01

    This presentation will focus on the NOAA Joint Polar Satellite System (JPSS) Program's Proving Ground and Risk Reduction (PGRR) initiative and how it has prepared NOAA users to effectively utilize new polar-orbiting capabilities. The PGRR Program was established in 2012, following the launch of the Suomi National Polar Partnership (SNPP) satellite. Two sets of PGRR Projects have been established grouped together in thirteen different initiatives. Details about how these projects have been continually tailored through the years to meet user requirements, will be highlighted. The presenter will focus on how the success of the first set of PGRR projects have been used to evaluate a follow-on set of projects and focus on exactly what the JPSS user community needs to meet their mission requirements. Details on the Dec 2014 PGRR Call-for-Proposals and the projects selected for funding will be discussed.

  2. Complex adaptive HIV/AIDS risk reduction: Plausible implications from findings in Limpopo Province, South Africa.

    Science.gov (United States)

    Burman, Chris J; Aphane, Marota A

    2016-05-16

    This article emphasises that when working with complex adaptive systems it is possible to stimulate new social practices and/or cognitive perspectives that contribute to risk reduction, associated with reducing aggregate community viral loads. The process of achieving this is highly participatory and is methodologically possible because evidence of 'attractors' that influence the social practices can be identified using qualitative research techniques. Using findings from Limpopo Province, South Africa, we argue that working with 'wellness attractors' and increasing their presence within the HIV/AIDS landscape could influence aggregate community viral loads. While the analysis that is presented is unconventional, it is plausible that this perspective may hold potential to develop a biosocial response - which the Joint United Nations Programme on HIV and AIDS (UNAIDS) has called for - that reinforces the biomedical opportunities that are now available to achieve the ambition of ending AIDS by 2030.

  3. Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction

    Directory of Open Access Journals (Sweden)

    Rebecca Gyawu

    2015-01-01

    Full Text Available In-store measures were utilized to evaluate the availability of healthy food choices and nutrition/health promotion messages for cancer risk reduction in the selected Alabama Black Belt counties/cities. Sixty one retail food outlets (RFOs were audited in 12 Alabama Black Belt cities. Store types included convenience stores (49.2%, restaurants (19.7%, fast food restaurants (16.4%, small supermarkets (8.2%, and large supermarket and farmers' markets (3.3 %, respectively. Although there were low numbers of farmers' markets/street stands and large supermarkets, these had significantly (p < 0.0001 higher health scores than the other store types. A few health promotion messages were highly visible or obscurely positioned in some RFOs. The Alabama Black Belt food environment had limited opportunities for healthy food choices.

  4. The impact of collaborative strategies on disaster risk reduction in Zimbabwe dairy supply chains in 2016

    Directory of Open Access Journals (Sweden)

    Felix Chari

    2017-09-01

    Full Text Available Disasters are on the increase globally with accompanying devastating effects on dairy supply chains. The devastating effects, caused by disasters on economies in various countries such as United States of America, Japan, Kenya, Uganda, Mozambique and Zimbabwe call for urgent sustainable mitigating measures in disaster risk reduction. These countries have experienced notable natural and man-made disasters in the past. The disasters negatively impacted the economies of both developed and developing countries, causing misery to people as hunger and poverty drastically increased. Zimbabwe’s dairy industry was not spared from these devastating effects as it was vulnerable to disasters such as droughts and cyclones. Disasters adversely affected supply chains in the country as evidenced by the closure of some dairy firms between the years 2000 and 2014. This article is set against the backdrop of declining output across all agricultural sectors in Zimbabwe, evident particularly in the dairy farming sector which has witnessed inadequate supply of raw milk and dairy products by local producers. The article assesses the impact of dairy organisations’ partnerships with government departments and non-governmental organisations in reducing disaster risks on the dairy supply chain cost efficiency. It also aims to show how partnerships can reduce disaster risks and weighs the benefits of reduced supply chain costs in improving the affordability of milk and milk products to the general public. The study employs a mixed-methods approach comprising structured questionnaires, administered to a sample of 92 respondents out of a randomly sampled population of 122 participants from dairy farming clusters across the country, with an 85% response rate. Key informants in the form of 18 dairy officers were purposively sampled for interviews throughout the dairy farming regions. The research findings will help government in the formulation of public policies for the

  5. School-based primary NCD risk reduction: education and public health perspectives.

    Science.gov (United States)

    Bay, Jacquie L; Hipkins, Rosemary; Siddiqi, Kamran; Huque, Rumana; Dixon, Robyn; Shirley, Debra; Tairea, Karen; Yaqona, Delaney; Mason-Jones, Amanda; Vickers, Mark H

    2017-04-01

    The rising global burden of noncommunicable diseases (NCDs) has heightened awareness of the necessity for primary risk prevention programmes. These aim to facilitate long-term behaviour changes in children and adolescents that can reduce NCD risk factors and disease onset in later-life. School-based programmes designed to improve childhood and adolescent health behaviours and wellbeing contribute to this; however, design and impact assessment of these is complex. These programmes should be multidisciplinary, utilizing both educational and health expertise. Health outcomes may not be evident in the short term, but may occur with learning-related behaviour modifications, highly effective when sustained over a lifetime. Thus assessment must analyse short-term learning and behaviour impacts as well as long-term capability, behaviour and health outcomes.The focus of assessment measures in the health and education sectors differs and often lacks depth in one or other area. Educators generally focus on identifying evidence of learning related to capability, attitude and/or behaviour changes, while public health practitioners typically focus on health measures (e.g. body mass index (BMI), mental health, or risk behaviours).We argue that multidisciplinary approaches incorporating education and health viewpoints clarify issues relating to the potential value of schools as a setting to facilitate primary NCD risk reduction. To demonstrate this, we need to: 1) build stronger understandings of the features of effective learning for behavioural change and the best way to evaluate these, and 2) convincingly correlate these measures with long-term metabolic health indicators by tracking learner behaviour and health over time. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Chain of custody as an organizing framework in seafood risk reduction.

    Science.gov (United States)

    Yasuda, Tomohide; Bowen, Robert E

    2006-01-01

    Changes in the terms and direction of international trade in seafood, an increased understanding of and concern for the public health risk imposed by seafood products, and advances in information management technology combine to open opportunities to manage more effectively seafood-borne risk. Present regulatory mandates and programs lack sufficient integration for effective risk mitigation and do not adequately reflect the trans-national nature of seafood trade or the increased complexity of seafood production. This paper argues that the concept of a "chain of custody" - from the ocean to the final consumer - provides a useful integrating framework for understanding and refining efforts to reduce public health concerns surrounding the consumption of seafood.

  7. Multi scale Disaster Risk Reduction Systems Space and Community based Experiences over HKH Region

    Science.gov (United States)

    Gurung, D. R.; Shrestha, M.; Shrestha, N.; Debnath, B.; Jishi, G.; Bajracharya, R.; Dhonju, H. K.; Pradhan, S.

    2014-11-01

    An increasing trend in the recurrence of natural disasters and associated impacts due to Floods, Glacier Lake out bursts, landslides and forest fire is reported over Hindu Kush Himalyan (HKH) region. Climate change and anthropogenic coupled factors are identified as primary factors for such increased vulnerability. The large degree of poverty, lack of infrastructure, poor accessibility and uncertainties involved in understanding high altitude land surface and climate dynamics poses serious challenges in reducing disaster vulnerability and mitigating disaster impacts. In this context effective development of Disaster Risk Reduction (DRR) protocols and mechanisms have been realized as an urgent need. The paper presents the adoption and experiences of multi scale DRR systems across different Himalayan member countries ranging from community based indigenous early warning to space based emergency response and decision support systems. The Establishment of a Regional Flood Information System (HKH-HYCOS) over Ganges-Brahmaputra-Meghna (GBM) and Indus river basins promoted the timely exchange of flood data and information for the reduction of flood vulnerability within and among the participating countries. Satellite based forest fire alert systems evoked significant response among diverse stakeholders to optimize fire incidence and control. Satellite rainfall estimation products, satellite altimetry based flood early warning systems, flood inundation modelling and products, model derived hydrology flow products from different global data-sharing networks constitutes diverse information to support multi scale DRR systems. Community-based Flood Early Warning System (FEWS) enabled by wireless technology established over the Singara and Jiadhal rivers in Assam also stands as one of the promising examples of minimizing flood risk. Disaster database and information system and decision support tools in Nepal serves as potential tool to support diverse stakeholders.

  8. Enriching the Description of Learning Resources on Disaster Risk Reduction in the Agricultural Domain: An Ontological Approach

    Science.gov (United States)

    Zschocke, Thomas; Villagrán de León, Juan Carlos; Beniest, Jan

    The collection, compilation and dissemination of relevant information and knowledge about the risk of natural disasters is a critical element in the Hyogo Framework for Action 2005-2015 for disaster risk reduction. Knowledge, innovation and education are needed not only to build a culture of safety and resilience at all levels, but also to mainstream disaster risk reduction especially in weather and climate-sensitive sectors such as agriculture. Describing learning resources about these topics with semantic metadata enhances their availability and further facilitates the search and retrieval process by using richer annotations based on ontologies. This paper reports about ongoing work concerning the creation of a domain ontology based on AGROVOC as well as the UN/ISDR and related terminology on disaster risk reduction for the description of associated learning resources in the agricultural domain.

  9. Mothers' knowledge and attitudes to sudden infant death syndrome risk reduction messages: results from a UK survey.

    Science.gov (United States)

    Pease, Anna S; Blair, Peter S; Ingram, Jenny; Fleming, Peter J

    2018-01-01

    To investigate mothers' knowledge of reducing the risks for sudden infant death syndrome (SIDS) and attitudes towards safer sleep practices. A cross-sectional survey was carried out in deprived areas of Bristol, UK. Recruitment took place in 2014 at local health visitor-led baby clinics. Of 432 mothers approached, 400 (93%) completed the face-to-face survey. Participants with infants at 'higher' risk of SIDS (using an algorithm based on a previous observational study) were compared with those at 'lower' risk. The survey asked participants to recall three SIDS risk reduction strategies (unprompted), and scored responses to 14 SIDS risk-related infant sleep scenarios (prompted). Overall, 48/400 (12%) mothers were classified as higher risk. Mothers in the higher risk group were less likely to breast feed (multivariate OR=3.59(95% CI 1.46 to 8.86)), less likely to be able to cite two or more unprompted correct SIDS risk reduction strategies (multivariate OR=2.05(95% CI 1.02 to 4.13)) and scored lower on prompted safer sleep scenarios overall.Notably, only 206/400 (52%) of all mothers surveyed (33% in the higher risk group) from these deprived areas in Bristol identified infant sleep position as a risk reduction strategy for SIDS, despite 25 years of campaigns. Mothers in the higher risk group were disadvantaged when it came to some aspects of knowledge of SIDS risk reduction and attitudes to safer sleep. The initial 'Back-to Sleep' message that dramatically reduced these deaths a generation ago needs more effective promotion for today's generation of mothers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. The effects of providing periodontal disease risk information on psychological outcomes - a randomized controlled trial.

    Science.gov (United States)

    Asimakopoulou, Koula; Newton, Jonathon Tim; Daly, Blánaid; Kutzer, Yvonne; Ide, Mark

    2015-04-01

    In a two arm randomized controlled trial this study compared the effects of a routine periodontal assessment consultation versus a routine consultation + individualized risk assessment communication intervention on patient thoughts and emotions about periodontal disease. Adults (N = 102) with moderate/advanced chronic periodontitis referred to a Periodontology Department of a large UK dental school, completed psychological measures before a periodontal assessment and again at the end of the visit. Intervention participants received an individualized calculation of their periodontal disease risk using PreViser Risk Calculator in addition to their routine assessment consultation. In routine care, patients' thoughts about periodontal disease seriousness (p periodontal disease. These effects were also seen in intervention participants. Additionally, the individualized risk communication intervention led to patients reporting i) periodontal disease treatment as more effective than they did pre-consultation (p periodontal management (p periodontal disease risk communication influences psychological variables that underpin adherence with periodontal instructions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Assessing adaptation to the health risks of climate change: what guidance can existing frameworks provide?

    Science.gov (United States)

    Füssel, Hans-Martin

    2008-02-01

    Climate change adaptation assessments aim at assisting policy-makers in reducing the health risks associated with climate change and variability. This paper identifies key characteristics of the climate-health relationship and of the adaptation decision problem that require consideration in climate change adaptation assessments. It then analyzes whether these characteristics are appropriately considered in existing guidelines for climate impact and adaptation assessment and in pertinent conceptual models from environmental epidemiology. The review finds three assessment guidelines based on a generalized risk management framework to be most useful for guiding adaptation assessments of human health. Since none of them adequately addresses all key challenges of the adaptation decision problem, actual adaptation assessments need to combine elements from different guidelines. Established conceptual models from environmental epidemiology are found to be of limited relevance for assessing and planning adaptation to climate change since the prevailing toxicological model of environmental health is not applicable to many climate-sensitive health risks.

  12. Drinking in social groups. Does 'groupdrink' provide safety in numbers when deciding about risk?

    Science.gov (United States)

    Hopthrow, Tim; Randsley de Moura, Georgina; Meleady, Rose; Abrams, Dominic; Swift, Hannah J

    2014-06-01

    To investigate the impact of alcohol consumption on risk decisions taken both individually and while part of a four- to six-person ad-hoc group. A 2 (alcohol: consuming versus not consuming alcohol) × 2 (decision: individual, group) mixed-model design; decision was a repeated measure. The dependent variable was risk preference, measured using choice dilemmas. Opportunity sampling in campus bars and a music event at a campus-based university in the United Kingdom. A total of 101 individuals were recruited from groups of four to six people who either were or were not consuming alcohol. Participants privately opted for a level of risk in response to a choice dilemma and then, as a group, responded to a second choice dilemma. The choice dilemmas asked participants the level of accident risk at which they would recommend someone could drive while intoxicated. Five three-level multi-level models were specified in the software program HLM 7. Decisions made in groups were less risky than those made individually (B = -0.73, P < 0.001). Individual alcohol consumers opted for higher risk than non-consumers (B = 1.27, P = 0.025). A significant alcohol × decision interaction (B = -2.79, P = 0.001) showed that individual consumers privately opted for higher risk than non-consumers, whereas risk judgements made in groups of either consumers or non-consumers were lower. Decisions made by groups of consumers were less risky than those made by groups of non-consumers (B = 1.23, P < 0.001). Moderate alcohol consumption appears to produce a propensity among individuals towards increased risk-taking in deciding to drive while intoxicated, which can be mitigated by group monitoring processes within small (four- to six-person) groups. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  13. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

    Science.gov (United States)

    Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

    2015-06-16

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

  14. Disaster risk reduction in the Omusati and Oshana regions of Namibia

    Directory of Open Access Journals (Sweden)

    Elina Amadhila

    2013-03-01

    Full Text Available Namibia often experiences heavy rains in the north and north-eastern parts of the country, which results in severe flooding. For this reason, the country has endorsed the Hyogo Framework for Action (HFA which seeks to develop the resilience of nations and communities to disasters and to assist countries to move away from the approach of emergency response to one of integrated disaster risk reduction. The aim of this article is to assess the resilience of the communities within the identified regions. A quantitative questionnaire was designed to assess people at risk of disaster related impacts. The questionnaire used 20 indicators to measure the level of progress at local level and how local governance plays a role in the mitigation and management of disasters. Analysis of data was done on a limited number of descriptors such as age, gender and local governance involvement, amongst others. There was generally a very high perception of threat (38% in the study regions. Women perceived threat more accurately (mean = 4.09 than men. The community perceived threat more accurately than local government and civil society (mean = 4.08.

  15. Left atrial appendage closure devices for cardiovascular risk reduction in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Cruz-Gonzalez I

    2015-05-01

    Full Text Available Ignacio Cruz-Gonzalez,* Juan Carlos Rama-Merchan,* Javier Rodriguez-Collado, Javier Martin-Moreiras, Alejandro Diego-Nieto, Antonio Arribas-Jimenez, Pedro Luís SanchezDepartment of Cardiology, University Hospital of Cardiology and IBSAL, Salamanca, Spain *Ignacio Cruz-Gonzalez and Juan Carlos Rama-Merchan have contributed equally to this work and should be considered co-first authors Abstract: Atrial fibrillation (AF is the most common sustained arrhythmia in clinical practice. AF is associated with a 4–5-fold increased risk of stroke and systemic embolism. Oral anticoagulant is the first-line therapy for this purpose, but it has various limitations and is often contraindicated or underutilized. Autopsy and surgical data have suggested that 90% of atrial thrombi in nonvalvular AF patients originate from the left atrial appendage, leading to the development of percutaneous closure for thromboembolic prevention. This paper examines the current evidence on left atrial appendage closure devices for cardiovascular risk reduction in AF patients. Keywords: atrial fibrillation, left atrial appendage, stroke, oral anticoagulant, percutaneous closure, thromboembolic prevention

  16. Gender identity, healthcare access, and risk reduction among Malaysia's mak nyah community.

    Science.gov (United States)

    Gibson, Britton A; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A; Kamarulzaman, Adeeba; Altice, Frederick L

    2016-01-01

    Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalise them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilisation patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally sensitive prevention and healthcare services for TGW.

  17. Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination.

    Science.gov (United States)

    Krajčinović, S S; Doronjski, A; Barišić, N; Stojanović, V

    2015-03-01

    False-positive blood cultures findings may lead to a falsely increased morbidity and increased hospital costs. The survey was conducted as retrospective - prospective study and included 239 preterm infants (born before 37 weeks of gestation) who were treated in Neonatal Intensive Care Unit (NICU) in Institute for Child and Youth Health Care of Vojvodina during one year (January 1st, 2012 to December 31st, 2012). The retrospective part of the study focused on examination of incidence of neonatal sepsis and determination of risk factors. In the prospective part of the study infants were sub-divided into two groups: Group 1- infants hospitalized in NICU during the first 6 months of the study; blood cultures were taken by the "clean technique" and checklists for this procedure were not taken. Group 2- neonates hospitalized in NICU during last 6 months of the study; blood cultures were taken by "sterile technique" and checklists for this procedure were taken. The main risk factors for sepsis were prelabor rupture of membranes, low gestational age, low birth weight, mechanical ventilation, umbilical venous catheter placement, and abdominal drainage. Staphylococcus aureus and coagulase negative Staphylococcus were the most frequently isolated microorganisms in false-positive blood samples. Education of employees, use of checklists and sterile sets for blood sampling, permanent control of false positive blood cultures, as well as regular and routine monthly reports are crucial for successful reduction of contamination rates.

  18. Gender identity, healthcare access, and risk reduction among Malaysia’s mak nyah community

    Science.gov (United States)

    Gibson, Britton A.; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Altice, Frederick L.

    2016-01-01

    Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalize them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilization patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally-sensitive prevention and healthcare services for TGW. PMID:26824463

  19. Regulatory Risk Reduction for Advanced Reactor Technologies – FY2016 Status and Work Plan Summary

    Energy Technology Data Exchange (ETDEWEB)

    Moe, Wayne Leland [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-08-01

    Millions of public and private sector dollars have been invested over recent decades to realize greater efficiency, reliability, and the inherent and passive safety offered by advanced nuclear reactor technologies. However, a major challenge in experiencing those benefits resides in the existing U.S. regulatory framework. This framework governs all commercial nuclear plant construction, operations, and safety issues and is highly large light water reactor (LWR) technology centric. The framework must be modernized to effectively deal with non-LWR advanced designs if those designs are to become part of the U.S energy supply. The U.S. Department of Energy’s (DOE) Advanced Reactor Technologies (ART) Regulatory Risk Reduction (RRR) initiative, managed by the Regulatory Affairs Department at the Idaho National Laboratory (INL), is establishing a capability that can systematically retire extraneous licensing risks associated with regulatory framework incompatibilities. This capability proposes to rely heavily on the perspectives of the affected regulated community (i.e., commercial advanced reactor designers/vendors and prospective owner/operators) yet remain tuned to assuring public safety and acceptability by regulators responsible for license issuance. The extent to which broad industry perspectives are being incorporated into the proposed framework makes this initiative unique and of potential benefit to all future domestic non-LWR applicants

  20. A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Type 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, particularly given its cultural familiarity. Methods This was a parallel, randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes. Primary outcomes included: changes in BMI, waist circumference, fasting blood glucose, postprandial blood glucose, insulin, insulin resistance, blood pressure, and cholesterol. We also looked at measures of psychological well-being including changes in depression, anxiety, positive and negative affect and perceived stress. Forty-one participants with elevated fasting blood glucose in Bangalore, India were randomized to either yoga (n = 21) or a walking control (n = 20). Participants were asked to either attend yoga classes or complete monitored walking 3–6 days per week for eight weeks. Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed, opaque envelopes generated by off-site study staff. Data were analyzed based on intention to treat. Results This study was feasible in terms of recruitment, retention and adherence. In addition, yoga participants had significantly greater reductions in weight, waist circumference and BMI versus control (weight −0.8 ± 2.1 vs. 1.4 ± 3.6, p = 0.02; waist circumference −4.2 ± 4.8 vs. 0.7 ± 4.2, p yoga intervention and walking control over the course of the study. Conclusion Among Indians with elevated fasting blood glucose, we found that participation in an 8-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control. Yoga offers a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and potentially increasing

  1. Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer.

    Science.gov (United States)

    Parada-Huerta, E; Alvarez-Dominguez, Tp; Uribe-Escamilla, R; Rodriguez-Joya, Jf; Ponce-Medrano, Ja Diaz; Padron-Lucio, S; Alfaro-Rodriguez, A; Bandala, C

    2016-01-01

    Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked β2-adrenergic receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel- Haenszel, Student t, and ANOVA tests were performed for data analysis. On average, patients were 54.8±11.8 years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for β1 - and β2 -adrenergic-receptors did not present metastasis globally, but patients treated with β1 BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. In Mexican patients with BCa and SAH treated with non-selective (β1- and β2-adrenergic receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

  2. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation.

    Science.gov (United States)

    Zibadi, Sherma; Rohdewald, Peter J; Park, Danna; Watson, Ronald Ross

    2008-05-01

    Patients with type 2 diabetes are at considerable risk of excessive morbidity and mortality from cardiovascular disease (CVD). We investigated the clinical effectiveness of Pycnogenol, a flavonoid-rich dietary supplement, in reducing antihypertensive medication use and CVD risk factors in subjects with type 2 diabetes. Forty-eight individuals were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patients were diagnosed with both type 2 diabetes and mild to moderate hypertension and were undergoing treatment with angiotensin-converting enzyme (ACE) inhibitors. Subjects were randomly assigned to receive either Pycnogenol pill (125 mg daily) or matched placebo for 12 weeks. According to the values of blood pressure (BP) measured at 2-week intervals, the pretrial ACE inhibitor dosage was left unchanged, reduced by 50%, or brought back to the pretrial dosage until a stable BP was obtained. Fasting plasma glucose, low-density lipoprotein (LDL) cholesterol, glycosylated hemoglobin (HbA1c), serum endothelin-1, and urinary albumin were evaluated monthly. Pycnogenol treatment achieved BP control in 58.3% of subjects at the end of the 12 weeks with 50% reduction in individual pretrial dose of ACE-inhibitors (P Pycnogenol-treated group vs 0.5 pg/mL increase in control group (P Pycnogenol-treated group (P Pycnogenol-treated group vs 5.7 mg/dL in control group (P Pycnogenol-treated group, declining by 12.7 mg/dL (P Pycnogenol resulted in improved diabetes control, lowered CVD risk factors, and reduced antihypertensive medicine use vs controls.

  3. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

    Directory of Open Access Journals (Sweden)

    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  4. Cardiovascular risk reduction and weight management at a hospital-based postpartum preeclampsia clinic.

    Science.gov (United States)

    Janmohamed, Rahim; Montgomery-Fajic, Erin; Sia, Winnie; Germaine, Debbie; Wilkie, Jodi; Khurana, Rshmi; Nerenberg, Kara A

    2015-04-01

    Women who develop preeclampsia during pregnancy are at high risk of developing future chronic diseases, including premature cardiovascular disease. We have established an interdisciplinary clinic that aims to prevent cardiovascular disease through educational counselling focused on lifestyle modifications in the early postpartum period. The objective of this study was to evaluate changes in weight and cardiovascular risk factors in participating women after six months of attendance at the clinic. We conducted a retrospective chart review of women who had a pregnancy complicated by preeclampsia, and who subsequently attended the Postpartum Preeclampsia Clinic. Study subjects had baseline assessments of lifestyle, physical, and laboratory parameters. Individualized goals for cardiovascular risk reduction and lifestyle were established, centering on physical activity and dietary modifications. The primary outcome was change in weight. Over the study period, 21 women were seen for a minimum of six months of follow-up. At an average (± SD) of 4.4 ± 1.4 months postpartum, subjects showed a non-significant improvement in weight (mean weight loss of 0.4 ± 4.5 kg) and BMI (mean decrease in BMI 0.1 ± 1.7 kg/m2). Physical activity improved significantly, from 14% of subjects participating in physical activity before pregnancy to 76% at a mean of 4.4 months postpartum. This study has demonstrated the early benefits of a longitudinal interdisciplinary intervention with counselling about lifestyle modifications for prevention of cardiovascular disease in women with recent preeclampsia. A study with a larger sample size and longer duration of follow-up is planned to confirm these findings.

  5. Effects of providing personalized feedback of child's obesity risk on mothers' food choices using a virtual reality buffet.

    Science.gov (United States)

    McBride, C M; Persky, S; Wagner, L K; Faith, M S; Ward, D S

    2013-10-01

    Providing personalized genetic-risk feedback of a child's susceptibility to adult-onset health conditions is a topic of considerable debate. Family health history (FHH), specifically parental overweight/obesity status, is a useful assessment for evaluating a child's genetic and environmental risk of becoming obese. It is unclear whether such risk information may influence parents' efforts to reduce their child's risk of obesity. To evaluate whether telling mothers the magnitude of their child's risk of becoming obese based on personal FHH influenced food choices for their young child from a virtual reality-based buffet restaurant. Overweight/obese mothers of a child aged 4-5 years who met eligibility criteria (N=221) were randomly assigned to one of three experimental arms, which emphasized different health information: arm 1, food safety control (Control); arm 2, behavioral-risk information (BRI) alone or arm 3, behavioral-risk information plus personal FHH-based risk assessment (BRI+FHH). Mothers donned a head-mounted display to be immersed in a virtual restaurant buffet, where they selected virtual food and beverages as a lunch for their child. Mothers who were randomized to BRI+FHH filled the index child's plate with an average of 45 fewer calories than those in the Control arm (Pparent). The influence of communicating a child's inherited risk of obesity on mothers' feeding practices may vary by the risk level conveyed. High-risk messages may best be coupled with strategies to increase mother's perceptions that efforts can be undertaken to reduce risk and build requisite behavioral skills to reduce risk.

  6. Exploring the Potential Emotional and Behavioural Impact of Providing Personalised Genomic Risk Information to the Public: A Focus Group Study.

    Science.gov (United States)

    Smit, Amelia K; Keogh, Louise A; Newson, Ainsley J; Hersch, Jolyn; Butow, Phyllis; Cust, Anne E

    2015-01-01

    To explore the potential emotional and behavioural impact of providing information on personalised genomic risk to the public, using melanoma as an example, to aid research translation. We conducted four focus groups in which 34 participants were presented with a hypothetical scenario of an individual's lifetime genomic risk of melanoma (using the term 'genetic risk'). We asked about understanding of genetic risk, who would choose to receive this risk information, potential emotional and behavioural impacts, and other concerns or potential benefits. Data were analysed thematically. Participants thought this risk information could potentially motivate preventive behaviours such as sun protection and related it to screening for other diseases including breast cancer. Factors identified as influencing the decision to receive genetic risk information included education level, children, age and gender. Participants identified potential negative impacts on the recipient such as anxiety and worry, and proposed that this could be mitigated by providing additional explanatory and prevention information, and contact details of a health professional for further discussion. Participants' concerns included workplace and insurance discrimination. Participants recognised the potential for both positive and negative emotional and behavioural impacts related to receiving information on the personalised genomic risk of melanoma. © 2015 S. Karger AG, Basel.

  7. HIV risk inside U.S. prisons: a systematic review of risk reduction interventions conducted in U.S. prisons.

    Science.gov (United States)

    Valera, Pamela; Chang, Yvonne; Lian, Zi

    2017-08-01

    HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.

  8. Reduction by coffee consumption of prostate cancer risk: Evidence from the Moli-sani cohort and cellular models.

    Science.gov (United States)

    Pounis, George; Tabolacci, Claudio; Costanzo, Simona; Cordella, Martina; Bonaccio, Marialaura; Rago, Livia; D'Arcangelo, Daniela; Filippo Di Castelnuovo, Augusto; de Gaetano, Giovanni; Donati, Maria Benedetta; Iacoviello, Licia; Facchiano, Francesco

    2017-07-01

    Meta-analytic data on the effect of coffee in prostate cancer risk are controversial. Caffeine as a bioactive compound of coffee has not yet been studied in deep in vitro. Our study aimed at evaluating in a population cohort the effect of Italian-style coffee consumption on prostate cancer risk and at investigating in vitro the potential antiproliferative and antimetastatic activity of caffeine on prostate cancer cell lines. 6,989 men of the Moli-sani cohort aged ≥50 years were followed for a mean of 4.24 ± 1.35 years and 100 new prostate cancer cases were identified. The European Prospective Investigation into Cancer and Nutrition-Food Frequency Questionnaire was used for the dietary assessment and the evaluation of Italian-style coffee consumption. Two human prostate cancer cell lines, PC-3 and DU145, were tested with increasing concentrations of caffeine, and their proliferative/metastatic features were evaluated. The newly diagnosed prostate cancer participants presented lower coffee consumption (60.1 ± 51.3 g/day) compared to the disease-free population (74.0 ± 51.7 g/day) (p 3 cups/day) had 53% lower prostate cancer risk as compared to participants at the lowest consumption (0-2 cups/day) (p = 0.02). Both human prostate cancer cell lines treated with caffeine showed a significant reduction in their proliferative and metastatic behaviors (p coffee consumption of prostate cancer risk (>3 cups/day) was observed in epidemiological level. Caffeine appeared to exert both antiproliferative and antimetastatic activity on two prostate cancer cell lines, thus providing a cellular confirmation for the cohort study results. © 2017 UICC.

  9. Mediators of behavior change resulting from a sexual risk reduction intervention for STI patients, Cape Town, South Africa.

    Science.gov (United States)

    Pitpitan, Eileen V; Kalichman, Seth C; Garcia, Randi L; Cain, Demetria; Eaton, Lisa A; Simbayi, Leickness C

    2015-04-01

    Theory-based sexual risk reduction interventions are often demonstrated effective, but few studies have examined the mechanisms that mediate their behavior changes. In addition, critical contextual factors, such as alcohol use, are often not accounted for by social cognitive theories and may add to the explanatory value of intervention effects. The purpose of this study is to examine the underlying mechanisms driving condom use following a brief sexual risk reduction intervention grounded in the information, motivation, behavioral skills (IMB) model of behavior change. We examined IMB theoretical constructs and alcohol-related contextual factors as potential mediators in separate models. Patients (n = 617) from an STI clinic in Cape Town, South Africa were randomly assigned to either a brief risk reduction intervention or an education-only control condition. We assessed IMB, and alcohol-related variables at baseline, 3, 6, 9, and 12 months and modeled IMB constructs and alcohol-related factors as mediators of behavior change. Results of growth-curve mediational modeling showed that 1 year after counseling, the intervention indirectly affected sexual risk behavior through alcohol-related constructs, but not IMB constructs. Alcohol use and related factors play critical roles in explaining HIV and STI risk reduction intervention effects. Interventions that directly address alcohol use as a factor in sexual risk behavior and behavior change should be the focus of future research.

  10. Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial.

    Science.gov (United States)

    Sosnoff, Jacob J; Moon, Yaejin; Wajda, Douglas A; Finlayson, Marcia L; McAuley, Edward; Peterson, Elizabeth W; Morrison, Steve; Motl, Robert W

    2015-10-01

    To determine the feasibility of three fall prevention programs delivered over 12 weeks among individuals with multiple sclerosis: (A) a home-based exercise program targeting physiological risk factors; (B) an educational program targeting behavioral risk factors; and (C) a combined exercise-and-education program targeting both factors. Randomized controlled trial. Home-based training with assessments at research laboratory. A total of 103 individuals inquired about the investigation. After screening, 37 individuals with multiple sclerosis who had fallen in the last year and ranged in age from 45-75 years volunteered for the investigation. A total of 34 participants completed postassessment following the 12-week intervention. Participants were randomly assigned into one of four conditions: (1) wait-list control (n = 9); (2) home-based exercise (n = 11); (3) education (n = 9); or (4) a combined exercise and education (n = 8) group. Before and after the 12-week interventions, participants underwent a fall risk assessment as determined by the physiological profile assessment and provided information on their fall prevention behaviors as indexed by the Falls Prevention Strategy Survey. Participants completed falls diaries during the three-months postintervention. A total of 34 participants completed postintervention testing. Procedures and processes were found to be feasible. Overall, fall risk scores were lower in the exercise groups (1.15 SD 1.31) compared with the non-exercise groups (2.04 SD 1.04) following the intervention (p 0.05). Further examination of home-based exercise/education programs for reducing falls in individuals with multiple sclerosis is warranted. A total of 108 participants would be needed in a larger randomized controlled trial.ClinicalTrials.org #NCT01956227. © The Author(s) 2014.

  11. Monitoring of Microbial Loads During Long Duration Missions as a Risk Reduction Tool

    Science.gov (United States)

    Roman, Monsi C.

    2011-01-01

    Humans have been exploring space for more than 40 years. For all those years microorganisms have accompanied, first un-manned spacecraft/cargo and later manned vessels. Microorganisms are everywhere on Earth, could easily adapt to new environments and/or can rapidly mutate to survive in very harsh conditions. Their presence in spacecraft and cargo have caused a few inconveniences over the years of humans spaceflight, ranging from crew health, life support systems challenges and material degradation. The sterilization of spacecraft that will host humans in long duration mission would be a costly operation that will not provide a long-term solution to the microbial colonization of the vessels. As soon as a human is exposed to the spacecraft, during the mission, microorganisms will start to populate the new environment. As the hum an presence in space increases in length, the risk from the microbial load, to hardware and crew will also increase. Mitigation of this risk includes several different strategies that will include minimizing the microbial load (in numbers and diversity) and monitoring. This presentation will provide a list of the risk mitigation strategies that should be implemented during ground processing, and during the mission. It will also discuss the areas that should be discussed before an effective in-flight microbial monitoring regimen is implemented. Microbial monitoring technologies will also be presented.

  12. Monitoring of Microbial Loads During Long Duration Missions as a Risk Reduction Tool

    Science.gov (United States)

    Roman, M. C.; Mena, K. D.

    2012-01-01

    Humans have been exploring space for more than 40 years. For all those years, microorganisms have accompanied both un-manned spacecraft/cargo and manned vessels. Microorganisms are everywhere on Earth, could easily adapt to new environments, and/or can rapidly mutate to survive in very harsh conditions. Their presence in spacecraft and cargo have caused a few inconveniences over the years of human spaceflight, ranging from crew health, life support systems challenges, and material degradation. The sterilization of spacecraft that will host humans in long duration mission would be a costly operation that will not provide a long-term solution to the microbial colonization of the vessels. As soon as a human is exposed to the spacecraft, microorganisms start populating the new environment during the mission. As the human presence in space increases in length, the risk from the microbial load to hardware and crew will also increase. Mitigation of this risk involves several different strategies that will include minimizing the microbial load (in numbers and diversity) and monitoring. This paper will provide a list of the risk mitigation strategies that should be implemented during ground processing, and during the mission. It will also discuss the areas that should be reviewed before an effective in-flight microbial monitoring regimen is implemented.

  13. Utilizing Provider Feedback to Develop Opioid Risk Mitigation Tools for the Military Health System

    Science.gov (United States)

    2017-08-27

    complex environment of care, treating patients who are often mobile and whose prior prescription history may be difficult to access. Clinical Decision...Support (CDS) tools provide healthcare providers with knowledge and detailed information to enhance decision-making in the clinical workflow and

  14. Mendelian randomisation analysis provides no evidence for a relationship between adult height and testicular cancer risk.

    Science.gov (United States)

    Levy, M; Hall, D; Sud, A; Law, P; Litchfield, K; Dudakia, D; Haugen, T B; Karlsson, R; Reid, A; Huddart, R A; Grotmol, T; Wiklund, F; Houlston, R S; Turnbull, C

    2017-09-01

    Observational studies have suggested anthropometric traits, particularly increased height are associated with an elevated risk of testicular cancer (testicular germ cell tumour). However, there is an inconsistency between study findings, suggesting the possibility of the influence of confounding factors. To examine the association between anthropometric traits and testicular germ cell tumour using an unbiased approach, we performed a Mendelian randomisation study. We used genotype data from genome wide association studies of testicular germ cell tumour totalling 5518 cases and 19,055 controls. Externally weighted polygenic risk scores were created and used to evaluate associations with testicular germ cell tumour risk per one standard deviation (s.d) increase in genetically-defined adult height, adult BMI, adult waist hip ratio adjusted for BMI (WHRadjBMI), adult hip circumference adjusted for BMI (HIPadjBMI), adult waist circumference adjusted for BMI (WCadjBMI), birth weight (BW) and childhood obesity. Mendelian randomisation analysis did not demonstrate an association between any anthropometric trait and testicular germ cell tumour risk. In particular, despite good power, there was no global evidence for association between height and testicular germ cell tumour. However, three SNPs for adult height individually showed association with testicular germ cell tumour (rs4624820: OR = 1.47, 95% CI: 1.41-1.55, p = 2.7 × 10-57 ; rs12228415: OR = 1.17, 95% CI: 1.11-1.22, p = 3.1 × 10-10 ; rs7568069: OR = 1.13, 95% CI: 1.07-1.18, p = 1.1 × 10-6 ). This Mendelian randomisation analysis, based on the largest testicular germ cell tumour genome wide association dataset to date, does not support a causal etiological association between anthropometric traits and testicular germ cell tumour aetiology. Our findings are more compatible with confounding by shared environmental factors, possibly related to prenatal growth with exposure to these risk factors

  15. Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients.

    Science.gov (United States)

    Castañeda, Sheila F; Giacinto, Rebeca E; Medeiros, Elizabeth A; Brongiel, Ilana; Cardona, Olga; Perez, Patricia; Talavera, Gregory A

    2016-06-01

    This collaborative study sought to address Latina breast cancer (BC) disparities by increasing health literacy (HL) in a community health center situated on the US-Mexico border region of San Diego County. An academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention with 109 individuals. The Spanish language program, entitled Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life), included six sessions targeting HL, women's health, BC risk reduction, and patient-provider communication; sessions include cooking demonstrations of recipes with cancer-risk-reducing ingredients. A pilot study with 47 community health center Latina patients was conducted to examine the program's acceptability, feasibility, and ability to impact knowledge and skills. Pre- and post-analyses demonstrated that participants improved their self-reported cancer screening, BC knowledge, daily fruit and vegetable intake, and ability to read a nutrition label (p < 0.05). Results of the pilot study demonstrate the importance of utilizing patient-centered culturally appropriate noninvasive means to educate and empower Latina patients.

  16. Earthquake Seismic Risk Reduction in Ohio: ODNR's Efforts to Address Issues with Natural and Induced Seismicity

    Science.gov (United States)

    Besana-Ostman, G. M.

    2013-05-01

    With the increasing concerns regarding both natural and induced seismicity in Ohio, ODNR (Ohio Department of Natural Resources) initial efforts on seismic risk reduction paved way to various changes and improvement to tackle several major issues. For natural earthquakes, regional seismicity indicates a NE-SW structure in the northern portion of the area associated with a number of moderate historical earthquakes but no active trace identified. On the other hand, earthquakes of 1986 and 2011 are most probably incidents of induced seismicity that trigger more public uproar against disposal of regulated waste waters through injections. ODNR, in efforts to adapt with increasing need to regulate all operations related to both the Utica and Marcellus shale play within the state, had recently strengthen itself both through additional human resources and improved infrastructure. Tougher regulations and additional field tests were required that took effect immediately when a M4 earthquake was associated with the operations of an injection well. Public meetings were undertaken focused on educating many local inhabitants related to oil and gas operations, hydraulic fracturing, injection wells, and seismicity. Trainings for new and existing staff were regularly done especially for field inspection, data management and technology advancements. Considering the existing seismic stations that are few and distant related to sites of the injection wells, additional seismic stations were installed to gather baseline data and monitor for earthquakes within the injection area(s). Furthermore, to assess if the sites of the injection wells are safe from active structures, initial geomorphic and structural analyses indicated possible active faults in the northern portion of state oriented NE-SW. With the above-mentioned recent changes, ODNR had made a significant leap not only in the improvement of its principal regulatory role in the state for oil and gas operations but also in its

  17. Echocardiographic epicardial adipose tissue measurements provide information about cardiovascular risk in hemodialysis patients.

    Science.gov (United States)

    Ulusal Okyay, Gülay; Okyay, Kaan; Polattaş Solak, Evşen; Sahinarslan, Asife; Paşaoğlu, Özge; Ayerden Ebinç, Fatma; Paşaoğlu, Hatice; Boztepe Derici, Ülver; Sindel, Şükrü; Arınsoy, Turgay

    2015-07-01

    Epicardial adipose tissue (EAT) is a cardiovascular risk predictor in general population. However, its value has not been well validated in maintainance hemodialysis (MHD) patients. We aimed to assess associations of EAT with cardiovascular risk predictors in nondiabetic MHD patients. In this cross-sectional study, we measured EAT thickness by transthoracic echocardiography in 50 MHD patients (45.8 ± 14.6 years of age, 37 male). Antropometric measurements, bioimpedance analysis, left ventricular (LV) mass, carotis intima media thickness, blood tests, homeostasis model assessment for insulin resistance (HOMA-IR) and hemodialysis dose by single-pool urea clearence index (spKt/V) were determined. The mean EAT thickness was 3.28 ± 1.04 mm. There were significant associations of EAT with body mass index (β = 0.590, P body fat mass (β = 0.562, P body fat mass (β = 0.408, P = 0.003), percentage of lean tissue mass (β = -0.421, P = 0.002), LV mass (β = 0.426, P = 0.002), carotis intima media thickness (β = 0.289, P = 0.042), triglyceride/high-density lipoprotein cholesterol ratio (β = 0.529, P  0.05). Body mass index, waist circumference, body fat mass, percentage of lean tissue mass, LV mass, triglyceride/high-density lipoprotein cholesterol ratio, HOMA-IR, and spKt/V appeared as independent predictors of EAT. EAT was significantly associated with body fat measures, cardiovascular risk predictors, and dialysis dose in MHD patients. © 2015 International Society for Hemodialysis.

  18. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05 and staff competencies (Coef. = 7.1, p<0.05. Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period

  19. The Healthy Teen Girls project: comparison of health education and STD risk reduction intervention for incarcerated adolescent females.

    Science.gov (United States)

    Robertson, Angela A; Robertson, Angela R; St Lawrence, Janet; Morse, David T; Baird-Thomas, Connie; Liew, Hui; Gresham, Kathleen

    2011-06-01

    Adolescent girls incarcerated in a state reformatory (N = 246) were recruited and assigned to an 18-session health education program or a time-equivalent HIV prevention program. Cohorts were assigned to conditions using a randomized block design separated by a washout period to reduce contamination. Post intervention, girls in the HIV risk reduction program demonstrated the acquisition of risk-reduction behavioral skills and improved condom application skill. At a follow-up assessment approximately 9 months after release from the correctional facility, girls in both conditions reported fewer unprotected sexual intercourse occasions and less sex while under the influence of alcohol or other drugs.

  20. Geology for Global Development: Mobilising and equipping young geologists to engage in disaster risk reduction

    Science.gov (United States)

    Gill, Joel

    2016-04-01

    Geology for Global Development (GfGD) is a not-for-profit organisation working to mobilise and equip geologists to engage in all aspects of sustainable development, including disaster risk reduction (DRR). Geologists have a crucial role to play in DRR, and the recently agreed Sendai Framework for DRR 2015-2030. This framework aims to significantly reduce loss of lives and livelihoods due to disasters. The geology community have an understanding of the Earth, its physical structure, and the processes by which it is constantly being shaped which are of particular relevance to Priorities for Action 1 and 4 noted within the Sendai Framework. Effective engagement by geologists, however, requires many skills beyond the standard geology curriculum. Cultural understanding, cross-disciplinary communication, diplomacy, community mobilization and participation, knowledge exchange, and an understanding of social science research tools are commonly necessary for effective research and engagement in the science-policy-practice interface. Topical and disciplinary knowledge, such as understanding social vulnerability, international policy frameworks and development theory are also rarely included in the education and professional training of a young geologist. Through the work of GfGD, we are training young geologists with these skills and the supporting knowledge required to make an effective contribution to reducing disaster risk, support civil society, empower communities and help to strengthen resilience. University chapters have been established in 14 major UK and Irish universities, coordinating extra-curricular seminars, workshops and discussion activities. Our work is currently focused on supporting young geologists, but we are increasingly a respected voice at international geoscience forums that gather a wide range of students and professionals. Wider (national and international) activities include conferences, placements and facilitating youth engagement in education

  1. Implementation of a Modified WHO Pediatric Procedural Sedation Safety Checklist and Its Impact on Risk Reduction.

    Science.gov (United States)

    Kahlenberg, Lindsay; Harsey, Lindsay; Patterson, Mary; Wachsberger, Don; Gothard, Dave; Holder, Michael; Forbes, Michael; Tirodker, Urmila

    2017-04-01

    Major adverse events (AEs) related to pediatric deep sedation occur at a low frequency but can be of high acuity. The high volume of deep sedations performed by 3 departments at our institution provided an opportunity to reduce variability and increase safety through implementation of a procedural sedation safety checklist. We hypothesized that implementation of a checklist would improve compliance of critical safety elements (CSEs) (primary outcome variable) and reduce the sedation-related AE rate (secondary outcome variable). This process improvement project was divided into 5 phases: a retrospective analysis to assess variability in capture of CSE within 3 departments that perform deep sedation and the association between noncapture of CSE and AE occurrence (phase 1), design of the checklist and trial in simulation (phase 2), provider education (phase 3), implementation and interim analysis of checklist completion (phase 4), and final analysis of completion and impact on outcome (phase 5). We demonstrated interdepartmental variability in compliance with CSE completion prechecklist implementation, and we identified elements associated with AEs. Completion of provider education was 100% in all 3 departments. Final analysis showed a checklist completion rate of 75%, and its use significantly improved capture of several critical safety elements. Its use did not significantly reduce AEs (P = .105). This study demonstrates that the implementation of a sedation checklist improved process adherence and capture of critical safety elements; however, it failed to show a significant reduction in sedation-related AEs. Copyright © 2017 by the American Academy of Pediatrics.

  2. Completion plug design provides improved operational efficiency and safety while minimizing environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Dum, Frank [T.D. Williamson, Inc., Tulsa, OK (United States)

    2012-07-01

    Pipeline repair standards have been raised with recent improvements for completion plugs when used with a brand new setting tool, resulting in lower environmental risks, improved operational efficiency and safety. The design changes were originally made to serve in an offshore environment in order to minimize the diver's time in the water and simplify steps by the diver to execute pipeline repair operations in cold, dark conditions. Enhancements in the design include fewer number of fittings, plugs, o-rings and gaskets isolating the pipeline product found inside the pipe. The new design is a step toward meeting strict operational and safety standards demanded in the field of pipeline maintenance and repair. (author)

  3. The potential of crowdsourcing and mobile technology to support flood disaster risk reduction

    Science.gov (United States)

    See, Linda; McCallum, Ian; Liu, Wei; Mechler, Reinhard; Keating, Adriana; Hochrainer-Stigler, Stefan; Mochizuki, Junko; Fritz, Steffen; Dugar, Sumit; Arestegui, Michael; Szoenyi, Michael; Laso-Bayas, Juan-Carlos; Burek, Peter; French, Adam; Moorthy, Inian

    2016-04-01

    The last decade has seen a rise in citizen science and crowdsourcing for carrying out a variety of tasks across a number of different fields, most notably the collection of data such as the identification of species (e.g. eBird and iNaturalist) and the classification of images (e.g. Galaxy Zoo and Geo-Wiki). Combining human computing with the proliferation of mobile technology has resulted in vast amounts of geo-located data that have considerable value across multiple domains including flood disaster risk reduction. Crowdsourcing technologies, in the form of online mapping, are now being utilized to great effect in post-disaster mapping and relief efforts, e.g. the activities of Humanitarian OpenStreetMap, complementing official channels of relief (e.g. Haiti, Nepal and New York). Disaster event monitoring efforts have been further complemented with the use of social media (e.g. twitter for earthquakes, flood monitoring, and fire detection). Much of the activity in this area has focused on ex-post emergency management while there is considerable potential for utilizing crowdsourcing and mobile technology for vulnerability assessment, early warning and to bolster resilience to flood events. This paper examines the use of crowdsourcing and mobile technology for measuring and monitoring flood hazards, exposure to floods, and vulnerability, drawing upon examples from the literature and ongoing projects on flooding and food security at IIASA.

  4. University-NGO connections for earthquake and tsunami risk reduction: lessons learned in West Sumatra

    Science.gov (United States)

    McCaughey, J.; Dewi, P. R.

    2013-12-01

    Scientists have information that is critical to policy and public education, yet lack field staff of their own to put this into practice. NGOs have field staff as well as connections with policymakers and the community, yet lack a direct connection to the latest scientific research. Scientists face pressure to obtain grants and publish; NGOs face pressure to deliver programs to as many people as possible. Lacking institutional incentives that recognize efforts to bridge the science-practice gap, it is often out of personal convictions that scientists seek to share their results with NGOs, and NGO practitioners seek to deepen their own scientific knowledge. Such individual efforts are impactful; however, more can be achieved with institutional commitments to closer collaboration. Science communication is dialogue, not a one-way transfer of knowledge from science to practice. On the university side, listening to our NGO partners has inspired faculty, staff, and students, identified new areas of fundamental scientific research inspired by practical use, and helped prioritize and clarify the scientific information that is most useful for disaster-risk-reduction practice. On the NGO side, connections to scientists have informed the content of public education and policy advocacy programs and clarified technical information; this new understanding has been incorporated in advocacy and community engagement programs.

  5. Vulnerability assessments, identity and spatial scale challenges in disaster-risk reduction

    Directory of Open Access Journals (Sweden)

    Edward R. Carr

    2015-02-01

    Full Text Available Current approaches to vulnerability assessment for disaster-risk reduction (DRR commonly apply generalised, a priori determinants of vulnerability to particular hazards in particular places. Although they may allow for policy-level legibility at high levels of spatial scale, these approaches suffer from attribution problems that become more acute as the level of analysis is localised and the population under investigation experiences greater vulnerability. In this article, we locate the source of this problem in a spatial scale mismatch between the essentialist framings of identity behind these generalised determinants of vulnerability and the intersectional, situational character of identity in the places where DRR interventions are designed and implemented. Using the Livelihoods as Intimate Government (LIG approach to identify and understand different vulnerabilities to flooding in a community in southern Zambia, we empirically demonstrate how essentialist framings of identity produce this mismatch. Further, we illustrate a means of operationalising intersectional, situational framings of identity to achieve greater and more productive understandings of hazard vulnerability than available through the application of general determinants of vulnerability to specific places and cases.

  6. Rethinking International Counterterrorism Assistance to the Greater Horn of Africa: Toward a Regional Risk Reduction Strategy

    Directory of Open Access Journals (Sweden)

    Matthew Schwartz

    2013-12-01

    Full Text Available The Horn of Africa has long been a recipient of foreign security assistance, with significant funds increasingly devoted to supporting subregional civilian-oriented counterterrorism efforts over the past decade. Despite efforts to better coordinate delivery, counterterrorism programming in the subregion generally remains fragmented, short-term, and siloed in implementation. This article argues that it is time to rethink the international community’s approach to counterterrorism assistance to the Horn of Africa and calls for a cohesive regional approach that not only bridges the gap between security and development, but also the gap between counterterrorism and human security. It emphasizes that the international community must not only better coordinate existing streams of counterterrorism assistance to the region, but also rethink how this assistance is designed and the ways it can be delivered to complement broader subregional development and security agendas. After a brief introduction to international counterterrorism assistance to the Horn of Africa, the article examines linkages across three thematic streams of programming being delivered to the subregion: anti-money laundering and countering the financing of terrorism; criminal justice capacity building assistance to counter terrorism; and, countering violent extremism. This discussion will highlight the need for a regional risk reduction strategy for the Horn of Africa that not only builds on the interplay of different streams of counterterrorism assistance, but on synergies across broader subregional development and security agendas as well.

  7. Considering Vulnerability in Disaster Risk Reduction Plans: From Policy to Practice in Ladakh, India

    Directory of Open Access Journals (Sweden)

    Virginie Le Masson

    2015-05-01

    Full Text Available In Ladakh, India, a mountainous region prone to natural hazards, particularly floods, it is critical to adapt disaster risk reduction (DRR measures to the local environment. The floods that struck Ladakh in 2010 created momentum for local authorities and nongovernmental organizations (NGOs to engage in DRR initiatives in order to better prepare people to cope with and recover from emergencies. This paper analyzes the way DRR approaches in Ladakh, from the central government to the district level, take both vulnerability and capacity into account. National and state policies are integrated and reflect the vulnerability concept quite well. However, as the case of Ladakh shows, establishing policies does not guarantee that appropriate practices will follow. Although NGOs' relief efforts in 2010 were praised for building on local communities' context and capacities, most practitioners still view DRR through a hazard-focused lens. Likewise, the policy framework for DRR does not yet address the socioeconomic construction of disasters and is not translated into adequate interventions that build on lessons learned during the 2010 emergency. Development obstacles, such as corruption, may also compromise efforts to translate DRR policies into appropriate and sustainable practices. However, local development projects that enhance the resilience of local mountain communities exist and could be valued as effective DRR. Emphasis should be placed on the practical integration of DRR in sustainable development efforts in order to better tackle disasters.

  8. Can Resilience Thinking Inform Resilience Investments? Learning from Resilience Principles for Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    Margot Hill Clarvis

    2015-07-01

    Full Text Available As the human and financial costs of natural disasters rise and state finances continue to deplete, increasing attention is being placed on the role of the private sector to support disaster and climate resilience. However, not only is there a recognised lack of private finance to fill this gap, but international institutional and financing bodies tend to prioritise specific reactive response over preparedness and general resilience building. This paper utilises the central tenets of resilience thinking that have emerged from scholarship on social-ecological system resilience as a lens through which to assess investing in disaster risk reduction (DRR for resilience. It draws on an established framework of resilience principles and examples of resilience investments to explore how resilience principles can actually inform decisions around DRR and resilience investing. It proposes some key lessons for diversifying sources of finance in order to, in turn, enhance “financial resilience”. In doing so, it suggests a series of questions to align investments with resilience building, and to better balance the achievement of the resilience principles with financial requirements such as financial diversification and replicability. It argues for a critical look to be taken at how resilience principles, which focus on longer-term systems perspectives, could complement the focus in DRR on critical and immediate stresses.

  9. Guidelines for risk reduction when handling gametes from infectious patients seeking assisted reproductive technologies.

    Science.gov (United States)

    Jindal, Sangita K; Rawlins, Richard G; Muller, Charles H; Drobnis, Erma Z

    2016-08-01

    According to the Americans with Disabilities Act (1990), couples with blood-borne viruses that lead to infectious disease cannot be denied fertility treatment as long as the direct threat to the health and safety of others can be reduced or eliminated by a modification of policies or procedures. Three types of infectious patients are commonly discussed in the context of fertility treatment: those with human immunodeficiency virus (HIV), hepatitis C or hepatitis B. Seventy-five per cent of hepatitis C or HIV positive men and women are in their reproductive years, and these couples look to assisted reproductive techniques for risk reduction in conceiving a pregnancy. In many cases, only one partner is infected. Legal and ethical questions about treatment of infectious patients aside, the question most asked by clinical embryologists and andrologists is: "What are the laboratory protocols for working with gametes and embryos from patients with infectious disease?" The serostatus of each patient is the key that informs appropriate treatments. This guidance document describes protocols for handling gametes from seroconcordant and serodiscordant couples with infectious disease. With minor modifications, infectious patients with stable disease status and undetectable or low viral load can be accommodated in the IVF laboratory. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  10. The efficacy of an HIV risk reduction intervention for Hispanic women.

    Science.gov (United States)

    Peragallo, Nilda; Gonzalez-Guarda, Rosa M; McCabe, Brian E; Cianelli, Rosina

    2012-07-01

    Culturally-specific HIV risk reduction interventions for Hispanic women are needed. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care) is a culturally-specific and theoretically-based group intervention for Hispanic women. The SEPA intervention consists of five sessions covering STI and HIV prevention; communication, condom negotiation and condom use; and violence prevention. A randomized trial tested the efficacy of SEPA with 548 adult U.S. Hispanic women (SEPA n = 274; delayed intervention control n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Intent-to-treat analyses indicated that SEPA decreased positive urine samples for Chlamydia; improved condom use, decreased substance abuse and IPV; improved communication with partner, improved HIV-related knowledge, improved intentions to use condoms, decreased barriers to condom use, and increased community prevention attitudes. Culturally-specific interventions have promise for preventing HIV for Hispanic women in the U.S. The effectiveness of SEPA should be tested in a translational community trial.

  11. Evaluation of HDL-modulating interventions for cardiovascular risk reduction using a systems pharmacology approach.

    Science.gov (United States)

    Gadkar, Kapil; Lu, James; Sahasranaman, Srikumar; Davis, John; Mazer, Norman A; Ramanujan, Saroja

    2016-01-01

    The recent failures of cholesteryl ester transport protein inhibitor drugs to decrease CVD risk, despite raising HDL cholesterol (HDL-C) levels, suggest that pharmacologic increases in HDL-C may not always reflect elevations in reverse cholesterol transport (RCT), the process by which HDL is believed to exert its beneficial effects. HDL-modulating therapies can affect HDL properties beyond total HDL-C, including particle numbers, size, and composition, and may contribute differently to RCT and CVD risk. The lack of validated easily measurable pharmacodynamic markers to link drug effects to RCT, and ultimately to CVD risk, complicates target and compound selection and evaluation. In this work, we use a systems pharmacology model to contextualize the roles of different HDL targets in cholesterol metabolism and provide quantitative links between HDL-related measurements and the associated changes in RCT rate to support target and compound evaluation in drug development. By quantifying the amount of cholesterol removed from the periphery over the short-term, our simulations show the potential for infused HDL to treat acute CVD. For the primary prevention of CVD, our analysis suggests that the induction of ApoA-I synthesis may be a more viable approach, due to the long-term increase in RCT rate. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

  12. Teaching Child Care Providers to Reduce the Risk of SIDS (Sudden Infant Death Syndrome)

    Science.gov (United States)

    Byington, Teresa; Martin, Sally; Reilly, Jackie; Weigel, Dan

    2011-01-01

    Keeping children safe and healthy is one of the main concerns of parents and child care providers. SIDS (Sudden Infant Death Syndrome) is the leading cause of death in infants 1 month to 12 months of age. Over 2,000 infants die from SIDS every year in the United States, and almost 15% of these deaths occur in child care settings. A targeted…

  13. Infant pacifiers for reduction in risk of sudden infant death syndrome.

    Science.gov (United States)

    Psaila, Kim; Foster, Jann P; Pulbrook, Neil; Jeffery, Heather E

    2017-04-05

    randomised controlled trials examining infant pacifiers for reduction in risk of SIDS. We found no randomised control trial evidence on which to support or refute the use of pacifiers for the prevention of SIDS.

  14. GSNL 2.0: leveraging on Open Science to promote science-based decision making in Disaster Risk Reduction

    Science.gov (United States)

    Salvi, Stefano; Rubbia, Giuliana; Abruzzese, Luigi

    2017-04-01

    In 2010 the GEO Geohazard Supersites and Natural Laboratories initiative (GSNL) launched the concept of a global partnership among the geophysical scientific community and the satellite and in situ data providers, aiming to promote scientific advancements in the knowledge of seismic and volcanic phenomena. The initial goal was successfully achieved, and many more new scientific results were obtained than it could have been possible if the Supersites had not existed (http://www.earthobservations.org/gsnl.php). At the same time the Supersites have demonstrated to be able to effectively support the rapid transfer of useful scientific information to the risk managers, exploiting the existing institutional relationships between the Supersite coordinators and the local decision makers. However, a more demanding call for action is given by the Sendai Framework 2015-2030 (outcome of the 2015 UN World Conference on Disaster Risk Reduction), where for the first time the knowledge of the risk components and the science based decision-making process are defined as top priorities for an effective DRR. There are evident possible synergies between the Sendai framework, GEO, the CEOS (Committee on Earth Observation Satellites), and GSNL, but for maximum benefit and effectiveness the latter needs to progress at a faster pace towards a full implementation of the Open Science approach to geohazard science. In the above global framework the Supersites can represent local test beds where to experiment coordination, collaboration and communication approaches and technological solutions tailored to the local situation, to ensure that the scientific community can contribute the information needed for the best possible decision making. This vision and the new developments of GSNL 2.0 have been approved by the GEO Program Board, and a clear roadmap has been set for the period 2017-2019. We will present the approach and the implementation plan at the conference.

  15. Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

    Science.gov (United States)

    Parry, C D H; Carney, T; Petersen Williams, P

    2017-12-01

    . There were no decreases in drug use practices such as use of cannabis, heroin, cocaine and Ecstasy after the intervention with drug users; however, there was a significant reduction in alcohol use following the intervention. While there was a substantial increase in the proportion of participants using drugs daily as opposed to more often, the reduction in the frequency of drug use was not statistically significant. Following the intervention, drug users had significantly fewer sexual partners, but there were no significant differences following the intervention with regard to frequency of sex or use of condoms. Substance use in general and during sex was, however, decreased. While the findings were mixed, the study shows that it is possible to provide HIV risk-reduction services to a population of substance users who are less likely to receive services through community outreach, and provide risk-reduction information, condoms and condom demonstration and other services. More intensive interventions might be needed to have a substantial impact on substance use and substance use-related HIV risk behaviours.

  16. A qualitative study of older and middle-aged adults' perception and attitudes towards dementia and dementia risk reduction.

    Science.gov (United States)

    Kim, Sarang; Sargent-Cox, Kerry A; Anstey, Kaarin J

    2015-07-01

    To investigate perceptions of dementia and dementia risk reduction held by people without dementia. Dementia does not only affect individuals with dementia, but also has an impact on family and friends, society and healthcare professionals. Recent research has identified modifiable risk and protective factors for dementia. However, it is unclear what knowledge people without dementia have about these risk factors and their attitudes towards addressing these risk factors to achieve dementia risk reduction are not known. Qualitative descriptive study using focus group methodology. A focus group study was conducted in February 2011 with 34 older adults aged between 52-90 years. The long-table approach was used to identify themes and categorize data on dementia knowledge, risk and attitudes. Participants correctly identified dementia risk factors as a group. Participants' responses about their perceived likelihood of developing dementia could be classified into three distinctive themes; fear, rational and cynical perceptions. Both fear of developing dementia and the need to improve dementia knowledge were considered major motivators towards adopting healthier lifestyle and health behaviours. Lack of knowledge on risk factors for dementia was identified as a major barrier for behavioural and lifestyle change. These findings can be used to develop effective and personalized interventions that increase motivators and reduce barriers by tailoring interventions to individual's dementia risk reduction literacy and motivations to change behaviours. Greater public-health promotion and education about risk and protective factors for dementia are also necessary to increase dementia health literacy and to reduce overall dementia prevalence. © 2015 John Wiley & Sons Ltd.

  17. Nature-based solutions for hydro-meteorological risk reduction and nutrient removal in the Nordic and Arctic regions

    Science.gov (United States)

    Bring, Arvid; Kalantari, Zahra

    2017-04-01

    Natural ecological functions provide essential and fundamental benefits to mankind, but can also be actively employed in nature-based solutions to specific challenges in society. For example, water-related ecosystem services have a role in such societal benefits as flood protection, erosion control, and excess nutrient removal. Ecosystem services may be produced and consumed in different locations, and research has recently attempted to formalize this discrepancy in identifying service providing areas (SPAs), service benefitting areas (SBAs), and service connecting areas (SCAs). However, in terms of water-related services, there is a lack of formal evaluation of how SPAs, SBAs, and SCAs are related to hydrological measures such as discharge, flood recurrence, excess nutrient removal, etc. We seek to map SPAs, SBAs and SCAs for a number of key ecosystem services in the Nordic and Arctic region though established ecological definitions (typically, based on land use) and evaluate the findings alongside metrics of hydrological connectivity (river networks), provisioning areas (runoff generating areas), and benefitting areas (river stretches where water flow is moderated). We make use of extensive GIS analysis using both high-resolution land cover data and river network maps. In the end, the results are expected to contribute to identifying how water-related ecosystem services can be employed as nature-based solutions for hydro-meteorological risk reduction and nutrient removal in a changing climate in the Nordic and Arctic regions.

  18. Hydro-meteorological risk reduction and climate change adaptation in the Sava River Basin

    Science.gov (United States)

    Brilly, Mitja; Šraj, Mojca; Kryžanowski, Andrej

    2017-04-01

    The Sava River Basin covered the teritory of several countries. There were, in past thirty years, several flood hazard events with almost hundred years return period. Parts of the basin suffer by severe droughts also. In the presentation we covered questions of: • Flood hazard in complex hydrology structure • Landslide and flush flood in mountainous regions • Floods on karst polje • Flood risk management in the complex international and hydrological condition. • Impact of man made structures: hydropower storages, inundation ponds, river regulation, alternate streams, levees system, pumping stations, Natura 2000 areas etc. • How to manage droughts in the international river basin The basin is well covered by information and managed by international the SRB Commission (http://savacommission.org/) that could help. We develop study for climate change impact on floods on entire river basin financing by UNECE. There is also study provide climate change impact on the water management provide by World Bank and on which we take part. Recently is out call by world bank for study »Flood risk management plan for the SRB«.

  19. Does Risk-Adjusted Payment Influence Primary Care Providers' Decision on Where to Set Up Practices?

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Anell, Anders; Dackehag, Margareta

    Providing equal access to health care is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where providers are free to establish themselves in any part of the country. To improve equity in access to care, 15 out 21 county...... capitation on the supply of private primary care centers. We use a dataset that combines information on all primary care centers in Sweden during 2005-2013, the payment system and other conditions for establishing new primary care centers used in the county councils, and demographic, geographic......-adjusted capitation significantly increase the number of private primary care centers in areas with relatively high Care Need Index values. The adjustment results in a changed distribution of private centers within county councils; the total number of private centers does not increase in county councils using care...

  20. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    Science.gov (United States)

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  1. Military Suicide: Developing an Understanding of Basic Issues to Provide a Lower Risk Force

    Science.gov (United States)

    In the last decade, the suicide rate for military personnel exceeded that of the general population ; additionally, the suicide rate for military...national mortality data, and national census data provided a more detailed view of the suicide decedent population . Both the general and military decedent... populations present specific trends in behavior and demographics that lead to suicidal behaviors. The research suggests that a significant proportion

  2. Assessing Knowledge and Attitudes of U.S. Healthcare Providers about Benefits and Risks of Consuming Seafood

    Science.gov (United States)

    Hicks, Doris T.; Pivarnik, Lori F.; Richard, Nicole Leydon; Gable, Robert K.; Morrissey, Michael T.

    2013-01-01

    An online needs assessment survey of healthcare providers was developed and implemented to determine knowledge and attitudes about the benefits and risks of consuming seafood along with how this might impact patient/clientele counseling. Only 6 of the 45 knowledge items queried (13%) met the 80% subject mastery or proficiency with a total…

  3. Evaluation of a Sexual Assault Risk Reduction and Self-Defense Program: A Prospective Analysis of a Revised Protocol

    Science.gov (United States)

    Orchowski, Lindsay M.; Gidycz, Christine A.; Raffle, Holly

    2008-01-01

    The current study extends the development and evaluation of an existing and previously evaluated sexual assault risk reduction program with a self-defense component for college women (N = 300). The program protocol was revised to address psychological barriers to responding assertively to risky dating situations, and a placebo-control group was…

  4. The Evaluation of a Sexual Assault Self-Defense and Risk-Reduction Program for College Women: A Prospective Study

    Science.gov (United States)

    Gidycz, Christine A.; Rich, Cindy L.; Orchowski, Lindsay; King, Carrie; Miller, Audrey K.

    2006-01-01

    The present study evaluated the efficacy of a sexual assault risk-reduction program that included a physical self-defense component for college women ("N"=500). Program group women significantly increased their protective behaviors over the 6-month follow-up period compared to the waiting-list control group. However, there were no significant…

  5. Modifying Alcohol Consumption among High School Students: An Efficacy Trial of an Alcohol Risk Reduction Program (PRIME for Life)

    Science.gov (United States)

    Hallgren, Mats A.; Sjolund, Torbjorn; Kallmen, Hakan; Andreasson, Sven

    2011-01-01

    Purpose: PRIME for Life is an alcohol risk reduction program that has been used and refined in the USA for over 20 years. A Swedish version of the program has recently been adapted for use among Swedish high-school students (age 18-19). The objective of the study is to evaluate the effects of the program on youth alcohol consumption (including…

  6. A Competence-Based Science Learning Framework Illustrated through the Study of Natural Hazards and Disaster Risk Reduction

    Science.gov (United States)

    Oyao, Sheila G.; Holbrook, Jack; Rannikmäe, Miia; Pagunsan, Marmon M.

    2015-01-01

    This article proposes a competence-based learning framework for science teaching, applied to the study of "big ideas", in this case to the study of natural hazards and disaster risk reduction (NH&DRR). The framework focuses on new visions of competence, placing emphasis on nurturing connectedness and behavioral actions toward…

  7. A Case Analysis of Disaster Risk Reduction Preparedness of Iloilo Province: Basis for A Comprehensive Intervention Program

    Directory of Open Access Journals (Sweden)

    Victoria D. Jurilla

    2016-08-01

    Full Text Available - This study determined the effectiveness of Disaster Risk Reduction Preparedness of Iloilo Province, Philippines in the areas of Dissemination, Implementation, and Resource Utilization and Operation as evaluated by the 390 citizens of the ten (10 selected municipalities from the five (5 Congressional Districts in the Province of Iloilo, Philippines. This descriptive method of research employed researcher-made instruments and random interviews. Descriptive statistics used were the mean and standard deviation while inferential statistics employed Ttest for independent samples and one-way analysis for variance set at .05 level of significances. Findings revealed that Disaster Risk Reduction Preparedness of Iloilo Province, Philippines is “more effective” in terms of dissemination, implementation, and resource utilization and operation according to the assessment of the 390 respondents of the ten (10 selected municipalities from the five (5 Congressional Districts when they were grouped as to personal variables. Finally, the findings revealed that three (3 out of ten (10 municipalities were very effective and among the five (5 districts, first district was very effective as to dissemination and resource utilization and operation of their respective Disaster Risk Reduction Preparedness Program but as a whole, Iloilo Province was more effective in its Disaster Risk Reduction Preparedness.

  8. Identification and analysis of uncertainty in disaster risk reduction and climate change adaptation in South and Southeast Asia

    NARCIS (Netherlands)

    Keur, van der Peter; Bers, van Caroline; Henriksen, Hans Jørgen; Nibanupudi, Hari Krishna; Yadav, Shobha; Wijaya, Rina; Subiyono, Andreas; Mukerjee, Nandan; Hausmann, Hans Jakob; Hare, Matt; Scheltinga, van Catharien Terwisscha; Pearn, Gregory; Jaspers, Fons

    2016-01-01

    This paper addresses the mainstreaming of uncertainty in Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) using as a case South and Southeast Asia, a region highly vulnerable to a wide range of natural disasters. Improvements in the implementation of DRR and CCA at the community

  9. REFLECTING ON THE PRACTICE OF INFANT MENTAL HEALTH AND THE REDUCTION OF RISK IN INFANCY AND EARLY PARENTHOOD: AN ESSAY.

    Science.gov (United States)

    Weatherston, Deborah J

    2017-01-01

    This essay discusses infant mental health (IMH) as well as its origins and relational framework. The author then reflects, professionally and personally, on the meaning of psychological vulnerability of boys under 5 years of age, the importance of early caregiving relationships to the reduction of risk, and implications for education and training in the IMH field. © 2016 Michigan Association for Infant Mental Health.

  10. Self-Esteem and Theoretical Mediators of Safer Sex among African American Female Adolescents: Implications for Sexual Risk Reduction Interventions

    Science.gov (United States)

    Salazar, Laura F.; Crosby, Richard A.; DiClemente, Ralph J.; Wingood, Gina M.; Lescano, Celia M.; Brown, Larry K.; Harrington, Kathy; Davies, Susan

    2005-01-01

    Theories of health behavior posit that change is accomplished by modifying factors deemed as mediators. A set of mediators from several theoretical models used in sexual risk reduction programs was assessed among a sample of 522 African American female adolescents. The goal was to determine whether self-esteem was associated with sexually…

  11. LastQuake: a comprehensive strategy for rapid engagement of earthquake eyewitnesses, massive crowdsourcing and risk reduction

    Science.gov (United States)

    Bossu, R.; Roussel, F.; Mazet-Roux, G.; Steed, R.; Frobert, L.

    2015-12-01

    LastQuake is a smartphone app, browser add-on and the most sophisticated Twitter robot (quakebot) for earthquakes currently in operation. It fulfills eyewitnesses' needs by offering information on felt earthquakes and their effects within tens of seconds of their occurrence. Associated with an active presence on Facebook, Pinterest and on websites, this proves a very efficient engagement strategy. For example, the app was installed thousands of times after the Ghorka earthquake in Nepal. Language barriers have been erased by using visual communication; for example, felt reports are collected through a set of cartoons representing different shaking levels. Within 3 weeks of the magnitude 7.8 Ghorka earthquakes, 7,000 felt reports with thousands of comments were collected related to the mainshock and tens of its aftershocks as well as 100 informative geo-located pics. The QuakeBot was essential in allowing us to be identified so well and interact with those affected. LastQuake is also a risk reduction tool since it provides rapid information. Rapid information is similar to prevention since when it does not exist, disasters can happen. When no information is available after a felt earthquake, the public block emergency lines by trying to find out the cause of the shaking, crowds form potentially leading to unpredictable crowd movement, rumors spread. In its next release LastQuake will also provide people with guidance immediately after a shaking through a number of pop-up cartoons illustrating "do/don't do" items (go to open places, do not phone emergency services except if people are injured…). LastQuake's app design is simple and intuitive and has a global audience. It benefited from a crowdfunding campaign (and the support of the Fondation MAIF) and more improvements have been planned after an online feedback campaign organized in early June with the Ghorka earthquake eyewitnesses. LastQuake is also a seismic risk reduction tools thanks to its very rapid

  12. Social network analysis of wild chimpanzees provides insights for predicting infectious disease risk.

    Science.gov (United States)

    Rushmore, Julie; Caillaud, Damien; Matamba, Leopold; Stumpf, Rebecca M; Borgatti, Stephen P; Altizer, Sonia

    2013-09-01

    1. Heterogeneity in host association patterns can alter pathogen transmission and strategies for control. Great apes are highly social and endangered animals that have experienced substantial population declines from directly transmitted pathogens; as such, network approaches to quantify contact heterogeneity could be crucially important for predicting infection probability and outbreak size following pathogen introduction, especially owing to challenges in collecting real-time infection data for endangered wildlife. 2. We present here the first study using network analysis to quantify contact heterogeneity in wild apes, with applications for predicting community-wide infectious disease risk. Specifically, within a wild chimpanzee community, we ask how associations between individuals vary over time, and we identify traits of highly connected individuals that might contribute disproportionately to pathogen spread. 3. We used field observations of behavioural encounters in a habituated wild chimpanzee community in Kibale National Park, Uganda to construct monthly party level (i.e. subgroup) and close-contact (i.e. ≤ 5 m) association networks over a 9-month period. 4. Network analysis revealed that networks were highly dynamic over time. In particular, oestrous events significantly increased pairwise party associations, suggesting that community-wide disease outbreaks should be more likely to occur when many females are in oestrus. 5. Bayesian models and permutation tests identified traits of chimpanzees that were highly connected within the network. Individuals with large families (i.e. mothers and their juveniles) that range in the core of the community territory and to a lesser extent high-ranking males were central to association networks, and thus represent the most important individuals to target for disease intervention strategies. 6. Overall, we show striking temporal variation in network structure and traits that predict association patterns in a wild

  13. Women's preferences for contralateral prophylactic mastectomy following unilateral breast cancer: What risk-reduction makes it worthwhile?

    Science.gov (United States)

    Tesson, Stephanie; Richards, Imogen; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Costa, Daniel; Musiello, Toni; Marven, Michelle; Butow, Phyllis

    2017-02-01

    Contralateral prophylactic mastectomy (CPM) reduces the risk of contralateral breast cancer (BC) following unilateral BC, but may not increase survival in BRCA1/2 mutation negative women. Despite this, and the risk for adverse physical and psychological impact, uptake is increasing in BRCA1/2 mutation negative women. We aimed to quantify the degree of reduction in lifetime contralateral BC risk women required to justify CPM, and to explore demographic, disease and psychosocial predictors of preferences using Protection Motivation Theory (PMT) as a theoretical framework. Reasoning behind preferences was also examined. 388 women previously diagnosed with unilateral BC, of negative or unknown BRCA1/2 status, were recruited from an advocacy group research database. Two hypothetical risk trade-off scenarios were used to quantify the reduction in lifetime contralateral BC risk that women judged necessary to justify CPM, using a 5% and 20% baseline. Demographic, disease and PMT measures were assessed using a questionnaire. Most women required their risk to be more than halved from a 5% or 20% baseline to justify CPM. Polarised preferences were also common, with some women consistently accepting or refusing CPM independent of risk/benefit trade-offs. Preferences were associated with coping self-efficacy and having a prior CPM. Explanations for judging CPM worthwhile included reducing or eliminating contralateral BC risk, attaining breast symmetry and reducing worry. Risk-reduction preferences were highly variable. Decisive factors in women's preferences for CPM related to clinical, psychological and cosmetic outcomes, but not to demographic or disease characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Subjectivity construction in school failure paths. Transition pathways provided for labour insertion for adolescents at risk

    Directory of Open Access Journals (Sweden)

    Míriam Abiétar-López

    2017-03-01

    Full Text Available The modernization of the vocational education system in Spain dates back to the 90s. Since then, it has evolved significantly, taking the European directives as a frame of reference. With the extension of compulsory schooling until the age of 16, in 1994 a vocational training scheme was introduced within the education system at a very low level of qualification, particularly designed for adolescents classified as low academic performers in secondary education and for adolescents in situation of social vulnerability. Such training scheme was reshaped in 2006 and 2013. Our contribution is framed in a wider research developed within a European Project, aiming to provide a review of the literature produced around these programs, in order to compare the evolution of those 3 types of training provision in terms of the educational possibilities each one has provided for the adolescents that have participated in them. In light of these data and those produced by our research, in this paper we argue how adolescent subjectivities are produced. We rely upon the speech of teachers, head teachers and guidance teams that deal with young people in such training provision in the city of Valencia.

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

    Science.gov (United States)

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

    2017-09-22

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

  16. Estimated cardiovascular relative risk reduction from fixed-dose combination pill (polypill) treatment in a wide range of patients with a moderate risk of cardiovascular disease

    NARCIS (Netherlands)

    Lafeber, Melvin; Webster, Ruth; Visseren, Frank L J; Bots, Michiel L.; Grobbee, Diederick E.; Spiering, W.; Rodgers, Anthony

    2016-01-01

    Aims Recent data indicate that fixed-dose combination (FDC) pills, polypills, can produce sizeable risk factor reductions. There are very few published data on the consistency of the effects of a polypill in different patient populations. It is unclear for example whether the effects of the polypill

  17. LOANS PROVIDED BY CHINESE GOVERNMENT: OPPORTUNITIES AND RISKS FOR THE REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Marina SOLOVIOVA

    2016-01-01

    Full Text Available As external development partners have put on hold their financial support for Moldova, contracting loans from China sparks an increasing interest. Because debates on this topic take place with very little information available, in this article we have made a synthesis of official data disseminated by the Chinese authorities, estimations made by the OECD and other organizations, records from the archive of the National Bank of Moldova, documents from the state register of legal acts, as well as of data published by the press. The results show that, although loans provided by the Chinese government are not an alternative to the loans offered by the IMF and other traditional creditors for budget and balance of payments support, they have a range of peculiar advantages and can be a convenient means of financing projects in the area of energy, industry, and agriculture.

  18. The effect of risk perception on public preferences and willingness to pay for reductions in the health risks posed by toxic cyanobacterial blooms.

    Science.gov (United States)

    Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A

    2012-06-01

    Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. The role of indigenous knowledge in drought risk reduction: A case of communal farmers in South Africa

    Directory of Open Access Journals (Sweden)

    Fummi Muyambo

    2017-01-01

    Full Text Available Even though the significance of indigenous knowledge in agriculture is internationally recognised, the role thereof in disaster risk reduction in South Africa is not well documented. This article determined the influence of indigenous knowledge in drought risk reduction in O.R. Tambo district of the Eastern Cape province (South Africa. Primary data were collected from 87 communal farmers through purposive sampling using a structured questionnaire. Focus group discussions were also held with the target group (farmers and extension officers to gain more information and clarification on indigenous knowledge. The finding indicated that the majority of respondents (64.4% relied on indigenous knowledge in their farming practice and drought risk reduction. Two-thirds (66.7% of the respondents revealed that indigenous knowledge contributed to the resilience of farmers towards drought. The respondents unanimously agreed that indigenous knowledge is losing its significance in farming and drought risk reduction, because the younger generation did not value it anymore. Lack of documentation and deterioration of its application by the younger generation were found to be the main challenge for most respondents. The study concluded that indigenous knowledge was still an integral part of agricultural practices, applied drought risk reduction strategies and contributed to resilience against disasters. Based on the findings, the study recommends that indigenous knowledge be compiled, documented and published so that all farmers can learn of effective farming practices, passed on from generation to generation. Community holders of such information are encouraged to make younger generations aware of the benefits of indigenous knowledge to promote its usage.

  20. High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Memon Ashraf

    2007-02-01

    Full Text Available Abstract Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3% IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA method. Syphilis tests (RPR & TPHA were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5% IDUs. Over half 94 (58.3% reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%. 1 of 161 was HIV positive (0.6%. The prevalence of hepatitis B was 12 (7.5%, hepatitis C 151 (94.3% and syphilis 21 (13.1%. IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom

  1. Climate Change Adaptation and Climate Related Disaster Risk Reduction Strategies in Zimbabwe and Malawi

    Science.gov (United States)

    Mubaya, C. P.; Ngepah, N.; Seyama, W.

    2015-12-01

    Climate Change Adaptation (CCA) and Disaster Risk Reduction (DRR) have similar aims and mutual benefits, and there is a very strong rationale for adopting a more integrated approach to these issues rather than analysing each of them as distinct from the other. One of the gaps that have been noted in this context is the lack of evidence in systematic integration of CCA and DRR in Southern Africa. In this regard, this study builds on understanding CCA and DRR policies from the perspectives of vulnerable groups- women and smallholder farmers, and conducts institutional and policy analysis of CCA and DRR in southern Africa, with specific focus on Malawi and Zimbabwe. Both quantitative and qualitative methodologies were employed to collect data for this study in the two countries. The analysis is centred on the conceptualization of DRR in the context of recovery time and CCA on livelihood changes. Findings of the study show that drought is no longer viewed as a hazard as it is a perennial and chronic occurrence in selected climate hotspots, with heightened intensity in certain identified years. Households are able to quickly recover from slow onset hazards such as droughts and dry spells more than they are able to recover from sudden onset floods, implying more capacity towards CCA than DRR. Government programmes and policies are also focused more on CCA than on DRR efforts that appear not to be a priority. Findings point towards female vulnerability from perceptions and practice where males tend to dominate where they are set to benefit from external assistance. We need to strengthen government capacity in implementation of DRR programmes, which is currently limited and development initiatives must deliberately target building the resilience of women.

  2. Extreme Events and Disaster Risk Reduction - a Future Earth KAN initiative

    Science.gov (United States)

    Frank, Dorothea; Reichstein, Markus

    2017-04-01

    The topic of Extreme Events in the context of global environmental change is both a scientifically challenging and exciting topic, and of very high societal relevance. The Future Earth Cluster initiative E3S organized in 2016 a cross-community/co-design workshop on Extreme Events and Environments from Climate to Society (http://www.e3s-future-earth.eu/index.php/ConferencesEvents/ConferencesAmpEvents). Based on the results, co-design research strategies and established network of the workshop, and previous activities, E3S is thriving to establish the basis for a longer-term research effort under the umbrella of Future Earth. These led to an initiative for a Future Earth Knowledge Action Network on Extreme Events and Disaster Risk Reduction. Example initial key question in this context include: What are meaningful indices to describe and quantify impact-relevant (e.g. climate) extremes? Which system properties yield resistance and resilience to extreme conditions? What are the key interactions between global urbanization processes, extreme events, and social and infrastructure vulnerability and resilience? The long-term goal of this KAN is to contribute to enhancing the resistance, resilience, and adaptive capacity of socio-ecological systems across spatial, temporal and institutional scales, in particular in the light of hazards affected by ongoing environmental change (e.g. climate change, global urbanization and land use/land cover change). This can be achieved by enhanced understanding, prediction, improved and open data and knowledge bases for detection and early warning decision making, and by new insights on natural and societal conditions and governance for resilience and adaptive capacity.

  3. Biological quality of soils containing hydrocarbons and efficacy of ecological risk reduction by bioremediation alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, A.J.; Napolitano, G.E.; Sample, B.E.

    1996-06-01

    This project provides technical support to the Petroleum Environmental Research Forum (PERF; a consortium of petroleum companies) on environmentally acceptable endpoints that may be used to help assess the ecological risk of petroleum hydrocarbon residuals in soils. The project, was designed in consultation with PERF representatives and focuses on the relationship between {open_quotes}chemically available{close_quotes} and {open_quotes}biologically available{close_quotes} measurements of petroleum hydrocarbon compounds in soils, a discrepancy of considerable interest to the petroleum industry. Presently, clean-up standards for soils contaminated with total petroleum hydrocarbon (TPH) constituents are based on concentrations of TPH, as measured in solvent extracts of soil samples. Interestingly, TPH includes a complex mixture of compounds which differ from one another in molecular weight and toxicity. Based on various studies with insecticides, herbicides and metals, some compounds apparently can slowly permeate into soil particles. If this situation occurs, the particle-embedded compounds may be extractable by use of organic solvents, and yet be unavailable biologically. This hypothesis serves as the central focus for our study. If this hypothesis is correct, then soil clean-up standards based on solvent-extractable TPH data may be more stringent than necessary to achieve a desired level of environmental risk. The economic significance of this possibility is considerable, because clean-up costs to achieve a low-risk status would, in most cases, be lower than those needed to achieve a standard based on present limits, which are based on measurements of {open_quotes}extractable{close_quotes} TPH.

  4. Maternal Mind-Mindedness Provides a Buffer for Pre-Adolescents at Risk for Disruptive Behavior.

    Science.gov (United States)

    Hughes, Claire; Aldercotte, Amanda; Foley, Sarah

    2017-02-01

    Maternal mind-mindedness, defined as the propensity to view one's child as an agent with independent thoughts and feelings, mitigates the impact of low maternal education on conduct problems in young children (Meins et al. 2013), but has been little studied beyond the preschool years. Addressing this gap, we applied a multi-measure and multi-informant approach to assess family adversity and disruptive behavior at age 12 for a socially diverse sample of 116 children for whom ratings of disruptive behavior at age 6 were available. Each mother was asked to describe her child and transcripts of these five-minute speech samples were coded for (i) mind-mindedness (defined by the proportion of child attributes that were mental rather than physical or behavioral) and (ii) positivity (defined by the proportion of child attributes that were positive rather than neutral or negative). Our regression results showed that, independent of associations with prior adjustment, family adversity, child gender and low maternal monitoring, mothers' mind-mindedness (but not positivity) predicted unique variance in disruptive behavior at age 12. In addition, a trend interaction term provided partial support for the hypothesis that pre-adolescents exposed to family adversity may benefit in particular from maternal mind-mindedness. We discuss the possible mechanisms underpinning these findings and their implications for clinical interventions to reduce disruptive behavior in adolescence.

  5. Landslide Catastrophes and Disaster Risk Reduction: A GIS Framework for Landslide Prevention and Management

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2010-09-01

    Full Text Available As catastrophic phenomena, landslides often cause large-scale socio-economic destruction including loss of life, economic collapse, and human injury. In addition, landslides can impair the functioning of critical infrastructure and destroy cultural heritage and ecological systems. In order to build a more landslide resistant and resilient society, an original GIS-based decision support system is put forth in order to help emergency managers better prepare for and respond to landslide disasters. The GIS-based landslide monitoring and management system includes a Central Repository System (CRS, Disaster Data Processing Modules (DDPM, a Command and Control System (CCS and a Portal Management System (PMS. This architecture provides valuable insights into landslide early warning, landslide risk and vulnerability analyses, and critical infrastructure damage assessments. Finally, internet-based communications are used to support landslide disaster modelling, monitoring and management.

  6. Framingham Risk Score and Estimated 10-Year Cardiovascular Disease Risk Reduction by a Short-Term Yoga-Based LifeStyle Intervention.

    Science.gov (United States)

    Yadav, Rashmi; Yadav, Raj Kumar; Sarvottam, Kumar; Netam, Ritesh

    2017-09-01

    The aim of this study was to evaluate the efficacy of a short-term yoga-based lifestyle intervention program in lowering Framingham Risk Score (FRS) and estimated 10-year cardiovascular risk. This was a single-arm, pre-post interventional study including data from a historical cohort with low to moderate risk for cardiovascular disease (CVD). It was conducted in a tertiary-care hospital. Participants with low (0 or 1 CVD risk factors) to moderately high risk (10-year risk between 10% and 20% and two or more CVD risk factors) were included. Participants with previously diagnosed CVD, defined as a history of myocardial infarction, congestive heart failure, or cerebrovascular accident, were excluded from the analysis. However, those with controlled hypertension were included. Intervention included a pretested short-term yoga-based lifestyle intervention, which included asanas (physical postures), pranayama (breathing exercises), meditation, relaxation techniques, stress management, group support, nutrition awareness program, and individualized advice. The intervention was for 10 days, spread over 2 weeks. However, participants were encouraged to include it in their day-to-day life. Outcomes included changes in FRS, and estimated 10-year CVD risk from baseline to week 2. A gender-based subgroup analysis was also done, and correlation between changes in FRS and cardiovascular risk factors was evaluated. Data for 554 subjects were screened, and 386 subjects (252 females) were included in the analysis. There was a significant reduction in FRS (p yoga-based intervention. There was a strong positive correlation between reduction in FRS and serum total cholesterol (r = 0.60; p yoga-based lifestyle intervention program significantly reduced the CVD risk, as shown by lowered FRS and estimated 10-year CVD risk. Further testing of this promising intervention is warranted in the long term.

  7. The Impact of Variable Wind Shear Coefficients on Risk Reduction of Wind Energy Projects.

    Science.gov (United States)

    Corscadden, Kenneth W; Thomson, Allan; Yoonesi, Behrang; McNutt, Josiah

    2016-01-01

    Estimation of wind speed at proposed hub heights is typically achieved using a wind shear exponent or wind shear coefficient (WSC), variation in wind speed as a function of height. The WSC is subject to temporal variation at low and high frequencies, ranging from diurnal and seasonal variations to disturbance caused by weather patterns; however, in many cases, it is assumed that the WSC remains constant. This assumption creates significant error in resource assessment, increasing uncertainty in projects and potentially significantly impacting the ability to control gird connected wind generators. This paper contributes to the body of knowledge relating to the evaluation and assessment of wind speed, with particular emphasis on the development of techniques to improve the accuracy of estimated wind speed above measurement height. It presents an evaluation of the use of a variable wind shear coefficient methodology based on a distribution of wind shear coefficients which have been implemented in real time. The results indicate that a VWSC provides a more accurate estimate of wind at hub height, ranging from 41% to 4% reduction in root mean squared error (RMSE) between predicted and actual wind speeds when using a variable wind shear coefficient at heights ranging from 33% to 100% above the highest actual wind measurement.

  8. The Impact of Variable Wind Shear Coefficients on Risk Reduction of Wind Energy Projects

    Science.gov (United States)

    Thomson, Allan; Yoonesi, Behrang; McNutt, Josiah

    2016-01-01

    Estimation of wind speed at proposed hub heights is typically achieved using a wind shear exponent or wind shear coefficient (WSC), variation in wind speed as a function of height. The WSC is subject to temporal variation at low and high frequencies, ranging from diurnal and seasonal variations to disturbance caused by weather patterns; however, in many cases, it is assumed that the WSC remains constant. This assumption creates significant error in resource assessment, increasing uncertainty in projects and potentially significantly impacting the ability to control gird connected wind generators. This paper contributes to the body of knowledge relating to the evaluation and assessment of wind speed, with particular emphasis on the development of techniques to improve the accuracy of estimated wind speed above measurement height. It presents an evaluation of the use of a variable wind shear coefficient methodology based on a distribution of wind shear coefficients which have been implemented in real time. The results indicate that a VWSC provides a more accurate estimate of wind at hub height, ranging from 41% to 4% reduction in root mean squared error (RMSE) between predicted and actual wind speeds when using a variable wind shear coefficient at heights ranging from 33% to 100% above the highest actual wind measurement. PMID:27872898

  9. Temblor, an App to Transform Seismic Science into Personal Risk Reduction

    Science.gov (United States)

    Sevilgen, V.; Jacobson, D. S.; Stein, R. S.; Lotto, G. C.; Sevilgen, S.; Kim, A.

    2016-12-01

    Government agencies and academic researchers provide a rich stream of seismic and engineering data. In addition to rapid earthquake notifications and damage assessments, these form the basis of probabilistic seismic hazard assessments and loss evaluations used by emergency management agencies, practicing engineers and geologists, and the insurance industry. But the data and the assessments that grow out of them are notoriously difficult for the public to comprehend. For example, who but the cognoscenti understands what "2% exceedance probability in 50 years," "0.5 g peak ground acceleration," or "moment-magnitude" mean? Nowhere is this divide more stark than in earthquake insurance. Using proprietary models, insurers calculate the probability of a payout above the deductible for your home policy, but sell the policy as "peace of mind" or "the strength to rebuild." How can a homeowner act in her best financial interests under these circumstances? Temblor (temblor.net) is our attempt to make seismic risk lucid, personal, and actionable. Free and ad-free, Temblor uses the best available public data and methods. Temblor gives you the seismic hazard rank of your location anywhere in the U.S. In its maps, you can see the active faults and recent quakes, and the landslide, liquefaction, tsunami inundation, and flood zones around you. Temblor also displays the Global Earthquake Activity Rate (GEAR) model of Bird et al. (2015). By entering the construction year and square footage for homes within the U.S., you learn the likely cost for seismic damage, and how that cost could be reduced by retrofit or covered by insurance. To give context to this decision, the app compares your seismic risk to other risks homeowners protect themselves against or insure for. Temblor estimates the cost and the most probable financial and safety benefits of a retrofit based on your location, home age and size, so you can decide if the expenditure makes sense. Seeking to make quakes more

  10. Towards a cross-domain interoperable framework for natural hazards and disaster risk reduction information

    Science.gov (United States)

    Tomas, Robert; Harrison, Matthew; Barredo, José I.; Thomas, Florian; Llorente Isidro, Miguel; Cerba, Otakar; Pfeiffer, Manuela

    2014-05-01

    The vast amount of information and data necessary for comprehensive hazard and risk assessment presents many challenges regarding the lack of accessibility, comparability, quality, organisation and dissemination of natural hazards spatial data. In order to mitigate these limitations an interoperable framework has been developed in the framework of the development of legally binding Implementing rules of the EU INSPIRE Directive1* aiming at the establishment of the European Spatial Data Infrastructure. The interoperability framework is described in the Data Specification on Natural risk zones - Technical Guidelines (DS) document2* that was finalized and published on 10.12. 2013. This framework provides means for facilitating access, integration, harmonisation and dissemination of natural hazard data from different domains and sources. The objective of this paper is twofold. Firstly, the paper demonstrates the applicability of the interoperable framework developed in the DS and highlights the key aspects of the interoperability to the various natural hazards communities. Secondly, the paper "translates" into common language the main features and potentiality of the interoperable framework of the DS for a wider audience of scientists and practitioners in the natural hazards domain. Further in this paper the main five aspects of the interoperable framework will be presented. First, the issue of a common terminology for the natural hazards domain will be addressed. A common data model to facilitate cross domain data integration will follow secondly. Thirdly, the common methodology developed to provide qualitative or quantitative assessments of natural hazards will be presented. Fourthly, the extensible classification schema for natural hazards developed from a literature review and key reference documents from the contributing community of practice will be shown. Finally, the applicability of the interoperable framework for the various stakeholder groups will be also

  11. A Bilateral U.S. - Russia Contribution to Disaster Risk Reduction in the Asia-Pacific Region

    Science.gov (United States)

    Eichelberger, J. C.; Gordeev, E.; Bratton, J.; Ismail-Zadeh, A.

    2012-12-01

    An accepted principle of disaster risk reduction is that all stakeholders should be engaged in the process. For extreme geophysical events, this almost always means stakeholders in more than one country. Even when the direct impacts on the ground from violent shaking or explosive eruptions are confined to a single country, effects to lives and property may be carried thousands of kilometers from the event source by tsunamis or ash clouds, respectively. The formation of G-EVER recognizes the need for neighbors to join together on disaster risk reduction. There is much to be gained by sharing real-time monitoring data and databases on past extreme events, mapping risks seamlessly across borders, and establishing best practices through sharing of experiences. Each extreme event is a learning opportunity, and the recent lessons have been particularly painful. Our science, while progressing, is still inadequate both in content and in application. There has also been lack of recognition that the "worst case" is indeed possible. Among the various collaborations needed to reduce disaster risk is bilateral collaboration, because borders are obstacles and exist between two countries with rules that have been determined by those countries. Borders are used by all countries for protection of national and economic security. They restrict flow of people, equipment, and information, but not seismic waves, tsunamis, and ash. Even the relatively minor event of sea ice arriving early in Nome, Alaska last fall involved both Russia and the U.S. in a relief effort to bring fuel. It is the responsibility of natural hazard scientists and crisis managers to work together across borders, and where necessary make the case to their governments for sharing of data and information based on an expanded view of national security. The Bilateral Presidential Commission initiated by U.S. President Barrack Obama and Russian President Dmitry Medvedev has provided a framework in which to expand

  12. Valuing the risk reduction of coastal ecosystems in data poor environments: an application in Quintana Roo, Mexico

    Science.gov (United States)

    Reguero, B. G.; Toimil, A.; Escudero, M.; Menendez, P.; Losada, I. J.; Beck, M. W.; Secaira, F.

    2016-12-01

    Coastal risks are increasing from both economic growth and climate change. Understanding such risks is critical to assessing adaptation needs and finding cost effective solutions for coastal sustainability. Interest is growing in the role that nature-based measures can play in adapting to climate change. Here we apply and advance a framework to value the risk reduction potential of coastal ecosystems, with an application in a large scale domain, the coast of Quintana Roo, México, relevant for coastal policy and management, but with limited data. We build from simple to use open-source tools. We first assess the hazards using stochastic simulation of historical tropical storms and inferring two scenarios of future climate change for the next 20 years, which include the effect of sea level rise and changes in frequency and intensity of storms. For each storm, we obtain wave and surge fields using parametrical models, corrected with pre-computed static wind surge numerical simulations. We then assess losses on capital stock and hotels and calculate total people flooded, after accounting for the effect of coastal ecosystems in reducing coastal hazards. We inferred the location of major barrier reefs and dune systems using available satellite imagery, and sections of bathymetry and elevation data. We also digitalized the surface of beaches and location of coastal structures from satellite imagery. In a poor data environment, where there is not bathymetry data for the whole of the region, we inferred representative coastal profiles of coral reef and dune sections and validated at available sections with measured data. Because we account for the effect of reefs, dunes and mangroves in coastal profiles every 200 m of shoreline, we are able to estimate the value of such ecosystems by comparing with benchmark simulations when we take them out of the propagation and flood model. Although limited in accuracy in comparison to more complex modeling, this approach is able to

  13. Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

    Science.gov (United States)

    Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

    2016-08-01

    BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); Phand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

  14. The role of atherosclerosis imaging in redefining normal and abnormal cholesterol values, and risk reduction in primary prevention statin trials.

    Science.gov (United States)

    Hecht, Harvey S

    2011-10-01

    The emergence of atherosclerosis imaging, using coronary calcium scanning (CAC) and carotid intima media thickness (CIMT) and plaque as stronger predictors of cardiovascular events than risk factors of atherosclerosis, has created a paradigm shift in the primary prevention of cardiovascular disease. Rather than population-derived indices to define normal or abnormal low-density lipoprotein (or other lipid values) in the untreated individual patient, it is more appropriate to define "normal" as "cholesterol values at which level there is no subclinical atherosclerosis" and "abnormal" as "cholesterol values at which level there is subclinical atherosclerosis," with the severity of "abnormal" depending on the degree of subclinical atherosclerosis. Similarly, the low-density lipoprotein treatment goal is the level at which atherosclerosis progression is halted. Extension of the subclinical atherosclerosis risk-based paradigms to primary prevention trials dramatically changes the manner in which trials should be conducted in the future, as well as the results of trials already performed. For example, asymptomatic patients with a CAC score of 0 have an extraordinarily low event rate but have been included in primary prevention statin trials even though their risk without treatment is very small. Reanalysis of the statin primary prevention trials after excluding the percentage (40%) of patients who would be expected to have a CAC score of 0 yields an absolute risk increase of 60% in both the placebo group (from 5.4% to 8.5%), and the statin group (from 3.0% to 4.8%). Absolute risk reduction increased by 58% (from 2.4% to 3.8%). Relative risk reduction of 44% was unchanged. In conclusion, 1) the presence or absence of atherosclerosis as measured by CAC redefines normal or abnormal lipid levels in an individual patient; 2) statin absolute risk reduction is significantly greater than previously appreciated; and 3) patients with a CAC score of 0 should be excluded from

  15. Reduction of risk of Salmonella infection from kitchen cleaning clothes by use of sodium hypochlorite disinfectant cleaner.

    Science.gov (United States)

    Chaidez, C; Soto-Beltran, M; Gerba, C P; Tamimi, A H

    2014-11-01

    The objective of this study was to evaluate the reduction of infection risk due to exposure to Salmonella sp. in kitchen cleaning clothes by the use of a bleach (sodium hypochlorite) cleaner utilizing a continuous-time dynamic exposure model. The only route of exposure considered was hand contamination during cloth use. The occurrence and numbers of Salmonella was studied in 60 homes over a 6-week period in which half disinfected kitchen cleaning clothes with a sodium hypochlorite based disinfectant cleaner. This study demonstrated that a significant risk exists for Salmonella infection from kitchen cleaning clothes in Mexican homes and that this risk can be reduced by almost 100-fold by soaking cleaning clothes in a bleach product. The risks of infection and illness could likely be further reduced by developing a more effective procedure for reducing Salmonella in cleaning clothes treated twice a day with a sodium hypochlorite disinfectant (i.e. longer soaking time) or using a greater concentration of the disinfectant. Hygiene intervention is a key strategy to reduce the potential risk of disease-causing micro-organisms in households. There is a lack of understanding of the human health risk associated with the use of contaminated kitchen cleaning cloths. The study used a quantitative microbial risk assessment to estimate the risk associated with the use of kitchen cleaning clothes by using disinfectant products. The results showed that the use of prescribe protocols can reduce the risk of Salmonella infections in household kitchens. © 2014 The Society for Applied Microbiology.

  16. REDUCTION OF THE RISK IN PUBLIC PROCUREMENT BY USING DESIGN-BUILD AS A MEANS FOR SUITABLE CONSTRUCTING

    Directory of Open Access Journals (Sweden)

    Jakub Blaťák

    2016-07-01

    Full Text Available Suitable and sustainable buildings have increased demands for design and for the transfer of design requirements to realization. That causes an increase of risk connected with the differences between planned and real parameters of the buildings. This article will outline the main theme comparison between DBB and DB projects concerning contractor’s risk management level. This comparative analysis explains, using the RIPRAN method, the hidden risks in each type of delivery method. The comparison identifies numerous contractual topics and risks included in both and gives deeper insight into risk management, both for the contracting party and also for public procurement. Applying risk analysis strategies and tools to the process will help decision-makers evaluate and select the suitable delivery method consistently and defensibly. This paper gives generic risk factors related to both project types. The results indicate risk factors with influence on the price, probability of occurrence and unfavourable impact on the project and help allocate risk level more properly in accordance with its high, middle or low probable impact. Public investment is a significant part of the public budget, the application of design-build can help with the reduction of corruption, and the public sector can benefit from the usage of DB projects to help eliminate the mistakes made by contracting authorities.

  17. Individual, provider, and system risk factors for breast and cervical cancer screening among underserved Black, Latina, and Arab women.

    Science.gov (United States)

    Roman, Leeanne; Meghea, Cristian; Ford, Sabrina; Penner, Louis; Hamade, Hiam; Estes, Tamika; Williams, Karen Patricia

    2014-01-01

    Socioeconomic and racial/ethnic disparities in breast and cervical cancer screening persist. An exploratory study was conducted to better understand co-occurring risk factors in underserved groups that could inform interventions to improve screening adherence. The objective of this study was to examine associations between breast and cervical cancer screening adherence and co-occurring risk factors in three racial/ethnic groups of underserved women. Black, Latina, and Arab women (N=514), ages 21 to 70 years, were enrolled into the Kin Keeper(SM) randomized controlled trial in communities around Detroit, Michigan. We used participant baseline assessments (e.g., demographic characteristics, health literacy) to explore screening risks using an additive approach and multivariate logistic analyses. For black women, having more health literacy risks were associated with reduced odds of a clinical breast exam (CBE), mammogram, and Papanicolaou (Pap) test; more competing priorities were associated with reduced odds of a Pap test; lack of doctor mammogram recommendation was significantly associated with decreased odds of CBE. For Latina women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test. For Arab women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test; more competing priorities were significantly associated with reduced odds of CBE and Pap test. All results were significant at pwomen. Interventions to improve screening should be tailored for racial/ethnic groups with particular attention to competing survival priorities, health literacy risks factors, and provider recommendations.

  18. Coupling Post-Event and Prospective Analyses for El Niño-related Risk Reduction in Peru

    Science.gov (United States)

    French, Adam; Keating, Adriana; Mechler, Reinhard; Szoenyi, Michael; Cisneros, Abel; Chuquisengo, Orlando; Etienne, Emilie; Ferradas, Pedro

    2017-04-01

    Analyses in the wake of natural disasters play an important role in identifying how ex ante risk reduction and ex post hazard response activities have both succeeded and fallen short in specific contexts, thereby contributing to recommendations for improving such measures in the future. Event analyses have particular relevance in settings where disasters are likely to reoccur, and especially where recurrence intervals are short. This paper applies the Post Event Review Capability (PERC) methodology to the context of frequently reoccurring El Niño Southern Oscillation (ENSO) events in the country of Peru, where over the last several decades ENSO impacts have generated high levels of damage and economic loss. Rather than analyzing the impacts of a single event, this study builds upon the existing PERC methodology by combining empirical event analysis with a critical examination of risk reduction and adaptation measures implemented both prior to and following several ENSO events in the late 20th and early 21st centuries. Additionally, the paper explores linking the empirical findings regarding the uptake and outcomes of particular risk reduction and adaptation strategies to a prospective, scenario-based approach for projecting risk several decades into the future.

  19. Significant reduction in hospital-acquired thrombosis: impact of national risk assessment and real-time feedback.

    Science.gov (United States)

    Rowswell, Huw Raymond; Nokes, Timothy J C

    2017-01-01

    Since 2010, National Health Service hospitals in England have been incentivised to risk assess for Venous Thromboembolism (VTE) in all adult patients admitted, using a national tool. We studied the impact of this, together with local real-time reporting of VTE events to senior clinicians, on cases of hospital-acquired thrombosis (HAT) diagnosed, since 2010. This was an observational cohort study reviewing all cases of VTE diagnosed between January 2010 and December 2016 in a single teaching hospital. These were matched against the number of patients admitted to produce crude incidence rates per thousand admissions. Similarly, all cases associated with inadequate thromboprophylaxis (TP) measures were documented over the same period. By the end of 2010, with 70% compliance with VTE risk assessment, improving to 90% (the national target) early in 2011, there were 217 HAT events from 103 845 admissions. In 2016, there were 176 HAT events from 119 128 admissions, being a significant reduction, relative risk (RR) 0.718 (95% CI 0.589 to 0.875; p=0.001). In 2010, there were 50 of 217 HAT events associated with inadequate TP, falling to 7 of 176 in 2016, also a significant reduction, RR 0.140 (95% CI 0.065 to 0.300; p=0.0001). National guidance on VTE prevention and mandatory risk assessment linked to local real-time reporting of VTE events are associated with significant reductions both in total HAT events and those associated with inadequate TP.

  20. Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers.

    Science.gov (United States)

    Tembuyser, Lien; Dequeker, Elisabeth M C

    2016-01-01

    Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

  1. Internal audit: the expert in providing comfort to the audit committee. The case of risk management and internal control

    OpenAIRE

    G. SARENS; I. DE BEELDE

    2006-01-01

    This study investigates to what extent audit committees feel uncomfortable about risk management and internal control, and focuses on how internal audit can be the expert in providing comfort in these areas, building upon the sociology of professions literature. Four case studies reveal that audit committees need comfort with respect to the control environment. Thanks to their internal position, their familiarity with the company, and their position close to people across the company, interna...

  2. Appraisement and benchmarking of third-party logistic service provider by exploration of risk-based approach

    Directory of Open Access Journals (Sweden)

    Nitin Kumar Sahu

    2015-12-01

    Full Text Available In the present era, Reverse Logistics Support has monitored as a momentous realm, where stuffs are transferred from point of consumption to origin. The companies who provide the logistic equipments, i.e. Truck, Joseph Cyril Bomford, and Shipment, etc. to its partner’s firms called Third-Party Logistics (3PL service provider. Today, the feasible 3PL service provider evaluation-opt problem is yet an amorous dilemma. The appraisement and benchmarking of logistics service providers in extent of index; allied risk-based indices and their interrelated metrics; outlooked as a great tool for each international firm, in order that firm could obtain their core goals. The novelty of manuscript is that here, a hairy-based approach has been integrated and then implemented upon a novel developed multi hierarchical third-party logistics (3PL service providers appraisement index in purpose to umpire the 3PL provider for their strong and ill’s core indices. Moreover, the overall score (Si system has also been carried out for benchmarking the 3PL provider companies, where s1 has been found as the best 3PL service provider. The developed approach enabled the manager of firms to make the verdict towards the best inclusive evaluation process of 3PL performance appraisement and benchmarking. A numerical illustration has also been provided to validate the verdict support system.

  3. Use of Western-based HIV risk-reduction interventions targeting adolescents in an African setting.

    Science.gov (United States)

    Fitzgerald, A M; Stanton, B F; Terreri, N; Shipena, H; Li, X; Kahihuata, J; Ricardo, I B; Galbraith, J S; De Jaeger, A M

    1999-07-01

    To evaluate an intervention (based on one which had previously been successful in reducing adolescent human immunodeficiency virus (HIV) risk behaviors in the United States) among adolescents residing in Namibia, a country located in sub-Saharan Africa. A randomized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sex was conducted among 515 youth (median age 17 years; median grade 11) attending 10 secondary schools located in two districts in Namibia. Knowledge, attitudes, intentions, and HIV risk behaviors were assessed at baseline and in the immediate postintervention period. Knowledge increased significantly among intervention compared to control youth (88% vs. 82%; correct responses, p sex, could have a girlfriend or boyfriend for a long time without having sex, could explain the process of impregnation, knew how to use a condom, and could ask for condoms in a clinic. Fewer intervention than control youth believed that if a girl refused to have sex with her boyfriend it was permissible for him to strike her, and that condoms took away a boy's pleasure. More intervention than control youth anticipated using a condom when they did have sex, and fewer expected to drink alcohol. Finally, after intervention, there was a trend for increased condom use. There were significant gender-related differences at baseline, although intervention impact was generally equivalent. These findings provide support for the judicious adaptation of successful Western HIV prevention programs in other cultural settings. A single intervention approach appears to be effective in short-term follow-up with both genders.

  4. Predictors of Comfort and Confidence Among Medical Students in Providing Care to Patients at Risk of Suicide.

    Science.gov (United States)

    Patel, Sunaina; Batterham, Philip J; Calear, Alison L; Cryer, Rachel

    2016-12-01

    The aim of this study was to identify factors associated with comfort and confidence in providing care to patients at risk of suicide, in a sample of Australian medical students. An online cross-sectional survey was completed by 116 current medical students (42 % male) aged between 20 and 41 years (M = 25, SD = 3.8). Greater personal experience of suicide and previous contact with patients with psychiatric problems were significantly associated with both increased perceived comfort and increased confidence in providing care for individuals with suicidal thoughts or behaviors, based on self-report. However, these effects may not reflect objective measures of competency and additional research is needed to assess generalizability of the findings due to the sampling method. Increasing medical student contact with patients at risk of suicide through the implementation of psychiatry placements, gateway programs, and early year exposure to patients with psychiatric problems may increase perceived confidence and comfort in providing care to individuals at risk of suicide. Further research should evaluate the impact of such programs on behavioral indices of clinical competency.

  5. Homoacetogenesis in Deep-Sea Chloroflexi, as Inferred by Single-Cell Genomics, Provides a Link to Reductive Dehalogenation in Terrestrial Dehalococcoidetes

    Directory of Open Access Journals (Sweden)

    Holly L. Sewell

    2017-12-01

    Full Text Available The deep marine subsurface is one of the largest unexplored biospheres on Earth and is widely inhabited by members of the phylum Chloroflexi. In this report, we investigated genomes of single cells obtained from deep-sea sediments of the Peruvian Margin, which are enriched in such Chloroflexi. 16S rRNA gene sequence analysis placed two of these single-cell-derived genomes (DscP3 and Dsc4 in a clade of subphylum I Chloroflexi which were previously recovered from deep-sea sediment in the Okinawa Trough and a third (DscP2-2 as a member of the previously reported DscP2 population from Peruvian Margin site 1230. The presence of genes encoding enzymes of a complete Wood-Ljungdahl pathway, glycolysis/gluconeogenesis, a Rhodobacter nitrogen fixation (Rnf complex, glyosyltransferases, and formate dehydrogenases in the single-cell genomes of DscP3 and Dsc4 and the presence of an NADH-dependent reduced ferredoxin:NADP oxidoreductase (Nfn and Rnf in the genome of DscP2-2 imply a homoacetogenic lifestyle of these abundant marine Chloroflexi. We also report here the first complete pathway for anaerobic benzoate oxidation to acetyl coenzyme A (CoA in the phylum Chloroflexi (DscP3 and Dsc4, including a class I benzoyl-CoA reductase. Of remarkable evolutionary significance, we discovered a gene encoding a formate dehydrogenase (FdnI with reciprocal closest identity to the formate dehydrogenase-like protein (complex iron-sulfur molybdoenzyme [CISM], DET0187 of terrestrial Dehalococcoides/Dehalogenimonas spp. This formate dehydrogenase-like protein has been shown to lack formate dehydrogenase activity in Dehalococcoides/Dehalogenimonas spp. and is instead hypothesized to couple HupL hydrogenase to a reductive dehalogenase in the catabolic reductive dehalogenation pathway. This finding of a close functional homologue provides an important missing link for understanding the origin and the metabolic core of terrestrial Dehalococcoides/Dehalogenimonas spp. and of

  6. Education and informed consent about increased risk donor kidneys: a national survey of non-physician transplant providers.

    Science.gov (United States)

    Gordon, E J; Mullee, J; Beauvais, N; Warren, E; Theodoropoulos, N; McNatt, G; Rassiwala, J; Ison, M G

    2014-04-01

    Transplant providers must understand the definition of increased risk donor (IRD) organs to effectively educate transplant candidates and obtain informed consent. This study surveyed non-physician providers from 20 transplant centers about their educational and informed consent practices of IRD kidneys. An anonymous, web-based survey about the content and timing of education and informed consent for potential recipients of IRD kidneys, providers' knowledge of IRD kidneys, and provider and center characteristics was completed by most (67%; 90 of 135) of those invited to participate; 87 responses were included in analysis. Most (80%) reported understanding the concept of IRD kidneys. However, few reported sufficient knowledge of the Organ Procurement and Transplantation Network definition of IRDs, risk factors, screening tests, window periods, and infection transmission rates. Most (56%) felt uncomfortable with obtaining specific informed consent for IRD kidneys. Most respondents received informal education about IRD kidneys (78%), and recognized the need for (98%) and were interested in receiving (99%) further education on this topic. Non-physician transplant providers need and are interested in better education about IRD kidneys to effectively educate patients and obtain patients' informed consent. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Innovative Surveillance and Risk Reduction Systems for Family Maltreatment, Suicidality and Substance Problems in the USAF

    National Research Council Canada - National Science Library

    Slep, Amy

    2004-01-01

    This project aims to enhance the capacity of the Air Force (AP) to reduce death, injury, and degraded force readiness via reduction of he prevalence and impact of family - maltreatment, suicidality, and alcohol/drug problems...

  8. Beyond anal sex: sexual practices associated with HIV risk reduction among men who have sex with men in Boston, Massachusetts.

    Science.gov (United States)

    Reisner, Sari L; Mimiaga, Matthew J; Skeer, Margie; Mayer, Kenneth H

    2009-07-01

    Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be "out"; odds ratio [OR] = 3.64; p < 0.05), and report oral sex with a condom in the prior 12 months (OR = 4.85; p < 0.01). They were less likely to report: depression (Center for Epidemiologic Studies Depression Scale [CES-D] score 16+; OR = 0.48; p < 0.05), a history of one or more sexually transmitted diseases (STDs; OR = 0.40; p < 0.05), and meeting sexual partners at public cruising areas (OR = 0.32; p < 0.01). In a multivariable model, risk reducers were less likely to report: alcohol use during sex (adjusted odds ratio [AOR] = 0.33; p < 0.05), depression (CESD score 16+; AOR = 0.32; p < 0.05), or meeting sexual partners at public cruising areas (AOR = 0.30; p < 0.05), or via the Internet (AOR = 0.12; p < 0.05) in the previous 12 months. Identifying and understanding such factors associated with risk reduction behaviors may be important to consider in designing effective prevention interventions to promote sexual health for MSM.

  9. Reduction of spatial distribution of risk factors for transportation of contaminants released by coal mining activities.

    Science.gov (United States)

    Karan, Shivesh Kishore; Samadder, Sukha Ranjan

    2016-09-15

    It is reported that water-energy nexus composes two of the biggest development and human health challenges. In the present study we presented a Risk Potential Index (RPI) model which encapsulates Source, Vector (Transport), and Target risks for forecasting surface water contamination. The main aim of the model is to identify critical surface water risk zones for an open cast mining environment, taking Jharia Coalfield, India as the study area. The model also helps in feasible sampling design. Based on spatial analysis various risk zones were successfully delineated. Monthly RPI distribution revealed that the risk of surface water contamination was highest during the monsoon months. Surface water samples were analysed to validate the model. A GIS based alternative management option was proposed to reduce surface water contamination risk and observed 96% and 86% decrease in the spatial distribution of very high risk areas for the months June and July respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-interve