WorldWideScience

Sample records for providing risk reduction

  1. Optimising risk reduction: An expected utility approach for marginal risk reduction during regulatory decision making

    International Nuclear Information System (INIS)

    Li Jiawei; Pollard, Simon; Kendall, Graham; Soane, Emma; Davies, Gareth

    2009-01-01

    In practice, risk and uncertainty are essentially unavoidable in many regulation processes. Regulators frequently face a risk-benefit trade-off since zero risk is neither practicable nor affordable. Although it is accepted that cost-benefit analysis is important in many scenarios of risk management, what role it should play in a decision process is still controversial. One criticism of cost-benefit analysis is that decision makers should consider marginal benefits and costs, not present ones, in their decision making. In this paper, we investigate the problem of regulatory decision making under risk by applying expected utility theory and present a new approach of cost-benefit analysis. Directly taking into consideration the reduction of the risks, this approach achieves marginal cost-benefit analysis. By applying this approach, the optimal regulatory decision that maximizes the marginal benefit of risk reduction can be considered. This provides a transparent and reasonable criterion for stakeholders involved in the regulatory activity. An example of evaluating seismic retrofitting alternatives is provided to demonstrate the potential of the proposed approach.

  2. 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.

  3. 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; Hatherly, Chris

    2014-01-01

    . Additionally, participants using the 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. Conclusions 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. PMID:26543904

  4. Absolute risk, absolute risk reduction and relative risk

    Directory of Open Access Journals (Sweden)

    Jose Andres Calvache

    2012-12-01

    Full Text Available This article illustrates the epidemiological concepts of absolute risk, absolute risk reduction and relative risk through a clinical example. In addition, it emphasizes the usefulness of these concepts in clinical practice, clinical research and health decision-making process.

  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. The efficacy of serostatus disclosure for HIV Transmission risk reduction.

    Science.gov (United States)

    O'Connell, Ann A; Reed, Sandra J; Serovich, Julianne A

    2015-02-01

    Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698-705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed.

  7. 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.

  8. 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

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

    OpenAIRE

    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 individuals to undertake flood risk mitigation measures, as well as the public's demand for flood protection, and therefore provide useful insights for flood risk management. This study empirically exa...

  10. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities

    International Nuclear Information System (INIS)

    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 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

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

    OpenAIRE

    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. Chapter 2 provides an overview of cost-benefit analysis (CBA) of flood risk management strategies under climate change uncertainty and new information. CBA is applied to determine optimal dike height...

  12. Workplace injuries and risk reduction practices in Malaysia.

    Science.gov (United States)

    Ali, Roslinah; Shaharudin, Rafiza; Omar, Azahadi; Yusoff, Fadhli

    2012-01-01

    This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006. This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire. Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers. Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.

  13. 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

  14. 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.

  15. 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

  16. Children capacity in disaster risk reduction: A call for action

    Directory of Open Access Journals (Sweden)

    Leila Mohammadinia

    2017-01-01

    Full Text Available Disasters have various physical, psychological, social and economical effects on all age group, particularly children who are more vulnerable than adults. In the aftermath of disasters, children like pregnant women, elderly and handicaps are special group with special needs. This is because they are at greater risk based on their specific physiological and psychological characteristics. Moreover,, according to the Sendai document, children need more attention in Disaster Risk Reduction (DRRprograms design, policies implementation with a proactive approach in Disaster Risk Reduction (1. In the Sendai document it is emphasized that policies regarding disaster risk reduction, cognition and risk perception about the risk property should be considered based upon the hazards and the environment in terms of vulnerability, capacity and exposure (2.Hyogo framework for action was also already have been focused on child priority on the legislation program (3. Accordingly, it is necessary to involve children in disaster risk reduction programs actively in order to overcome their needs and their problems (4. As children are more affected groups in various aspects of disasters in most countries, their potential utilization, the conditions and space should be provided based on laws, national policies, training and capacity. Although after disaster children required particular needs and attention(5-6, they should be considered as an active group who could participate in DRR program and help their family and also the community.(4, 7 Some evidences suggest on value of children team working for community preparedness. Iran had a successful experience for using adolescence capacity as a pillar in activation of early warning; including notification announced while observing the rising sea levels for local community in order to reduce the risk of flood disaster at a local area in the North of Iran. According to the Hyogo and the Sendai documents, it seems that using

  17. 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.

  18. Assessment of aircraft risk reduction at Pantex Plant

    International Nuclear Information System (INIS)

    Lin, Y.T.; Hedtke, R.; Fike, D.; Diniz, J.

    1996-01-01

    The possibility of an aircraft crashing into the Department of Energy's (DOE) Pantex plant facility has been of concern in risk assessments. In response to public concerns, and in an effort to reduce risks associated with overflights of Pantex, several changes to navigational aids at Amarillo International Airport have been implemented. For over one year, a radar airspace monitor and recording system has been connected to the airport surveillance radar at Amarillo to record the flight paths, aircraft types, and traffic density of aircraft in the vicinity of the Pantex plant. The data has provided a better understanding of the overflight risk at Pantex as well as a means to measure the effectiveness of risk reduction efforts

  19. Reflections from the interface between seismological research and earthquake risk reduction

    Science.gov (United States)

    Sargeant, S.

    2012-04-01

    Scientific understanding of earthquakes and their attendant hazards is vital for the development of effective earthquake risk reduction strategies. Within the global disaster reduction policy framework (the Hyogo Framework for Action, overseen by the UN International Strategy for Disaster Reduction), the anticipated role of science and scientists is clear, with respect to risk assessment, loss estimation, space-based observation, early warning and forecasting. The importance of information sharing and cooperation, cross-disciplinary networks and developing technical and institutional capacity for effective disaster management is also highlighted. In practice, the degree to which seismological information is successfully delivered to and applied by individuals, groups or organisations working to manage or reduce the risk from earthquakes is variable. The challenge for scientists is to provide fit-for-purpose information that can be integrated simply into decision-making and risk reduction activities at all levels of governance and at different geographic scales, often by a non-technical audience (i.e. people without any seismological/earthquake engineering training). The interface between seismological research and earthquake risk reduction (defined here in terms of both the relationship between the science and its application, and the scientist and other risk stakeholders) is complex. This complexity is a function of a range issues that arise relating to communication, multidisciplinary working, politics, organisational practices, inter-organisational collaboration, working practices, sectoral cultures, individual and organisational values, worldviews and expectations. These factors can present significant obstacles to scientific information being incorporated into the decision-making process. The purpose of this paper is to present some personal reflections on the nature of the interface between the worlds of seismological research and risk reduction, and the

  20. Outage risk reduction at Diablo Canyon

    International Nuclear Information System (INIS)

    Burnett, Tobias W.T.; Eugene Newman, C.

    2004-01-01

    A formal risk reduction program was conducted at the Diablo Canyon Nuclear Generating plant as part of EPRI's Outage Risk Assessment and Management Program. The program began with a probabilistic and deterministic assessment of the frequency of core coolant boiling and core uncovery during shutdown operations. This step identified important contributors to risk, periods of high vulnerability, and potential mechanisms for reducing risk. Next, recovery strategies were evaluated and procedures, training, and outage schedules modified. Twelve risk reduction enhancements were developed and implemented. These enhancements and their impact are described in this paper. These enhancements reduced the calculated risk of core uncovery by about a factor of four for a refueling outage without lengthening the outage schedule; increased the outage efficiency, contributing to completing 11 days ahead of schedule; and helped to earn the highest achievable SALP rating from the NRC. (author)

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

    African Journals Online (AJOL)

    Adaptation of an HIV behavioural disinhibition risk reduction intervention for ... disinhibition risk reduction interventions for recently circumcised men for use in clinic ... medicine HIV prevention technologies into the male circumcision contexts.

  2. Disaster risk reduction and sustainable development

    International Nuclear Information System (INIS)

    Khurshedi, N.

    2005-01-01

    During the past four decades, natural hazards such as earthquakes, volcanic activity, and slides, tsunami tropical cyclones and other severe storms, tornadoes and high winds, river floods and coastal flooding, wildfire and associated haze drought, sand/dust storms, and insect infestations have caused major loss of human lives and livelihoods, the destruction of economic and social infrastructure, as well as environmental damages. Economic losses have increased almost ten times during this period. As it happen in recent Asia Tsunami, in which over 2, 00,000 people reportedly killed, estimated five million homeless, and resulted in massive displacement of population and extensive damage to infrastructure. The escalation of severe disaster events triggered by natural hazards and related technological and environment disasters is increasingly threatening both sustainable development and poverty-reduction initiatives. The loss of human lives and the rise in the cost of reconstruction efforts and loss of development assets has forced the issue of disaster reduction and risk management higher on the policy agenda of affected governments as well a multilateral and bilateral agencies and NGOs. For this Disaster risk reduction-.strategies are aimed at enabling societies at risk to become engaged in the conscious management of risk and the reduction of vulnerability. The adoption of appropriate development policies can reduce disaster risk. These policies should be gender sensitive and need the necessary political commitment. They involve the adoption of suitable regulatory and other legal measures, institutional reform, improved analytical and methodological capabilities, financial planning, education and awareness. (author)

  3. Optimal Risk Reduction in the Railway Industry by Using Dynamic Programming

    OpenAIRE

    Michael Todinov; Eberechi Weli

    2013-01-01

    The paper suggests for the first time the use of dynamic programming techniques for optimal risk reduction in the railway industry. It is shown that by using the concept ‘amount of removed risk by a risk reduction option’, the problem related to optimal allocation of a fixed budget to achieve a maximum risk reduction in the railway industry can be reduced to an optimisation problem from dynamic programming. For n risk reduction options and size of the available risk reduction budget B (expres...

  4. Baseline risk and marginal willingness to pay for health risk reduction.

    Science.gov (United States)

    Gerking, Shelby; Adamowicz, Wiktor; Dickie, Mark; Veronesi, Marcella

    2017-01-01

    Empirical results presented in this paper suggest that parents' marginal willingness to pay (MWTP) for a reduction in morbidity risk from heart disease is inversely related to baseline risk (i.e., the amount of risk initially faced) both for themselves and for their children. For instance, a 40% reduction from the mean of baseline risk results in an increase in MWTP by 70% or more. Thus, estimates of monetary benefits of public programs to reduce heart disease risk would be understated if the standard practice is followed of evaluating MWTP at initial risk levels and then multiplying this value by the number of cases avoided. Estimates are supported by: (1) unique quantitative information on perceptions of the risk of getting heart disease that allow baseline risk to be defined at an individual level and (2) improved econometric procedures to control for well-known difficulties associated with stated preference data.

  5. Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

    Science.gov (United States)

    Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

    2018-04-01

    In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  6. NASA Propulsion Concept Studies and Risk Reduction Activities for Resource Prospector Lander

    Science.gov (United States)

    Trinh, Huu P.; Williams, Hunter; Burnside, Chris

    2015-01-01

    The trade study has led to the selection of propulsion concept with the lowest cost and net lowest risk -Government-owned, flight qualified components -Meet mission requirements although the configuration is not optimized. Risk reduction activities have provided an opportunity -Implement design improvements while development with the early-test approach. -Gain knowledge on the operation and identify operation limit -Data to anchor analytical models for future flight designs; The propulsion system cold flow tests series have provided valuable data for future design. -The pressure surge from the system priming and waterhammer within component operation limits. -Enable to optimize the ullage volume to reduce the propellant tank mass; RS-34 hot fire tests have successfully demonstrated of using the engines for the RP mission -No degradation of performance due to extended storage life of the hardware. -Enable to operate the engine for RP flight mission scenarios, outside of the qualification regime. -Provide extended data for the thermal and GNC designs. Significant progress has been made on NASA propulsion concept design and risk reductions for Resource Prospector lander.

  7. Risk reduction by filtered venting in PWR large dry-containments

    International Nuclear Information System (INIS)

    Gazzillo, F.; Kastenberg, W.E.

    1984-01-01

    The potential risk reduction associated with a Filtered-Vented Containment System is evaluated. A low-volume venting strategy has been considered and data referring to the Zion power plant, along with the results of the Zion Probabilistic Safety Study, have been used. An estimate of the reduction factor is first made for a single core melt accident sequence whose containment failure mode is late overpressure. The result, interpreted as a reduction factor applicable to the release category associated with containment late overpressure is then used for the estimation of the overall risk reduction factor. In particular, the case of internal and external risk for the Zion power plant are considered. Because the contribution from seismic events dominates the overall risk, the importance of different assumptions for seismic fragility is also assessed. Finally an uncertainty analysis of the risk reduction factor for a single accident sequence is performed. An estimate is also obtained on the level of confidence with which certain required values of risk reduction can be achieved. (orig.)

  8. 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.

  9. US-Soviet cooperation in countering nuclear terrorism: the role of risk reduction centers

    International Nuclear Information System (INIS)

    Nunn, S.; Warner, J.W.

    1987-01-01

    Preventing nuclear terrorism should be high on the agenda of US-Soviet relations. Indeed, the specter of nuclear terrorism, more than any other factor originally prompted and has subsequently sustained the author's deep interest in US-Soviet agreements on establishment of US-Soviet Nuclear Risk Reduction Centers and other important risk-reduction measures. Such centers can play an invaluable role in facilitating discussions aimed at forestalling possible contingencies and in providing a mechanism for dampening escalatory dangers that might otherwise result from any future nuclear terrorism incident. In addition to these crucial substantive functions, the centers could serve to reassure anxious publics that the governments they have entrusted with command authority over tens of thousands of nuclear devices are giving the highest priority to reducing the risk that any of them will ever be used, whether by design or by accident. Nuclear risk Reduction Centers are an idea whose time has come

  10. Earth observation for disaster risk reduction in Pakistan

    International Nuclear Information System (INIS)

    Rafiq, L.

    2012-01-01

    This thesis investigates the role of Earth Observation (EO) for disaster risk reduction for Pakistan. It demonstrates that significant improvements are possible through the utilization of EO data for natural disaster risk reduction activities in Pakistan. In this thesis, a multi hazard approach is proposed in order to identify vulnerability and risk at district level in Pakistan. In particular, a methodology for ranking hazards, vulnerabilities and risks based on Delphi methods is developed. This method is implemented and the results are mapped for four selected hazards i.e., earthquakes, floods, cyclones and droughts. Based on the final risk rankings, the potential of EO is explored with a focus on vulnerability assessment through detailed analysis of two case studies i.e.; Flood and Cyclone/Tsunami. The study also reviews and evaluates the institutional framework of the National Disaster Management Authority of Pakistan in order to identify existing gaps and address them in view of modern technology being used globally. Results reveal that these gaps are mainly related to policies, coordination and communication of different stakeholders at the national level. The work also reviews the available Early Warning System (EWS) in Pakistan and particularly its usage during disasters. Within the context of EWS, multi-sensor satellite data have been utilized for the analysis of structure of an Arabian Sea tropical Cyclone. Results of this focal study provide useful information for operational analysis and forecasting as well as for designing disaster mitigation measures. This information may also play a major role in the development of cyclone warning strategies in the future. (author)

  11. POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

    Science.gov (United States)

    The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

  12. Communication about melanoma and risk reduction after melanoma diagnosis.

    Science.gov (United States)

    Rodríguez, Vivian M; Berwick, Marianne; Hay, Jennifer L

    2017-12-01

    Melanoma patients are advised to perform regular risk-reduction practices, including sun protection as well as skin self-examinations (SSEs) and physician-led examinations. Melanoma-specific communication regarding family risk and screening may promote such behaviors. To this end, associations between patients' melanoma-specific communication and risk reduction were examined. Melanoma patients (N = 169) drawn from a population-based cancer registry reported their current risk-reduction practices, perceived risk of future melanoma, and communication with physicians and relatives about melanoma risk and screening. Patients were, on average, 56 years old and 6.7 years' post diagnosis; 51% were male, 93% reported "fair/very fair" skin color, 75% completed at least some college, and 22% reported a family history of melanoma. Patients reported varying levels of regular (always/nearly always) sun protection: sunscreen use (79%), shade seeking (60%), hat use (54%), and long-sleeve shirt use (30%). Only 28% performed thorough SSE regularly, whereas 92% reported undergoing physician-led skin examinations within the past year. Participants who were female, younger, and had a higher perceived risk of future melanoma were more likely to report past communication. In adjusted analyses, communication remained uniquely associated with increased sunscreen use and SSE. Encouraging melanoma patients to have a more active role in discussions concerning melanoma risk and screening with relatives and physicians alike may be a useful strategy to promote 2 key risk-reduction practices post melanoma diagnosis and treatment. Future research is needed to identify additional strategies to improve comprehensive risk reduction in long-term melanoma patients. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Integrated risk reduction framework to improve railway hazardous materials transportation safety

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xiang, E-mail: liu94@illinois.edu; Saat, M. Rapik, E-mail: mohdsaat@illinois.edu; Barkan, Christopher P.L., E-mail: cbarkan@illinois.edu

    2013-09-15

    Highlights: • An integrated framework is developed to optimize risk reduction. • A negative binomial regression model is developed to analyze accident-cause-specific railcar derailment probability. • A Pareto-optimality technique is applied to determine the lowest risk given any level of resource. • A multi-attribute decision model is developed to determine the optimal amount of investment for risk reduction. • The models could aid the government and rail industry in developing cost-efficient risk reduction policy and practice. -- Abstract: Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation.

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

    Science.gov (United States)

    Fang, David; Fang, Chen-Ling; Tsai, Bi-Kun; Lan, Li-Chi; Hsu, Wen-Shan

    2012-01-01

    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. PMID:23066394

  15. 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.

  16. 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.

  17. Disaster management and risk reduction in South Africa

    CSIR Research Space (South Africa)

    Bruwer, A

    2017-12-01

    Full Text Available The 2015 Global Assessment Report on Disaster Risk Reduction concludes that the mortality and economic loss associated with extensive risks (minor but recurrent disaster risks) in low- and middle-income countries are trending up. In the last decade...

  18. Integrated risk reduction framework to improve railway hazardous materials transportation safety.

    Science.gov (United States)

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

    2013-09-15

    Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation. Copyright © 2013 Elsevier B.V. All rights reserved.

  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. 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...

  1. 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

  2. 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....

  3. An office-based approach to emotional and behavioral risk factor reduction for cardiovascular disease.

    Science.gov (United States)

    Hochman, Daniel M; Feinstein, Robert E; Stauter, Erinn C

    2013-01-01

    There are many psychological risk factors for cardiovascular disease, and the ability to reduce mortality depends on an ability to integrate care of these risk factors with traditional Framingham cardiovascular risk and use them both in routine practice. The aim of this article is to provide an update of all the major emotional and behavioral cardiovascular risk factors along with a practical treatment model for implementation. First, we provide a review of major emotional and behavioral cardiovascular risk factors, the associated primary effect, and proposed mechanism of action. Second, we provide an office-based approach to cardiovascular risk factor reduction and methods of reducing barriers to implementation, called Prevention Oriented Primary Care-Abridged. The approach integrates several forms of detection, assessment using the 3As (ask, assess, assist), and Stages of Change approaches, and subsequent efficient and targeted treatment with either Motivational Interviewing or further office intervention. A case example is provided to help illustrate this process.

  4. 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

  5. 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.

  6. Risk avoidance versus risk reduction: a framework and segmentation profile for understanding adolescent sexual activity.

    Science.gov (United States)

    Hopkins, Christopher D; Tanner, John F; Raymond, Mary Anne

    2004-01-01

    The teen birthrate in the United States is twice that of other industrialized nations. Adolescents in the U.S. are among high-risk groups for HIV/AIDS and other sexually transmitted diseases. As a result, the Department of Health and Human Services changed its policy on the promotion of abstinence to teenagers from a focus on a risk reduction strategy to a focus on a risk avoidance strategy. In order to create more effective risk avoidance as well as risk reduction campaigns, this study proposes a framework to illustrate the distinction that teens make between spontaneous sexual activity and planned sexual activity, as well as those teens that make a commitment to abstinence versus abstinence by default. Furthermore, this study classifies teens into three behavior segments (abstemious, promiscuous and monogamous) and then assesses specific differences that exist within these groups relative to their attitudes and perceptions concerning abstinence, sexual activity, contraception, fear and norms. This change in focus from a risk reduction to a risk avoidance strategy has important implications for social marketing, public policy and marketing theory.

  7. A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.

    Science.gov (United States)

    Sheridan, Stacey L; Pignone, Michael P; Lewis, Carmen L

    2003-11-01

    Commentators have suggested that patients may understand quantitative information about treatment benefits better when they are presented as numbers needed to treat (NNT) rather than as absolute or relative risk reductions. To determine whether NNT helps patients interpret treatment benefits better than absolute risk reduction (ARR), relative risk reduction (RRR), or a combination of all three of these risk reduction presentations (COMBO). Randomized cross-sectional survey. University internal medicine clinic. Three hundred fifty-seven men and women, ages 50 to 80, who presented for health care. Subjects were given written information about the baseline risk of a hypothetical "disease Y" and were asked (1) to compare the benefits of two drug treatments for disease Y, stating which provided more benefit; and (2) to calculate the effect of one of those drug treatments on a given baseline risk of disease. Risk information was presented to each subject in one of four randomly allocated risk formats: NNT, ARR, RRR, or COMBO. When asked to state which of two treatments provided more benefit, subjects who received the RRR format responded correctly most often (60% correct vs 43% for COMBO, 42% for ARR, and 30% for NNT, P =.001). Most subjects were unable to calculate the effect of drug treatment on the given baseline risk of disease, although subjects receiving the RRR and ARR formats responded correctly more often (21% and 17% compared to 7% for COMBO and 6% for NNT, P =.004). Patients are best able to interpret the benefits of treatment when they are presented in an RRR format with a given baseline risk of disease. ARR also is easily interpreted. NNT is often misinterpreted by patients and should not be used alone to communicate risk to patients.

  8. Merging Cultural Heritage Assessments with Risk Reduction and Disaster Recovery

    DEFF Research Database (Denmark)

    Bojsen, Ann Kristina Mikkelsen

    heritage. These limitations serve as motivation for the introduction of the ACTOR framework (Assessing Cultural Threats, Obstacles and Resilience) ACTOR aims at merging cultural heritage assessments with risk reduction and disaster recovery, and provide disaster management students with a learning......Abstract There is a general professional consensus that vulnerability and risk assessments are crucial tasks in any serious attempt to substantially reduce disaster losses and enhance the reconciliation or recovery in the post event phase. However, cultural heritage is often considered...... as an overarching element that should be assessed, rather than a permanent key component of the assessments. Research in disaster management noticeably illustrates how cultural heritage is increasingly at risk from disasters caused by natural and human-made hazards, as well as the effects of climate change. Still...

  9. 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

  10. Breast Cancer Incidence and Risk Reduction in the Hispanic Population.

    Science.gov (United States)

    Power, Eric J; Chin, Megan L; Haq, Mohamed M

    2018-02-26

    Breast cancer is the most common non-skin cancer amongst women worldwide and is the fifth leading cause of cancer-related mortality overall. It is also the foremost reason for cancer-related mortality in Hispanic females in the United States (US). Although the current incidence of breast cancer is significantly lower in Hispanics compared to that of non-Hispanic Whites (NHW) and Blacks, (91.9, 128.1, and 124.3 per 100,000, respectively, annually), this may increase if Hispanics develop similar lifestyle behaviors to other American women, in categories such as weight management, age at first birth, number of children, and breastfeeding habits. Stage-for-stage mortality for Hispanics is similar to NHWs, but the mortality rate is not declining as rapidly in this ethnic group. Hispanic women share many of the same risk factors for developing breast cancer as NHWs and Blacks. This suggests that many of the risk reduction strategies used in other racial populations may also benefit this group. Providing education about breast cancer and implementing risk reduction strategies in culturally-aware environments could help keep incidence low and reduce cancer-related mortality. Since Hispanics are the largest minority group in the US, this could have a significant impact on the incidence and mortality nationally.

  11. Risk reduction and TQM: A corporate culture of continuous improvement

    International Nuclear Information System (INIS)

    Nau, D.C.

    1992-01-01

    A company supplying products and services to the nuclear industry that implements a cultural commitment to continuous improvement, in addition to providing higher quality products and services, also represents a significant reduction in operational risk to that industry. The implementation of a culture of total quality management (TQM), initiated by Sorrento Electronics (SE) in 1989, involves total commitment to the basic TQM principles: continuous improvement, people performing the work are the best sources of how to do it better, and employees must be empowered to make the improvements. What this means to the nuclear industry is a significant reduction in operational risk through: (1) products based on simpler, standardized, proven designs with established operational track records, enhancing confidence that they will perform as expected; (2) the highest confidence that products and supporting documentation are delivered with zero defects; (3) critical power plant schedules can be supported through the shortest possible equipment delivery times; (4) highly motivated employees with extremely positive attitudes, working together in cross-functional teams, virtually eliminate the possibility of deliberate product tampering or sabotage

  12. 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.

  13. 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.

  14. Software for Probabilistic Risk Reduction

    Science.gov (United States)

    Hensley, Scott; Michel, Thierry; Madsen, Soren; Chapin, Elaine; Rodriguez, Ernesto

    2004-01-01

    A computer program implements a methodology, denoted probabilistic risk reduction, that is intended to aid in planning the development of complex software and/or hardware systems. This methodology integrates two complementary prior methodologies: (1) that of probabilistic risk assessment and (2) a risk-based planning methodology, implemented in a prior computer program known as Defect Detection and Prevention (DDP), in which multiple requirements and the beneficial effects of risk-mitigation actions are taken into account. The present methodology and the software are able to accommodate both process knowledge (notably of the efficacy of development practices) and product knowledge (notably of the logical structure of a system, the development of which one seeks to plan). Estimates of the costs and benefits of a planned development can be derived. Functional and non-functional aspects of software can be taken into account, and trades made among them. It becomes possible to optimize the planning process in the sense that it becomes possible to select the best suite of process steps and design choices to maximize the expectation of success while remaining within budget.

  15. Development of risk reduction behavioral counseling for Ebola virus disease survivors enrolled in the Sierra Leone Ebola Virus Persistence Study, 2015-2016.

    Science.gov (United States)

    Abad, Neetu; Malik, Tasneem; Ariyarajah, Archchun; Ongpin, Patricia; Hogben, Matthew; McDonald, Suzanna L R; Marrinan, Jaclyn; Massaquoi, Thomas; Thorson, Anna; Ervin, Elizabeth; Bernstein, Kyle; Ross, Christine; Liu, William J; Kroeger, Karen; Durski, Kara N; Broutet, Nathalie; Knust, Barbara; Deen, Gibrilla F

    2017-09-01

    During the 2014-2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants' individual test results. The behavioral counseling protocol enabled study staff to translate the study's body fluid test results into individualized information for study participants. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries.

  16. Evaluating a Health Risk Reduction Program.

    Science.gov (United States)

    Nagelberg, Daniel B.

    1981-01-01

    A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

  17. Disaster risk reduction capacity assessment for precarious settlements in Guatemala City.

    Science.gov (United States)

    Miles, Scott B; Green, Rebekah A; Svekla, Walter

    2012-07-01

    This study presents findings of an institutional capacity analysis of urban disaster risk reduction for informal settlements in the Guatemala Metropolitan Region. It uses a resource access perspective of vulnerability, actor-network theory, and qualitative data collection. The analysis reveals that there is interest in disaster risk reduction for the informal settlements; however, there is little in the way of direct financial or oversight relationships between informal settlement residents and all other actors. Respondents observed that informal settlements would probably remain inhabited; thus, there is a need for disaster risk reduction within these settlements. Disaster risk reduction capacity for informal settlements exists and can be further leveraged, as long as steps are taken to ensure appropriate access to and control of resources and oversight. Further, the nascent institutional arrangements should be strengthened through increased communication and coordination between actors, a decentralization of oversight and financial relationships, and mediation of identified resource conflicts. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  18. Towards improved public awareness for climate related disaster risk reduction in South Africa: A Participatory Development Communication perspective

    Directory of Open Access Journals (Sweden)

    Tigere Chagutah

    2009-04-01

    Full Text Available Southern Africa has frequently been struck by damaging climate hazards which increasingly continue to threaten sustainable development efforts. Ominously, climate models predict that the incidence of major ‘wet’ events, such as floods and cyclones will increase in frequency against the background of a changing climate. Unfortunately, local mechanisms for communicating and raising public awareness of the consequent risks and appropriate risk reduction options remain weak. At the core of policy responses to the threat posed by climate related hazards, the South African government has adopted a disaster risk reduction approach to disaster management. This article details how, among many other measures to limit the adverse impacts of natural hazards, South Africa’s National Disaster Management Framework calls for the implementation of effective public awareness activities to increase the knowledge among communities of the risks they face and what risk-minimising actions they can take. Emphasis is laid on the importance of information provision and knowledge building among at-risk communities. Citing established theories and strategies, the author proposes a participatory development communication approach through Development Support Communication strategies for the provision of disaster risk reduction public awareness activities by government and other disaster risk reduction role-players in South Africa. By way of a review of completed studies and literature, the article provides guidance on the planning and execution of successful public communication campaigns and also discusses the constraints of communication campaigns as an intervention for comprehensive disaster risk reduction.

  19. Measuring the Value of Mortality Risk Reductions in Turkey

    Science.gov (United States)

    Tekeşin, Cem; Ara, Shihomi

    2014-01-01

    The willingness to pay (WTP) for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident) are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical life (VSL) estimated for Afsin-Elbistan, Kutahya-Tavsanli, Ankara and the pooled case are found as 0.56, 0.35, 0.46 and 0.49 million Purchasing Power Parity (PPP) adjusted 2012 US dollars (USD). Different types of risk cause different VSL estimates and we found the lung cancer premium of 213% against traffic accident. The effects of one-year-delayed provision of risk-reduction service are the reduction of WTP by 482 TL ($318 in PPP adjusted USD) per person on average, and the disutility from status-quo (zero risk reduction) against alternative is found to be 891 TL ($589 in PPP adjusted USD) per person on average. Senior discounts of VSL are partially determined by status-quo preference and the amount of discount decreases once the status-quo bias is removed. The peak VSL is found to be for the age group 30–39 and the average VSL for the age group is 0.8 million PPP adjusted USD). Turkey’s compliance to European Union (EU) air quality standard will cause welfare gains of total 373 million PPP adjusted USD for our study areas in terms of reduced number of premature mortality. PMID:25000150

  20. Measuring the Value of Mortality Risk Reductions in Turkey

    Directory of Open Access Journals (Sweden)

    Cem Tekeşin

    2014-07-01

    Full Text Available The willingness to pay (WTP for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical life (VSL estimated for Afsin-Elbistan, Kutahya-Tavsanli, Ankara and the pooled case are found as 0.56, 0.35, 0.46 and 0.49 million Purchasing Power Parity (PPP adjusted 2012 US dollars (USD. Different types of risk cause different VSL estimates and we found the lung cancer premium of 213% against traffic accident. The effects of one-year-delayed provision of risk-reduction service are the reduction of WTP by 482 TL ($318 in PPP adjusted USD per person on average, and the disutility from status-quo (zero risk reduction against alternative is found to be 891 TL ($589 in PPP adjusted USD per person on average. Senior discounts of VSL are partially determined by status-quo preference and the amount of discount decreases once the status-quo bias is removed. The peak VSL is found to be for the age group 30–39 and the average VSL for the age group is 0.8 million PPP adjusted USD. Turkey’s compliance to European Union (EU air quality standard will cause welfare gains of total 373 million PPP adjusted USD for our study areas in terms of reduced number of premature mortality.

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

    International Nuclear Information System (INIS)

    Koh, Eng-Siew; Paul, Narinder; Hodgson, David C; Tran, Tu Huan; Heydarian, Mostafa; Sachs, Rainer K; Tsang, Richard W; Brenner, David J; Pintilie, Melania; Xu, Tony; Chung, June

    2007-01-01

    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. 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. 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. 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. 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.

  3. 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.

  4. 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.

  5. Breast and Ovarian Cancer Risk and Risk Reduction in Jewish BRCA1/2 Mutation Carriers

    Science.gov (United States)

    Finkelman, Brian S.; Rubinstein, Wendy S.; Friedman, Sue; Friebel, Tara M.; Dubitsky, Shera; Schonberger, Niecee Singer; Shoretz, Rochelle; Singer, Christian F.; Blum, Joanne L.; Tung, Nadine; Olopade, Olufunmilayo I.; Weitzel, Jeffrey N.; Lynch, Henry T.; Snyder, Carrie; Garber, Judy E.; Schildkraut, Joellen; Daly, Mary B.; Isaacs, Claudine; Pichert, Gabrielle; Neuhausen, Susan L.; Couch, Fergus J.; van't Veer, Laura; Eeles, Rosalind; Bancroft, Elizabeth; Evans, D. Gareth; Ganz, Patricia A.; Tomlinson, Gail E.; Narod, Steven A.; Matloff, Ellen; Domchek, Susan; Rebbeck, Timothy R.

    2012-01-01

    Purpose Mutations in BRCA1/2 dramatically increase the risk of both breast and ovarian cancers. Three mutations in these genes (185delAG, 5382insC, and 6174delT) occur at high frequency in Ashkenazi Jews. We evaluated how these common Jewish mutations (CJMs) affect cancer risks and risk reduction. Methods Our cohort comprised 4,649 women with disease-associated BRCA1/2 mutations from 22 centers in the Prevention and Observation of Surgical End Points Consortium. Of these women, 969 were self-identified Jewish women. Cox proportional hazards models were used to estimate breast and ovarian cancer risks, as well as risk reduction from risk-reducing salpingo-oophorectomy (RRSO), by CJM and self-identified Jewish status. Results Ninety-one percent of Jewish BRCA1/2-positive women carried a CJM. Jewish women were significantly more likely to undergo RRSO than non-Jewish women (54% v 41%, respectively; odds ratio, 1.87; 95% CI, 1.44 to 2.42). Relative risks of cancer varied by CJM, with the relative risk of breast cancer being significantly lower in 6174delT mutation carriers than in non-CJM BRCA2 carriers (hazard ratio, 0.35; 95% CI, 0.18 to 0.69). No significant difference was seen in cancer risk reduction after RRSO among subgroups. Conclusion Consistent with previous results, risks for breast and ovarian cancer varied by CJM in BRCA1/2 carriers. In particular, 6174delT carriers had a lower risk of breast cancer. This finding requires additional confirmation in larger prospective and population-based cohort studies before being integrated into clinical care. PMID:22430266

  6. [Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

    Science.gov (United States)

    Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

    2014-01-01

    Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

  7. Reduction of cancer risk by optimization of Computed Tomography head protocols: far eastern Cuban experience

    International Nuclear Information System (INIS)

    Miller Clemente, R.; Adame Brooks, D.; Lores Guevara, M.; Perez Diaz, M.; Arias Garlobo, M. L.; Ortega Rodriguez, O.; Nepite Haber, R.; Grinnan Hernandez, O.; Guillama Llosas, A.

    2015-01-01

    The cancer risk estimation constitutes one way for the evaluation of the public health, regarding computed tomography (CT) exposures. Starting from the hypothesis that the optimization of CT protocols would reduce significantly the added cancer risk, the purpose of this research was the application of optimization strategies regarding head CT protocols, in order to reduce the factors affecting the risk of induced cancer. The applied systemic approach included technological and human components, represented by quantitative physical factors. the volumetric kerma indexes, compared with respect to standard, optimized and reference values, were evaluated with multiple means comparison method. The added cancer risk resulted from the application of the methodology for biological effects evaluation, at low doses with low Linear Energy Transfer. Human observers in all scenarios evaluated the image quality. the reduced dose was significantly lower than for standard head protocols and reference levels, where: (1) for pediatric patients, by using an Automatic Exposure Control system, a reduction of 31% compared with standard protocol and ages range of 10-14, and (2) adults, using a Bilateral Filter for images obtained at low doses of 62% from those of standard head protocol. The risk reduction was higher than 25%. The systemic approach used allows the effective identification of factors involved on cancer risk related with exposures to CT. The combination of dose modulation and image restoration with Bilateral Filter, provide a significantly reduction of cancer risk, with acceptable diagnostic image quality. (Author)

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

    NARCIS (Netherlands)

    Apronti, Priscilla; Saito, Osamu; Otsuki, K.|info:eu-repo/dai/nl/306279258; 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

  9. Risk reduction and the privatization option: First principles

    International Nuclear Information System (INIS)

    Bjornstad, D.J.; Jones, D.W.; Russell, M.; Cummings, R.C.; Valdez, G.; Duemmer, C.L.

    1997-01-01

    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

  10. 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.

  11. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, B.; Vikhrov, Dmytro; Kelman, I.; Stojanov, R.; Jakubínský, J.

    2015-01-01

    Roč. 20, č. 4 (2015), s. 499-504 ISSN 1381-2386 Institutional support: RVO:67985998 Keywords : flood risk reduction * household adaptation * Czech Republic Subject RIV: AH - Economics Impact factor: 3.085, year: 2015

  12. Eighteenth annual risk reduction engineering laboratory research symposium

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The Eighteenth Annual Risk Reduction Engineering Laboratory Research Symposium was held in Cincinnati, Ohio, April 14-16, 1992. The purpose of this Symposium was to present the latest significant research findings from ongoing and recently completed projects funded by the Risk Reduction Engineering Laboratory (RREL). These Proceedings are organized into two sections. Sessions A and B, which contain extended abstracts of the paper presentations. A list of poster displays is also included. Subjects include remedial action, treatment, and control technologies for waste disposal, landfill liner and cover systems, underground storage tanks, and demonstration and development of innovative/alternative treatment technologies for hazardous waste. Alternative technology subjects include thermal destruction of hazardous wastes, field evaluations, existing treatment options, emerging treatment processes, waste minimization, and biosystems for hazardous waste destruction

  13. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, B.; Vikhrov, Dmytro; Kelman, I.; Stojanov, R.; Jakubínský, J.

    2015-01-01

    Roč. 20, č. 4 (2015), s. 499-504 ISSN 1381-2386 Institutional support: PRVOUK-P23 Keywords : flood risk reduction * household adaptation * Czech Republic Subject RIV: AH - Economics Impact factor: 3.085, year: 2015

  14. Failure detection system risk reduction assessment

    Science.gov (United States)

    Aguilar, Robert B. (Inventor); Huang, Zhaofeng (Inventor)

    2012-01-01

    A process includes determining a probability of a failure mode of a system being analyzed reaching a failure limit as a function of time to failure limit, determining a probability of a mitigation of the failure mode as a function of a time to failure limit, and quantifying a risk reduction based on the probability of the failure mode reaching the failure limit and the probability of the mitigation.

  15. Historic Landslide Data Combined with Sentinel Satellite Data to Improve Modelling for Disaster Risk Reduction

    Science.gov (United States)

    Bye, B. L.; Kontoes, C.; Catarino, N.; De Lathouwer, B.; Concalves, P.; Meyer-Arnek, J.; Mueller, A.; Kraft, C.; Grosso, N.; Goor, E.; Voidrot, M. F.; Trypitsidis, A.

    2017-12-01

    Landslides are geohazards potentially resulting in disasters. Landslides both vary enormously in their distribution in space and time. The surface deformation varies considerably from one type of instability to another. Individual ground instabilities may have a common trigger (extreme rainfall, earthquake), and therefore occur alongside many equivalent occurrences over a large area. This means that they can have a significant regional impact demanding national and international disaster risk reduction strategies. Regional impacts require collaboration across boarders as reflected in The Sendai Framework for Disaster Risk Reduction (2015-2030). The data demands related to the SDGs are unprecedented, another factor that will require coordinated efforts at the global, regional and national levels. Data of good quality are vital for governments, international organizations, civil society, the private sector and the general public in order to make informed decisions, included for disaster risk reduction. The NextGEOSS project evolves the European vision of a user driven GEOSS data exploitation for innovation and business, relying on 3 main pillars; engaging communities of practice, delivering technological advancements, and advocating the use of GEOSS. These 3 pillars support the creation and deployment of Earth observation based innovative research activities and commercial services. In this presentation we will explain how one of the 10 NextGEOSS pilots, Disaster Risk Reduction (DRR), plan to provide an enhanced multi-hazard risk assessment framework based on statistical analysis of long time series of data. Landslide events monitoring and landslides susceptibility estimation will be emphazised. Workflows will be based on models developed in the context of the Copernicus Emergency Management Service. Data envisaged to be used are: Radar SAR data; Yearly ground deformation/velocities; Historic landslide inventory; data related to topographic, geological, hydrological

  16. Microenterprise development interventions for sexual risk reduction: a systematic review.

    Science.gov (United States)

    Cui, Rosa R; Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E; Tucker, Joseph D

    2013-11-01

    Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

  17. 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

  18. Estimating the Value of Price Risk Reduction in Energy Efficiency Investments in Buildings

    Directory of Open Access Journals (Sweden)

    Pekka Tuominen

    2017-10-01

    Full Text Available This paper presents a method for calculating the value of price risk reduction to a consumer that can be achieved with investments in energy efficiency. The value of price risk reduction is discussed to some length in general terms in the literature reviewed but, so far, no methodology for calculating the value has been presented. Here we suggest such a method. The problem of valuating price risk reduction is approached using a variation of the Black–Scholes model by considering a hypothetical financial instrument that a consumer would purchase to insure herself against unexpected price hikes. This hypothetical instrument is then compared with an actual energy efficiency investment that reaches the same level of price risk reduction. To demonstrate the usability of the method, case examples are calculated for typical single-family houses in Finland. The results show that the price risk entailed in household energy consumption can be reduced by a meaningful amount with energy efficiency investments, and that the monetary value of this reduction can be calculated. It is argued that this often-overlooked benefit of energy efficiency investments merits more consideration in future studies.

  19. 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.

  20. Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans.

    Science.gov (United States)

    Liou, Doreen; Bauer, Kathleen; Bai, Yeon

    2014-11-01

    The purpose of this research was to examine the attitudes, beliefs and behaviours related to obesity risk reduction in Chinese Americans. A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviours and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analysed for different acculturation groups. 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practised behaviour to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviours included convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviours, attitude was significant for 'western-identified' individuals. In 'Asian-identified' individuals, perceived behavioural control, self-efficacy and perceived benefits were salient. Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviours for obesity risk reduction that are socially acceptable. © Royal Society for Public Health 2013.

  1. Pengaruh Brand Credibility Terhadap Information Efficiency Dan Risk Reduction, Serta Dampaknya Atas Repurchase Intention

    OpenAIRE

    Faisal, Aekram

    2015-01-01

    This research conducted to know the influence of Brand Credibility to Information efficiency and Risk reduction, also the influence of Information efficiency and Risk reduction to Repurchase intention. This research aimed to know the influence of Brand Credibility to Repurchase intention that mediated by Information efficiency and Risk reduction. The methodology of this research is testing hypothesis research. The sample collecting by questionnaire of 150 respondents from Starb...

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Suzanne Phibbs

    2016-12-01

    Full Text Available 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.

  4. 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.

  5. 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....

  6. Evolving strategies, opportunistic implementation: HIV risk reduction in Tanzania in the context of an incentive-based HIV prevention intervention.

    Directory of Open Access Journals (Sweden)

    Laura Packel

    Full Text Available Behavior change communication (BCC interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection.In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction.We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence.Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for

  7. Introduction to cost-effectiveness analysis of risk reduction measures in energy systems

    International Nuclear Information System (INIS)

    1986-07-01

    The aim of this report is to introduce readers to methods of cost-effectiveness analysis and their application in risk reduction, especially in connection with the energy-producing industries. The background to the assessment of risk and the problems in estimating it quantitatively are outlined. The methodology of cost-effectiveness analysis is then described, particular attention being given to the way in which results are derived and the overall use that can be made of them. This is followed by a discussion of quantitative applications and an outline of the methods that may be used to derive estimates both of risk and the cost of reducing it. The use of cost-effectiveness analysis is illustrated in an appendix, which gives as a worked example a case study on the reduction of public risk associated with radioactive releases during normal operation of a PWR. After drawing some general conclusions the report recommends that such analyses should normally be used as an aid to risk management whenever several alternative risk reduction measures are under consideration

  8. Chronic kidney disease risk reduction in a Hispanic population through pharmacist-based disease-state management.

    Science.gov (United States)

    Leal, Sandra; Soto, Marisa

    2008-04-01

    The purpose of this study was to evaluate the ability of a pharmacist-based disease-state management service to improve the care of indigent, predominately Spanish-speaking patients with diabetes mellitus and common comorbid conditions at high risk for the development of chronic kidney disease (CKD). Patients at high risk for developing CKD who have diabetes at a community health center were placed in a pharmacist-based disease state management service for CKD risk reduction. A residency-trained, bilingual, certified diabetes educator, with a PharmD served as the patient's provider using diagnostic, educational, and therapeutic management services under a medical staff approved collaborative practice agreement. Outcomes were assessed by using national standards of care for disease control and prevention screening. The impact on CKD was shown with a mean A1C decrease of 2% and improvement in the proportion of patients at target goals for blood pressure, A1C, and cholesterol levels and receiving aspirin and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. A pharmacist-based disease-state management service for CKD risk reduction, care of diabetes, and frequently associated comorbid conditions improved compliance with national standards for diabetes care in a high-risk population.

  9. 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.

  10. Review of the severe accident risk reduction program (SARRP) containment event trees

    International Nuclear Information System (INIS)

    1986-05-01

    A part of the Severe Accident Risk Reduction Program, researchers at Sandia National Laboratories have constructed a group of containment event trees to be used in the analysis of key accident sequences for light water reactors (LWR) during postulated severe accidents. The ultimate goal of the program is to provide to the NRC staff a current assessment of the risk from severe reactor accidents for a group of five light water reactors. This review specifically focuses on the development and construction of the containment event trees and the results for containment failure probability, modes and timing. The report first gives the background on the program, the review criteria, and a summary of the observations, findings and recommendations. secondly, the individual reviews of each committee member on the event trees is presented. Finally, a review is provided on the computer model used to construct and evaluate the event trees

  11. Cancer risk in aluminum reduction plant workers (Canada)

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, J.J.; Demers, P.A.; Le, N.D.; Friesen, M.D.; Lorenzi, M.F.; Fang, R.; Gallagher, R.P. [British Columbia Cancer Agency, Vancouver, BC (Canada)

    2006-09-15

    A 14-year update to a previously published historical cohort study of aluminum reduction plant workers was conducted. All men with three or more years at an aluminum reduction plant in British Columbia (BC), Canada between the years 1954 and 1997 were included; a total of 6,423 workers. A total of 662 men were diagnosed with cancer, representing a 400% increase from the original study. Standardized mortality and incidence ratios were used to compare the cancer mortality and incidence of the cohort to that of the BC population. Poisson regression was used to examine risk by cumulative exposure to coal tar pitch volatiles (CTPV) measured as benzene soluble materials (BSM) and benzo(a)pyrene (BaP). The risk for bladder cancer was related to cumulative exposure to CTPV measured as BSM and BaP (p trends < 0.001), and the risk for stomach cancer was related to exposure measured by BaP (p trend BaP < 0.05). The risks for lung cancer (p trend < 0.001), non-Hodgkin lymphoma (p trend < 0.001), and kidney cancer (p trend < 0.01) also increased with increasing exposure, although the overall rates were similar to that of the general population. Analysis of the joint effect of smoking and CTPV exposure on cancer showed the observed dose-response relationships to be independent of smoking.

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

    African Journals Online (AJOL)

    Results indicated that HIV-related knowledge; condom knowledge and risk perception were enhanced by the HIV- related risk reduction programme. However, there is a need for improvement, especially with regard to attitudes towards condoms since some students still had negative attitudes even after the intervention ...

  13. 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

  14. Assessment of reduction in perception of nuclear risk related to perception of environmental risk

    International Nuclear Information System (INIS)

    Boemer, Veronica Araujo; Aquino, Afonso Rodrigues de

    2009-01-01

    This work presents a bibliographic research accomplished to evaluate the matter of reduction in risk perception, on people in general, that nuclear energy can show, for generation of electric power, face to perception of risk associated to environmental questions, as the global warming, from greenhouse effect, addressing the matter to the relevance of public acceptance for the development of new technologies. (author)

  15. Indigenous knowledge for disaster risk reduction: An African perspective

    Directory of Open Access Journals (Sweden)

    Nnamdi G. Iloka

    2016-07-01

    Full Text Available Indigenous knowledge is valuable knowledge that has helped local communities all over the world survive for generations. This knowledge originates from the interaction between members of the community and the environment in which they live. Although much has been written about indigenous knowledge, its documentation in the area of disaster risk reduction and climate change in Africa has been very limited. The wealth of this knowledge has not been well-recognised in the disaster risk reduction field, as policy-makers still rely on mitigation strategies based on scientific knowledge. Colonialism and lack of proper documentation of indigenous knowledge are some of the contributing factors to this. Ignoring the importance of understanding adaptive strategies of the local people has led to failed projects. Understanding how local people in Africa have managed to survive and adapt for generations, before the arrival of Western education, may be the key to developing sustainable policies to mitigate future challenges. Literature used in this article, obtained from the books, papers and publications of various experts in the fields of disaster risk reduction, climate change, indigenous knowledge and adaptation, highlight the need for more interest to be shown in indigenous knowledge, especially in the developing country context. This would lead to better strategies which originate from the community level but would aim for overall sustainable development in Africa.

  16. Governance of disaster risk reduction in Cameroon: The need to empower local government

    Directory of Open Access Journals (Sweden)

    Henry N. Bang

    2013-02-01

    Full Text Available The impact of natural hazards and/or disasters in Cameroon continues to hit local communities hardest, but local government lacks the ability to manage disaster risks adequately. This is partly due to the fact that the necessity to mainstream disaster risk reduction into local governance and development practices is not yet an underlying principle of Cameroon’s disaster management framework. Using empirical and secondary data, this paper analyses the governance of disaster risks in Cameroon with particular focus on the challenges local government faces in implementing disaster risk reduction strategies. The hypothesis is that the governance of disaster risks is too centralised at the national level, with huge implications for the effective governance of disaster risks at the local level. Although Cameroon has reinvigorated efforts to address growing disaster risks in a proactive way, it is argued that the practical actions are more reactive than proactive in nature. The overall aim is to explore the challenges and opportunities that local government has in the governance of disaster risks. Based on the findings from this research, policy recommendations are suggested on ways to mainstream disaster risk reduction strategies into local governance, and advance understanding and practice in the local governance of disaster risks in the country.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Cost-effectiveness analysis of risk reduction at nuclear power plants: What have we learned from experience

    International Nuclear Information System (INIS)

    Lochard, J.; Pages, P.

    1984-01-01

    Within the field of risk management techniques, cost-effectiveness analysis of risk reduction is now recognized as an adequate method for evaluating and defining the optimal allocation of protection and safety resources within large industrial systems. The paper considers some of the issues that arise in connection with cost-effectiveness analysis of risk reduction at nuclear power stations. Particular attention is called to both the interdependence between criteria that characterize risk reduction problems and the resulting aggregation and weighting procedures needed when the multidimensionality of criteria is explicitly taken into account. The discussion of these problems is illustrated with results of case studies on both public and occupational risk reduction at French PWRs during normal operation. (author)

  4. Parallel structures for disaster risk reduction and climate change adaptation in Southern Africa

    Directory of Open Access Journals (Sweden)

    Per Becker

    2013-01-01

    Full Text Available During the last decade, the interest of the international community in the concepts of disaster risk reduction and climate change adaptation has been growing immensely. Even though an increasing number of scholars seem to view these concepts as two sides of the same coin (at least when not considering the potentially positive effects of climate change, in practice the two concepts have developed in parallel rather than in an integrated manner when it comes to policy, rhetoric and funding opportunities amongst international organisations and donors. This study investigates the extent of the creation of parallel structures for disaster risk reduction and climate change adaptation in the Southern African Development Community (SADC region. The chosen methodology for the study is a comparative case study and the data are collected through focus groups and content analysis of documentary sources, as well as interviews with key informants. The results indicate that parallel structures for disaster risk reduction and climate change adaptation have been established in all but one of the studied countries. The qualitative interviews performed in some of the countries indicate that stakeholders in disaster risk reduction view this duplication of structures as unfortunate, inefficient and a fertile setup for conflict over resources for the implementation of similar activities. Additional research is called for in order to study the concrete effects of having these parallel structures as a foundation for advocacy for more efficient future disaster risk reduction and climate change adaptation.

  5. Cost-effectiveness analysis of risk reduction at nuclear power plants

    International Nuclear Information System (INIS)

    Lochard, J.; Maccia, C.; Pages, P.

    1985-01-01

    Cost-effectiveness analysis of risk reduction is now widely accepted as a rational analytical framework to consistently address the resource allocation problem underlying any risk management process. This paper presents how this technique can be usefully applied to complex systems such as the management of radioactive releases from nuclear power plants into the environment. (orig.) [de

  6. Meditation and Cardiovascular Risk Reduction: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Levine, Glenn N; Lange, Richard A; Bairey-Merz, C Noel; Davidson, Richard J; Jamerson, Kenneth; Mehta, Puja K; Michos, Erin D; Norris, Keith; Ray, Indranill Basu; Saban, Karen L; Shah, Tina; Stein, Richard; Smith, Sidney C

    2017-09-28

    Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long

  7. GEO activities towards improved Geophysical monitoring. A key input to Disaster Risk Reduction.

    Science.gov (United States)

    Achache, J.; Rum, G.

    2007-05-01

    GEO has been established in 2005 with the main objective to put in place a Global, Coordinated, Comprehensive and Sustained System of Observing Systems (GEOSS) to serve 9 Social Benefit Areas, among which Disaster Risk Reduction. The paper will first set up the reference GEO framework, through a brief description of GEOSS key features, architectural functions and capacity building, and then will recall the value of the Geophysical observations, coming both from in situ and remote (satellite) systems, and, even more important, of their integration. GEO activities related to Geophysical monitoring and the use of related observation to foster social benefits in the Disaster Risk Reduction area will then be shortly described, together with the on-going key actions, including specific examples on key scientific/technical and data sharing aspects associated to GEOSS implementation. Special attention will be devoted on how Capacity Building strategy and activities are addressed through GEOSS development, building on infrastructure and programs under consolidation within GEO framework, such as the GEOSS Information collection and dissemination systems under development (GEONETCast, GEO Web Portal, GEO Clearinghouse) and the UN programs such as SPIDER (SPace based Information for Disaster management and Emergency Response) and UNOSAT. The paper will provide recommendations on the way forward for the implementation of Disaster Risk Management provisions as an integral part of sustainable development, also with the objective of creating within GEO a supporting framework to UNDP and World Bank activities on Risk Identification and Assessment.

  8. 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

  9. 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.

  10. Sexual risk-reduction strategies among HIV-infected men receiving ART in Kibera, Nairobi.

    Science.gov (United States)

    Ragnarsson, Anders; Thorson, Anna; Dover, Paul; Carter, Jane; Ilako, Festus; Indalo, Dorcas; Ekstrom, Anna Mia

    2011-03-01

    This paper explores motivational factors and barriers to sexual behaviour change among men receiving antiretroviral treatment (ART). Twenty in-depth interviews were undertaken with male patients enrolled at the African Medical and Research Foundation clinic in Africa's largest urban informal settlement, Kibera in Nairobi, Kenya. All participants experienced prolonged and severe illness prior to the initiation of ART. Fear of symptom relapse was the main trigger for sexual behaviour change. Partner reduction was reported as a first option for behaviour change since this decision could be made by the individual. Condom use was perceived as more difficult as it had to be negotiated with female partners. Cultural norms regarding expectations for reproduction and marriage were not supportive of sexual risk-reduction strategies. Thus, local sociocultural contexts of HIV-infected people must be incorporated into the contextual adaptation and design of ART programmes and services as they have an over-riding influence on sexual behaviour and programme effectiveness. Also, HIV-prevention interventions need to address both personal, micro- and macro-level factors of behaviour to encourage individuals to take on sexual risk-reduction strategies. In order to achieve the anticipated preventive effect of ART, these issues are important for the donor community and policy-makers, who are the major providers of ART programme support within weak health systems in sub-Saharan Africa.

  11. 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.

  12. 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.

  13. Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

    Science.gov (United States)

    Wang, Wenyu; Jin, Jianjun; He, Rui; Gong, Haozhou; Tian, Yuhong

    2018-01-01

    This study aimed to estimate farmers’ willingness to pay (WTP) for health risk reductions of pesticide use by applying the contingent valuation method (CVM) and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income) per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers’ socioeconomic and attitudinal factors that significantly affect their WTP include farmers’ farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents’ social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world. PMID:29596345

  14. Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

    Directory of Open Access Journals (Sweden)

    Wenyu Wang

    2018-03-01

    Full Text Available This study aimed to estimate farmers’ willingness to pay (WTP for health risk reductions of pesticide use by applying the contingent valuation method (CVM and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers’ socioeconomic and attitudinal factors that significantly affect their WTP include farmers’ farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents’ social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world.

  15. 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.

  16. 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.

  17. 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.

  18. Patterns of NPS Use and Risk Reduction in Slovenia.

    Science.gov (United States)

    Sande, Matej; Paš, Mina; Nahtigal, Klara; Šabić, Simona

    2018-01-15

    The following study presents factors influencing the decision to use/not to use new psychoactive substances (NPS), various patterns of NPS use, the problems experienced by users, and the methods for reducing the risks associated with NPS use. The study seeks to provide an in-depth look into the characteristics of NPS use and support the planning of targeted interventions in the field of NPS. The study involved 19 in-depth interviews carried out with 25 individuals divided into three subsamples in order to gain insight into the various experiences of NPS users. The interviews were conducted in Slovenia between December 2013 and October 2014. The sample was obtained by using the convenience sampling and snowball sampling methods. The main pattern of NPS use determined by the study concerned synthetic cathinones, specifically 3-MMC, with binge use spanning several days being a prominent feature. The main risks involving NPS use were: mixing various drugs, inappropriate dosing, lack of information prior to use, and the use of unknown substances. Several users spoke about effective strategies for reducing risks, such as obtaining information beforehand, using one's own implements and using only small quantities of unknown substances. Conclusions/Importance: The study revealed various factors based on which users decide to use NPS. Furthermore, users reported a number of problems resulting from NPS use, while risk reduction strategies are employed to a much lesser extent. Based on the results obtained, specific intervention efforts concerning NPS use and targeting specific groups of younger users were designed.

  19. 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…

  20. A Group Intervention for HIV/STI Risk Reduction among Indian Couples

    Directory of Open Access Journals (Sweden)

    Ritu Nehra

    2013-12-01

    Full Text Available Background: HIV in India is transmitted primarily by heterosexual contact. The present study sought to test the feasibility of a group HIV/STI risk reduction intervention among heterosexual couples in India. Methods: Focus groups and key informant interviews were used in 2008 to culturally tailor the intervention. Thirty sexually active and HIV/STI negative couples were enrolled and assessed regarding risk behavior and sexual barrier acceptability. Gender-concordant group sessions used cognitive behavioral strategies for HIV/STI prevention. Results: At baseline, male condom use was low (36%; no participants reported use of female condoms or vaginal gels. HIV knowledge was low; women had more HIV knowledge and more positive attitudes towards condom use than men. Post-intervention, willingness to use all barrier products (t = 10.0, P< .001 and intentions to avoid risk behavior increased (t = 5.62, P< .001. Conclusion: This study illustrates the feasibility of utilizing a group intervention to enhance HIV/STI risk reduction among Indian couples.

  1. 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

  2. Constructing post-carbon institutions: Assessing EU carbon reduction efforts through an institutional risk governance approach

    International Nuclear Information System (INIS)

    LaBelle, Michael

    2012-01-01

    This paper examines three different governance approaches the European Union (EU) and Member States (MS) are relying on to reach a low carbon economy by 2050. Current governance literature explains the operational methods of the EU's new governance approach to reduce carbon emissions. However, the literature neglects to account for the perceived risks that inhibit the roll-out of new low carbon technology. This article, through a novel approach, uses a grounded theoretical framework to reframe traditional risk literature and provides a connection to governance literature in order to assess the ability of EU governance mechanisms to reduce carbon emissions. The empirical research is based on responses from European energy stakeholders who participated in a Delphi method discussion and in semi-structured interviews; these identified three essential requirements for carbon emissions to be reduced to near zero by 2050: (1) an integrated European energy network, (2) carbon pricing and (3) demand reduction. These features correspond to institutionalized responses by the EU and MS: the Agency for the Cooperation of Energy Regulators (ACER); European Union Emission Trading Scheme (EU ETS) and energy efficiency directives and policies integrated into existing MS institutions. The theoretical and empirical findings suggest that governance by facilitation (energy efficiency) fails to induce significant investment and new policy approaches and cannot be relied on to achieve requisite reductions in demand. Governance by negotiation (ACER) and governance by hierarchy (EU ETS) do reduce risks and may encourage the necessary technological uptake. The term ‘risk governance’ is used to explain the important role governance plays in reducing risks and advancing new technology and thereby lowering carbon emissions in the energy sector. - Highlights: ► This article assesses the role of EU institutions in reducing carbon emissions by 2050. ► Empirical research is based on Delphi

  3. Farmers prone to drought risk : why some farmers undertake farm-level risk-reduction measures while others not?

    NARCIS (Netherlands)

    Gidey, T.G.; van der Veen, A.

    2015-01-01

    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

  4. 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.

  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. Living with risk. A global review of disaster reduction initiatives. Preliminary version

    International Nuclear Information System (INIS)

    2002-01-01

    In recent years the world has witnessed an interminable succession of disasters - floods, storms, earthquakes, landslides, volcanic eruptions and wildfires that have claimed many thousands of lives, caused material losses in the tens of billions of dollars, and inflicted a terrible toll on developing countries in particular, where disasters divert attention and resources needed desperately to escape poverty. Communities will always face natural hazards, but today's disasters are often generated by, or at least exacerbated by, human activities. At the most dramatic level, human activities are changing the natural balance of the earth, interfering as never before with the atmosphere, the oceans, the polar ice caps, the forest cover and the natural pillars that make our world a livable home. But we are also putting ourselves in harm's way in less visible ways. At no time in human history have so many people lived in cities clustered around seismically active areas. Destitution and demographic pressure have led more people than ever before to live in flood plains or in areas prone to landslides. Poor land-use planning; environmental mismanagement; and a lack of regulatory mechanisms both increase the risk and exacerbate the effects of disasters. Living with risk: a global review of disaster reduction is the first comprehensive effort by the United Nations system to take stock of disaster reduction initiatives throughout the world. Coordinated by the secretariat of the International Strategy for Disaster Reduction (ISDR), the report discusses current disaster trends, assesses policies aimed at mitigating the impact of disasters, and offers examples of successful initiatives. It also recommends that risk reduction be integrated into sustainable development at all levels - global, national and local. Most of all, Living with risk shows that we are far from helpless in the face of natural hazards. Early warning and risk reduction measures have been important factors in

  7. 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

  8. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, Barbora; Vikhrov, Dmytro; Kelman, I.; Stojanov, Robert; Jakubínský, Jiří

    2015-01-01

    Roč. 18, č. 8 (2015), s. 1-6 ISSN 1381-2386 R&D Projects: GA MŠk(CZ) EE2.4.31.0056; GA MŠk(CZ) LD13032; GA MŠk(CZ) LD13033 Institutional support: RVO:67179843 Keywords : Bečva River Basin * Czech Republic * flood risk reduction * floods * household adaptation * household coping Subject RIV: AO - Sociology, Demography Impact factor: 3.085, year: 2015

  9. 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...

  10. 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...

  11. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

    Science.gov (United States)

    Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

    2002-03-01

    To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

  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

    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...... 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...

  13. The cardiovascular event reduction tool (CERT)--a simplified cardiac risk prediction model developed from the West of Scotland Coronary Prevention Study (WOSCOPS).

    Science.gov (United States)

    L'Italien, G; Ford, I; Norrie, J; LaPuerta, P; Ehreth, J; Jackson, J; Shepherd, J

    2000-03-15

    The clinical decision to treat hypercholesterolemia is premised on an awareness of patient risk, and cardiac risk prediction models offer a practical means of determining such risk. However, these models are based on observational cohorts where estimates of the treatment benefit are largely inferred. The West of Scotland Coronary Prevention Study (WOSCOPS) provides an opportunity to develop a risk-benefit prediction model from the actual observed primary event reduction seen in the trial. Five-year Cox model risk estimates were derived from all WOSCOPS subjects (n = 6,595 men, aged 45 to 64 years old at baseline) using factors previously shown to be predictive of definite fatal coronary heart disease or nonfatal myocardial infarction. Model risk factors included age, diastolic blood pressure, total cholesterol/ high-density lipoprotein ratio (TC/HDL), current smoking, diabetes, family history of fatal coronary heart disease, nitrate use or angina, and treatment (placebo/ 40-mg pravastatin). All risk factors were expressed as categorical variables to facilitate risk assessment. Risk estimates were incorporated into a simple, hand-held slide rule or risk tool. Risk estimates were identified for 5-year age bands (45 to 65 years), 4 categories of TC/HDL ratio ( or = 7.5), 2 levels of diastolic blood pressure ( or = 90 mm Hg), from 0 to 3 additional risk factors (current smoking, diabetes, family history of premature fatal coronary heart disease, nitrate use or angina), and pravastatin treatment. Five-year risk estimates ranged from 2% in very low-risk subjects to 61% in the very high-risk subjects. Risk reduction due to pravastatin treatment averaged 31%. Thus, the Cardiovascular Event Reduction Tool (CERT) is a risk prediction model derived from the WOSCOPS trial. Its use will help physicians identify patients who will benefit from cholesterol reduction.

  14. Vorapaxar: The Current Role and Future Directions of a Novel Protease-Activated Receptor Antagonist for Risk Reduction in Atherosclerotic Disease

    OpenAIRE

    Gryka, Rebecca J.; Buckley, Leo F.; Anderson, Sarah M.

    2017-01-01

    Introduction Despite the current standard of care, patients with cardiovascular disease remain at a high risk for recurrent events. Inhibition of thrombin-mediated platelet activation through protease-activated receptor-1 antagonism may provide reductions in atherosclerotic disease beyond those achievable with the current standard of care. Objective Our primary objective is to evaluate the clinical literature regarding the role of vorapaxar (Zontivity?) in the reduction of cardiovascular even...

  15. 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. PMID:26153891

  16. Mitigating fall risk: A community fall reduction program.

    Science.gov (United States)

    Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

    One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. 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.

  18. 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.

  19. NGNP Risk Management Database: A Model for Managing Risk

    International Nuclear Information System (INIS)

    Collins, John

    2009-01-01

    To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft(reg s ign) Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool's design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

  20. NGNP Risk Management Database: A Model for Managing Risk

    Energy Technology Data Exchange (ETDEWEB)

    John Collins

    2009-09-01

    To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft® Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool’s design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

  1. 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

  2. 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

  3. Social Geology and Landslide Disaster Risk Reduction in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Jayasingha P

    2017-03-01

    Full Text Available AbstractLandslide disaster risk reduction is presently a challenging task facing by Sri Lankangeologists. Increasing trend of population growth in Sri Lanka has adversely affected thestability of central highland due to various human activities. Among them establishment ofhuman settlements and change in land use pattern have become a serious issue in triggeringland instabilities in central highland of the country. National Building Research Oragnisationwhich is the main focal point in land slide disaster risk reduction in Sri Lanka has takenvaluable and timely needed actions including preparation of landslide hazard zonation maps,early warnings and mitigations. Though the landslide is a geological phenomenon, it is highlyinteracted with human societies. Hence managing the issues arising with the landslideoccurrence should be addressed with a sociological approach. This new approach is known asSocio Geological approach which is discussed here.Key words: Landslide, Geology, Socio Geology, Social Geologist

  4. What are the most effective risk-reduction strategies in sport concussion?

    Science.gov (United States)

    Benson, Brian W; McIntosh, Andrew S; Maddocks, David; Herring, Stanley A; Raftery, Martin; Dvorák, Jirí

    2013-04-01

    To critically review the evidence to determine the efficacy and effectiveness of protective equipment, rule changes, neck strength and legislation in reducing sport concussion risk. Electronic databases, grey literature and bibliographies were used to search the evidence using Medical Subject Headings and text words. Inclusion/exclusion criteria were used to select articles for the clinical equipment studies. The quality of evidence was assessed using epidemiological criteria regarding internal/external validity (eg, strength of design, sample size/power, bias and confounding). No new valid, conclusive evidence was provided to suggest the use of headgear in rugby, or mouth guards in American football, significantly reduced players' risk of concussion. No evidence was provided to suggest an association between neck strength increases and concussion risk reduction. There was evidence in ice hockey to suggest fair-play rules and eliminating body checking among 11-years-olds to 12-years-olds were effective injury prevention strategies. Evidence is lacking on the effects of legislation on concussion prevention. Equipment self-selection bias was a common limitation, as was the lack of measurement and control for potential confounding variables. Lastly, helmets need to be able to protect from impacts resulting in a head change in velocities of up to 10 and 7 m/s in professional American and Australian football, respectively, as well as reduce head resultant linear and angular acceleration to below 50 g and 1500 rad/s(2), respectively, to optimise their effectiveness. A multifactorial approach is needed for concussion prevention. Future well-designed and sport-specific prospective analytical studies of sufficient power are warranted.

  5. The sexual double standard in African American adolescent women's sexual risk reduction socialization.

    Science.gov (United States)

    Fasula, Amy M; Miller, Kim S; Wiener, Jeffrey

    2007-01-01

    This study explored the sexual double standard (SDS) (in which males are afforded more freedom and power than females in heterosexual interactions) in African American mothers' sexual messages to sons and daughters. We used a convenience sample of 129 African American adolescents, aged 14 to 17 years, and their mothers who reported SDS attitudes. Qualitative analyses revealed gender differences based on an SDS in mothers' sexual risk reduction socialization. Mothers typically took a proactive approach with sons and a neutral or prohibitive approach with daughters. Findings provide directions for socially relevant programs for African American parents, schools, and communities.

  6. 41 CFR 102-80.55 - Are Federal agencies responsible for managing the execution of risk reduction projects?

    Science.gov (United States)

    2010-07-01

    ... Management Risks and Risk Reduction Strategies § 102-80.55 Are Federal agencies responsible for managing the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are Federal agencies responsible for managing the execution of risk reduction projects? 102-80.55 Section 102-80.55 Public...

  7. 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.

  8. 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 potential to

  9. 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

  10. The RACER (risk analysis, communication, evaluation, and reduction) stakeholder environmental data transparency project for Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Echohawk, John Chris; Dorries, Alison M.; Eberhart, Craig F.; Werdel, Nancy

    2008-01-01

    The RACER (Risk Analysis, Communication, Evaluation, and Reduction) project was created in 2003, as an effort to enhance the Los Alamos National Laboratory's ability to effectively communicate the data and processes used to evaluate environmental risks to the public and the environment. The RACER project staff consists of members of Risk Assessment Corporation, Los Alamos National Laboratory (LANL), and the New Mexico Environment Department (NMED). RACER staff worked closely with members of the community, tribal governments, and others within NMED and LANL to create innovative tools and a process that could provide information to regulators, LANL and the community about the sources of public health risk and ecological impact from LAN L operations. The RACER Data Analysis Tool (DA T) provides the public with webbased access to environmental measurement data collected in and around the LANL site. Its purpose is to provide a 'transparent' view to the public of all data collected by LANL and NMED regarding the LANL site. The DAT is available to the public at 'www.racernm.com'.

  11. Dam risk reduction study for a number of large tailings dams in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Verma, N. [AMEC Earth and Environmental Ltd., Mississauga, ON (Canada); Small, A. [AMEC Earth and Environmental Ltd., Fredericton, NB (Canada); Martin, T. [AMEC Earth and Environmental, Burnaby, BC (Canada); Cacciotti, D. [AMEC Earth and Environmental Ltd., Sudbury, ON (Canada); Ross, T. [Vale Inco Ltd., Sudbury, ON (Canada)

    2009-07-01

    This paper discussed a risk reduction study conducted for 10 large tailings dams located at a central tailings facility in Ontario. Located near large industrial and urban developments, the tailings dams were built using an upstream method of construction that did not involve beach compaction or the provision of under-drainage. The study provided a historical background for the dam and presented results from investigations and instrumentation data. The methods used to develop the dam configurations were discussed, and remedial measures and risk assessment measures used on the dams were reviewed. The aim of the study was to address key sources of risk, which include the presence of high pore pressures and hydraulic gradients; the potential for liquefaction; slope instability; and the potential for overtopping. A borehole investigation was conducted and piezocone probes were used to obtain continuous data and determine soil and groundwater conditions. The study identified that the lower portion of the dam slopes were of concern. Erosion gullies could lead to larger scale failures, and elevated pore pressures could lead to the risk of seepage breakouts. It was concluded that remedial measures are now being conducted to ensure slope stability. 6 refs., 1 tab., 6 figs.

  12. Modeling a Theory-Based Approach to Examine the Influence of Neurocognitive Impairment on HIV Risk Reduction Behaviors Among Drug Users in Treatment.

    Science.gov (United States)

    Huedo-Medina, Tania B; Shrestha, Roman; Copenhaver, Michael

    2016-08-01

    Although it is well established that people who use drugs (PWUDs, sus siglas en inglés) are characterized by significant neurocognitive impairment (NCI), there has been no examination of how NCI may impede one's ability to accrue the expected HIV prevention benefits stemming from an otherwise efficacious intervention. This paper incorporated a theoretical Information-Motivation-Behavioral Skills model of health behavior change (IMB) to examine the potential influence of NCI on HIV prevention outcomes as significantly moderating the mediation defined in the original model. The analysis included 304 HIV-negative opioid-dependent individuals enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed interaction effects between NCI and HIV risk reduction information such that the predicted influence of HIV risk reduction behavioral skills on HIV prevention behaviors was significantly weakened as a function of NCI severity. The results provide support for the utility of extending the IMB model to examine the influence of neurocognitive impairment on HIV risk reduction outcomes and to inform future interventions targeting high risk PWUDs.

  13. Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip.

    Science.gov (United States)

    Schur, Mathew D; Lee, Christopher; Arkader, Alexandre; Catalano, Anthony; Choi, Paul D

    2016-06-01

    The purpose of this study was to identify and evaluate risk factors of avascular necrosis (AVN) after closed treatment for developmental dysplasia of the hip (DDH). A retrospective review of children diagnosed with DDH at a tertiary-care children's hospital between 1986 and 2009 was performed. The presence of AVN was assessed according to Salter's classification system. Eighty-two affected hips in 70 children with an average age of 10 months at closed reduction (range 1-31 months) and 5 years (range 2-19 years) of follow-up met the inclusion criteria. Twenty-nine (of 82, 35 %) affected hips developed AVN. The use of pre-reduction traction (p = 0.019) increased the risk of AVN, while preoperative Pavlik harness or brace trial (p = 0.28), presence of ossific nucleus at the time of closed reduction (p = 0.16), and adductor tenotomy (p = 0.37) were not significant factors. Laterality (right vs. left) was also not a significant risk factor (p = 0.75), but patients who underwent closed reduction for bilateral DDH were less likely to develop AVN (p = 0.027). Overall, the degree of abduction did not affect the rate of AVN (p = 0.87). However, in patients treated with closed reduction younger than 6 months of age, the rate of AVN was increased with abduction ≥50° (9/15, 60 %) compared to abduction AVN were more likely to require subsequent surgery (p = 0.034) and more likely to report a fair/poor clinical outcome (p = 0.049). The risk of AVN (35 %) following closed reduction and spica casting for DDH is high. The degree of abduction in spica casts appears to be a risk factor in patients ≤6 months old. The authors recommend that abduction in spica casts should be limited to <50° in children younger than 6 months of age. IV.

  14. Estimating mortality risk reduction and economic benefits from controlling ozone air pollution

    National Research Council Canada - National Science Library

    Committee on Estimating Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure

    2008-01-01

    ... in life expectancy, and to assess methods for estimating the monetary value of the reduced risk of premature death and increased life expectancy in the context of health-benefits analysis. Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution details the committee's findings and posits several recommendations to address these issues.

  15. Investigating the risk reduction potential of disaster insurance across Europe

    NARCIS (Netherlands)

    Surminski, Swenja; Hudson, Paul

    2017-01-01

    The notion that insurance can play a significant role in risk reduction has recently gained increasing attention in the wake of rising losses from natural disasters. While this notion is accepted in theory, we notice that, in practice, little is known about if and how insurance promotes efforts to

  16. 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.

  17. 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.

  18. 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.

  19. The contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe: A big call to practitioners

    Directory of Open Access Journals (Sweden)

    Ernest Dube

    2018-03-01

    Full Text Available This article examined the contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe. The current discourse underrates the use of indigenous knowledge of communities by practitioners when dealing with disasters’, as the knowledge is often viewed as outdated and primitive. This study, which was conducted in 2016, sought to examine this problem through analysing the potential contribution of indigenous knowledge as a useful disaster risk reduction intervention. Tsholotsho district in Matabeleland, North province of Zimbabwe, which frequently experiences perennial devastating floods, was used as a case study. Interviews and researcher observations were used to gather data from 40 research participants. The findings were that communities understand weather patterns and could predict imminent flooding after studying trees and clouds, and the behaviours of certain animal species. Local communities also use available local resources to put structural measures in place as part of disaster risk reduction interventions. Despite this important potential, the study found that the indigenous knowledge of disaster risk reduction of the communities is often shunned by practitioners. The practitioners claim that indigenous knowledge lacks documentation, it is not found in all generational classes, it is contextualised to particular communities and the knowledge cannot be scientifically validated. The study concluded that both local communities and disaster risk reduction practitioners can benefit from the indigenous knowledge of communities. This research has the potential to benefit communities, policymakers and disaster risk reduction practitioners.

  20. Blood Glucose Reduction by Diabetic Drugs with Minimal Hypoglycemia Risk for Cardiovascular Outcomes

    DEFF Research Database (Denmark)

    Huang, Chi-Jung; Wang, Wei-Ting; Sung, Shih-Hsien

    2018-01-01

    of antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and the Cochrane Library up to January 27, 2018. Mixed-effects meta-regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse...... concentration was 0.42% lower (median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The meta-regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, -0.39 to -0.55; P...-40%) for MACE. By contrast, the meta-regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P>0.74). CONCLUSIONS: Compared with placebo, newer T2D agents with less hypoglycemic hazard significantly reduced...

  1. Health risk reduction programs in employer-sponsored health plans: Part II-law and ethics.

    Science.gov (United States)

    Rothstein, Mark A; Harrell, Heather L

    2009-08-01

    We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests.

  2. Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

    Science.gov (United States)

    Rothstein, Mark A.; Harrell, Heather L.

    2011-01-01

    Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

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

    Science.gov (United States)

    Crocker, Andrew M.; Doering, Kimberly B; Meadows, Robert G.; Lariviere, Brian W.; Graham, Jerry B.

    2015-01-01

    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 Atlas V engine that could also potentially 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. The test article is scheduled to complete critical design review this fall and begin testing in 2017. Dynetics has also designed, developed, and built innovative tank and structure assemblies using friction stir welding to leverage recent NASA investments in manufacturing tools, facilities, and processes, significantly reducing development and recurring costs. The full-scale cryotank assembly was used to verify the structural design and prove affordable processes. Dynetics performed hydrostatic and cryothermal proof tests on the assembly to verify the assembly meets performance requirements. This paper will discuss the ABEDRR engine task and structures task achievements to date and the remaining effort through the end of the contract.

  4. Smoke and mirrors: Limited value of relative risk reductions for assessing the benefits of disease-modifying therapies for multiple sclerosis.

    Science.gov (United States)

    Zakaria, Magd

    2015-05-01

    A reduction in relapse rate is the main primary outcome in most clinical trials in patients with multiple sclerosis (MS), with the effect of a treatment commonly expressed as relative risk reduction for this outcome. Physicians often assume that a drug with a higher relative risk reduction demonstrated in one trial is more effective than a drug with a lower relative risk reduction in another, and may pass this idea on to younger physicians and to patients. The use of the relative risk reduction as a measure of drug efficacy can be misleading, as it depends on the nature of the population studied: a treatment effect characterized by a lower relative risk reduction may be more clinically meaningful than one with a higher relative risk reduction. This concept is especially important with regard to clinical trials in patients with MS, where relapse rates in placebo groups have been declining in recent decades. Direct, head-to-head comparisons are the only way to compare the efficacy of the different treatments for MS. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. 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...

  6. 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.

  7. Analysis of risk reduction methods for interfacing system LOCAs [loss-of-coolant accidents] at PWRs

    International Nuclear Information System (INIS)

    Bozoki, G.; Kohut, P.; Fitzpatrick, R.

    1988-01-01

    The Reactor Safety Study (WASH-1400) predicted that Interfacing System Loss-of-Coolant Accidents (ISL) events were significant contributors to risk even though they were calculated to be relatively low frequency events. However, there are substantial uncertainties involved in determining the probability and consequences of the ISL sequences. For example, the assumed valve failure modes, common cause contributions and the location of the break/leak are all uncertain and can significantly influence the predicted risk from ISL events. In order to provide more realistic estimates for the core damage frequencies (CDFs) and a reduction in the magnitude of the uncertainties, a reexamination of ISL scenarios at PWRs has been performed by Brookhaven National Laboratory. The objective of this study was to investigate the vulnerability of pressurized water reactor designs to ISLs and identify any improvements that could significantly reduce the frequency/risk of these events

  8. Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke.

    Science.gov (United States)

    Goljar, Nika; Globokar, Daniel; Puzić, Nataša; Kopitar, Natalija; Vrabič, Maja; Ivanovski, Matic; Vidmar, Gaj

    2016-09-01

    To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients. A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010-2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006-2014 period to evaluate effectiveness of fall-risk reduction measures. The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55-101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014. The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention. Implications for Rehabilitation Recognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards. Assessing the fall risk is a team tasks and combines information from various sources. Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient.

  9. Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa.

    Science.gov (United States)

    Morojele, Neo K; Kitleli, Naledi; Ngako, Kgalabi; Kekwaletswe, Connie T; Nkosi, Sebenzile; Fritz, Katherine; Parry, Charles D H

    2014-01-01

    Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and referrals to the patrons of the bars. 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. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the community at large) was an important contributor to the feasibility and acceptability of the intervention.

  10. 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.

  11. A semi-quantitative model for risk appreciation and risk weighing

    DEFF Research Database (Denmark)

    Bos, Peter M.J.; Boon, Polly E.; van der Voet, Hilko

    2009-01-01

    Risk managers need detailed information on (1) the type of effect, (2) the size (severity) of the expected effect(s) and (3) the fraction of the population at risk to decide on well-balanced risk reduction measures. A previously developed integrated probabilistic risk assessment (IPRA) model...... provides quantitative information on these three parameters. A semi-quantitative tool is presented that combines information on these parameters into easy-readable charts that will facilitate risk evaluations of exposure situations and decisions on risk reduction measures. This tool is based on a concept...... detailed information on the estimated health impact in a given exposure situation. These graphs will facilitate the discussions on appropriate risk reduction measures to be taken....

  12. 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

  13. Disaster Risk Reduction through school learners’ awareness and preparedness

    Directory of Open Access Journals (Sweden)

    Takalani S. Rambau

    2012-11-01

    Full Text Available In 2006, the ISDR (International Strategy for Disaster Reduction (2007 initiated a campaign called Disaster Risk Reduction Begins at School to encourage the integration of disaster risk education into school curricula in countries vulnerable to disasters. A study was initiated to determine how education, in particular curriculum development and teaching, contributes to South African learners’ hazard awareness and disaster preparedness. Mixed method research (consisting of questionnaires, interviews and document reviews was done to collect data. 150 educators from Gauteng, the Western Cape, KwaZulu-Natal, North West and the Eastern Cape completed questionnaires. Five curriculum coordinators, three disaster specialists and two disaster lecturers were interviewed to record their perspectives. The first finding of the study was that the majority of educators, disaster specialists and curriculum coordinators identified floods, fire, droughts, epidemics, road accidents and storms as the most prevalent disasters in the country. The second finding from the literature and empirical data collection revealed that South African communities, particularly people residing in informal settlements and other poor areas, are more vulnerable to disasters than their counterparts in more affluent areas. The third finding of the study was that teaching learners about hazards and disasters is vital and must be expanded.

  14. 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.

  15. Breast cancer prevention knowledge, beliefs, and information sources between non-Hispanic and Hispanic college women for risk reduction focus.

    Science.gov (United States)

    Kratzke, Cynthia; Amatya, Anup; Vilchis, Hugo

    2015-02-01

    Although growing research focuses on breast cancer screenings, little is known about breast cancer prevention with risk reduction awareness for ethnic differences among college-age women. This study examined breast cancer prevention knowledge, beliefs, and information sources between non-Hispanic and Hispanic college women. Using a cross-sectional study, women at a university in the Southwest completed a 51-item survey about breast cancer risk factors, beliefs, and media and interpersonal information sources. The study was guided by McGuire's Input Output Persuasion Model. Of the 546 participants, non-Hispanic college women (n = 277) and Hispanic college women (n = 269) reported similar basic knowledge levels of modifiable breast cancer risk factors for alcohol consumption (52 %), obesity (72 %), childbearing after age 35 (63 %), and menopausal hormone therapy (68 %) using bivariate analyses. Most common information sources were Internet (75 %), magazines (69 %), provider (76 %) and friends (61 %). Least common sources were radio (44 %), newspapers (34 %), and mothers (36 %). Non-Hispanic college women with breast cancer family history were more likely to receive information from providers, friends, and mothers. Hispanic college women with a breast cancer family history were more likely to receive information from their mothers. Breast cancer prevention education for college women is needed to include risk reduction for modifiable health behavior changes as a new focus. Health professionals may target college women with more information sources including the Internet or apps.

  16. Preferences for breast cancer risk reduction among BRCA1/BRCA2 mutation carriers: a discrete-choice experiment.

    Science.gov (United States)

    Liede, Alexander; Mansfield, Carol A; Metcalfe, Kelly A; Price, Melanie A; Snyder, Carrie; Lynch, Henry T; Friedman, Sue; Amelio, Justyna; Posner, Joshua; Narod, Steven A; Lindeman, Geoffrey J; Evans, D Gareth

    2017-09-01

    Unaffected women who carry BRCA1 or BRCA2 mutations face difficult choices about reducing their breast cancer risk. Understanding their treatment preferences could help us improve patient counseling and inform drug trials. The objective was to explore preferences for various risk-reducing options among women with germline BRCA1/2 mutations using a discrete-choice experiment survey and to compare expressed preferences with actual behaviors. A discrete-choice experiment survey was designed wherein women choose between hypothetical treatments to reduce breast cancer risk. The hypothetical treatments were characterized by the extent of breast cancer risk reduction, treatment duration, impact on fertility, hormone levels, risk of uterine cancer, and ease and mode of administration. Data were analyzed using a random-parameters logit model. Women were also asked to express their preference between surgical and chemoprevention options and to report on their actual risk-reduction actions. Women aged 25-55 years with germline BRCA1/2 mutations who were unaffected with breast or ovarian cancer were recruited through research registries at five clinics and a patient advocacy group. Between January 2015 and March 2016, 622 women completed the survey. Breast cancer risk reduction was the most important consideration expressed, followed by maintaining fertility. Among the subset of women who wished to have children in future, the ability to maintain fertility was the most important factor, followed by the extent of risk reduction. Many more women said they would take a chemoprevention drug than had actually taken chemoprevention. Women with BRCA1/2 mutations indicated strong preferences for breast cancer risk reduction and maintaining fertility. The expressed desire to have a safe chemoprevention drug available to them was not met by current chemoprevention options.

  17. Levelized cost-risk reduction prioritization of waste disposal options

    International Nuclear Information System (INIS)

    Wilkinson, V.K.; Young, J.M.

    1992-01-01

    The prioritization of solid waste disposal options in terms of reduced risk to workers, the public, and the environment has recently generated considerable governmental and public interest. In this paper we address the development of a methodology to establish priorities for waste disposal options, such as incineration, landfills, long-term storage, waste minimization, etc. The study is one result of an overall project to develop methodologies for Probabilistic Risk Assessments (PRAs) of non-reactor nuclear facilities for the US Department of Energy. Option preferences are based on a levelized cost-risk reduction analysis. Option rankings are developed as functions of disposal option cost and timing, relative long- and short-term risks, and possible accident scenarios. We examine the annual costs and risks for each option over a large number of years. Risk, in this paper, is defined in terms of annual fatalities (both prompt and long-term) and environmental restoration costs that might result from either an accidental release or long-term exposure to both plant workers and the public near the site or facility. We use event timing to weigh both costs and risks; near-term costs and risks are discounted less than future expenditures and fatalities. This technique levels the timing of cash flows and benefits by converting future costs and benefits to present value costs and benefits. We give an example Levelized Cost-Benefit Analysis of incinerator location options to demonstrate the methodology and required data

  18. 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

  19. 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.

  20. A Dutch Perspective on Coastal Louisiana Flood Risk Reduction and Landscape Stabilization

    National Research Council Canada - National Science Library

    Dijkman, Jos

    2007-01-01

    .... The project was aimed at identifying options for the long-term reduction of flood risks and landscape stabilization in Planning Areas I and 2 in Louisiana, in the framework of the Louisiana Coastal...

  1. Vorapaxar: The Current Role and Future Directions of a Novel Protease-Activated Receptor Antagonist for Risk Reduction in Atherosclerotic Disease.

    Science.gov (United States)

    Gryka, Rebecca J; Buckley, Leo F; Anderson, Sarah M

    2017-03-01

    Despite the current standard of care, patients with cardiovascular disease remain at a high risk for recurrent events. Inhibition of thrombin-mediated platelet activation through protease-activated receptor-1 antagonism may provide reductions in atherosclerotic disease beyond those achievable with the current standard of care. Our primary objective is to evaluate the clinical literature regarding the role of vorapaxar (Zontivity™) in the reduction of cardiovascular events in patients with a history of myocardial infarction and peripheral artery disease. In particular, we focus on the potential future directions for protease-activating receptor antagonists in the treatment of a broad range of atherosclerotic diseases. A literature search of PubMed and EBSCO was conducted to identify randomized clinical trials from August 2005 to June 2016 using the search terms: 'vorapaxar', 'SCH 530348', 'protease-activated receptor-1 antagonist', and 'Zontivity™'. Bibliographies were searched and additional resources were obtained. Vorapaxar is a first-in-class, protease-activated receptor-1 antagonist. The Thrombin Receptor Antagonist for Clinical Event Reduction (TRACER) trial did not demonstrate a significant reduction in a broad primary composite endpoint. However, the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P-TIMI 50) trial examined a more traditional composite endpoint and found a significant benefit with vorapaxar. Vorapaxar significantly increased bleeding compared with standard care. Ongoing trials will help define the role of vorapaxar in patients with peripheral arterial disease, patients with diabetes mellitus, and other important subgroups. The use of multivariate modeling may enable the identification of subgroups with maximal benefit and minimal harm from vorapaxar. Vorapaxar provides clinicians with a novel mechanism of action to further reduce the burden of ischemic heart disease. Identification of

  2. Theoretical framework to study exercise motivation for breast cancer risk reduction.

    Science.gov (United States)

    Wood, Maureen E

    2008-01-01

    To identify an appropriate theoretical framework to study exercise motivation for breast cancer risk reduction among high-risk women. An extensive review of the literature was conducted to gather relevant information pertaining to the Health Promotion Model, self-determination theory, social cognitive theory, Health Belief Model, Transtheoretical Model, theory of planned behavior, and protection motivation theory. An iterative approach was used to summarize the literature related to exercise motivation within each theoretical framework. Protection motivation theory could be used to examine the effects of perceived risk and self-efficacy in motivating women to exercise to facilitate health-related behavioral change. Evidence-based research within a chosen theoretical model can aid practitioners when making practical recommendations to reduce breast cancer risk.

  3. Beyond the Sendai Framework for Disaster Risk Reduction: Vulnerability Reduction as a Challenge Involving Historical and Traditional Buildings

    Directory of Open Access Journals (Sweden)

    Valentina Pica

    2018-03-01

    Full Text Available In observance of the international procedures on disaster risk management, and in particular the Sendai Framework (2015, this research focuses on how more specific procedures related to it can be made effective in the treatment of historic areas worldwide. Disaster risk management is now viewed as being important in the context of historic buildings, as they are strongly related to cultural identity as well as to resilient communities, and can have a large impact on local economies. The study points out that cultural heritage might be the core field of action for capacity building in less vulnerable places, and that its protection is one of the main tasks to attend to in order to achieve the goal of vulnerability reduction. The paper also aims to answer questions such as: which actions could allow better protection of cultural heritage? Is it correct to involve local communities in reconstruction plans by capacity building and self-managed projects? How have reconstruction plans been managed recently worldwide? By further developing the applicability of the priority areas of action of the Sendai Framework, the research illustrates critical points and best practices that will hopefully support disaster risk reduction based on strategic management and remote monitoring, involving technologies and social participation.

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

    International Nuclear Information System (INIS)

    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

  5. 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.

  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. 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

  8. Resilience and disaster risk reduction: an etymological journey

    Science.gov (United States)

    Alexander, D. E.

    2013-04-01

    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. Sagitta in lapidem numquam figitur, interdum resiliens percutit dirigentem. ("An arrow never lodges in a stone: often it recoils upon its sender.") St. John Chrysostom (c. 347-407), Archbishop of Constantinople.

  9. 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.

  10. Ibrutinib-associated bleeding: pathogenesis, management and risk reduction strategies.

    Science.gov (United States)

    Shatzel, J J; Olson, S R; Tao, D L; McCarty, O J T; Danilov, A V; DeLoughery, T G

    2017-05-01

    Ibrutinib is an irreversible inhibitor of Bruton's tyrosine kinase (Btk) that has proven to be an effective therapeutic agent for multiple B-cell-mediated lymphoproliferative disorders. Ibrutinib, however, carries an increased bleeding risk compared with standard chemotherapy. Bleeding events range from minor mucocutaneous bleeding to life-threatening hemorrhage, due in large part to the effects of ibrutinib on several distinct platelet signaling pathways. There is currently a minimal amount of data to guide clinicians regarding the use of ibrutinib in patients at high risk of bleeding or on anticoagulant or antiplatelet therapy. In addition, the potential cardiovascular protective effects of ibrutinib monotherapy in patients at risk of vascular disease are unknown. Patients should be cautioned against using non-steroidal anti-inflammatory drugs, fish oils, vitamin E and aspirin-containing products, and consider replacing ibrutinib with a different agent if dual antiplatelet therapy is indicated. Patients should not take vitamin K antagonists concurrently with ibrutinib; direct oral anticoagulants should be used if extended anticoagulation is strongly indicated. In this review, we describe the pathophysiology of ibrutinib-mediated bleeding and suggest risk reduction strategies for common clinical scenarios associated with ibrutinib. © 2017 International Society on Thrombosis and Haemostasis.

  11. 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.

  12. 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.

  13. Beyond the physical examination: the nurse practitioner's role in adolescent risk reduction and resiliency building in a school-based health center.

    Science.gov (United States)

    Davis, Teresa K

    2005-12-01

    School-based health centers in high schools provide a unique setting in which to deliver risk-reduction and resilience-building services to adolescents. The traditional health care system operating in the United States focuses on the treatment of illness and disease rather than on preventing problems originating from health risk behaviors. Nurse practitioners can promote healthy behavior in adolescents through linkages to parents, schools, and community organizations; by conducting individual risk assessments; and by providing health education and access to creative health programs that build resilience and promote protective factors. With a focus on wellness, nurse practitioners as advanced practice nurses and specialists in disease prevention and health promotion can establish students' health priorities in the context of the primary health care they deliver on a daily basis.

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Risk management study for the retired Hanford Site facilities: Risk management executive summary

    International Nuclear Information System (INIS)

    Coles, G.A.; Shultz, M.V.; 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 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 document is the first in a four volume series that comprise the risk management study for the retired, surplus facilities. Volume 2 is the risk evaluation work procedure; volume 3 provides the results for the risk evaluation; and volume 4 is the risk-reduction cost comparison

  17. 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.

  18. HIV Risk Reduction Among Young Adult Chronic Psychiatric Patients

    Science.gov (United States)

    1990-08-28

    emotional language to convey information on risk reduction. Common myths concerning transmission are presented and the audience is specifically told that...current study include: ’Can contact with semen (cum) from the penis result In AIDS?’,’ Can a person get AIDS from vaginal fluids in a woman’s vagina ? Can...hands. It doesn’t like being exposed to sunlight or air. Female: The AIDS virus lives inside the human body, in the blood, in a woman’s vagina and

  19. 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

  20. Disaster risk reduction in developing countries: costs, benefits and institutions.

    Science.gov (United States)

    Kenny, Charles

    2012-10-01

    Some 60,000 people worldwide die annually in natural disasters, mostly due to the collapse of buildings in earthquakes, and primarily in the developing world. This is despite the fact that engineering solutions exist that can eliminate almost completely the risk of such deaths. Why is this? The solutions are expensive and technically demanding, so their cost-benefit ratio often is unfavourable as compared to other interventions. Nonetheless, there are various public disaster risk reduction interventions that are highly cost-effective. That such interventions frequently remain unimplemented or ineffectively executed points to a role for issues of political economy. Building regulations in developing countries appear to have limited impact in many cases, perhaps because of inadequate capacity and corruption. Public construction often is of low quality, perhaps for similar reasons. This suggests the need for approaches that emphasise simple and limited disaster risk regulation covering only the most at-risk structures-and that, preferably, non-experts can monitor-as well as numerous transparency and oversight mechanisms for public construction projects. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  1. 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…

  2. Financial risk sharing with providers in health maintenance organizations, 1999.

    Science.gov (United States)

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?

  3. 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.

  4. Harm reduction principles for healthcare settings

    Directory of Open Access Journals (Sweden)

    Mary Hawk

    2017-10-01

    Full Text Available Abstract Background Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Methods Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. Results We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. Conclusion This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of

  5. Harm reduction principles for healthcare settings.

    Science.gov (United States)

    Hawk, Mary; Coulter, Robert W S; Egan, James E; Fisk, Stuart; Reuel Friedman, M; Tula, Monique; Kinsky, Suzanne

    2017-10-24

    Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health

  6. 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 < .05) and 2.49 times (p < .08) more likely to have used contraception or a condom at last intercourse, respectively. Parents, schools, or traditional media as 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.

  7. 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

  8. 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

  9. Social intervention and risk reduction - indirect countermeasures

    International Nuclear Information System (INIS)

    Higgins, N.A.; Morrey, M.

    1996-01-01

    An indirect countermeasure (IC) is an action which is intended to mitigate detrimental effects experienced by individuals or the community after an accident. Indirect countermeasures (ICs) achieve this, both by averting radiation risks arising from the accident, but by removing or reducing other risks and sources of stress or harm to which the community may be subject. ICs naturally fall into two categories: social action ICs, which range from introducing compensation payments to providing information centres; and risk reducing ICs which mitigate risks to which the population might be exposed, such as radon. By including a consideration of ICs in an assessment of the optimal response, it is likely that a decision maker will become aware of a greater range of harms and benefits that might result from the application of a countermeasure. The decision maker will then be in a better position to judge the appropriateness of any action. (author)

  10. 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

  11. 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

  12. 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

    generally have an aversion to risk reduction strategies. Some variation was found, however, in the rejection of the strategies. Thus, more acceptable strategies are characterised by a low degree of technological interference, and by being close to the consumer’s experience in everyday life and/or familiar...

  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. Risk Assessment and Integration Team (RAIT) Portfolio Risk Analysis Strategy

    Science.gov (United States)

    Edwards, Michelle

    2010-01-01

    Impact at management level: Qualitative assessment of risk criticality in conjunction with risk consequence, likelihood, and severity enable development of an "investment policy" towards managing a portfolio of risks. Impact at research level: Quantitative risk assessments enable researchers to develop risk mitigation strategies with meaningful risk reduction results. Quantitative assessment approach provides useful risk mitigation information.

  15. Risk reduction for nonmelanoma skin cancer with childhood sunscreen use

    International Nuclear Information System (INIS)

    Stern, R.S.; Weinstein, M.C.; Baker, S.G.

    1986-01-01

    Exposure to ultraviolet radiation is the principle cause of basal and squamous cell carcinomas of the skin, which are the most frequent tumors occurring in white residents of the United States. Using a mathematical model based on epidemiologic data, we quantified the potential benefits of using a sunscreen with a sun protective factor of 15 and estimate that regular use of such a sunscreen during the first 18 years of life would reduce the lifetime incidence of these tumors by 78%. Additional benefits of sunscreen use during childhood include reduced risk of sunburn, retarding the pace of skin aging, and possible reduction in melanoma risk. We recommend that pediatricians encourage sunscreen use and sun avoidance as a regular part of pediatric preventive health care

  16. 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.

  17. Use of focus groups to develop methods to communicate cardiovascular disease risk and potential for risk reduction to people with type 2 diabetes.

    Science.gov (United States)

    Price, Hermione C; Dudley, Christina; Barrow, Beryl; Kennedy, Ian; Griffin, Simon J; Holman, Rury R

    2009-10-01

    People need to perceive a risk in order to build an intention-to-change behaviour yet our ability to interpret information about risk is highly variable. We aimed to use a user-centred design process to develop an animated interface for the UK Prospective Diabetes Study (UKPDS) Risk Engine to illustrate cardiovascular disease (CVD) risk and the potential to reduce this risk. In addition, we sought to use the same approach to develop a brief lifestyle advice intervention. Three focus groups were held. Participants were provided with examples of materials used to communicate CVD risk and a leaflet containing a draft brief lifestyle advice intervention and considered their potential to increase motivation-to-change behaviours including diet, physical activity, and smoking in order to reduce CVD risk. Discussions were tape-recorded, transcribed and coded and recurring themes sought. Sixty-two percent of participants were male, mean age was 66 years (range = 47-76 years) and median age at leaving full-time education was 18 years (range = 15-40 years). Sixteen had type 2 diabetes and none had a prior history of CVD. Recurring themes from focus group discussions included the following: being less numerate is common, CVD risk reduction is important and a clear visual representation aids comprehension. A simple animated interface of the UKPDS Risk Engine to illustrate CVD risk and the potential for reducing this risk has been developed for use as a motivational tool, along with a brief lifestyle advice intervention. Future work will investigate whether use of this interactive version of the UKPDS Risk Engine and brief lifestyle advice is associated with increased behavioural intentions and changes in health behaviours designed to reduce CVD risk.

  18. Teaching medical students cancer risk reduction nutrition counseling using a multimedia program.

    Science.gov (United States)

    Kolasa, K M; Jobe, A C; Miller, M G; Clay, M C

    1999-03-01

    There are many barriers to medical students receiving education about the linkage between nutrition and cancer, including the lack of role models and teachers and insufficient curricular time. We tested the use of a multimedia program as a possible solution to teaching diet-risk assessment and counseling skills. Images of Cancer Prevention, The Nutrition Link is a CD-ROM multimedia program that was developed and evaluated by 147 medical students. Pre-use and post-use surveys, computer log files, and recorded response sessions were used to determine the learner's 1) ease in using the program, 2) attitudes about the treatment of the content, 3) knowledge gain, and 4) attitudes about the role of physicians in nutrition assessment and counseling for cancer risk reduction. Students improved their knowledge of dietary guidelines for cancer risk reduction and made positive changes in their attitudes toward the role of physicians in dietary counseling. However, most students reported that they would not use the program unless it was required that they do so. The multimedia program was successful; it affected students' knowledge and attitudes concerning nutrition as a modifiable risk factor for some cancers. In addition, the design and delivery of the multimedia product was positively reviewed by the students for ease of access, message design, individualized instruction, and flexibility. Despite these favorable ratings, it was not clear that students would use the program unless required to do so.

  19. 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.

  20. Environmental Assessment: Bird Strike Risk Reduction at Laughlin Air Force Base, Texas

    Science.gov (United States)

    2008-01-01

    mglkg in rats, 291 - 609 mglkg in mice, > 1000 mglkg in sheep , > 100 mglkg in dogs and > 1000 mglkg in rabbits (Pesticide Residues in Food-1987... vineyards . Wildl. Soc. Bull. 21:47-51. LAFB Strike Risk Reduction EA - 39 Gaines, T.B. 1969. Acute toxicity of pesticides. Toxicol. Appl. Pharmacol

  1. Does Pregnancy Provide Vaccine-Like Protection Against Rheumatoid Arthritis?

    Science.gov (United States)

    Guthrie, Katherine A.; Dugowson, Carin E.; Voigt, Lynda F.; Koepsell, Thomas D.; Nelson, J. Lee

    2010-01-01

    Objectives Previous studies have evaluated rheumatoid arthritis (RA) risk according to pregnancy history with conflicting results. Fetal cells acquired during pregnancy provide a potential explanation for modulation of RA risk by pregnancy. Methods We examined parity and RA risk in results from a population-based prospective study in the Seattle, Washington area, comparing women with newly diagnosed RA (n=310) to control women (n=1418). We also evaluated the distribution of parity in cases according to HLA-genotype. Results We found a significant reduction of RA risk associated with parity, relative risk (RR) 0.61, 95% confidence interval 0.43-0.86 (p=0.005). RA risk reduction in parous women was strongest for younger women. Most striking was that RA risk reduction correlated with time elapsed since a woman’s last birth. RA risk was lowest among women 1 to 5 years from their last birth (RR 0.29) with risk reduction progressively lessening with increasing time (5-15 years, 0.51 and >15 years, 0.76), compared to nulliparous women (p=0.007 for trend). No correlation was observed with age at first birth or total number of births. Among cases with the highest genetic risk of RA (2 copies of RA-associated HLA alleles) a significant under-representation of parous vs. nulliparous women was observed (p=0.02). Conclusions We found a significantly lower risk of RA in parous women which correlated strongly with time elapsed from a woman’s last birth. While the explanation for our findings is not known, HLA-disparate fetal microchimerism can persist many years after a birth and could confer temporary protection against RA. PMID:20309863

  2. 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…

  3. Risks and crises for healthcare providers: the impact of cloud computing.

    Science.gov (United States)

    Glasberg, Ronald; Hartmann, Michael; Draheim, Michael; Tamm, Gerrit; Hessel, Franz

    2014-01-01

    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.

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

    OpenAIRE

    Glasberg, Ronald; Hartmann, Michael; Draheim, Michael; Tamm, Gerrit; Hessel, Franz

    2014-01-01

    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.

  5. Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: A Taiwan nationwide population-based cohort study.

    Science.gov (United States)

    Liang, Sophie Hsin-Yi; Yang, Yao-Hsu; Kuo, Ting-Yu; Liao, Yin-To; Lin, Tzu-Chin; Lee, Yena; McIntyre, Roger S; Kelsen, Brent A; Wang, Tsu-Nai; Chen, Vincent Chin-Hung

    2018-01-01

    Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. To investigate the MPH usage and the risk of suicide attempt among ADHD youths. We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models. Among ADHD youths, reduction of suicide risk was found in patients prescribed 90-180days of MPH after adjusting for confounding factors (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.19-0.90) and a greater reduction in those prescribed more than 180days of MPH (HR: 0.28, 95% CI: 0.17-0.48). We observed a 59% suicide attempt risk reduction among ADHD youths prescribed between 90 and 180days and a 72% risk reduction in those prescribed more than 180days of MPH. The protective benefit observed by the group prescribed MPH for longer duration underscores the importance of psychoeducation and compliance enhancement as part of ADHD management. Indication bias is identified as a limitation of this study, and future self-case control study to investigate the association between suicide attempt and ADHD medication is suggested. This nationwide population-based cohort study showed that among ADHD youths, reduction of suicide risk was observed in patients prescribed MPH for duration 90days and longer, underscoring the importance of appropriate ADHD pharmacotherapy and enhancing drug compliance. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.

    Science.gov (United States)

    Gillette, Chris; Blalock, Susan J; Rao, Jaya K; Williams, Dennis; Loughlin, Ceila E; Sleath, Betsy

    2014-08-01

    The objectives of this study were to: (1) describe the extent to which general pediatric providers discuss risks associated with asthma control medications with families, and (2) examine factors that are associated with risk discussions. This study was a cross-sectional secondary analysis of audio taped medical visits involving 35 pediatric providers and 248 children with asthma with their caregivers. Transcripts of the visits were coded for discussions about asthma medication risks. Generalized estimating equations were used to analyze the data. Providers discussed asthma control medication risks during 23% of visits. Risks were more likely to be discussed when the visit was longer and when the provider prescribed a new asthma control medication. When providers discussed asthma control medication risks, they were most likely to ask the family general questions and make general statements. Across all of the visits, caregivers asked a total of 16 questions and made a total of 20 statements about risks associated with asthma medications; children asked a total of 3 questions and made two statements about risks associated with asthma control medications. Providers discussed risks associated with asthma control medications in less than one-quarter of medical visits. Providers should involve families in discussions about risks associated with medications during every visit to assess potential barriers to medication adherence. © 2013 Wiley Periodicals, Inc.

  7. Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

    Science.gov (United States)

    Menning, Chadwick; Holtzman, Mellisa

    2015-01-01

    Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month…

  8. 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.

  9. Modeling Fuel Treatment Leverage: Encounter Rates, Risk Reduction, and Suppression Cost Impacts

    Directory of Open Access Journals (Sweden)

    Matthew P. Thompson

    2017-11-01

    Full Text Available The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the frequency and magnitude of fire-treatment encounters, which are critical determinants of treatment efficacy. Additionally, we examined avoided area burned, avoided suppression costs, and avoided damages, and combined all three under the umbrella of leverage to explore multiple dimensions with which to characterize return on investment. We chose the Sierra National Forest, California, USA, as our study site, due to previous work providing relevant data and analytical products, and because it has the potential for large, long-duration fires and corresponding potential for high suppression expenditures. Modeling results generally confirmed that fire-treatment encounters are rare, such that median suppression cost savings are zero, but in extreme years, savings can more than offset upfront investments. Further, reductions in risk can expand areas where moderated suppression response would be appropriate, and these areas can be mapped in relation to fire control opportunities.

  10. Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

    Science.gov (United States)

    El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Landis, J Richard; Remien, Robert H

    2016-06-01

    Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.

  11. 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.

  12. Competing risk model for reduction in life expectancy from radiogenic latent cancer

    International Nuclear Information System (INIS)

    Davis, H.T.

    1978-01-01

    Because of the large number of persons who could potentially receive low doses of radiation as a result of a nuclear reactor accident, the number of fatalities from latent cancers is generally larger than the early, or prompt, fatalities. For this reason the latent cancer fatality risk of reactor accidents is perceived as being more important than the early fatality risk. In addition, there exists the temptation to add the latent cancer fatality risk to the early fatality risk for the purpose of comparing reactor accident risks to other risks that society is exposed to, such as automobile accidents, airplane accidents, hurricanes, etc. However, the impact on the individual, and society as a whole, due to latent cancer fatalities is significantly different from the impact produced by early fatalities. Early fatalities generally result in appreciable life shortening for the affected individual while latent cancer fatalities generally result in very limited life shortening. A mathematical model was developed to express the reduction in life expectancy due to latent radiogenic cancer as a function of dose received

  13. Children with Disabilities in Disability-Inclusive Disaster Risk Reduction: Focussing on School Settings

    Science.gov (United States)

    Ronoh, Steve; Gaillard, J. C.; Marlowe, Jay

    2017-01-01

    Every year, worldwide, disasters affect approximately seven million children with disabilities, highlighting their potential vulnerability. Although there is a growing move internationally to promote the rights of children with disabilities, they still receive little attention from disaster risk reduction (DRR) researchers and policy makers. They…

  14. Risk reduction of international mining projects by means of investor consortia and diversification of external financing

    International Nuclear Information System (INIS)

    Kirchner, C.

    1982-01-01

    Investors and creditors of international mining projects bear specific risks which may be reduced by means of forming investor and financing consortia. Risk is defined for each actor separately. Project risk and investor risk respectively credit risk are useful categories in order to analyze risk reduction. In each case formation of consortia has a positive influence on the economic viability of the project, and thus reduces the project risk. Furthermore, formation of consortia leads to better compliance of the host country of the mining project with the project and financing agreements. Thus, investor and credit risk may be reduced. (orig.) [de

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

    DEFF Research Database (Denmark)

    Govindan, Kannan; Chaudhuri, Atanu

    2016-01-01

    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......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...... management, flexibility of its operations and also geographical coverage of their services....

  16. Use of GIS in the estimation and development of risk reduction technology

    International Nuclear Information System (INIS)

    Ha, Jae Joo

    1998-03-01

    The occurrence probability of a severe accident in the nuclear power plant is very small because the safety of a plant and the public is considered in the design and operation of a nuclear power plant. However, if a severe accident occurs, the establishment of a reduction strategy of damages resulting from it is essential because the effect of it on the human and the environment is very large. The important criterion which determines the severity of an accident is risk, which is defined as the product of its frequently and the consequence. The establishment of countermeasures in order to estimate and reduce risks quantitatively can be a very powerful tool to minimize the effect of an accident on the human and the environment. The research on the establishment of a framework which integrates a geographic information system (GIS), a database management system (DBMS), and decision making support system (DMSS) is considered very actively. Based on these systems, we can accomplish the estimation and display of risks and the development of reduction methodologies which are essential parts of an accident management of a nuclear power plant. The GIS plays a role to support users to systematize and comprehend spatial relationships of information which are necessary for the decision making. Through the DBMS, we can establish and manage spatial and attribute data, and use them in the query and selection. The DMSS is a computer-based information system which makes a necessary decision easily. In this study, we reviewed the fundamental concepts of a GIS and examined the methodology for the use of it in the estimation and display of risks. Also, we established the fundamental GIS platform of a Yonggwang site and the necessary database systems for the estimation of risks. (author). 17 refs., 9 tabs., 34 figs

  17. 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.

  18. 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.

  19. Evaluation of severe accident risks and the potential for risk reduction: Grand Gulf, Unit 1. Draft for comment, February 1987

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C N [Technadyne Engineering Consultants, Inc., Albuquerque, NM (United States); Benjamin, A S; Kunsman, D M; Williams, D C [Sandia National Laboratories, Albuquerque, NM (United States); Boyd, G J; Lewis, S R [Safety and Reliability Optimization Services, Inc., Knoxville, TN (United States); Smith, L N [Science Applications International Corporation, Albuquerque, NM (United States)

    1987-04-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a boiling water reactor with a Mark III containment (Grand Gulf, 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 low relative to previous studies; for example, most of the uncertainty range is lower than the point estimate of risk for the Peach Bottom plant in the Reactor Safety Study (RSS). However, certain unresolved issues cause the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. These issues include the diesel generator failure rate, iodine and cesium revolatilization after vessel breach and the possibility of reactor vessel pedestal failure caused by core debris attack. Some of the postulated safety options appear to be potentially cost effective for the Grand Gulf power plant, particularly when onsite accidents costs are included in the evaluation of benefits. Principally these include procedural modifications and relatively inexpensive hardware additions to insure core cooling in the event of a station blackout. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150. (author)

  20. Case Study of Cardiovascular Risk Reduction in the Northwest Region and TRICARE Region 11

    National Research Council Canada - National Science Library

    Murphy, Rosemary

    2003-01-01

    ... and TRICARE Lead Agent Region 11. The outcomes management team developed a cardiovascular risk reduction scorecard and metrics in which to evaluate the care being given to the TRICARE prime enrollees with a cardiovascular disease diagnosis...

  1. Minority Households' Willingness-to-Pay for Public and Private Wildfire Risk Reduction in Florida

    Science.gov (United States)

    Gonzalez-Caban, A.; Sanchez, J. J.

    2017-12-01

    The purpose of this work is to estimate willingness-to-pay (WTP) for minority (African-American and Hispanic) homeowners in Florida for private and public wildfire risk reduction programs and also to test for differences in response between the two groups. A random parameter logit and latent class models allowed us to determine if there is difference in wildfire mitigation program preferences, whether WTP is higher for public or private actions for wildfire risk reduction, and whether households with personal experience and who perceive that they live in higher-risk areas have significantly higher WTP. We also compare FL minority homeowners' WTP values with Florida original homeowners' estimates. Results suggest that FL minority homeowners are willing to invest in public programs, with African-Americans WTP values at a higher rate than Hispanics. In addition, the highest priority for cost sharing funds would go to low-income homeowners, especially to cost-share private actions on their own land. These results may help fire managers optimize allocation of scarce cost-sharing funds for public versus private actions.

  2. Semantic Mediation Tool for Risk Reduction, Phase I

    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...

  3. Risk factors in limb reduction defects.

    Science.gov (United States)

    Stoll, C; Alembik, Y; Dott, B; Roth, M P

    1992-07-01

    Risk factors were studied in 123 children with limb reduction defects (LRD) from 118,265 consecutive births of known outcome during the period from 1979 to 1987 in the area which is covered by our registry of congenital malformations. For each case a control was studied. The LRD was localised and classified according to the EUROCAT guide for the description and classification of limb defects. The prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0% were late spontaneous abortion or stillborn and termination was performed in 4.0% of the cases. The proportion of males was 0.55. The most common malformations in the 51.2% of children who had at least one other anomaly than LRD were associated cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was more often complicated by oligohydramnios, polyhydramnios and threatened abortion but there were no differences in parental characteristics. However, 9.7% of marriages were consanguineous (P less than 0.01) and the incidence of LRD in first-degree relatives of the children with LRD was high. First-degree relatives also had more non-limb malformations than did those of controls.

  4. The effect of alternative summary statistics for communicating risk reduction on decisions about taking statins: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Cheryl L L Carling

    2009-08-01

    Full Text Available BACKGROUND: While different ways of presenting treatment effects can affect health care decisions, little is known about which presentations best help people make decisions consistent with their own values. We compared six summary statistics for communicating coronary heart disease (CHD risk reduction with statins: relative risk reduction and five absolute summary measures-absolute risk reduction, number needed to treat, event rates, tablets needed to take, and natural frequencies. METHODS AND FINDINGS: We conducted a randomized trial to determine which presentation resulted in choices most consistent with participants' values. We recruited adult volunteers who participated through an interactive Web site. Participants rated the relative importance of outcomes using visual analogue scales (VAS. We then randomized participants to one of the six summary statistics and asked them to choose whether to take statins based on this information. We calculated a relative importance score (RIS by subtracting the VAS scores for the downsides of taking statins from the VAS score for CHD. We used logistic regression to determine the association between participants' RIS and their choice. 2,978 participants completed the study. Relative risk reduction resulted in a 21% higher probability of choosing to take statins over all values of RIS compared to the absolute summary statistics. This corresponds to a number needed to treat (NNT of 5; i.e., for every five participants shown the relative risk reduction one additional participant chose to take statins, compared to the other summary statistics. There were no significant differences among the absolute summary statistics in the association between RIS and participants' decisions whether to take statins. Natural frequencies were best understood (86% reported they understood them well or very well, and participants were most satisfied with this information. CONCLUSIONS: Presenting the benefits of taking statins as

  5. Public risk-reduction measures: cost-effectiveness from a global point-of-view

    International Nuclear Information System (INIS)

    Oliveira, L.F.S. de; Motta Barros, E.B. da; Fleming, P.V.; Rosa, L.P.

    1985-05-01

    A review of systemic or global approach to cost-effectiveness analysis of risk-reduction measures is presented, and its advantages and limitations are discussed. The method is applied for problem of the cost-effectiveness of increasing the Angra 3 reactor containment wall thickness from 60cm to 180cm thick, in case of a direct commercial aircraft crash on it. (Author) [pt

  6. Prevalence of malaria and use of malaria risk reduction measures among resettled pregnant women in South Sudan

    DEFF Research Database (Denmark)

    Dræbel, Tania; Gueth Kueil, Bill; Meyrowitsch, Dan Wolf

    2013-01-01

    Background: The study assessed aspects of malaria infection, prevention and treatment in a population of resettled pregnant women in South Sudan. Methods: During April and May 2008, a cross-sectional study was carried out to estimate malaria prevalence and to assess the use of malaria risk...... ¼ 3.20, 95% CI 1.26–8.16; p ¼ 0.015). Conclusions: The results suggest that educational attainment need not be very advanced to affect practices of malaria prevention and treatment. Primary school attendance was a stronger predictor for use of malaria risk reduction measures than any of the other...... selected background characteristics. Educational attainment, information and communication about malaria prevention and control play a pivotal role in increasing and improving use of malaria risk reduction measures....

  7. Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

    The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting ...

  8. Mediation of an efficacious HIV risk reduction intervention for South African men.

    Science.gov (United States)

    O'Leary, Ann; Jemmott, John B; Jemmott, Loretta S; Bellamy, Scarlett; Icard, Larry D; Ngwane, Zolani

    2015-10-01

    "Men, Together Making a Difference!" is an HIV/STD risk-reduction intervention that significantly increased self-reported consistent condom use during vaginal intercourse compared with a health-promotion attention-control intervention among men (N = 1181) in Eastern Cape Province, South Africa. The present analyses were designed to identify mediators of the intervention's efficacy. The potential mediators were Social Cognitive Theory (SCT) constructs that the intervention targeted, including several aspects of condom-use self-efficacy, outcome expectancies, and knowledge. Mediation was assessed using a product-of-coefficients approach where an α path (the intervention's effect on the potential mediator) and a β path (the potential mediator's effect on the outcome of interest, adjusting for intervention) were estimated independently in a generalized estimating equations framework. Condom-use negotiation self-efficacy, technical-skill self-efficacy, and impulse-control self-efficacy were significant mediators. Although not mediators, descriptive norm and expected friends' approval of condom use predicted subsequent self-reported condom use, whereas the expected approval of sexual partner did not. The present results suggest that HIV/STD risk-reduction interventions that draw upon SCT and that address self-efficacy to negotiate condom use, to apply condoms correctly, and to exercise sufficient control when sexually aroused to use condoms may contribute to efforts to reduce sexual risk behavior among South African men. Future research must examine whether approaches that build normative support for condom use among men's friends are also efficacious.

  9. Livelihoods and climate change : combining disaster risk reduction, natural resource management and climate change adaptation in a new approach to the reduction of vulnerability and poverty

    International Nuclear Information System (INIS)

    Burton, I.; Soussan, J.; Hammill, A.

    2003-01-01

    This paper provides a framework for researchers and policy-makers that are taking action on climate change adaptation. It presents innovative and sustainable ways to respond to the changing global climate. It focuses, in particular, on international research and policy initiatives on climate change, vulnerable communities and adaptation. The international and multi-disciplinary task force that put the framework together includes experts from the fields of disaster risk reduction, climate change, conservation and poverty reduction. The report emphasizes that successful climate change adaptation should be accomplished through actions that reduce the vulnerabilities of poor people and poor countries because people's livelihoods shape poverty and their ability to move out of poverty. The task force identifies the need to integrate a climate change adaptation approach based on the livelihoods of vulnerable communities in different parts of the world. The examples cited in this report include: (1) mangrove rehabilitation in Vietnam, (2) community-based rang eland rehabilitation for carbon sequestration in Sudan, (3) agro-ecological roots of resilience in Honduras, Nicaragua and Guatemala, and (4) watershed restoration and development in Maharashtra State, India. refs., figs

  10. Pharmacists as providers: targeting pneumococcal vaccinations to high risk populations.

    Science.gov (United States)

    Taitel, Michael; Cohen, Ed; Duncan, Ian; Pegus, Cheryl

    2011-10-19

    Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal. As more people seek annual influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide PPSV. The objective of this study was to evaluate the impact of pharmacists educating at-risk patients on the importance of receiving a pneumococcal vaccination. Using de-identified claims from a large, national pharmacy chain, all patients who had received an influenza vaccination between August 1, 2010 and November 14, 2010 and who were eligible for PPSV were identified for the analysis. Based on the Advisory Committee on Immunization Practices recommendations, at-risk patients were identified as over 65 years of age or as aged 2-64 with a comorbid conditions. A benchmark medical and pharmacy claims database of commercial and Medicare health plan members was used to derive a PPSV vaccination rate typical of traditional care delivery to compare to pharmacy-based vaccination. Period incidence of PPSV was calculated and compared. Among the 1.3 million at-risk patients who were vaccinated by a pharmacist during the study period, 65,598 (4.88%) also received a pneumococcal vaccine. This vaccination rate was significantly higher than the benchmark rate of 2.90% (34,917/1,204,104; pvaccination rate (6.60%; 26,430/400,454) of any age group. Pharmacists were successful at identifying at-risk patients and providing additional immunization services. Concurrent immunization of PPSV with influenza vaccination by pharmacists has potential to improve PPSV coverage. These results support the expanding role of community pharmacists in the provision of wellness and prevention services. Copyright © 2011 Elsevier Ltd. All rights

  11. Justice policy reform for high-risk juveniles: using science to achieve large-scale crime reduction.

    Science.gov (United States)

    Skeem, Jennifer L; Scott, Elizabeth; Mulvey, Edward P

    2014-01-01

    After a distinctly punitive era, a period of remarkable reform in juvenile crime regulation has begun. Practical urgency has fueled interest in both crime reduction and research on the prediction and malleability of criminal behavior. In this rapidly changing context, high-risk juveniles--the small proportion of the population where crime becomes concentrated--present a conundrum. Research indicates that these are precisely the individuals to treat intensively to maximize crime reduction, but there are both real and imagined barriers to doing so. Mitigation principles (during early adolescence, ages 10-13) and institutional placement or criminal court processing (during mid-late adolescence, ages 14-18) can prevent these juveniles from receiving interventions that would best protect public safety. In this review, we synthesize relevant research to help resolve this challenge in a manner that is consistent with the law's core principles. In our view, early adolescence offers unique opportunities for risk reduction that could (with modifications) be realized in the juvenile justice system in cooperation with other social institutions.

  12. 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.

  13. How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research.

    Science.gov (United States)

    Fielden, Hannah G; Brown, Stephen L; Saini, Pooja; Beesley, Helen; Salmon, Peter

    2017-09-01

    Risk-reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk-reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception-June 2015). Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk-reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk-reducing procedures without such deliberation. Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically-based ethical reflection is required to determine whether and when it is appropriate to provide risk-reduction procedures to alleviate worry. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  14. Current strategies for dosage reduction in computed tomography

    International Nuclear Information System (INIS)

    May, M.S.; Wuest, W.; Lell, M.M.; Uder, M.; Kalender, W.A.; Schmidt, B.

    2012-01-01

    The potential risks of radiation exposure associated with computed tomography (CT) imaging are reason for ongoing concern for both medical staff and patients. Radiation dose reduction is, according to the as low as reasonably achievable principle, an important issue in clinical routine, research and development. The complex interaction of preparation, examination and post-processing provides a high potential for optimization on the one hand but on the other a high risk for errors. The radiologist is responsible for the quality of the CT examination which requires specialized and up-to-date knowledge. Most of the techniques for radiation dose reduction are independent of the system and manufacturer. The basic principle should be radiation dose optimization without loss of diagnostic image quality rather than just reduction. (orig.) [de

  15. Science and Technology Networks : A Helping Hand to Boost Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030?

    NARCIS (Netherlands)

    Trogrlić, RobertŠakić; Cumiskey, Lydia; Triyanti, Annisa; Duncan, Melanie J.; Eltinay, Nuha; Hogeboom, Rick J.; Jasuja, Mansi; Meechaiya, Chinaporn; Pickering, Christina J.; Murray, Virginia

    2017-01-01

    The Sendai Framework for Disaster Risk Reduction 2015–2030 underlines the importance of Science and Technology (S&T) and S&T networks for effective disaster risk reduction (DRR). The knowledge of existing S&T networks and their exact role in DRR, however, is limited. This opinion piece initiates a

  16. 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...

  17. Revitalising Evidence-based Policy for the Sendai Framework for Disaster Risk Reduction 2015-2030: Lessons from Existing International Science Partnerships.

    Science.gov (United States)

    Carabine, Elizabeth

    2015-04-23

    The convergence of agreements on disaster risk reduction (DRR), development finance, sustainable development and climate change in 2015 presents a unique opportunity for coherence across these inter-related policy areas. At the same time, demand is growing for a more prominent and effective role for science and technology in providing evidence for policy, with the international community recognising that successful disaster risk reduction (DRR) depends on it. Reflecting this ambition, science is included as a core aspect of the Sendai Framework for Disaster Risk Reduction 2015-2030, although the ways in which this will be implemented in practice is still unclear. This paper aims to inform the implementation of international science coordination for DRR by examining a number of existing international science partnerships used across other relevant areas of policy to understand best practice, options for coordination and lessons identified. In the field of DRR, the science-policy interface needs to be strengthened in line with the best practice described in this review. An enhanced UNISDR Scientific and Technical Advisory Group will be given the mandate for to enhance the evidence base for DRR and mobilise science and technical work in coordination with a broad range of stakeholders. The structure and function of an enhanced STAG must be as open, as inclusive and as participatory as possible in order to build trust in new and existing institutions at local, national, regional and global levels. The challenge for the international community is to facilitate evidence-based policy making by formally recognising the links between DRR, development finance, sustainable development and climate change in the upcoming post-2015 agreements.

  18. Application of Probabilistic Modeling to Quantify the Reduction Levels of Hepatocellular Carcinoma Risk Attributable to Chronic Aflatoxins Exposure.

    Science.gov (United States)

    Wambui, Joseph M; Karuri, Edward G; Ojiambo, Julia A; Njage, Patrick M K

    2017-01-01

    Epidemiological studies show a definite connection between areas of high aflatoxin content and a high occurrence of human hepatocellular carcinoma (HCC). Hepatitis B virus in individuals further increases the risk of HCC. The two risk factors are prevalent in rural Kenya and continuously predispose the rural populations to HCC. A quantitative cancer risk assessment therefore quantified the levels at which potential pre- and postharvest interventions reduce the HCC risk attributable to consumption of contaminated maize and groundnuts. The assessment applied a probabilistic model to derive probability distributions of HCC cases and percentage reductions levels of the risk from secondary data. Contaminated maize and groundnuts contributed to 1,847 ± 514 and 158 ± 52 HCC cases per annum, respectively. The total contribution of both foods to the risk was additive as it resulted in 2,000 ± 518 cases per annum. Consumption and contamination levels contributed significantly to the risk whereby lower age groups were most affected. Nonetheless, pre- and postharvest interventions might reduce the risk by 23.0-83.4% and 4.8-95.1%, respectively. Therefore, chronic exposure to aflatoxins increases the HCC risk in rural Kenya, but a significant reduction of the risk can be achieved by applying specific pre- and postharvest interventions.

  19. 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...

  20. Designing a Physical Security System for Risk Reduction in a Hypothetical Nuclear Facility

    International Nuclear Information System (INIS)

    Saleh, A.A.; Abd Elaziz, M.

    2017-01-01

    Physical security in a nuclear facility means detection, prevention and response to threat, the ft, sabotage, unauthorized access and illegal transfer involving radioactive and nuclear material. This paper proposes a physical security system designing concepts to reduce the risk associated with variant threats to a nuclear facility. This paper presents a study of the unauthorized removal and sabotage in a hypothetical nuclear facility considering deter, delay and response layers. More over, the study involves performing any required upgrading to the security system by investigating the nuclear facility layout and considering all physical security layers design to enhance the weakness for risk reduction

  1. Reduction of diabetes risk in routine clinical practice: are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Morrell Stephen L

    2010-10-01

    Full Text Available Abstract Background The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from randomised trials of structured, intensive interventions conducted in several countries over the past two decades. The challenge is to translate them into routine clinical settings. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care settings are feasible and effective in achieving reductions in risk factors for diabetes. Methods Data sources: MEDLINE (PubMed, EMBASE, CINAHL, The Cochrane Library, Google Scholar, and grey literature were searched for English-language articles published from January 1990 to August 2009. The reference lists of all articles collected were checked to ensure that no relevant suitable studies were missed. Study selection: We included RCTs, before/after evaluations, cohort studies with or without a control group and interrupted time series analyses of lifestyle interventions with the stated aim of diabetes risk reduction or diabetes prevention, conducted in routine clinical settings and delivered by healthcare providers such as family physicians, practice nurses, allied health personnel, or other healthcare staff associated with a health service. Outcomes of interest were weight loss, reduction in waist circumference, improvement of impaired fasting glucose or oral glucose tolerance test (OGTT results, improvements in fat and fibre intakes, increased level of engagement in physical activity and reduction in diabetes incidence. Results Twelve from 41 potentially relevant studies were included in the review. Four studies were suitable for meta-analysis. A significant positive effect of the interventions on weight was reported by all study types. The meta-analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year

  2. Reduction of diabetes risk in routine clinical practice: are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis.

    Science.gov (United States)

    Cardona-Morrell, Magnolia; Rychetnik, Lucie; Morrell, Stephen L; Espinel, Paola T; Bauman, Adrian

    2010-10-29

    The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from randomised trials of structured, intensive interventions conducted in several countries over the past two decades. The challenge is to translate them into routine clinical settings. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care settings are feasible and effective in achieving reductions in risk factors for diabetes. MEDLINE (PubMed), EMBASE, CINAHL, The Cochrane Library, Google Scholar, and grey literature were searched for English-language articles published from January 1990 to August 2009. The reference lists of all articles collected were checked to ensure that no relevant suitable studies were missed. We included RCTs, before/after evaluations, cohort studies with or without a control group and interrupted time series analyses of lifestyle interventions with the stated aim of diabetes risk reduction or diabetes prevention, conducted in routine clinical settings and delivered by healthcare providers such as family physicians, practice nurses, allied health personnel, or other healthcare staff associated with a health service. Outcomes of interest were weight loss, reduction in waist circumference, improvement of impaired fasting glucose or oral glucose tolerance test (OGTT) results, improvements in fat and fibre intakes, increased level of engagement in physical activity and reduction in diabetes incidence. Twelve from 41 potentially relevant studies were included in the review. Four studies were suitable for meta-analysis. A significant positive effect of the interventions on weight was reported by all study types. The meta-analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year. However, no clear effects on biochemical or clinical parameters were observed, possibly

  3. 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.

  4. Moderation and Mediation of an Efficacious Sexual Risk-Reduction Intervention for South African Adolescents

    Science.gov (United States)

    O’Leary, Ann; Jemmott, John B.; Jemmott, Loretta Sweet; Bellamy, Scarlett; Ngwane, Zolani; Icard, Larry

    2015-01-01

    Background “Let Us Protect Our Future” is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period. Purpose The present analyses were conducted to identify moderators of the intervention’s efficacy as well as which theory-based variables mediated the intervention’s effects. Methods: Intervention efficacy over the 3-, 6-, and 12-month follow-ups was tested using generalized estimating equation (GEE) models. Results Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention’s effect on abstinence. Conclusions This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents. PMID:22618963

  5. How can health care organisations make and justify decisions about risk reduction? Lessons from a cross-industry review and a health care stakeholder consensus development process

    International Nuclear Information System (INIS)

    Sujan, Mark A.; Habli, Ibrahim; Kelly, Tim P.; Gühnemann, Astrid; Pozzi, Simone; Johnson, Christopher W.

    2017-01-01

    Interventions to reduce risk often have an associated cost. In UK industries decisions about risk reduction are made and justified within a shared regulatory framework that requires that risk be reduced as low as reasonably practicable. In health care no such regulatory framework exists, and the practice of making decisions about risk reduction is varied and lacks transparency. Can health care organisations learn from relevant industry experiences about making and justifying risk reduction decisions? This paper presents lessons from a qualitative study undertaken with 21 participants from five industries about how such decisions are made and justified in UK industry. Recommendations were developed based on a consensus development exercise undertaken with 20 health care stakeholders. The paper argues that there is a need in health care to develop a regulatory framework and an agreed process for managing explicitly the trade-off between risk reduction and cost. The framework should include guidance about a health care specific notion of acceptable levels of risk, guidance about standardised risk reduction interventions, it should include regulatory incentives for health care organisations to reduce risk, and it should encourage the adoption of an approach for documenting explicitly an organisation's risk position. - Highlights: • Empirical description of industry perceptions on making risk reduction decisions. • Health care consensus development identified five recommendations. • Risk concept should be better integrated into safety management. • Education and awareness about risk concept are required. • Health systems need to start a dialogue about acceptable levels of risk.

  6. Is there evidence showing that salt intake reduction reduces cardiovascular morbidity and mortality risk?

    Directory of Open Access Journals (Sweden)

    Fernando Lanas

    2012-02-01

    Full Text Available A recent systematic review of Cochrane collaboration about the effect of reducing dietary salt concluded that “there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity in normotensive or hypertensive populations”. This conclusion has generated an important debate, because the estimation that salt reduction can prevent 24% of strokes and 18% of myocardial infarctions has decided the health authorities of several nations to implement salt consumption reduction programs. The review of ecological studies and clinical trials allow to conclude that a reduction in salt consumption reduces blood pressure and methodological well conducted cohort studies has shown that cardiovascular events risk decreases progressively with lower levels of blood pressure. Combining this two finding we can assume that population should benefice from a decrease on salt consumption although there are no studies that shown a reduction in cardiovascular events in population with high sodium intake when dietary salt is reduced.

  7. Therapeutical approach to plasma homocysteine and cardiovascular risk reduction

    Directory of Open Access Journals (Sweden)

    Marcello Ciaccio

    2008-03-01

    Full Text Available Marcello Ciaccio, Giulia Bivona, Chiara BelliaDepartment of Medical Biotechnologies and Forensic Medicine, Faculty of Medicine, University of Palermo, ItalyAbstract: Homocysteine is a sulfur-containing aminoacid produced during metabolism of methionine. Since 1969 the relationship between altered homocysteine metabolism and both coronary and peripheral atherotrombosis is known; in recent years experimental evidences have shown that elevated plasma levels of homocysteine are associated with an increased risk of atherosclerosis and cardiovascular ischemic events. Several mechanisms by which elevated homocysteine impairs vascular function have been proposed, including impairment of endothelial function, production of reactive oxygen species (ROS and consequent oxidation of low-density lipids. Endothelial function is altered in subjects with hyperhomocysteinemia, and endothelial dysfunction is correlated with plasma levels of homocysteine. Folic acid and B vitamins, required for remethylation of homocysteine to methionine, are the most important dietary determinants of homocysteine and daily supplementation typically lowers plasma homocysteine levels; it is still unclear whether the decreased plasma levels of homocysteine through diet or drugs may be paralleled by a reduction in cardiovascular risk.Keywords: homocysteine, MTHFR, cardiovascular disease, folate, B vitamin

  8. Nutritional approaches in the risk reduction and management of Alzheimer's disease.

    Science.gov (United States)

    Mi, Weiqian; van Wijk, Nick; Cansev, Mehmet; Sijben, John W C; Kamphuis, Patrick J G H

    2013-09-01

    Alzheimer's disease (AD) is a heterogeneous and devastating neurodegenerative disease with increasing socioeconomic burden for society. In the past 30 y, notwithstanding advances in the understanding of the pathogenesis of the disease and consequent development of therapeutic approaches to novel pathogenic targets, no cure has so far emerged. This contribution focuses on recent nutritional approaches in the risk reduction and management of AD with emphasis on factors providing a rationale for nutritional approaches in AD, including compromised nutritional status, altered nutrient uptake and metabolism, and nutrient requirements for synapse formation. Collectively these factors are believed to result in specific nutritional requirement in AD. The chapter also emphasizes investigated nutritional interventions in patients with AD, including studies with single nutrients and with the specific nutrient combination Fortasyn Connect and discusses the current shift of paradigm to intervene in earlier stages of AD, which offers opportunities for investigating nutritional strategies to reduce the risk for disease progression. Fortasyn Connect was designed to enhance synapse formation and function in AD by addressing the putative specific nutritional requirements and contains docosahexaenoic acid, eicosapentaenoic acid, uridine-5'-mono-phosphate, choline, phospholipids, antioxidants, and B vitamins. Two randomized controlled trials (RCTs) with the medical food Souvenaid, containing Fortasyn Connect, showed that this intervention improved memory performance in mild, drug-naïve patients with AD. Electroencephalography outcome in one of these clinical studies suggests that Souvenaid has an effect on brain functional connectivity, which is a derivative of changed synaptic activity. Thus, these studies suggest that nutritional requirements in AD can be successfully addressed and result in improvements in behavioral and neuro-physiological alterations that are characteristic to AD

  9. Evaluation of a Peer-Led Drug Abuse Risk Reduction Project for Runaway/Homeless Youths.

    Science.gov (United States)

    Fors, Stuart W.; Jarvis, Sara

    1995-01-01

    Evaluates the Drug Prevention in Youth risk reduction program that was implemented in shelters for runaway/homeless youths in the southeastern United States. An evaluation strategy was developed allowing for comparisons between peer-led, adult-led and nonintervention groups. Well-trained and motivated peer/near-peer leaders made particularly…

  10. 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.

  11. 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.

    2014-01-01

    Objective To evaluate providers’ perspectives regarding the delivery of prenatal care to women with psychosocial risk factors. Methods A random, national sample of 2095 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. Results 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. Conclusions 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. PMID:24740719

  12. Performing the lockout/tagout risk assessment.

    Science.gov (United States)

    Wallace, W Jon

    2007-03-01

    Lockout/tagout provides the greatest level routine, repetitive, and integral to the production process, a risk assessment should be performed. If the task performed poses an unacceptable risk, acceptable risk reduction methods should be implemented to reduce the risk to acceptable levels.

  13. Communication products for the Science Application for Risk Reduction (SAFRR) tsunami scenario: Chapter K in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Perry, Suzanne C.

    2013-01-01

    Science Application for Risk Reduction (SAFRR), like its predecessor the Multi-Hazards Demonstration Project, has a mission to increase the use of science by decision-makers of all kinds. Thus, an important part of any SAFRR scenario is development of products that enhance usability of the science. In this tsunami scenario, the focus has been on development of three kinds of products: products that augment typical outputs of scientific studies, such as reports, to make the results of the scenario more relevant and usable to nonscientists; products that distill local impacts and allow users in specific locales to identify which aspects of the broad regional study apply to their local area; and

  14. Reduction of radiation risks in patients undergoing some X-ray examinations by using optimal projections: A Monte Carlo program-based mathematical calculation

    Directory of Open Access Journals (Sweden)

    A Chaparian

    2014-01-01

    Full Text Available The objectives of this paper were calculation and comparison of the effective doses, the risks of exposure-induced cancer, and dose reduction in the gonads for male and female patients in different projections of some X-ray examinations. Radiographies of lumbar spine [in the eight projections of anteroposterior (AP, posteroanterior (PA, right lateral (RLAT, left lateral (LLAT, right anterior-posterior oblique (RAO, left anterior-posterior oblique (LAO, right posterior-anterior oblique (RPO, and left posterior-anterior oblique (LPO], abdomen (in the two projections of AP and PA, and pelvis (in the two projections of AP and PA were investigated. A solid-state dosimeter was used for the measuring of the entrance skin exposure. A Monte Carlo program was used for calculation of effective doses, the risks of radiation-induced cancer, and doses to the gonads related to the different projections. Results of this study showed that PA projection of abdomen, lumbar spine, and pelvis radiographies caused 50%-57% lower effective doses than AP projection and 50%-60% reduction in radiation risks. Also use of LAO projection of lumbar spine X-ray examination caused 53% lower effective dose than RPO projection and 56% and 63% reduction in radiation risk for male and female, respectively, and RAO projection caused 28% lower effective dose than LPO projection and 52% and 39% reduction in radiation risk for males and females, respectively. About dose reduction in the gonads, using of the PA position rather than AP in the radiographies of the abdomen, lumbar spine, and pelvis can result in reduction of the ovaries doses in women, 38%, 31%, and 25%, respectively and reduction of the testicles doses in males, 76%, 86%, and 94%, respectively. Also for oblique projections of lumbar spine X-ray examination, with employment of LAO rather than RPO and also RAO rather than LPO, demonstrated 22% and 13% reductions to the ovaries doses and 66% and 54% reductions in the

  15. Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal.

    Science.gov (United States)

    Poudel, Krishna C; Buchanan, David R; Poudel-Tandukar, Kalpana

    2015-06-01

    We evaluated the efficacy of a sexual risk reduction intervention utilizing protection motivation and social cognitive theories to address knowledge, threat and coping appraisals, and condom use intentions among HIV-positive individuals in Nepal. Using a quasi-experimental research design, we assigned 277 participants to intervention (n=146) and control (n=131) groups. The intervention group received six sessions on sexual risk reduction strategies and the control group six sessions on medication adherence, smoking, and mental health. Data were collected at baseline and immediately after the intervention. Results indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners. The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders. In conclusion, our theory-based sexual risk reduction intervention was effective in improving HIV transmission knowledge, perceived threat and coping appraisals, and condom use intentions. Further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors.

  16. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Tracy L. Schumacher

    2016-09-01

    Full Text Available Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18–70 years, 47% male, five with CVD diagnosis. Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived “need” to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family “ringleader” to influence involvement and capitalising on personal accountability to other family members.

  17. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease.

    Science.gov (United States)

    Schumacher, Tracy L; Burrows, Tracy L; Thompson, Deborah I; Callister, Robin; Spratt, Neil J; Collins, Clare E

    2016-09-30

    Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.

  18. Breast Reduction Surgery

    Science.gov (United States)

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as ...

  19. 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.

  20. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report of the co-ordinated research programme

    International Nuclear Information System (INIS)

    Lochard, Jacques

    1989-08-01

    This report presents the three French case studies performed in the framework of the coordinated research program on 'Comparison of Cost-effectiveness of Risk Reduction among different Energy Systems': Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; Cost-effectiveness of protection actions to reduce occupational exposures in underground uranium mines; Cost-effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains

  1. 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...

  2. 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

  3. New GOES-R Risk Reduction Activities at CIRA

    Science.gov (United States)

    Rogers, M. A.; Miller, S. D.; Grasso, L. D.; Haynes, J. M.; NOH, Y. J.; Forsythe, J.; Zupanski, M.; Lindsey, D. T.

    2017-12-01

    A team of atmospheric scientists at the Cooperative Institute for Research in the Atmosphere (CIRA) at the Colorado State University has been selected by the National Oceanic and Atmospheric Administration's (NOAA) GOES-R Risk Reduction (GOES-R3) science program to develop applications to enhance the utilization of the GOES-R sensors, including the Advanced Baseline Imager (ABI) and the Geostationary Lightning Mapper (GLM). The selected project topics follow NOAA's Research and Development Objectives listed in its 5-year Strategic Plan. The projects will be carried out over a three-year period which started on 1 July 2017 and will end on 30 June 2019. CIRA is working on five GOES-R3 application developments: 1) Developing an Environmental Awareness Repertoire of ABI Imagery (`DEAR-ABII') to Advise the Operational Weather Forecaster. DEAR-ABII maximizes the vast potential of the new GOES-R/GOES-16 sensor technology. 2) GOES-R ABI channel differencing used to reveal cloud-free zones of `precursors of convective initiation'. This product identifies where convective initiation may occur in cloud free skies. 3) Improving the ABI Cloud Layers Product for Multiple Layer Cloud Systems and Aviation Forecast Applications. This project aims to improve the GOES-16 cloud layer product by providing information on the boundaries of cloud layers even when one layer overlies another. 4) Using the New Capabilities of GOES-R to Improve Blended, Multisensor Water Vapor Products for Forecasters. GOES-R TPW retrievals will be merged with TPW derived from polar orbiter and surface data to improve the operational NOAA blended TPW product. 5) Data assimilation of GLM observations in HWRF/GSI system. Assimilation of GOES-R GLM observations for the NOAA operational hurricane model with the goal to improve operational hurricane forecasting. Examples for each of these applications will be presented.

  4. Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

    Directory of Open Access Journals (Sweden)

    Sarah Bandali

    2014-01-01

    Full Text Available The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs.

  5. Communicating Treatment Risk Reduction to People With Low Numeracy Skills: A Cross-Cultural Comparison

    Science.gov (United States)

    2009-01-01

    Objectives. We sought to address denominator neglect (i.e. the focus on the number of treated and nontreated patients who died, without sufficiently considering the overall numbers of patients) in estimates of treatment risk reduction, and analyzed whether icon arrays aid comprehension. Methods. We performed a survey of probabilistic, national samples in the United States and Germany in July and August of 2008. Participants received scenarios involving equally effective treatments but differing in the overall number of treated and nontreated patients. In some conditions, the number who received a treatment equaled the number who did not; in others the number was smaller or larger. Some participants received icon arrays. Results. Participants—particularly those with low numeracy skills—showed denominator neglect in treatment risk reduction perceptions. Icon arrays were an effective method for eliminating denominator neglect. We found cross-cultural differences that are important in light of the countries' different medical systems. Conclusions. Problems understanding numerical information often reside not in the mind but in the problem's representation. These findings suggest suitable ways to communicate quantitative medical data. PMID:19833983

  6. 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.

  7. 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.

  8. Hand hygiene regimens for the reduction of risk in food service environments.

    Science.gov (United States)

    Edmonds, Sarah L; McCormack, Robert R; Zhou, Sifang Steve; Macinga, David R; Fricker, Christopher M

    2012-07-01

    Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities.

  9. Reducing shame in a game that predicts HIV risk reduction for young adult MSM: a randomized trial delivered nationally over the Web.

    Science.gov (United States)

    Christensen, John L; Miller, Lynn Carol; Appleby, Paul Robert; Corsbie-Massay, Charisse; Godoy, Carlos Gustavo; Marsella, Stacy C; Read, Stephen J

    2013-11-13

    Men who have sex with men (MSM) often face socially sanctioned disapproval of sexual deviance from the heterosexual "normal." Such sexual stigma can be internalized producing a painful affective state (i.e., shame). Although shame (e.g., addiction) can predict risk-taking (e.g., alcohol abuse), sexual shame's link to sexual risk-taking is unclear. Socially Optimized Learning in Virtual Environments (SOLVE) was designed to reduce MSM's sexual shame, but whether it does so, and if that reduction predicts HIV risk reduction, is unclear. To test if at baseline, MSM's reported past unprotected anal intercourse (UAI) is related to shame; MSM's exposure to SOLVE compared to a wait-list control (WLC) condition reduces MSM's shame; and shame-reduction mediates the link between WLC condition and UAI risk reduction. HIV-negative, self-identified African American, Latino or White MSM, aged 18-24 years, who had had UAI with a non-primary/casual partner in the past three months were recruited for a national online study. Eligible MSM were computer randomized to either WLC or a web-delivered SOLVE. Retained MSM completed baseline measures (e.g., UAI in the past three months; current level of shame) and, in the SOLVE group, viewed at least one level of the game. At the end of the first session, shame was measured again. MSM completed follow-up UAI measures three months later. All data from 921 retained MSM (WLC condition, 484; SOLVE condition, 437) were analyzed, with missing data multiply imputed. At baseline, MSM reporting more risky sexual behaviour reported more shame (r s=0.21; peffect was significant (point estimate -0.10, 95% bias-corrected CI [-0.01 to -0.23] such that participants in the SOLVE treatment condition reported greater reductions in shame, which in turn predicted reductions in risky sexual behaviour at follow-up. The direct effect, however, was not significant. SOLVE is the first intervention to: (1) significantly reduce shame for MSM; and (2) demonstrate that

  10. 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

  11. Risk-based enteric pathogen reduction targets for non-potable and direct potable use of roof runoff, stormwater, and greywater

    Science.gov (United States)

    This paper presents risk-based enteric pathogen log reduction targets for non-potable and potable uses of a variety of alternative source waters (i.e., locally-collected greywater, roof runoff, and stormwater). A probabilistic Quantitative Microbial Risk Assessment (QMRA) was use...

  12. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report of the co-ordinated research programme

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, Jacques [ed.

    1989-08-01

    This report presents the three French case studies performed in the framework of the coordinated research program on 'Comparison of Cost-effectiveness of Risk Reduction among different Energy Systems': Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; Cost-effectiveness of protection actions to reduce occupational exposures in underground uranium mines; Cost-effectiveness of safety measures to reduce public risk associated with the transportation of UF{sub 6} by truck and trains.

  13. 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…

  14. Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

    Science.gov (United States)

    Igel, L I; Saunders, K H; Fins, J J

    2018-05-21

    In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

  15. Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees.

    Science.gov (United States)

    Lenz, Thomas L; Gillespie, Nicole D; Skrabal, Maryann Z; Faulkner, Michele A; Skradski, Jessica J; Ferguson, Liz A; Pagenkemper, Joni J; Moore, Geri A; Jorgensen, Diane

    2013-03-01

    A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

  16. Comparing expressed and revealed preferences for risk reduction: different hazards and question frames

    International Nuclear Information System (INIS)

    McDaniels, T.L.

    1988-01-01

    Studies often note the wide differences that exist in costs per death avoided across US federal programs and regulatory contexts. This paper explores two new, related explanations for these differences. First, it argues that the patterns of revealed preferences (public allocations) may be related to public values, which are measured here through subjects' expressed preference responses to a contingent valuation survey regarding risk reduction. Subjects' expressed values are compared to actual (and proposed) costs of safety regulations for a similar set of hazards. The authors discover strong congruence in the ranking of expressed values and actual values. Second, the paper presents the results of a subsequent survey that investigates why the patterns observed in the first survey might occur. It suggests that one reason for the observed similarities between revealed and expressed preferences may be in how choices are framed. The paper hypothesizes that both subjects and decision makers may frame valuation decisions in the same way: as percentage changes from the reference point provided by the base rate of deaths for that hazard

  17. Prognostic indicators for failed nonsurgical reduction of intussusception

    Directory of Open Access Journals (Sweden)

    Khorana J

    2016-08-01

    Full Text Available Jiraporn Khorana,1 Jesda Singhavejsakul,1 Nuthapong Ukarapol,2 Mongkol Laohapensang,3 Jakraphan Siriwongmongkol,1 Jayanton Patumanond4 1Division of Pediatric Surgery, Department of Surgery, 2Division of Gastroenterology, Department of Pediatrics, Chiang Mai University Hospital, Chiang Mai, 3Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, 4Center of Excellence in Applied Epidemiology, Thammasat University Hospital, Pathumthani, Thailand Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0–15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004, symptom duration >3 days (RR =1.26, P<0.001, vomiting (RR =1.63, P<0.001, rectal bleeding (RR =1.50, P<0.001, abdominal distension (RR =1.60, P=0.003, temperature >37.8°C (RR =1.51, P<0.001, palpable abdominal mass (RR =1.26, P<0.001, location of mass (left over right side (RR =1.48, P<0.001, poor prognostic signs on ultrasound scans (RR =1.35, P<0.001, and method of reduction (hydrostatic over pneumatic (RR =1

  18. Development of a module for Cost-Benefit analysis of risk reduction measures for natural hazards for the CHANGES-SDSS platform

    Science.gov (United States)

    Berlin, Julian; Bogaard, Thom; Van Westen, Cees; Bakker, Wim; Mostert, Eric; Dopheide, Emile

    2014-05-01

    Cost benefit analysis (CBA) is a well know method used widely for the assessment of investments either in the private and public sector. In the context of risk mitigation and the evaluation of risk reduction alternatives for natural hazards its use is very important to evaluate the effectiveness of such efforts in terms of avoided monetary losses. However the current method has some disadvantages related to the spatial distribution of the costs and benefits, the geographical distribution of the avoided damage and losses, the variation in areas that are benefited in terms of invested money and avoided monetary risk. Decision-makers are often interested in how the costs and benefits are distributed among different administrative units of a large area or region, so they will be able to compare and analyse the cost and benefits per administrative unit as a result of the implementation of the risk reduction projects. In this work we first examined the Cost benefit procedure for natural hazards, how the costs are assessed for several structural and non-structural risk reduction alternatives, we also examined the current problems of the method such as the inclusion of cultural and social considerations that are complex to monetize , the problem of discounting future values using a defined interest rate and the spatial distribution of cost and benefits. We also examined the additional benefits and the indirect costs associated with the implementation of the risk reduction alternatives such as the cost of having a ugly landscape (also called negative benefits). In the last part we examined the current tools and software used in natural hazards assessment with support to conduct CBA and we propose design considerations for the implementation of the CBA module for the CHANGES-SDSS Platform an initiative of the ongoing 7th Framework Programme "CHANGES of the European commission. Keywords: Risk management, Economics of risk mitigation, EU Flood Directive, resilience, prevention

  19. Susceptibility of murine norovirus and hepatitis A virus to electron beam irradiation in oysters and quantifying the reduction in potential infection risks.

    Science.gov (United States)

    Praveen, Chandni; Dancho, Brooke A; Kingsley, David H; Calci, Kevin R; Meade, Gloria K; Mena, Kristina D; Pillai, Suresh D

    2013-06-01

    Consumption of raw oysters is an exposure route for human norovirus (NoV) and hepatitis A virus (HAV). Therefore, efficient postharvest oyster treatment technology is needed to reduce public health risks. This study evaluated the inactivation of HAV and the NoV research surrogate, murine norovirus-1 (MNV-1), in oysters (Crassostrea virginica) by electron beam (E-beam) irradiation. The reduction of potential infection risks was quantified for E-beam irradiation technology employed on raw oysters at various virus contamination levels. The E-beam dose required to reduce the MNV and HAV titer by 90% (D(10) value) in whole oysters was 4.05 (standard deviations [SD], ±0.63) and 4.83 (SD, ±0.08) kGy, respectively. Microbial risk assessment suggests that if a typical serving of 12 raw oysters was contaminated with 10(5) PFU, a 5-kGy treatment would achieve a 12% reduction (from 4.49 out of 10 persons to 3.95 out of 10 persons) in NoV infection and a 16% reduction (from 9.21 out of 10 persons to 7.76 out of 10 persons) in HAV infections. If the serving size contained only 10(2) PFU of viruses, a 5-kGy treatment would achieve a 26% reduction (2.74 out of 10 persons to 2.03 out of 10 persons) of NoV and 91% reduction (2.1 out of 10 persons to 1.93 out of 100 persons) of HAV infection risks. This study shows that although E-beam processing cannot completely eliminate the risk of viral illness, infection risks can be reduced.

  20. A randomized noninferiority trial of standard versus enhanced risk reduction and adherence counseling for individuals receiving post-exposure prophylaxis following sexual exposures to HIV.

    Science.gov (United States)

    Roland, Michelle E; Neilands, Torsten B; Krone, Melissa R; Coates, Thomas J; Franses, Karena; Chesney, Margaret A; Kahn, James S; Martin, Jeffrey N

    2011-07-01

    The National HIV/AIDS Strategy proposes to scale-up post-exposure prophylaxis (PEP). Intensive risk reduction and adherence counseling appear to be effective but are resource intensive. Identifying simpler interventions that maximize the HIV prevention potential of PEP is critical. A randomized noninferiority study comparing 2 (standard) or 5 (enhanced) risk reduction counseling sessions was performed. Adherence counseling was provided in the enhanced arm. We measured changes in unprotected sexual intercourse acts at 12 months, compared with baseline; HIV acquisition; and PEP adherence. Outcomes were stratified by degree of baseline risk. We enrolled 457 individuals reporting unprotected intercourse within 72 h with an HIV-infected or at-risk partner. Participants were 96% male and 71% white. There were 1.8 and 2.3 fewer unprotected sex acts in the standard and enhanced groups. The maximum potential risk difference, reflected by the upper bound of the 95% confidence interval, was 3.9 acts. The difference in the riskier subset may have been as many as 19.6 acts. The incidence of HIV seroconversion was 2.9% and 2.6% among persons randomized to standard and enhanced counseling, respectively, with a maximum potential difference of 3.4%. The absolute and maximal HIV seroconversion incidence was 9.9% and 20.4% greater in the riskier group randomized to standard, compared with enhanced, counseling. Adherence outcomes were similar, with noninferiority in the lower risk group and concerning differences among the higher-risk group. Risk assessment is critical at PEP initiation. Standard counseling is only noninferior for individuals with lower baseline risk; thus, enhanced counseling should be targeted to individuals at higher risk. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

  1. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours.

    Science.gov (United States)

    Wintemute, Garen J

    2011-12-01

    Alcohol use and firearm ownership are risk factors for violent injury and death. To determine whether firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours, the author conducted a cross-sectional study using Behavioral Risk Factor Surveillance System data for eight states in the USA from 1996 to 1997 (the most recent data available). Altogether, 15 474 respondents provided information on firearm exposure. After adjustment for demographics and state of residence, firearm owners were more likely than those with no firearms at home to have ≥5 drinks on one occasion (OR 1.32; 95% CI 1.16 to 1.50), to drink and drive (OR 1.79; 95% CI 1.34 to 2.39) and to have ≥60 drinks per month (OR 1.45; 95% CI 1.14 to 1.83). Heavy alcohol use was most common among firearm owners who also engaged in behaviours such as carrying a firearm for protection against other people and keeping a firearm at home that was both loaded and not locked away. The author concludes that firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours.

  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. Forging process design for risk reduction

    Science.gov (United States)

    Mao, Yongning

    In this dissertation, forging process design has been investigated with the primary concern on risk reduction. Different forged components have been studied, especially those ones that could cause catastrophic loss if failure occurs. As an effective modeling methodology, finite element analysis is applied extensively in this work. Three examples, titanium compressor disk, superalloy turbine disk, and titanium hip prosthesis, have been discussed to demonstrate this approach. Discrete defects such as hard alpha anomalies are known to cause disastrous failure if they are present in those stress critical components. In this research, hard-alpha inclusion movement during forging of titanium compressor disk is studied by finite element analysis. By combining the results from Finite Element Method (FEM), regression modeling and Monte Carlo simulation, it is shown that changing the forging path is able to mitigate the failure risk of the components during the service. The second example goes with a turbine disk made of superalloy IN 718. The effect of forging on microstructure is the main consideration in this study. Microstructure defines the as-forged disk properties. Considering specific forging conditions, preform has its own effect on the microstructure. Through a sensitivity study it is found that forging temperature and speed have significant influence on the microstructure. In order to choose the processing parameters to optimize the microstructure, the dependence of microstructure on die speed and temperature is thoroughly studied using design of numerical experiments. For various desired goals, optimal solutions are determined. The narrow processing window of titanium alloy makes the isothermal forging a preferred way to produce forged parts without forging defects. However, the cost of isothermal forging (dies at the same temperature as the workpiece) limits its wide application. In this research, it has been demonstrated that with proper process design, the die

  4. Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure.

    Science.gov (United States)

    Benotti, Peter N; Wood, G Craig; Carey, David J; Mehra, Vishal C; Mirshahi, Tooraj; Lent, Michelle R; Petrick, Anthony T; Still, Christopher; Gerhard, Glenn S; Hirsch, Annemarie G

    2017-05-23

    Obesity and its association with reduced life expectancy are well established, with cardiovascular disease as one of the major causes of fatality. Metabolic surgery is a powerful intervention for severe obesity, resulting in improvement in comorbid diseases and in cardiovascular risk factors. This study investigates the relationship between metabolic surgery and long-term cardiovascular events. A cohort of Roux-en-Y gastric bypass surgery (RYGB) patients was tightly matched by age, body mass index, sex, Framingham Risk Score, smoking history, use of antihypertension medication, diabetes mellitus status, and calendar year with a concurrent cohort of nonoperated control patients. The primary study end points of major cardiovascular events (myocardial infarction, stroke, and congestive heart failure) were evaluated using Cox regression. Secondary end points of longitudinal cardiovascular risk factors were evaluated using repeated-measures regression. The RYGB and matched controls (N=1724 in each cohort) were followed for up to 12 years after surgery (overall median of 6.3 years). Kaplan-Meier analysis revealed a statistically significant reduction in incident major composite cardiovascular events ( P =0.017) and congestive heart failure (0.0077) for the RYGB cohort. Adjusted Cox regression models confirmed the reductions in severe composite cardiovascular events in the RYGB cohort (hazard ratio=0.58, 95% CI=0.42-0.82). Improvements of cardiovascular risk factors (eg, 10-year cardiovascular risk score, total cholesterol, high-density lipoprotein, systolic blood pressure, and diabetes mellitus) were observed within the RYGB cohort after surgery. Gastric bypass is associated with a reduced risk of major cardiovascular events and the development of congestive heart failure. © 2017 The Authors and Geisinger Clinic. Published on behalf of the American Heart Association, Inc., by Wiley.

  5. Risk reductions for cardiovascular disease with pravastatin treatment by dyslipidemia phenotype: a post hoc analysis of the MEGA Study.

    Science.gov (United States)

    Nishiwaki, Masato; Ikewaki, Katsunori; Ayaori, Makoto; Mizuno, Kyoichi; Ohashi, Yasuo; Ohsuzu, Fumitaka; Ishikawa, Toshitsugu; Nakamura, Haruo

    2013-03-01

    The beneficial effect of statins for cardiovascular disease (CVD) prevention has been well established. However, the effectiveness among different phenotypes of dyslipidemia has not been confirmed. We evaluated the effect of pravastatin on the incidence of CVD in relation to the phenotype of dyslipidemia. The MEGA Study evaluated the effect of low-dose pravastatin on primary prevention of CVD in 7832 Japanese patients, who were randomized to diet alone or diet plus pravastatin and followed for more than 5 years. These patients were classified into phenotype IIa (n=5589) and IIb (n=2041) based on the electrophoretic pattern for this post hoc analysis. In the diet group there was no significant difference in the incidence of coronary heart disease (CHD), stroke, CVD, and total mortality between the two phenotypes. Phenotype IIb patients, compared to phenotype IIa, had lower levels of high-density lipoprotein cholesterol (HDL-C) and a significantly higher incidence of CVD in relation to a low HDL-C level (dyslipidemia. Significant risk reductions were observed for CHD by 38% (p=0.04) and CVD by 31% (p=0.02) in type IIa dyslipidemia but not in phenotype IIb. Pravastatin therapy provided significant risk reductions for CHD and CVD in patients with phenotype IIa dyslipidemia, but not in those with phenotype IIb dyslipidemia. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Tom P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Technologies Area. Building Technology and Urban Systems Division

    2016-08-22

    This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses in these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.

  7. Impact of a computer-assisted, provider-delivered intervention on sexual risk behaviors in HIV-positive men who have sex with men (MSM) in a primary care setting.

    Science.gov (United States)

    Bachmann, Laura H; Grimley, Diane M; Gao, Hongjiang; Aban, Inmaculada; Chen, Huey; Raper, James L; Saag, Michael S; Rhodes, Scott D; Hook, Edward W

    2013-04-01

    Innovative strategies are needed to assist providers with delivering secondary HIV prevention in the primary care setting. This longitudinal HIV clinic-based study conducted from 2004-2007 in a Birmingham, Alabama HIV primary care clinic tested a computer-assisted, provider-delivered intervention designed to increase condom use with oral, anal and vaginal sex, decrease numbers of sexual partners and increase HIV disclosure among HIV-positive men-who-have-sex-with-men (MSM). Significant declines were found for the number of unprotected insertive anal intercourse acts with HIV+ male partners during the intervention period (p = 0.0003) and with HIV-/UK male partners (p = 0.0007), as well as a 47% reduction in the number of male sexual partners within the preceding 6 months compared with baseline (p = 0.0008). These findings confirm and extend prior reports by demonstrating the effectiveness of computer-assisted, provider-delivered messaging to accomplish risk reduction in patients in the HIV primary care setting.

  8. Correlates of HIV Risk Reduction Self-Efficacy among Youth in South Africa

    Directory of Open Access Journals (Sweden)

    Julia Louw

    2012-01-01

    Full Text Available Even though a decline in HIV prevalence has been reported among South African youth 15–24 from 10.3% in 2005 to 8.6% in 2008, the prevalence remains disproportionately high for females overall in comparison to males. This study examines factors associated by HIV risk reduction self-efficacy of South African youth as part of an evaluation of the impact of loveLife, a youth focused HIV prevention programme. A cross-sectional population-based household survey was conducted with persons of ages 18 to 24 years in four selected provinces in South Africa. Among female respondents (, factors associated with high self-efficacy in the adjusted model were having a low HIV risk perception, HIV/AIDS stigma, ever using drugs, and having life goals. Male respondents ( with high self-efficacy were more likely to have been tested for HIV, have concurrent sexual partners, have had a transactional sex partner in lifetime, a low HIV risk perception, difficulty in having condoms, agreed with coercive sex, high relationship control, and had loveLife face-to-face programme participation. The factors identified with high self-efficacy and HIV-sexual risk behaviour may be considered to strengthen youth HIV prevention programmes in South Africa.

  9. Evaluation of severe accident risks and the potential for risk reduction: Peach Bottom, Unit 2. Main report. Draft for comment, February 1987

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C N [Technadyne Engineering Consultants, Inc., Albuquerque, NM (United States); Benjamin, A S; Griesmeyer, J M; Haskin, F E; Kunsman, D M [Sandia National Laboratories, Albuquerque, NM (United States); Boyd, G J; Lewis, S R [Safety and Reliability Optimization Services, Inc., Knoxville, TN (United States); Helton, J C [Arizona State University, Tempe, AZ (United States); Smith, L N [Science Applications International Corporation, Albuquerque, NM (United States)

    1987-04-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a boiling water reactor with a Mark I containment (Peach Bottom, Unit 2). 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 low relative to previous studies; for example, most of the uncertainty range is lower than the point estimate of risk for the Peach Bottom plant in the Reactor Safety Study (RSS). However, certain unresolved issues cause the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. These issues include the modeling of the common-mode failures for the dc power system, the likelihood of offsite power recovery versus time during a station blackout, the probability of drywell failure resulting from meltthrough of the drywell shell, the magnitude of the fission product releases during core-concrete interactions, and the decontamination effectiveness of the reactor enclosure building. Most of the postulated safety options do not appear to be cost effective, although some based on changes to procedures or inexpensive hardware additions may be marginally cost effective. This draft for comment of the SARRP report for Peach Bottom does not include detailed technical appendices, which are still in preparation. The appendices will be issued under separate cover when completed. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150. (author)

  10. Psychological impact of providing women with personalised 10-year breast cancer risk estimates.

    Science.gov (United States)

    French, David P; Southworth, Jake; Howell, Anthony; Harvie, Michelle; Stavrinos, Paula; Watterson, Donna; Sampson, Sarah; Evans, D Gareth; Donnelly, Louise S

    2018-05-08

    The Predicting Risk of Cancer at Screening (PROCAS) study estimated 10-year breast cancer risk for 53,596 women attending NHS Breast Screening Programme. The present study, nested within the PROCAS study, aimed to assess the psychological impact of receiving breast cancer risk estimates, based on: (a) the Tyrer-Cuzick (T-C) algorithm including breast density or (b) T-C including breast density plus single-nucleotide polymorphisms (SNPs), versus (c) comparison women awaiting results. A sample of 2138 women from the PROCAS study was stratified by testing groups: T-C only, T-C(+SNPs) and comparison women; and by 10-year risk estimates received: 'moderate' (5-7.99%), 'average' (2-4.99%) or 'below average' (<1.99%) risk. Postal questionnaires were returned by 765 (36%) women. Overall state anxiety and cancer worry were low, and similar for women in T-C only and T-C(+SNPs) groups. Women in both T-C only and T-C(+SNPs) groups showed lower-state anxiety but slightly higher cancer worry than comparison women awaiting results. Risk information had no consistent effects on intentions to change behaviour. Most women were satisfied with information provided. There was considerable variation in understanding. No major harms of providing women with 10-year breast cancer risk estimates were detected. Research to establish the feasibility of risk-stratified breast screening is warranted.

  11. Analysis of risk-reduction measures for multiunit essential service water systems

    International Nuclear Information System (INIS)

    Kohut, P.; Musicki, Z.; Fitzpatrick, R.

    1989-01-01

    Many risk analyses have indicated the potentially significant contribution to core damage frequency (CDF) due to the loss of the essential service water (ESW) function. The ESW system serves as the ultimate heat sink, and its failure can affect numerous safety components and systems, although it does not directly perform a frontline safety function. As such, probabilistic risk assessment studies usually analyze its failures through support system modeling; however, the direct loss of the ESW as an initiator may or may not be explicitly treated. In addition, the actual analysis is made more complex due to the linked initiating event nature of these events, since the system fault trees are coupled to the initiator in these cases. Previously, a specific safety issue was identified concerning the increase in core-melt vulnerability caused by the failure of the ESW system in pressurized water reactor (PWR) multiplant units that have only two service water (SW) pumps per unit with a backup crosstie capability to the other unit. The main objective of the present study was to establish a realistic measure of the core damage vulnerability, to identify potential improvements for the ESW systems, and to obtain generic estimates of their risk-reduction potential and cost-effectiveness

  12. 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

  13. 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.

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

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

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

  15. Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

    2017-05-01

    This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

  16. 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.

  17. Building Capacity for Disaster Risk Reduction

    Science.gov (United States)

    McAdoo, B. G.; Bryner, V.

    2013-05-01

    Disaster risk is acutely high in many emerging economies due to a combination of geophysical hazards and social and ecological vulnerabilities. The risk associated with natural hazards can be a critical component of a nation's wealth, hence knowledge of these hazards will affect foreign investment in these emergent economies. On the hazard side of the risk profile, geophysicists research the frequency and magnitude of the extant hazards. These geophysicists, both local and foreign, have a responsibility to communicate these risks in the public sphere - whether they are through the mass media, or in personal conversations. Because of this implicit responsibility, it is incumbent upon geophysicists to understand the overall risk, not just the hazards. When it comes to communicating these risks, local scientists are often more effective because they speak the language, understand the social context, and are often connected to various modes of communication unavailable to foreign researchers. Investment in multidisciplinary undergraduate education is critical, as is training of established local scientists in understanding the complexities of risk assessment as well as communicating these risks effectively to broad audiences. Onagawa, Japan. 2011.

  18. 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-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. A qualitative descriptive study of risk reduction for coronary disease among the Hong Kong Chinese.

    Science.gov (United States)

    Chan, Choi Wan; Lopez, Violeta

    2014-01-01

    Achieving optimal control and reduction in coronary heart disease (CHD) risks in Hong Kong (HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. An interview schedule was used to guide discussions during focus group interviews. Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. © 2013 Wiley Periodicals, Inc.

  20. 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

  1. The USAID Office of U.S. Foreign Disaster Assistance: Using Disaster Risk Reduction Programs to Increase Community Resiliency to Geologic Hazards and Promote Sustained Development

    Science.gov (United States)

    Mayberry, G. C.

    2009-12-01

    The U.S. Agency for International Development’s (USAID) Office of U.S. Foreign Disaster Assistance (OFDA) supports several geologic-hazard related projects that help reduce the impact of geologic disasters by utilizing advances in science to monitor hazards and mitigate their effects. OFDA’s main responsibility is to rapidly respond to disasters, but OFDA also supports disaster risk reduction activities that aim to ultimately decrease the need for external responders and help to sustain development efforts by lessening the impact of potential disasters and strengthening at-risk community’s resiliency. One of OFDA’s success stories in geologic hazard risk reduction is the Volcano Disaster Assistance Program (VDAP). Following the deadly 1985 eruption of Nevado del Ruiz volcano in Colombia that killed about 25,000 people, the U.S. Geological Survey (USGS) and OFDA formed the VDAP team to provide technical assistance worldwide when potentially dangerous volcanoes show signs of unrest. VDAP also provides technical assistance for capacity-building projects at foreign observatories in order to strengthen their volcano monitoring networks and better prepare them for future activity. VDAP has deployed to 24 major crises in the past 23 years and helped to build infrastructure in 12 countries. They have helped their local counterparts save tens of thousands of lives, and hundreds of millions of dollars in property. Several factors contribute to VDAP’s success: sustained technical assistance allows VDAP to build upon previous efforts, working in the background with counterparts promotes independence, and addressing response and capacity-building needs leads to sustained development among counterpart agencies. Some of the lessons learned from VDAP will be parlayed into the newly formed OFDA-USGS Earthquake Disaster Assistance Team (EDAT), which will provide technical assistance to scientists shortly after large earthquakes occur in foreign countries so that they can

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

    OpenAIRE

    Emily Adhiambo Okonjo; Peterson Obara Magutu; Richard Bitange Nyaoga

    2016-01-01

    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 ...

  4. Reduction of Risk Factors in Patients with Behavioral Dysphonia After Vocal Group Therapy.

    Science.gov (United States)

    Silva, Wégina Jordâna Nascimento da; Lopes, Leonardo Wanderley; Macedo, Anny Elizabety Ramalho de; Costa, Denise Batista da; Almeida, Anna Alice Figueiredo de

    2017-01-01

    The origin and development of dysphonia, particularly behavioral dysphonia, is associated with several risk factors. Here, we verified the effectiveness of group therapy in reducing the risk factors, and established the association between risk factors and sex, age, profession, and diagnosis of laryngeal disorders in patients with behavioral dysphonia. This is a descriptive, quantitative, field intervention study. Participants (n = 26, adult patients of both sexes), with a diagnosis of behavioral dysphonia, received group therapy intervention. Data for risk factors were collected pre- and posttherapy using the Vocal Screening Protocol. The data were analyzed using descriptive and inferential statistics (Student t test, chi-squared test or Spearman correlation test). The majority (80.8%, n = 21) of patients were female, 65.4% (n = 17) were not in a vocal profession, and 42.3% (n = 11) presented with a lesion in the membranous portion of the vocal fold. The number of personal risk factors decreased after group therapy (P = 0.04). In addition, age was correlated with total (P = 0.001), environmental (P = 0.002), and personal (P = 0.003) vocal risk factors posttherapy. This study revealed an association between the reduction of personal risk factors and vocal group therapy, and a correlation between age and total, environmental, and personal vocal risk factors posttherapy. Thus, maintenance and origins of the behaviors that modify the behavioral aspects of the participants directly influence the production of individual vocal habits. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. On-ground casualty risk reduction by structural design for demise

    Science.gov (United States)

    Lemmens, Stijn; Funke, Quirin; Krag, Holger

    2015-06-01

    In recent years, awareness concerning the on-ground risk posed by un-controlled re-entering space systems has increased. On average over the past decade, an object with mass above 800 kg re-enters every week from which only a few, e.g. ESA's GOCE in 2013 and NASA's UARS in 2011, appeared prominent in international media. Space agencies and nations have discussed requirements to limit the on-ground risk for future missions. To meet the requirements, the amount of debris falling back on Earth has to be limited in number, mass and size. Design for demise (D4D) refers to all measures taken in the design of a space object to increase the potential for demise of the object and its components during re-entry. SCARAB (Spacecraft Atmospheric Re-entry and Break-Up) is ESA's high-fidelity tool which analyses the thermal and structural effects of atmospheric re-entry on spacecraft with a finite-element approach. For this study, a model of a representative satellite is developed in SCARAB to serve as test-bed for D4D analyses on a structural level. The model is used as starting point for different D4D approaches based on increasing the exposure of the satellite components to the aero-thermal environment, as a way to speed up the demise. Statistical bootstrapping is applied to the resulting on-ground fragment lists in order to compare the different re-entry scenarios and to determine the uncertainties of the results. Moreover, the bootstrap results can be used to analyse the casualty risk estimator from a theoretical point of view. The risk reductions for the analysed D4D techniques are presented with respect to the reference scenario for the modelled representative satellite.

  6. Responding to Sea Level Rise: Does Short-Term Risk Reduction Inhibit Successful Long-Term Adaptation?

    Science.gov (United States)

    Keeler, A. G.; McNamara, D. E.; Irish, J. L.

    2018-04-01

    Most existing coastal climate-adaptation planning processes, and the research supporting them, tightly focus on how to use land use planning, policy tools, and infrastructure spending to reduce risks from rising seas and changing storm conditions. While central to community response to sea level rise, we argue that the exclusive nature of this focus biases against and delays decisions to take more discontinuous, yet proactive, actions to adapt—for example, relocation and aggressive individual protection investments. Public policies should anticipate real estate market responses to risk reduction to avoid large costs—social and financial—when and if sea level rise and other climate-related factors elevate the risks to such high levels that discontinuous responses become the least bad alternative.

  7. Treatment options for hypertriglyceridemia: from risk reduction to pancreatitis

    Science.gov (United States)

    Berglund, Lars; Brunzell, John D.; Goldberg, Anne C.; Goldberg, Ira J.; Stalenhoef, Anton

    2013-01-01

    While there has been considerable focus on the role and treatment of LDL cholesterol levels, a definitive role of triglycerides in the management of cardiovascular disease has been uncertain. Notably, with increasing triglyceride levels, there is a parallel increase in cholesterol levels carried by triglyceride-rich lipoproteins, which has prompted interest in the use of non-HDL cholesterol levels as a tool guiding interventions. Recent studies have provided evidence for an independent role of triglyceride levels as a cardiovascular risk factor, and recently, an Endocrine Society guideline was published for treatment of hypertriglyceridemia. In contrast to the relative uncertainty regarding triglycerides and cardiovascular disease, a role of very high triglyceride levels as a risk factor for pancreatitis has been well known. The present paper summarizes the underlying evidence for a risk role for triglyceride levels in cardiovascular disease and pancreatitis, current treatment recommendations and areas of future research. PMID:24840268

  8. 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

  9. 20 CFR 10.812 - If OWCP reduces a fee, may a provider request reconsideration of the reduction?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false If OWCP reduces a fee, may a provider request reconsideration of the reduction? 10.812 Section 10.812 Employees' Benefits OFFICE OF WORKERS' COMPENSATION.... Department of Labor, Office of Workers' Compensation Programs, Washington, DC 20210, or from the Internet at...

  10. Risk reduction category (RRC-A) accident studies in the safety analysis report of the EPR trademark reactor

    International Nuclear Information System (INIS)

    Poehlmann, M.; Bleher, G.; Ismaier, A.; Knoll, A.; Levi, P.; Garcia, E. Vera; Schels, A.; Seitz, H.; Lima Campos, L.

    2013-01-01

    The Risk Reduction Category (RRC-A) is considered in the safety demonstration of nuclear reactors in addition to design basis operating conditions (Plant Condition Category, PCC), in order to analyze with a risk reduction approach any operating conditions with multiple failures. As extending the operating conditions of the plant 'beyond design basis', the Risk Reduction Category (RRC-A) is also denoted as Design Extension Condition (DEC-A). In the German licensing framework, the RRCA (or DEC-A) transients correspond to safety assessment level '4b' of the 'Sicherheitsanforderungen an Kernkraftwerke' (Safety Requirements for Nuclear Power Plants), Az. RS I 5 - 13303/01 of the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety. These RRC-A (or DEC-A) operating conditions require specific design provisions (implemented by manual or automatic action), known as RRC-A measures, intended to render consequences of accumulated failures admissible. In contrast, RRC-B constitute severe accidents that lead to core melt. Identification of RRC-A operating conditions and corresponding RRC-A measures is based on the use of results of probabilistic safety assessments. After the Fukushima accident the RRC-A accidents like Station Black Out (SBO) or Loss of Ultimate Heat Sink (LUHS) are of particular interest in the safety assessment of nuclear new builds. In several chapters of the Safety Analysis Report it is demonstrated that the AREVA EPRTM design is resistant at RRC-A accident conditions. (orig.)

  11. 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.

  12. 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.

  13. 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.

  14. New photocatalytic process provides 99.9+% reduction of VOC at Superfund site

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1999-03-01

    A new photocatalytic process, dubbed the A-I-R-2000 Process, is described. The process is said to offer marked economic advantages, while providing consistent 99.9+% reduction of volatile organic compounds (VOCs) from soil vapours and groundwater at the Stamina Mills Superfund site in North Smithfield, Rhode Island. The A-I-R-2000 process has been developed by KSE Inc., of Amherst, Massachusetts, and has been licensed exclusively worldwide to Trojan Technologies, Inc., of London, Ontario. The process consists essentially of adsorption of VOCs onto a UV light-activated proprietary catalysts, for breakdown to carbon dioxide and water, and also to hydrochloric acid and a small amount of chlorine gas when the VOCs are chlorinated. With a maximum internal operating temperature of 125 degrees F, it is a low-energy system when compared to other catalytic technologies that feature thermal catalytic equipment. 1 photo.

  15. 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

  16. 20 CFR 30.712 - If OWCP reduces a fee, may a provider request reconsideration of the reduction?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false If OWCP reduces a fee, may a provider request reconsideration of the reduction? 30.712 Section 30.712 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... Internet at http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/main.htm. Within 30 days of receiving the...

  17. Economic Valuation of Contamination Risks and its Effect on Site Investigations

    International Nuclear Information System (INIS)

    Back, Paer-Erik; Rosen, Lars

    2006-01-01

    Risk management is an important part of contaminated land projects and different types of risks must be considered both during investigation and remediation phases, e.g. human health risks, ecological risks, risks for workers during remediation, and project risks. The latter can be risks associated with e.g. time delays due to technical or juridical problems, or failure of remediation techniques. To provide cost-efficient management of remediation projects, there is an incentive for economic valuation of the risk reduction provided by further investigation or remedial actions. The purpose of this paper is (1) to describe problems and possibilities with economic valuation of risk reductions, and (2) to illustrate how different valuation perspectives affect the extent of investigations. A decision analysis model is presented for integrating the valuation of health, ecological, and project risks

  18. Economic Valuation of Contamination Risks and its Effect on Site Investigations

    Energy Technology Data Exchange (ETDEWEB)

    Back, Paer-Erik; Rosen, Lars [Chalmers Univ. of Technology, Goeteborg (Sweden). Dept. of Civil Engineering

    2006-09-15

    Risk management is an important part of contaminated land projects and different types of risks must be considered both during investigation and remediation phases, e.g. human health risks, ecological risks, risks for workers during remediation, and project risks. The latter can be risks associated with e.g. time delays due to technical or juridical problems, or failure of remediation techniques. To provide cost-efficient management of remediation projects, there is an incentive for economic valuation of the risk reduction provided by further investigation or remedial actions. The purpose of this paper is (1) to describe problems and possibilities with economic valuation of risk reductions, and (2) to illustrate how different valuation perspectives affect the extent of investigations. A decision analysis model is presented for integrating the valuation of health, ecological, and project risks.

  19. Consideration on the health risk reduction related to attainment of the new particulate matter standards in Poland: A top-down policy risk assessment approach.

    Science.gov (United States)

    Kobza, Joanna; Pastuszka, Józef S; Gulis, Gabriel

    2016-01-01

    Policies can influence health of a population in various ways. Numerous epidemiological studies supported by toxicological investigations demonstrate a positive association between ambient concentrations of airborne particulate matter and increased adverse cardio-respiratory events, including morbidity and mortality. The aim of this paper was to present the concept of the top-down health policy risk assessment approach model developed to estimate the expected health risk reduction associated with policy aiming at attaining the new particulate matter ≤ 10 μm in diameter (PM10) standards in Poland. The top-down approach guides the analysis of causal chains from the policy to health outcomes. In this case study we tried to estimate the predicted health effects of the policy change over the past 20 years. Since Polish annual standard for PM10 changed from 50 μg/m³ in 1990 to 40 μg/m³ in 2010, we calculated the relative risk associated with decreasing PM10 in diameter to 10 μg/m3 in the annual level of PM10 for 6 adverse health effects. The relative risk slightly decreased for almost all adverse health effects, which means that the relative decrease in the incidence of health effects from the baseline incidence should range from about 0.5-0.6% for heart disease admissions to > 1% for respiratory admissions. The obtained results indicate that implementation of the new ambient air standards could influence improvement of the health status of Polish population. A top-down policy health risk assessment model can be one of the main tools in this process, providing harmonized guidance how to seek evidence-based information, which could serve policy-makers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  20. 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.

  1. The estimated effect of mass or footprint reduction in recent light-duty vehicles on U.S. societal fatality risk per vehicle mile traveled.

    Science.gov (United States)

    Wenzel, Tom

    2013-10-01

    The National Highway Traffic Safety Administration (NHTSA) recently updated its 2003 and 2010 logistic regression analyses of the effect of a reduction in light-duty vehicle mass on US societal fatality risk per vehicle mile traveled (VMT; Kahane, 2012). Societal fatality risk includes the risk to both the occupants of the case vehicle as well as any crash partner or pedestrians. The current analysis is the most thorough investigation of this issue to date. This paper replicates the Kahane analysis and extends it by testing the sensitivity of his results to changes in the definition of risk, and the data and control variables used in the regression models. An assessment by Lawrence Berkeley National Laboratory (LBNL) indicates that the estimated effect of mass reduction on risk is smaller than in Kahane's previous studies, and is statistically non-significant for all but the lightest cars (Wenzel, 2012a). The estimated effects of a reduction in mass or footprint (i.e. wheelbase times track width) are small relative to other vehicle, driver, and crash variables used in the regression models. The recent historical correlation between mass and footprint is not so large to prohibit including both variables in the same regression model; excluding footprint from the model, i.e. allowing footprint to decrease with mass, increases the estimated detrimental effect of mass reduction on risk in cars and crossover utility vehicles (CUVs)/minivans, but has virtually no effect on light trucks. Analysis by footprint deciles indicates that risk does not consistently increase with reduced mass for vehicles of similar footprint. Finally, the estimated effects of mass and footprint reduction are sensitive to the measure of exposure used (fatalities per induced exposure crash, rather than per VMT), as well as other changes in the data or control variables used. It appears that the safety penalty from lower mass can be mitigated with careful vehicle design, and that manufacturers can

  2. Party drugs - use and harm reduction.

    Science.gov (United States)

    Frei, Matthew

    2010-08-01

    Party drug use, the intermittent use of stimulants, ecstasy and so-called 'designer drugs' at dance parties or 'raves', is now part of the culture of many young Australians. This article discusses the risks associated with the use of 'party drugs' and describes an useful approach to general practitioner assessment and management of patients who may be using party drugs. Party drug use is associated with a range of harms, including risks associated with behaviour while drug affected, toxicity and overdose, mental health complications and physical morbidity. Multiple substance use, particularly combining sedatives, further amplifies risk. If GPs have some understanding of these drugs and their effects, they are well placed to provide an effective intervention in party drug users by supporting the reduction of harm.

  3. Results and assessment of participation of VUPEK in coordinated research project of the IAEA ''Comparison of cost-effectiveness of risk reduction among different energy systems''

    International Nuclear Information System (INIS)

    Kadlec, J.; Horacek, P.

    1989-01-01

    The results and conclusions are summarized of the research programme ''Comparison of cost-effectiveness of risk reduction among different energy systems'' co-ordinated in 1983 to 1988 by the International Atomic Energy Agency. Institutes in 18 member states were involved which performed 33 case studies in the field of risk reduction in various power systems or their parts. A comparison with cost-effectiveness of risk reduction in other fields was made as well. The health risks (occupational, those of population) and the environmental risks were evaluated. The case studies cover various stages of the decision-making process and various decision makers. The solution resulted in 5 methodological studies and 16 models. 11 case studies and 1 methodological study were conducted by the Research Institute of the Fuel and Energy Complex. The experiences obtained, the questions so far unanswered and recommendations for those who will perform similar studies are given. (author). 1 fig., 2 tabs., 3 refs

  4. Interdisciplinary approach for disaster risk reduction in Valtellina Valley, northern Italy

    Science.gov (United States)

    Garcia, Carolina; Blahut, Jan; Luna, Byron Quan; Poretti, Ilaria; Camera, Corrado; de Amicis, Mattia; Sterlacchini, Simone

    2010-05-01

    Inside the framework of the European research network Mountain Risks, an interdisciplinary research group has been working in the Consortium of Mountain Municipalities of Valtellina di Tirano (northern Italy). This area has been continuously affected by several mountain hazards such as landslides, debris flows and floods that directly affect the population, and in some cases caused several deaths and million euros of losses. An aim of the interdisciplinary work in this study area, is to integrate different scientific products of the research group, in the areas of risk assessment, management and governance, in order to generate, among others, risk reduction tools addressed to general public and stakeholders. Two types of phenomena have been particularly investigated: debris flows and floods. The scientific products range from modeling to mapping of hazard and risk, emergency planning based on real time decision support systems, surveying for the evaluation of risk perception and preparedness, among others. Outputs from medium scale hazard and risk modeling could be used for decision makers and spatial planners as well as civil protection authorities to have a general overview of the area and indentify hot spots for further detailed analysis. Subsequently, local scale analysis is necessary to define possible events and risk scenarios for emergency planning. As for the modeling of past events and new scenarios of debris flows, physical outputs were used as inputs into physical vulnerability assessment and quantitative risk analysis within dynamic runout models. On a pilot zone, the physical damage was quantified for each affected structure within the context of physical vulnerability and different empirical vulnerability curves were obtained. Prospective economic direct losses were estimated. For floods hazard assessment, different approaches and models are being tested, in order to produce flood maps for various return periods, and related to registered rainfalls

  5. Primary HPV testing recommendations of US providers, 2015.

    Science.gov (United States)

    Cooper, Crystale Purvis; Saraiya, Mona

    2017-12-01

    To investigate the HPV testing recommendations of US physicians who perform cervical cancer screening. Data from the 2015 DocStyles survey of U.S. health care providers were analyzed using multivariate logistic regression to identify provider characteristics associated with routine recommendation of primary HPV testing for average-risk, asymptomatic women ≥30years old. The analysis was limited to primary care physicians and obstetrician-gynecologists who performed cervical cancer screening (N=843). Primary HPV testing for average-risk, asymptomatic women ≥30years old was recommended by 40.8% of physicians who performed cervical cancer screening, and 90.1% of these providers recommended primary HPV testing for women of all ages. The screening intervals most commonly recommended for primary HPV testing with average-risk, asymptomatic women ≥30years old were every 3years (35.5%) and annually (30.2%). Physicians who reported that patient HPV vaccination status influenced their cervical cancer screening practices were almost four times more likely to recommend primary HPV testing for average-risk, asymptomatic women ≥30years old than other providers (Adj OR=3.96, 95% CI=2.82-5.57). Many US physicians recommended primary HPV testing for women of all ages, contrary to guidelines which limit this screening approach to women ≥25years old. The association between provider recommendation of primary HPV testing and patient HPV vaccination status may be due to anticipated reductions in the most oncogenic HPV types among vaccinated women. Published by Elsevier Inc.

  6. Disaster risk reduction in the Omusati and Oshana regions of Namibia

    Directory of Open Access Journals (Sweden)

    Elina Amadhila

    2013-08-01

    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.

  7. HIV testing and counseling: test providers' experiences of best practices.

    Science.gov (United States)

    Myers, Ted; Worthington, Catherine; Haubrich, Dennis J; Ryder, Karen; Calzavara, Liviana

    2003-08-01

    Although education is central to HIV testing and counseling, little is known about the educational processes within the testing experience. This study investigated test providers' understandings of testing and counseling best practices. Interviews with a purposive sample of 24 test providers were thematically analyzed. Analysis revealed five best practices specific to HIV education and public health--ensuring information and education for HIV risk reduction, individualization of risk assessment, ensuring test results are given in person, providing information and referrals, and facilitating partner notification--and six practices not specific to HIV counseling relationship building. The latter were building trust and rapport; maintaining professional boundaries; ensuring a comfortable, safe environment; ensuring confidentiality; imparting nonjudgmntal attitude; and self-determination. The identified best practices demonstrated remarkable consistency across respondent subgroups. Although counseling was seen as largely educational and with a preventive focus, it included individualized messages based on assessments of risk, knowledge, and social and cultural characteristics.

  8. Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico

    Science.gov (United States)

    Galárraga, Omar; Sosa-Rubí, Sandra G.; Infante, César; Gertler, Paul J.; Bertozzi, Stefano M.

    2014-01-01

    The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9% for the monthly model, and 80.4% for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and it was 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$288 per person per year, but it was lower for MSW: USD$156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM & MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average willingness-to-accept estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model for targeted HIV/STI prevention. PMID:23377757

  9. Profile of elementary school science teacher instruction in disaster risk reduction: case study of volcano disaster

    Science.gov (United States)

    Pujianto; Prabowo; Wasis

    2018-04-01

    This study examined the profile of science' teacher instruction in Disaster Risk Reduction (DRR), as a feature of instructional quality, on students’ learning experiences. A qualitative study was done to observe teacher activities in teaching of disaster preparedness. Science teacher and 14 students at grade 4 of SDN (elementary school) Kiyaran 2 are involved as the subject of this study. Teacher’ instruction was coded with regard to preparation, action, and evaluation using observation sheets and documentation. Data analysis results showed a positive significant effect of the readiness during preparation on learning process of disaster risk reduction and an indirect effect of teacher’ action on students’ learning experiences. There is a lack of teaching materials about volcano disaster in the elementary school. Teacher found difficulties on evaluation of student achievement in disaster preparedness. These findings highlight the importance of DRR in uphold science teachers’ education. Items of teachers’ skill in preparing of DRR may be used to offer model of concrete instruction situation during university workshop for maintain teacher education.

  10. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report for the period 1 May 1982 - 20 February 1988

    International Nuclear Information System (INIS)

    Lochard, J.

    1989-08-01

    The report presents the three French case studies performed in the framework of the co-ordinated research programme on ''Comparison of Cost-Effectiveness of Risk Reduction Among Different Energy Systems'': cost-effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; cost-effectiveness of protection actions to reduce occupational exposure in underground uranium mines; cost effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains. Figs and tabs

  11. Falling Less in Kansas: Development of a Fall Risk Reduction Toolkit

    Directory of Open Access Journals (Sweden)

    Teresa S. Radebaugh

    2011-01-01

    Full Text Available Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas.

  12. 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.

  13. 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

  14. Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study.

    Directory of Open Access Journals (Sweden)

    Rab Nawaz Samo

    Full Text Available Retention of male people who inject drugs (PWIDs is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan.We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study.The median age of the participants was 29 years (interquartile range: 23-36. Active outreach accounted for 76% (483/636 of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636. In multivariable logistic regression, younger age (AOR: 0.97, 95% CI: 0.92-0.99, p = 0.028, clients from other provinces than Sindh (AOR: 1.49, 95% CI: 1.01-2.22, p = 0.046, having no formal education (AOR: 3.44, 95% CI: 2.35-4.90, p<0.001, a history of incarceration (AOR: 1.68, 95% CI: 1.14-2.46, p<0.008, and being homeless (AOR: 1.47, 95% CI: 1.00-2.19, p<0.049 were associated with loss to follow-up.Our cohort retained 74.5% of male PWIDs in Karachi for 24 months. Its loss to follow up rate suggested substantial ongoing programmatic challenges. Programmatic enhancements are needed for the highest risk male PWIDs, i.e., younger men, men not from Sindh Province, men who are poorly educated, formerly incarcerated, and/or homeless.

  15. 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.

  16. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report for the period 1 May 1982 - 20 February 1988

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, J [CEPN Centre d` Etude sur l` Evaluation de la Protection dans le Domaine Nucleaire, Fontenay-Aux-Roses (France)

    1989-08-01

    The report presents the three French case studies performed in the framework of the co-ordinated research programme on ``Comparison of Cost-Effectiveness of Risk Reduction Among Different Energy Systems``: cost-effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; cost-effectiveness of protection actions to reduce occupational exposure in underground uranium mines; cost effectiveness of safety measures to reduce public risk associated with the transportation of UF{sub 6} by truck and trains. Figs and tabs.

  17. An obesity/cardiometabolic risk reduction disease management program: a population-based approach.

    Science.gov (United States)

    Villagra, Victor G

    2009-04-01

    Obesity is a critical health concern that has captured the attention of public and private healthcare payers who are interested in controlling costs and mitigating the long-term economic consequences of the obesity epidemic. Population-based approaches to obesity management have been proposed that take advantage of a chronic care model (CCM), including patient self-care, the use of community-based resources, and the realization of care continuity through ongoing communications with patients, information technology, and public policy changes. Payer-sponsored disease management programs represent an important conduit to delivering population-based care founded on similar CCM concepts. Disease management is founded on population-based disease identification, evidence-based care protocols, and collaborative practices between clinicians. While substantial clinician training, technology infrastructure commitments, and financial support at the payer level will be needed for the success of disease management programs in obesity and cardiometabolic risk reduction, these barriers can be overcome with the proper commitment. Disease management programs represent an important tool to combat the growing societal risks of overweight and obesity.

  18. Application of Probabilistic Modeling to Quantify the Reduction Levels of Hepatocellular Carcinoma Risk Attributable to Chronic Aflatoxins Exposure

    DEFF Research Database (Denmark)

    Wambui, Joseph M.; Karuri, Edward G.; Ojiambo, Julia A.

    2017-01-01

    the rural populations to HCC. A quantitative cancer risk assessment therefore quantified the levels at which potential pre- and postharvest interventions reduce the HCC risk attributable to consumption of contaminated maize and groundnuts. The assessment applied a probabilistic model to derive probability......Epidemiological studies show a definite connection between areas of high aflatoxin content and a high occurrence of human hepatocellular carcinoma (HCC). Hepatitis B virus in individuals further increases the risk of HCC. The two risk factors are prevalent in rural Kenya and continuously predispose...... distributions of HCC cases and percentage reductions levels of the risk from secondary data. Contaminated maize and groundnuts contributed to 1,847 +/- 514 and 158 +/- 52 HCC cases per annum, respectively. The total contribution of both foods to the risk was additive as it resulted in 2,000 +/- 518 cases per...

  19. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    Science.gov (United States)

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  20. Understanding Motivations for Abstinence among Adolescent Young Women: Insights into Effective Sexual Risk Reduction Strategies

    Science.gov (United States)

    Long-Middleton, Ellen R.; Burke, Pamela J.; Lawrence, Cheryl A. Cahill; Blanchard, Lauren B.; Amudala, Naomi H.; Rankin, Sally H.

    2012-01-01

    Introduction Pregnancy and sexually transmitted infections pose a significant threat to the health and wellbeing of adolescent young women. Abstinence when practiced provides the most effective means in preventing these problems, yet the perspective of abstinent young women is not well understood. The purpose of the investigation was to characterize female adolescents’ motivations for abstinence. Method As part of a larger, cross-sectional quantitative study investigating predictors of HIV risk reduction behaviors, qualitative responses from study participants who never had intercourse were analyzed in a consensus-based process using content analysis and frequency counts. An urban primary care site in a tertiary care center served as the setting, with adolescent young women ages 15–19 years included in the sample. Results Five broad topic categories emerged from the data that characterized motivations for abstinence in this sample: 1) Personal Readiness, 2) Fear, 3) Beliefs and Values, 4) Partner Worthiness and 5) Lack of Opportunity. Discussion A better understanding of the motivations for abstinence may serve to guide the development of interventions to delay intercourse. PMID:22525893

  1. Operational Remote Sensing Services in North Eastern Region of India for Natural Resources Management, Early Warning for Disaster Risk Reduction and Dissemination of Information and Services

    Science.gov (United States)

    Raju, P. L. N.; Sarma, K. K.; Barman, D.; Handique, B. K.; Chutia, D.; Kundu, S. S.; Das, R. Kr.; Chakraborty, K.; Das, R.; Goswami, J.; Das, P.; Devi, H. S.; Nongkynrih, J. M.; Bhusan, K.; Singh, M. S.; Singh, P. S.; Saikhom, V.; Goswami, C.; Pebam, R.; Borgohain, A.; Gogoi, R. B.; Singh, N. R.; Bharali, A.; Sarma, D.; Lyngdoh, R. B.; Mandal, P. P.; Chabukdhara, M.

    2016-06-01

    North Eastern Region (NER) of India comprising of eight states considered to be most unique and one of the most challenging regions to govern due to its unique physiographic condition, rich biodiversity, disaster prone and diverse socio-economic characteristics. Operational Remote Sensing services increased manifolds in the region with the establishment of North Eastern Space Applications Centre (NESAC) in the year 2000. Since inception, NESAC has been providing remote sensing services in generating inventory, planning and developmental activities, and management of natural resources, disasters and dissemination of information and services through geo-web services for NER. The operational remote sensing services provided by NESAC can be broadly divided into three categories viz. natural resource planning and developmental services, disaster risk reduction and early warning services and information dissemination through geo-portal services. As a apart of natural resources planning and developmental services NESAC supports the state forest departments in preparing the forest working plans by providing geospatial inputs covering entire NER, identifying the suitable culturable wastelands for cultivation of silkworm food plants, mapping of natural resources such as land use/land cover, wastelands, land degradation etc. on temporal basis. In the area of disaster risk reduction, NESAC has initiated operational services for early warning and post disaster assessment inputs for flood early warning system (FLEWS) using satellite remote sensing, numerical weather prediction, hydrological modeling etc.; forest fire alert system with actionable attribute information; Japanese Encephalitis Early Warning System (JEWS) based on mosquito vector abundance, pig population and historical disease intensity and agriculture drought monitoring for the region. The large volumes of geo-spatial databases generated as part of operational services are made available to the administrators and

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

    International Nuclear Information System (INIS)

    Brassard, Guy

    2012-01-01

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

  3. 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

  4. 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.

  5. Mapping Disaster Risk Reduction and Climate Change Adaptation: progress in South Africa

    Science.gov (United States)

    Storie, Judith M.

    2018-05-01

    Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) strategies in Africa are on the increase. South Africa is no different, and a number of strategies have seen the light in aid of reducing disaster risk and adapting to cli-mate change. The DRR and CCA processes include the mapping of location and extent of known and potential hazards, vulnerable communities and environments, and opportunities that may exist to manage these risks. However, the mapping of often fast-changing urban and rural spaces in a standardized manner presents challenges that relate to processes, scales of data capture, level of detail recorded, software and compatibility related to data formats and net-works, human resources skills and understanding, as well as differences in approaches to the nature in which the map-ping processes are executed and spatial data is managed. As a result, projects and implementation of strategies that re-late to the use of such data is affected, and the success of activities based on the data may therefore be uncertain. This paper investigates data custodianship and data categories that is processed and managed across South Africa. It explores the process and content management of disaster risk and climate change related information and defines the challenges that exist in terms of governance. The paper also comments on the challenges and potential solutions for the situation as it gives rise to varying degrees of accuracy, effectiveness for use, and applicability of the spatial data available to affect DRR and improve the value of CCA programmes in the region.

  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. Proceedings of the 1998 diesel engine emissions reduction workshop [DEER

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    This workshop was held July 6--9, 1998 in Castine, Maine. The purpose of this workshop was to provide a multidisciplinary forum for exchange of state-of-the-art information on reduction of diesel engine emissions. Attention was focused on the following: agency/organization concerns on engine emissions; diesel engine issues and challenges; health risks from diesel engines emissions; fuels and lubrication technologies; non-thermal plasma and urea after-treatment technologies; and diesel engine technologies for emission reduction 1 and 2.

  8. 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

  9. 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

  10. 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

  11. Springtime Flood Risk Reduction in Rural Arctic: A Comparative Study of Interior Alaska, United States and Central Yakutia, Russia

    Directory of Open Access Journals (Sweden)

    Yekaterina Y. Kontar

    2018-03-01

    Full Text Available Every spring, riverine communities throughout the Arctic face flood risk. As the river ice begins to thaw and break up, ice jams—accumulation of chunks and sheets of ice in the river channel, force melt water and ice floes to back up for dozens of kilometers and flood vulnerable communities upstream. Via a comparative analysis between two flood-prone communities in Alaska and Yakutia (Siberia, this study examines key components of flood risk—hazards, exposure, and vulnerability, and existing practices in flood risk reduction in rural Arctic. The research sites are two rural communities—Galena (Yukon River and Edeytsy (Lena River, which sustained major ice-jam floods in May 2013. The data was acquired through a combination of direct observations on site, review of documents and archives, focus group discussions, and surveys. Five focus groups with US and Russian representatives from disaster management agencies revealed a few similar patterns as well as significant differences in flood risk reduction strategies. The main differences included higher reliance on mechanical and short-term ice jam and flood mitigation efforts (e.g., ice-jam demolition in the Russian Arctic, and lack of a centralized flood management model in the US. Surveys conducted among population at risk during the site visits to Edeytsy (November 2015 and Galena (March 2016 revealed higher satisfaction levels with the existing flood risk reduction efforts among Edeytsy residents. Survey respondents in Galena indicated the lack of ice jam removal and other flood prevention measures as the key drawback in the existing flood management. Historical analysis, conducted via the disaster Pressure and Release (PAR model, revealed that springtime flood risk in both regions results from complex interactions among a series of natural processes that generate conditions of hazard, and human actions that generate conditions of communities’ exposure and vulnerability. The analysis

  12. Fibrates are an essential part of modern anti-dyslipidemic arsenal: spotlight on atherogenic dyslipidemia and residual risk reduction

    Directory of Open Access Journals (Sweden)

    Tenenbaum Alexander

    2012-10-01

    Full Text Available Abstract Currently the world faces epidemic of several closely related conditions: obesity, metabolic syndrome and type 2 diabetes (T2DM. The lipid profile of these patients and those with metabolic syndrome is characterized by the concurrent presence of qualitative as well as quantitative lipoprotein abnormalities: low levels of HDL, increased triglycerides, and prevalence of LDL particles that are smaller and denser than normal. This lipid phenotype has been defined as atherogenic dyslipidemia. Overwhelming evidences demonstrate that all components of the atherogenic dyslipidemia are important risk-factors for cardiovascular diseases. Optimal reduction of cardiovascular risk through comprehensive management of atherogenic dyslipidemias basically depends of the presence of efficacious lipid-modulating agents (beyond statin-based reduction of LDL-C. The most important class of medications which can be effectively used nowadays to combat atherogenic dyslipidemias is the fibrates. From a clinical point of view, in all available 5 randomized control trials beneficial effects of major fibrates (gemfibrozil, fenofibrate, bezafibrate were clearly demonstrated and were highly significant in patients with atherogenic dyslipidemia. In these circumstances, the main determinant of the overall results of the trial is mainly dependent of the number of the included appropriate patients with atherogenic dyslipidemia. In a meta-analysis of dyslipidemic subgroups totaling 4726 patients a significant 35% relative risk reduction in cardiovascular events was observed compared with a non significant 6% reduction in those without dyslipidemia. However, different fibrates may have a somewhat different spectrum of effects. Currently only fenofibrate was investigated and proved to be effective in reducing microvascular complications of diabetes. Bezafibrate reduced the severity of intermittent claudication. Cardinal differences between bezafibrate and other fibrates are

  13. Fibrates are an essential part of modern anti-dyslipidemic arsenal: spotlight on atherogenic dyslipidemia and residual risk reduction.

    Science.gov (United States)

    Tenenbaum, Alexander; Fisman, Enrique Z

    2012-10-11

    Currently the world faces epidemic of several closely related conditions: obesity, metabolic syndrome and type 2 diabetes (T2DM). The lipid profile of these patients and those with metabolic syndrome is characterized by the concurrent presence of qualitative as well as quantitative lipoprotein abnormalities: low levels of HDL, increased triglycerides, and prevalence of LDL particles that are smaller and denser than normal. This lipid phenotype has been defined as atherogenic dyslipidemia. Overwhelming evidences demonstrate that all components of the atherogenic dyslipidemia are important risk-factors for cardiovascular diseases. Optimal reduction of cardiovascular risk through comprehensive management of atherogenic dyslipidemias basically depends of the presence of efficacious lipid-modulating agents (beyond statin-based reduction of LDL-C). The most important class of medications which can be effectively used nowadays to combat atherogenic dyslipidemias is the fibrates. From a clinical point of view, in all available 5 randomized control trials beneficial effects of major fibrates (gemfibrozil, fenofibrate, bezafibrate) were clearly demonstrated and were highly significant in patients with atherogenic dyslipidemia. In these circumstances, the main determinant of the overall results of the trial is mainly dependent of the number of the included appropriate patients with atherogenic dyslipidemia. In a meta-analysis of dyslipidemic subgroups totaling 4726 patients a significant 35% relative risk reduction in cardiovascular events was observed compared with a non significant 6% reduction in those without dyslipidemia. However, different fibrates may have a somewhat different spectrum of effects. Currently only fenofibrate was investigated and proved to be effective in reducing microvascular complications of diabetes. Bezafibrate reduced the severity of intermittent claudication. Cardinal differences between bezafibrate and other fibrates are related to the effects on

  14. Peace and Development : Democratization, Poverty Reduction and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Peace and Development : Democratization, Poverty Reduction and Risk Mitigation in Fragile and Post Conflict States. Both the social science literature and policymakers tend to take for granted that poverty reduction, risk mitigation and democratization are mutually reinforcing. This basic assumption was first challenged ...

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. Radiological risk comparison guidelines

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  19. Disaster Risks Reduction for Extreme Natural Hazards

    Science.gov (United States)

    Plag, H.; Jules-Plag, S.

    2013-12-01

    Mega disasters associated with extreme natural hazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Floods and droughts are major threats that potentially could reach planetary extent, particularly through secondary economic and social impacts. Earthquakes and tsunamis frequently cause disasters that eventually could exceed the immediate coping capacity of the global economy, particularly since we have built mega cities in hazardous areas that are now ready to be harvested by natural hazards. Unfortunately, the more we learn to cope with the relatively frequent hazards (50 to 100 years events), the less we are worried about the low-probability, high-impact events (a few hundred and more years events). As a consequence, threats from the 500 years flood, drought, volcano eruption are not appropriately accounted for in disaster risk reduction (DRR) discussions. Extreme geohazards have occurred regularly throughout the past, but mostly did not cause major disasters because exposure of human assets to hazards was much lower in the past. The most extreme events that occurred during the last 2,000 years would today cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. Recent extreme earthquakes have illustrated the destruction they can inflict, both directly and indirectly through tsunamis. Large volcano eruptions have the potential to impact climate, anthropogenic infrastructure and resource supplies on global scale. During the last 2,000 years several large volcano eruptions occurred, which under today's conditions are associated with extreme disaster risk. The comparison of earthquakes and volcano eruptions indicates that large volcano eruptions are the low-probability geohazards with potentially the highest impact on our civilization

  20. The effect of discounting, different mortality reduction schemes and predictive cohort life tables on risk acceptability criteria

    International Nuclear Information System (INIS)

    Rackwitz, Ruediger

    2006-01-01

    Technical facilities should be optimal with respect to benefits and cost. Optimization of technical facilities involving risks for human life and limb require an acceptability criterion and suitable discount rates both for the public and the operator depending on for whom the optimization is carried out. The life quality index is presented and embedded into modem socio-economic concepts. A general risk acceptability criterion is derived. The societal life saving cost to be used in optimization as life saving or compensation cost and the societal willingness-to-pay based on the societal value of a statistical life or on the societal life quality index are developed. Different mortality reduction schemes are studied. Also, predictive cohort life tables are derived and applied. Discount rates γ must be long-term averages in view of the time horizon of some 20 to more than 100 years for the facilities of interest and net of inflation and taxes. While the operator may use long-term averages from the financial market for his cost-benefit analysis the assessment of interest rates for investments of the public into risk reduction is more difficult. The classical Ramsey model decomposes the real interest rate (=output growth rate) into the rate of time preference of consumption and the rate of economical growth multiplied by the elasticity of marginal utility of consumption. It is proposed to use a relatively small interest rate of 3% implying a rate of time preference of consumption of about 1%. This appears intergenerationally acceptable from an ethical point of view. Risk-consequence curves are derived for an example

  1. Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

    Science.gov (United States)

    Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

    2018-01-01

    Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links. PMID:29670057

  2. 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.

  3. Improving End-To-End Tsunami Warning for Risk Reduction on Canada’s West Coast

    Science.gov (United States)

    2015-01-01

    in 2014, up from 455 cals in 2013 (Chamber of Shipping, 2014). Even the more traditional forms of marine tourism such as sports fishing have been...some of the most noteworthy areas of new economic activity to emerge have been aquaculture, recreation and tourism , research and oil, gas and other...Risk Reduction on Canada’s West Coast (CSSP-2013-TI-1033) 3   annual value of output over $590 milion (Fisheries and Oceans Canada, 2013). Tourism

  4. Thinking through cancer risk: characterizing smokers' process of risk determination.

    Science.gov (United States)

    Hay, Jennifer; Shuk, Elyse; Cruz, Gustavo; Ostroff, Jamie

    2005-10-01

    The perception of cancer risk motivates cancer risk reduction behaviors. However, common measurement strategies for cancer risk perceptions, which involve numerical likelihood estimates, do not adequately capture individuals' thoughts and feelings about cancer risk. To guide the development of novel measurement strategies, the authors used semistructured interviews to examine the thought processes used by smokers (N = 15) as they considered their cancer risk. They used grounded theory to guide systematic data coding and develop a heuristic model describing smokers' risk perception process that includes a cognitive, primarily rational process whereby salient personal risk factors for cancer are considered and combined, and an affective/attitudinal process, which shifts risk perceptions either up or down. The model provides a tentative explanation concerning how people hold cancer risk perceptions that diverge from rational assessment of their risks and will be useful in guiding the development of non-numerical measurements strategies for cancer risk perceptions.

  5. An intensive nurse-led, multi-interventional clinic is more successful in achieving vascular risk reduction targets than standard diabetes care.

    LENUS (Irish Health Repository)

    MacMahon Tone, J

    2009-06-01

    The aim of this research was to determine whether an intensive, nurse-led clinic could achieve recommended vascular risk reduction targets in patients with type 2 diabetes as compared to standard diabetes management.

  6. Evaluation of a School-Based Train-the-Trainer Intervention Program to Teach First Aid and Risk Reduction among High School Students

    Science.gov (United States)

    Carruth, Ann K.; Pryor, Susan; Cormier, Cathy; Bateman, Aaron; Matzke, Brenda; Gilmore, Karen

    2010-01-01

    Background: Farming is a hazardous occupation posing health risks from agricultural exposures for the farm owner and family members. First Aid for Rural Medical Emergencies (F.A.R.M.E.) was developed to support a train-the-trainer (TTT) program to prepare high school students to teach first aid skills and risk reduction through peer interaction.…

  7. 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

  8. Minors, Moral Psychology, and the Harm Reduction Debate: The Case of Tobacco and Nicotine.

    Science.gov (United States)

    Kozlowski, Lynn T

    2017-12-01

    Harm reduction debates are important in health policy. Although it has been established that morality affects policy, this article proposes that perspectives from moral psychology help to explain the challenges of developing evidence-based policy on prohibition-only versus tobacco/nicotine harm reduction for minors. Protecting youth from tobacco is critical, especially since tobacco/nicotine products are legal for adults, who usually begin using when young. Although cigarettes and other combustibles are the deadliest tobacco products, other products such as smokeless tobacco and electronic cigarettes, though unsafe, are upward of 90 percent less harmful than cigarettes. Disgust at contaminating the "purity" of youth, especially "good," low-risk youth, with any tobacco/nicotine products opposes harm reduction, as does contempt for violating so-called community values and disrespecting authority. Support for harm reduction arises from anger at failing to provide reduced harm to "bad," high-risk individuals and denying them the "liberty" to decide. Fast-thinking, moral-emotional intuitions are supported by rationalizations arising from slow-thinking processes. The recognition of such moral psychological influences and the efforts to minimize their impact may help lead to amelioration and compromise. This example from tobacco control, with divided concerns for low-risk and high-risk youth, can be applied to other harm reduction versus prohibition-only policies directed at minors. Copyright © 2017 by Duke University Press.

  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.

    2013-12-01

    This research project adopted an interdisciplinary approach to volcanic risk reduction on the remote volcanic island of Tristan da Cunha (South Atlantic). 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. Despite their isolation and prolonged periods of hardship, islanders have demonstrated an ability to cope with and recover from adverse events. This resilience is likely a function of remoteness, strong kinship ties, bonding social capital, and persistence of shared values and principles established at community inception. While there is good knowledge of the styles of volcanic activity on Tristan, given the high degree of scientific uncertainty about the timing, size and location of future volcanism, a qualitative scenario planning approach was used as a vehicle to convey this information to the islanders. This deliberative, anticipatory method allowed on-island decision makers to take ownership of risk identification, management and capacity building within their community. This paper demonstrates the value of integrating social and physical sciences with development of effective, tailored communication strategies in volcanic risk reduction.

  10. Directions of the US Geological Survey Landslide Hazards Reduction Program

    Science.gov (United States)

    Wieczorek, G.F.

    1993-01-01

    The US Geological Survey (USGS) Landslide Hazards Reduction Program includes studies of landslide process and prediction, landslide susceptibility and risk mapping, landslide recurrence and slope evolution, and research application and technology transfer. Studies of landslide processes have been recently conducted in Virginia, Utah, California, Alaska, and Hawaii, Landslide susceptibility maps provide a very important tool for landslide hazard reduction. The effects of engineering-geologic characteristics of rocks, seismic activity, short and long-term climatic change on landslide recurrence are under study. Detailed measurement of movement and deformation has begun on some active landslides. -from Author

  11. Substance Use and Mild Traumatic Brain Injury Risk Reduction and Prevention: A Novel Model for Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer H. Olson-Madden

    2012-01-01

    Full Text Available Traumatic brain injury (TBI and substance use disorders (SUDs frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances before and after injury. Further, a growing body of literature supports the relationship between comorbid histories of mild TBI (mTBI and SUDs and negative outcomes. Alcohol and other drug use are strongly associated with risk taking. Disinhibition, impaired executive function, and/or impulsivity as a result of mTBI also contribute to an individual’s proclivity towards risk-taking. Risk-taking behavior may therefore, be a direct result of SUD and/or history of mTBI, and risky behaviors may predispose individuals for subsequent injury or continued use of substances. Based on these findings, evaluation of risk-taking behavior associated with the co-occurrence of SUD and mTBI should be a standard clinical practice. Interventions aimed at reducing risky behavior among members of this population may assist in decreasing negative outcomes. A novel intervention (Substance Use and Traumatic Brain Injury Risk Reduction and Prevention (STRRP for reducing and preventing risky behaviors among individuals with co-occurring mTBI and SUD is presented. Areas for further research are discussed.

  12. The role of risk and cost benefit in program budgeting

    Energy Technology Data Exchange (ETDEWEB)

    Henry, C.J.; Alchowiak, J. [Dept. of Energy, Washington, DC (United States)

    1995-12-31

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground {open_quote}The First Step,{close_quote} provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget.

  13. The role of risk and cost benefit in program budgeting

    International Nuclear Information System (INIS)

    Henry, C.J.; Alchowiak, J.

    1995-01-01

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground open-quote The First Step,close-quote provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget

  14. 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

    . The COMRADE questionnaire was used to measure patients' confidence in their decision and satisfaction with the risk communication. RESULTS: Of the 240 patients included for analyses, 112 were allocated to POL information and 128 to ARR. Patients redeeming a statin prescription totalled six (5.4%) when...... informed using POL, and 32 (25.0%) when using ARR. The level of confidence in decision and satisfaction with risk communication did not differ between the risk formats. CONCLUSION: Patients redeemed statin prescriptions less often when their GP communicated treatment effectiveness using POL compared......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...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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…

  17. 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

  18. 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

    ...-2011-0025] Study on Protection of Certain Railroad Risk Reduction Data From Discovery or Use in... Act of 2008 (RSIA), FRA is soliciting public comment on the issue of whether it is in the public... withhold from discovery or use in litigation in a Federal or State court proceeding for damages involving...

  19. Effects of Patient-Provider Race Concordance and Smoking Status on Lung Cancer Risk Perception Accuracy among African Americans

    Science.gov (United States)

    Persky, Susan; Kaphingst, Kimberly A.; Allen, Vincent C.; Senay, Ibrahim

    2013-01-01

    Background Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. Purpose A controlled experiment assessed whether perceived physician race influenced African-American patients’ (n=127) risk perception accuracy following the provision of objective lung cancer risk information. Methods Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Results Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94)=4.02, p=.048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. Conclusions The current study demonstrates that African-American patients’ perceptions of a doctor’s race are sufficient to independently impact their processing of lung cancer risk information. PMID:23389688

  20. Effects of patient-provider race concordance and smoking status on lung cancer risk perception accuracy among African-Americans.

    Science.gov (United States)

    Persky, Susan; Kaphingst, Kimberly A; Allen, Vincent C; Senay, Ibrahim

    2013-06-01

    Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. A controlled experiment assessed whether perceived physician race influenced African-American patients' (n = 127) risk perception accuracy following the provision of objective lung cancer risk information. Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94) = 4.02, p = .048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. The current study demonstrates that African-American patients' perceptions of a doctor's race are sufficient to independently impact their processing of lung cancer risk information.

  1. 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.

  2. OPERATIONAL REMOTE SENSING SERVICES IN NORTH EASTERN REGION OF INDIA FOR NATURAL RESOURCES MANAGEMENT, EARLY WARNING FOR DISASTER RISK REDUCTION AND DISSEMINATION OF INFORMATION AND SERVICES

    Directory of Open Access Journals (Sweden)

    P. L. N. Raju

    2016-06-01

    Full Text Available North Eastern Region (NER of India comprising of eight states considered to be most unique and one of the most challenging regions to govern due to its unique physiographic condition, rich biodiversity, disaster prone and diverse socio-economic characteristics. Operational Remote Sensing services increased manifolds in the region with the establishment of North Eastern Space Applications Centre (NESAC in the year 2000. Since inception, NESAC has been providing remote sensing services in generating inventory, planning and developmental activities, and management of natural resources, disasters and dissemination of information and services through geo-web services for NER. The operational remote sensing services provided by NESAC can be broadly divided into three categories viz. natural resource planning and developmental services, disaster risk reduction and early warning services and information dissemination through geo-portal services. As a apart of natural resources planning and developmental services NESAC supports the state forest departments in preparing the forest working plans by providing geospatial inputs covering entire NER, identifying the suitable culturable wastelands for cultivation of silkworm food plants, mapping of natural resources such as land use/land cover, wastelands, land degradation etc. on temporal basis. In the area of disaster risk reduction, NESAC has initiated operational services for early warning and post disaster assessment inputs for flood early warning system (FLEWS using satellite remote sensing, numerical weather prediction, hydrological modeling etc.; forest fire alert system with actionable attribute information; Japanese Encephalitis Early Warning System (JEWS based on mosquito vector abundance, pig population and historical disease intensity and agriculture drought monitoring for the region. The large volumes of geo-spatial databases generated as part of operational services are made available to the

  3. Risk analysis local grids. Mapping and reduction of risks in electric power grids; Riskanalysmetod lokalnaet. Kartlaeggning och reduktion av risker i elnaet

    Energy Technology Data Exchange (ETDEWEB)

    Kylefors, Martin; Fredholm, Lotta; Sandstroem, Cecilia

    2007-11-15

    The objective of the project has been to contribute to development of risk analysis applications that correspond to the need of investments as an effect of new regulation. The aim has been to develop a method for screening and assessing risks, and for ranking risk reducing measures in order of priority. Phase 1 has consisted of an overview of methods, selection of appropriate methods, and development of principles regarding application suitable for power distribution companies. Phase 2 has consisted of adjustments and tests of the method. The method focuses on risks associated with power failures, with a duration exceeding 12 hours, in medium voltage local networks. Stations are excluded. The suggested method is based on principles of Preliminary Hazard Analysis and Cost-Benefit Analysis. Risks are suggested to be assessed based on three main factors (load, exposure and alternative supply). The quota between the highest and lowest value is 20 for each factor. Each factor is assessed by underlying factors such as type of cable/wire, number of customers and average power consumption. By multiplying the factors a resulting risk level is obtained in the range of 0.05 to 400. The level determines the need for further investments. Appropriate risk reducing measure is selected by putting the risk reduction (benefit) in relation to the total costs for investment and maintenance, for each alternative measure. There is a further need for development of a method for stations. There is also a further need for development of a priority model in city networks where power failures less than 12 hours are taken into account. Finally there is a need to turn the functional requirement (no power failures exceeding 24 hours) into an acceptable risk level

  4. 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.

  5. Improving disaster risk reduction capacity of District Civil Protection Units in managing veld fires: A case of Mangwe District in Matabeleland South Province, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Ernest Dube

    2015-05-01

    Full Text Available This article analysed disaster risk reduction capacity of District Civil Protection Units (DCPUs in managing veld fires in Mangwe District of Matabeleland South Province, Zimbabwe. Veld fires have resulted in unnecessary material, environmental and economic losses. Communities’ livelihoods and property have been destroyed, and the natural environment depleted. The research sought to improve disaster risk reduction capacity of DCPUs in managing veld fires, through new intervention strategies and a new model. The objectives of the study were to investigate the main causes of veld fires; to analyse their impacts; to examine the effectiveness of the current intervention strategies; and to identify challenges in implementing these interventions. Furthermore, the study sought to recommend new possible intervention strategies. This mainly qualitative study employed self-administered questionnaires, interviews and focus-group discussions. Questionnaires were used to investigate members of the DCPU’s ideas, views and experiences, interviews solicited perceptions of community leaders and their subjects, whilst focus-group discussions assisted with information from members of the District Civil Protection Planning Committee. Veld fires in the district are mainly caused by human activities, and they are prevalent during the months of September and October. They affect livelihoods and the natural environment the most. This study found that DCPUs are not prepared to manage veld fires and therefore recommended new strategies and adoption of the community-based disaster risk reduction model. The new strategies include involving community leaders and members of the communities in DCPUs; regular training and workshops to members of DCPUs on veld fire management; creation of fire protection associations; regular campaigns and rehearsal of emergency drills by the DCPU personnel; the introduction of competitions and incentives in veld fire management; vigorous

  6. NOAA's Joint Polar Satellite System's (JPSS) Proving Ground and Risk Reduction (PGRR) Program - Bringing JPSS Science into Support of Key NOAA Missions!

    Science.gov (United States)

    Sjoberg, W.; McWilliams, G.

    2017-12-01

    This presentation will focus on the continuity of the NOAA Joint Polar Satellite System (JPSS) Program's Proving Ground and Risk Reduction (PGRR) and key activities of the PGRR Initiatives. The PGRR Program was established in 2012, following the launch of the Suomi National Polar Partnership (SNPP) satellite. The JPSS Program Office has used two PGRR Project Proposals to establish an effective approach to managing its science and algorithm teams in order to focus on key NOAA missions. The presenter will provide details of the Initiatives and the processes used by the initiatives that have proven so successful. Details of the new 2017 PGRR Call-for-Proposals and the status of project selections will be discussed.

  7. 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

  8. Occupational trichloroethylene exposure and renal carcinoma risk: evidence of genetic susceptibility by reductive metabolism gene variants

    Science.gov (United States)

    Moore, Lee E.; Boffetta, Paolo; Karami, Sara; Brennan, Paul; Stewart, Patricia S; Hung, Rayjean; Zaridze, David; Matveev, Vsevolod; Janout, Vladimir; Kollarova, Helena; Bencko, Vladimir; Navratilova, Marie; Szeszenia-Dabrowska, Neonila; Mates, Dana; Gromiec, Jan; Holcatova, Ivana; Merino, Maria; Chanock, Stephen; Chow, Wong-Ho; Rothman, Nathaniel

    2010-01-01

    Trichloroethylene (TCE) is a suspected renal carcinogen. TCE-associated renal genotoxicity occurs predominantly through glutathione S-transferase (GST) conjugation and bioactivation by renal cysteine beta-lyase (CCBL1). We conducted a case-control study in Central Europe (1,097 cases/1,476 controls), specifically designed to assess risk associated with occupational exposure to TCE through analysis of detailed job histories. All jobs were coded for organic/chlorinated solvent and TCE exposure (ever/never) as well as the frequency and intensity of exposure based on detailed occupational questionnaires, specialized questionnaires, and expert assessments. Increased risk was observed among subjects ever TCE-exposed (OR=1.63, 95% CI: 1.04–2.54). Exposure-response trends were observed among subjects above and below the median exposure [average intensity (OR=1.38, 95% CI:0.81–2.35; OR=2.34, 95% CI:1.05–5.21, p-trend=0.02)]. A significant association was found among TCE-exposed subjects with at least one intact GSTT1 allele (active genotype) (OR=1.88, 95% CI:1.06–3.33) but not among subjects with two deleted alleles (null genotype) (OR=0.93, 95% CI:0.35–2.44, p-interaction=0.18). Similar associations for all exposure metrics including average intensity were observed among GSTT1 active subjects (OR=1.56, 95% CI:0.79–3.10; OR=2.77, 95% CI:1.01–7.58, p-trend=0.02) but not among GSTT1 nulls (OR=0.81, 95% CI:0.24–2.72; OR=1.16, 95% CI:0.27–5.04, p-trend=1.00, p-interaction=0.34). Further evidence of heterogeneity was seen among TCE-exposed subjects with ≥1 minor allele of several CCBL1 tagging SNPs: [rs2293968, rs2280841, rs2259043, rs941960]. These findings provide the strongest evidence to date that TCE exposure is associated with increased renal cancer risk, particularly among individuals carrying polymorphisms in genes that are important in the reductive metabolism of this chemical, and provides biological plausibility of the association in humans. PMID

  9. Systemic cost-effectiveness analysis of food hazard reduction

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Lawson, Lartey Godwin; Lund, Mogens

    2015-01-01

    stage are considered. Cost analyses are conducted for different risk reduction targets and for three alternative scenarios concerning the acceptable range of interventions. Results demonstrate that using a system-wide policy approach to risk reduction can be more cost-effective than a policy focusing...

  10. Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction

    Science.gov (United States)

    Gyawu, Rebecca; Quansah, Joseph E.; Fall, Souleymane; Gichuhi, Peter N.; Bovell-Benjamin, Adelia C.

    2015-01-01

    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 food environment had limited opportunities for healthy food choices. PMID:26844138

  11. Extent and agenda of emission reduction policies in front of climate risks: lessons learned from integrated models

    International Nuclear Information System (INIS)

    Ambrosi, Ph.

    2004-05-01

    After having highlighted the main difficulties met when trying to take decisions on emission reductions (i.e. disequilibrium between short term action and long term dynamics, series of uncertainties, lack of a clear information on threats), this research aims at studying the extent and the agenda of CO 2 emission reduction efforts at a global scale. First, the author explores under various perspectives the relationship between the extent of climate change and the extent of its impacts and modes of analysis of climate policies. Then, he examines how different attitudes towards the climate risk are translated into recommendations for action which are obtained by always more complex models. In order to compare results, simulations are performed, based on optimal control models belonging to the RESPONSE family. Three different options or attitudes are then studied and assessed with RESPONSE: firstly, the uncertainty on impact and damage assessment is still too important to have confidence in present assessments; secondly, while being sceptical on damage assessment, more confidence is given to climate model results, and thirdly, an explicit representation of climate damages is used to introduce rationality issues in the debate on risks

  12. 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.

  13. 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

  14. 41 CFR 102-80.50 - Are Federal agencies responsible for identifying/estimating risks and for appropriate risk...

    Science.gov (United States)

    2010-07-01

    ... Environmental Management Risks and Risk Reduction Strategies § 102-80.50 Are Federal agencies responsible for... identify and estimate safety and environmental management risks and appropriate risk reduction strategies... responsible for identifying/estimating risks and for appropriate risk reduction strategies? 102-80.50 Section...

  15. Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali, Indonesia.

    Science.gov (United States)

    Sawitri, Anak Agung Sagung; Hartawan, Anak Agung Gede; Craine, Noel; Sari, Ayu Kartika; Septarini, Ni Wayan; Wirawan, Dewa Nyoman

    2016-01-01

    The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia. A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix. Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8 percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV. The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics. The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting. This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.

  16. 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).

  17. Still "at risk": An examination of how street-involved young people understand, experience, and engage with "harm reduction" in Vancouver's inner city.

    Science.gov (United States)

    Bozinoff, Nikki; Small, Will; Long, Cathy; DeBeck, Kora; Fast, Danya

    2017-07-01

    Vancouver is an international leader in implementing interventions to reduce harms related to drug use. However, street-involved young people who use drugs continue to be vulnerable to overdose death, hepatitis C (HCV) infection, and high rates of syringe sharing. To better understand this in the context of the intensive public health response, we examined how young people, who are involved in the 'street drug scene', understood, experienced and engaged with harm reduction. Twelve semi-structured interviews were conducted in 2013 with 13 young people (ages 17-28) recruited from the At-Risk Youth Study, a prospective cohort of street-involved and drug-using young people. These interviews were embedded within a larger, eight-year program of ethnographic research and explored participants' understandings of harm reduction, their use of specific services, and their ideas about improving their day-to-day lives. Interviews were transcribed verbatim and a thematic analysis was performed. Young peoples' ideas about harm reduction were diverse and expansive. They articulated the limitations of existing programs, indicating that while they are positioned to reduce the risk of HIV and HCV transmission, they offer little meaningful support to improve young peoples' broader life chances. Young people described strategies to mitigate risk and harm in their own lives, including transitioning to drugs deemed less harmful and attempting to gain access to drug treatment. Finally, young people indicated that spatial considerations (e.g., distance from Vancouver's Downtown Eastside) strongly determined access to services. In Vancouver, a large, well established harm reduction infrastructure seeks to reduce HIV and HCV transmission among street-involved young people. However, young peoples' multiple understandings, experiences and engagements with harm reduction in this setting illustrate the limitations of the existing infrastructure in improving their broader life chances. Copyright

  18. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    Directory of Open Access Journals (Sweden)

    Miriam Taegtmeyer

    Full Text Available The role of men who have sex with men (MSM in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

  19. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    Science.gov (United States)

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

  20. 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.

  1. Reduction of risk factors for nuclear power plants due to personnel psychological data, including attitude, morale and motivation

    International Nuclear Information System (INIS)

    Abramova, V.N.

    1997-01-01

    The possibilities of reduction of risk factors for personnel activity and performance due to attitudes, motivation and moral are presented. Methodology and experience in psychology, sociopsychology, psychophisiology and sociology mistake sources are discussed. Authorization to job, stages of estimating occupational fitness and modules system of personnel psychological and sociopsychological training probabilistic are explained. (author). 3 figs, 1 tab

  2. Discussion of a method for providing general risk information by linking with the nuclear information

    International Nuclear Information System (INIS)

    Shobu, Nobuhiro; Yokomizo, Shirou; Umezawa, Sayaka

    2004-06-01

    'Risk information navigator (http://www.ricotti.jp/risknavi/)', an internet tool for arousing public interest and fostering people's risk literacy, has been developed as the contents for the official website of Techno Community Square 'RICOTTI' (http://www.ricotti.jp) at TOKAI village. In this report we classified the risk information into the fields, Health/Daily Life', 'Society/Crime/Disaster' and Technology/Environment/Energy', for the internet tool contents. According to these categories we discussed a method for providing various risk information on general fields by linking with the information on nuclear field. The web contents are attached to this report with the CD-R media. (author)

  3. Reduction in health risk induced by semi-volatile organic compounds and metals in a drinking water treatment plant

    International Nuclear Information System (INIS)

    Zhao, F.; Yin, J.; Zhang, X. X.; Chen, Y.; Zhang, Y.; Wu, B.; Li, M.

    2015-01-01

    This study investigated health risk reduction in a drinking water treatment plant of Nanjing City (China) based on chemical detection of 22 semi-volatile organic compounds (SVOCs) and 24 metallic elements in source water and drinking water during 2009–2011. Chemical analysis showed that 15 SVOCs and 9 metals were present in the water. Health risk assessment revealed that hazard quotient of each pollutant and hazard index (HI) of all the detectable pollutants were below 1.00, indicating that the chemicals posed negligible non-carcinogenic risk to local residents. Benzo(a)pyrene may induce carcinogenic risk since its risk index via both oral and dermal exposure exceeded the safety level (1.00E-6), but other SVOCs induced no carcinogenic risk. Total HI of the SVOCs was 1.08E-3 for the source water and 1.56E-3 for the drinking water, suggesting that the used conventional treatment processes (coagulation/sedimentation, sand filtration and chlorine disinfection) cannot effectively reduce the non-carcinogenic risk. The source water had higher carcinogenic risk than the drinking water, but risk index of the drinking water still exceeded 1.00E-6. This study might serve as a basis for health risk assessment of drinking water and also as a benchmark for the authorities to reduce health risk arising from trace-level hazardous pollutants.

  4. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  5. Reducing the risks of diabetes complications through diabetes self-management education and support.

    Science.gov (United States)

    Kent, Dan; D'Eramo Melkus, Gail; Stuart, Patricia Mickey W; McKoy, June M; Urbanski, Patti; Boren, Suzanne Austin; Coke, Lola; Winters, Janis E; Horsley, Neil L; Sherr, Dawn; Lipman, Ruth

    2013-04-01

    People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion. This report summarizes the discussion and presents recommendations to incorporate into practice to improve outcomes. The objective of the symposium was to develop practical advice for diabetes educators and other members of the diabetes care team regarding the reduction of diabetes-related risks. Optimal diabetes management requires patients to actively participate in their care, which occurs most effectively with a multidisciplinary team. Diabetes education is an integral part of this team approach because it not only helps the patient understand diabetes, its progression, and possible complications, but also provides guidance and encouragement to the patient to engage in proactive risk-reduction decisions for optimal health. A variety of tools are available to help the diabetes educator develop an individualized, patient-centered plan for risk reduction. More research is needed regarding intervention efficacy, best practices to improve adherence, and quantification of benefits from ongoing diabetes support in risk reduction. Diabetes educators are urged to stay abreast of evolving models of care and to build relationships with health care providers both within and beyond the diabetes care team.

  6. Focus-on-Teens, sexual risk-reduction intervention for high-school adolescents: impact on knowledge, change of risk-behaviours, and prevalence of sexually transmitted diseases.

    Science.gov (United States)

    Gaydos, C A; Hsieh, Y-H; Galbraith, J S; Barnes, M; Waterfield, G; Stanton, B

    2008-10-01

    A community-based intervention, Focus-on-Kids (FOK) has demonstrated risk-behaviour reduction of urban youth. We modified FOK to Focus-on-Teens (FOT) for high schools. High school adolescents (n=1190) were enrolled over successive school semesters. The small-group sessions were presented during the school-lunch hours. Confidential surveys were conducted at baseline, immediate, six-, and 12-month postintervention for demographics, parental communication/monitoring, sexual risk behaviours and sexually transmitted diseases (STDs)/HIV/condom-usage knowledge. Sexually active participants were encouraged to volunteer for urine-based STDs testing at the School-Based Health Centres. Many (47.4%) students reported having had sexual intercourse at baseline. Overall behaviours changed towards 'safer' sex behaviours (intent-to-use and using condoms, communicating with partner/parents about sex/condoms/STDs) with time (Pcorrect knowledge of STDs/HIV increased to 88% at time 4 from 80% at baseline after adjusting for age, gender and sexual activity (Pcondom usage, decreases in sexual risk behaviours supported the effectiveness of this intervention.

  7. Eliciting affect via immersive virtual reality: a tool for adolescent risk reduction.

    Science.gov (United States)

    Hadley, Wendy; Houck, Christopher D; Barker, David H; Garcia, Abbe Marrs; Spitalnick, Josh S; Curtis, Virginia; Roye, Scott; Brown, Larry K

    2014-04-01

    A virtual reality environment (VRE) was designed to expose participants to substance use and sexual risk-taking cues to examine the utility of VR in eliciting adolescent physiological arousal. 42 adolescents (55% male) with a mean age of 14.54 years (SD = 1.13) participated. Physiological arousal was examined through heart rate (HR), respiratory sinus arrhythmia (RSA), and self-reported somatic arousal. A within-subject design (neutral VRE, VR party, and neutral VRE) was utilized to examine changes in arousal. The VR party demonstrated an increase in physiological arousal relative to a neutral VRE. Examination of individual segments of the party (e.g., orientation, substance use, and sexual risk) demonstrated that HR was significantly elevated across all segments, whereas only the orientation and sexual risk segments demonstrated significant impact on RSA. This study provides preliminary evidence that VREs can be used to generate physiological arousal in response to substance use and sexual risk cues.

  8. Managed alcohol as a harm reduction intervention for alcohol addiction in populations at high risk for substance abuse.

    Science.gov (United States)

    Muckle, Wendy; Muckle, Jamie; Welch, Vivian; Tugwell, Peter

    2012-12-12

    Managed alcohol programmes (MAP) are a harm reduction strategy used to minimise the personal harm and adverse societal effects that alcohol dependence can lead to by providing an alternative to zero-tolerance approaches that incorporate drinking goals (abstinence or moderation) that are compatible with the needs of the individual, and promoting access to services by offering low-threshold alternatives. This enables clients to gain access to services despite continued alcohol consumption and works to help the patient understand the risks involved in their behaviour and make decisions about their own treatment goals. To assess the effectiveness of MAP treatment regimens (serving limited quantities of alcohol daily to alcoholics) on their own or as compared to moderate drinking (self-controlled drinking), screening and brief intervention using a harm reduction approach, traditional abstinence-based interventions (12 step programmes) and no intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO up to March 2012. This search was expanded by handsearching of high-yield journals and conference proceedings that had not already been handsearched on behalf of The Cochrane Collaboration, searching reference lists of all papers and relevant reviews identified, references to ongoing and recently completed clinical trials in the National Research Register and IFPMA Clinical Trials Database (which contains ClinicalTrials.gov, Centerwatch, Current Controlled Trials and ClinicalStudyResults.gov, and Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali). Trials registers, grey literature and reference lists were also searched. Individuals, organisations and experts in the field were contacted. Randomised control trials (RCT), controlled clinical trials (CCT), interrupted time series (ITS) studies, and control before and after (CBA) studies involving vulnerable people aged 18 years or older who were

  9. Goals and activities of the JICA technical cooperation project on reduction of seismic risk in Romania

    International Nuclear Information System (INIS)

    Vacareanu, R.; Kato, H.

    2007-01-01

    Japan International Cooperation Agency (JICA) Technical Cooperation Project on Reduction of Seismic Risk for Buildings and Structures started in Romania on October 1, 2002. The aim of the Project is to strengthen the capacity of earthquake disaster related activities in Romania. The Project approval is the result of four years of intensive efforts made by professionals from Technical University of Civil Engineering Bucharest (UTCB), Ministry of Transport, Constructions and Tourism (MTCT), Romania, National Building Research Institute (INCERC) Bucharest, JICA, Building Research Institute (BRI), Tsukuba, and National Institute for Land, Infrastructure and Management (NILIM), Tsukuba, Japan. The duration of the Project is five years. The implementing agency is the National Center for Seismic Risk Reduction (NCSRR) as a public institution of national interest under MTCT. The activities are carried out by NCSRR in partnership with UTCB and INCERC. During the Project period, 29 young Romanian engineers were trained in Japan, 7 Japanese experts and 37 Japanese experts worked for long-term and short-term, respectively in Romania. Equipment for seismic instrumentation, dynamic characterization of soil and structural testing rising up approximately to 260 million yens (i.e. 2.17 million USD) were donated by JICA to Romania, through NCSRR. The total cost of the Project is roughly 7 million USD. The paper describes the main activities and results of the Project until the JICA Final Evaluation Mission (March 2007). (authors)

  10. A procedure for seismic risk reduction in Campania Region

    International Nuclear Information System (INIS)

    Zuccaro, G.; Palmieri, M.; Cicalese, S.; Grassi, V.; Rauci, M.; Maggio, F.

    2008-01-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  11. A procedure for seismic risk reduction in Campania Region

    Science.gov (United States)

    Zuccaro, G.; Palmieri, M.; Maggiò, F.; Cicalese, S.; Grassi, V.; Rauci, M.

    2008-07-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  12. Investigation of the Effect of Control Measures on Reduction of Risk Events in an Edible Oil Factory in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Malihe Kolahdouzi

    2017-07-01

    Full Text Available Background & Aims of the Study: Identification of hazards is one of the first goals of risk analysis. Failure mode and effect analysis method (FMEA is universally defined as efficient procedures for finding potential failures aimed to remove or decrease the risk which is related to them. This study aimed to investigate the effect of control measures on reduction of risk events in an edible oil factory in Tehran. Methods: This cross-sectional study was conducted in an edible oil factory in Tehran, Iran. For this, a four-member team of safety engineer experts was formed. Some factory units were selected randomly. After that, in all units, probability, severity and detection probability of hazards in all processes and tasks were assessed based on FMEA method. Regarding to the RPN, some control measures were taken to reduce the risk of events. After 9 months, risk assessment was repeated; primary and secondary RPNs were compared with each other to investigate the effect of interventions. Results: The results showed that highest and lowest probability of hazard were related to installation and can production unit, respectively. The highest and lowest severity of hazard were related to tool and can production unit, respectively. There was a significant difference between the probability of hazard in can-making and filling units, before and after the interventions. There was a significant difference between the severity of hazard in can-making, filling and neutralization units, before and after the interventions. As well, total probability, severity and RPN had a significant difference in all parts of the factory before and after the interventions. Conclusions: According to the results of this study and the overall risk reduction caused by interventional measures, it can be concluded that, FMEA is a successful method for identifying hazards and risk control measures.

  13. A Study on the Risk Reduction Effect by MLCS (Mid-loop Level Control System) of EUAPR using the Low-Power and Shutdown PSA Result

    International Nuclear Information System (INIS)

    Lee, Keunsung; Choi, Sunmi; Kim, Eden

    2016-01-01

    The EU-APR design has been developed in order to expand and diversify the global nuclear power market of APR1400. For the improvement of shutdown risk for the EUAPR, the mid-loop level control system (MLCS) is considered during mid-loop operation for the EU-APR, which is not incorporated into SKN 3 and 4 (APR1400 Type) in Korea. Commonly, the risk associated with the NPP can be identified through the PSA. Thus, this paper discusses the low power and shutdown (LPSD) risk reduction effect by MLCS using the Low-Power and Shutdown PSA Result. LPSD level 1 PSA models for EU-APR have been developed. The risk reduction effect by MLCS is discussed. Because the loss of shutdown cooling function during mid-loop is one of the most vulnerable events, the MLCS have a significant influence on CDF in LPSD PSA. The shutdown risk of domestic power plants would likely be reduced if the MLCS is adopted in all operating NPPs in Korea during the mid-loop operation. It is expected that this work will contribute to reduce shutdown risk of domestic power plants

  14. Investing in finite-life carbon emissions reduction program under risk and idiosyncratic uncertainty

    International Nuclear Information System (INIS)

    Fouilloux, Jessica; Moraux, Franck; Viviani, Jean-Laurent

    2015-01-01

    This paper aims at emphasizing the ability of new frameworks of real option model to highlight key characteristics of industrial Carbon Emissions Reduction Program investment decision. We develop both theoretical arguments and numerical simulations with structural parameters calibrated on real-life data. We find that both radical uncertainty and risk lead to speed-up green investments, compared to the predictions of real option models that are normally used in green investment literature. The conventional “wait and see” attitude, questioned in recent developments of the real option theory, is not validated. In conclusion, our results should foster companies to implement green investments and help governments to define appropriate incentives to encourage green investments. Of particular note, the paper highlights that finance theory is not necessarily an obstacle to green investment decisions. -- Highlights: •We use real option model to identify key features of CERP investment decision. •We determine the optimal carbon price threshold to undertake a CERP. •Investment decision is a non-monotonic function of idiosyncratic uncertainty. •Increasing uncertainty until a moderate level can accelerate investment decision. •Decreasing idiosyncratic risk can accelerate investment decision

  15. Sitewide risk perspectives for the Rocky Flats Environmental Technology Site

    International Nuclear Information System (INIS)

    Olinger, S.J.

    1998-05-01

    The US Department of Energy (DOE) has recently finalized a closure plan (originally called the Ten Year Plan) for closure and environmental cleanup of previous nuclear weapons facilities. The DOE Rocky Flats Field Office has established priorities for risk reduction work to Support closure activities, as well as addressing those hazards associated with storage and management of radioactive materials and hazardous chemicals. To provide information for future National Environmental Policy Act (NEPA) or other regulatory assessments of specific risk reduction projects identified in the Closure Plan, a risk assessment of normal operations and potential accidents was recently prepared to provide an updated baseline of the cumulative impacts to the worker, public and environment due to the Site's operations, activities, and environmental conditions in light of the Site's change in mission, and of future closure projects. This paper summarizes the risk assessment approach, results, and conclusions

  16. Up and down the sanitation ladder: Harmonizing the treatment and multiple-barrier perspectives on risk reduction in wastewater irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, P.; Konradsen, Flemming

    2010-01-01

    This paper discusses two prominent perspectives in the debate on risk reduction in wastewater irrigation; reliance on conventional wastewater treatment and the multiple-barrier approach. The treatment perspective is based on water-quality standards for wastewater irrigation with treatment...... considered the ultimate risk reductionmeasure. The somewhat broader multiple-barrier perspective supports the use of a combination of pre-farm, on-farm and postfarm barriers, including, where possible, wastewater treatment, to meet required health targets. The discussion in this paper shows that each...

  17. 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.

  18. Reduction of hexavalent chromium by fasted and fed human gastric fluid. II. Ex vivo gastric reduction modeling

    Energy Technology Data Exchange (ETDEWEB)

    Kirman, Christopher R., E-mail: ckirman@summittoxicology.com [Summit Toxicology, Orange Village, OH, 44022 (United States); Suh, Mina, E-mail: msuh@toxstrategies.com [ToxStrategies, Inc., Mission Viejo, CA, 92692 (United States); Hays, Sean M., E-mail: shays@summittoxicology.com [Summit Toxicology, Allenspark, CO, 8040 (United States); Gürleyük, Hakan, E-mail: hakan@brooksrand.com [Brooks Applied Labs, Bothell, WA, 98011 (United States); Gerads, Russ, E-mail: russ@brooksrand.com [Brooks Applied Labs, Bothell, WA, 98011 (United States); De Flora, Silvio, E-mail: sdf@unige.it [Department of Health Sciences, University of Genoa, 16132 Genoa (Italy); Parker, William, E-mail: william.parker@duke.edu [Duke University Medical Center, Department of Surgery, Durham, NC, 27710 (United States); Lin, Shu, E-mail: shu.lin@duke.edu [Duke University Medical Center, Department of Surgery, Durham, NC, 27710 (United States); Haws, Laurie C., E-mail: lhaws@toxstrategies.com [ToxStrategies, Inc., Katy, TX, 77494 (United States); Harris, Mark A., E-mail: mharris@toxstrategies.com [ToxStrategies, Inc., Austin, TX, 78751 (United States); Proctor, Deborah M., E-mail: dproctor@toxstrategies.com [ToxStrategies, Inc., Mission Viejo, CA, 92692 (United States)

    2016-09-01

    To extend previous models of hexavalent chromium [Cr(VI)] reduction by gastric fluid (GF), ex vivo experiments were conducted to address data gaps and limitations identified with respect to (1) GF dilution in the model; (2) reduction of Cr(VI) in fed human GF samples; (3) the number of Cr(VI) reduction pools present in human GF under fed, fasted, and proton pump inhibitor (PPI)-use conditions; and (4) an appropriate form for the pH-dependence of Cr(VI) reduction rate constants. Rates and capacities of Cr(VI) reduction were characterized in gastric contents from fed and fasted volunteers, and from fasted pre-operative patients treated with PPIs. Reduction capacities were first estimated over a 4-h reduction period. Once reduction capacity was established, a dual-spike approach was used in speciated isotope dilution mass spectrometry analyses to characterize the concentration-dependence of the 2nd order reduction rate constants. These data, when combined with previously collected data, were well described by a three-pool model (pool 1 = fast reaction with low capacity; pool 2 = slow reaction with higher capacity; pool 3 = very slow reaction with higher capacity) using pH-dependent rate constants characterized by a piecewise, log-linear relationship. These data indicate that human gastric samples, like those collected from rats and mice, contain multiple pools of reducing agents, and low concentrations of Cr(VI) (< 0.7 mg/L) are reduced more rapidly than high concentrations. The data and revised modeling results herein provide improved characterization of Cr(VI) gastric reduction kinetics, critical for Cr(VI) pharmacokinetic modeling and human health risk assessment. - Highlights: • SIDMS allows for measurement of Cr(VI) reduction rate in gastric fluid ex vivo • Human gastric fluid has three reducing pools • Cr(VI) in drinking water at < 0.7 mg/L is rapidly reduced in human gastric fluid • Reduction rate is concentration- and pH-dependent • A refined PK

  19. Valuing environmental services provided by local stormwater management

    Science.gov (United States)

    Brent, Daniel A.; Gangadharan, Lata; Lassiter, Allison; Leroux, Anke; Raschky, Paul A.

    2017-06-01

    The management of stormwater runoff via distributed green infrastructures delivers a number of environmental services that go beyond the reduction of flood risk, which has been the focus of conventional stormwater systems. Not all of these services may be equally valued by the public, however. This paper estimates households' willingness to pay (WTP) for improvements in water security, stream health, recreational and amenity values, as well as reduction in flood risk and urban heat island effect. We use data from nearly 1000 personal interviews with residential homeowners in Melbourne and Sydney, Australia. Our results suggest that the WTP for the highest levels of all environmental services is A799 per household per year. WTP is mainly driven by residents valuing improvements in local stream health, exemptions in water restrictions, the prevention of flash flooding, and decreased peak urban temperatures respectively at A297, A244, A104 and A$65 per year. We further conduct a benefit transfer analysis and find that the WTP and compensating surplus are not significantly different between the study areas. Our findings provide additional support that stormwater management via green infrastructures have large nonmarket benefits and that, under certain conditions, benefit values can be transferred to different locations.

  20. Landfill reduction experience in The Netherlands

    International Nuclear Information System (INIS)

    Scharff, Heijo

    2014-01-01

    Highlights: • ‘Zero waste’ initiatives never consider risks, side effects or experience of achieved low levels of landfill. • This paper provides insight into what works and what not. • Where strong gradients in regulations and tax occur between countries, waste will find its way to landfills across borders. • Strong landfill reduction can create a fierce competition over the remaining waste to be landfilled resulting in losses. • At some point a public organisation should take responsibility for the operation of a ‘safety net’ in waste management. - Abstract: Modern waste legislation aims at resource efficiency and landfill reduction. This paper analyses more than 20 years of landfill reduction in the Netherlands. The combination of landfill regulations, landfill tax and landfill bans resulted in the desired landfill reduction, but also had negative effects. A fierce competition developed over the remaining waste to be landfilled. In 2013 the Dutch landfill industry generated €40 million of annual revenue, had €58 million annual costs and therefore incurred an annual loss of €18 million. It is not an attractive option to prematurely end business. There is a risk that Dutch landfill operators will not be able to fulfil the financial obligations for closure and aftercare. Contrary to the polluter pays principle the burden may end up with society. EU regulations prohibiting export of waste for disposal are in place. Strong differentials in landfill tax rate between nations have nevertheless resulted in transboundary shipment of waste and in non-compliance with the self-sufficiency and proximity principles. During the transformation from a disposal society to a recycling society, it is important to carefully plan required capacity and to guide the reorganisation of the landfill sector. At some point, it is no longer profitable to provide landfill services. It may be necessary for public organisations or the state to take responsibility for the

  1. Landfill reduction experience in The Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Scharff, Heijo, E-mail: h.scharff@afvalzorg.nl

    2014-11-15

    Highlights: • ‘Zero waste’ initiatives never consider risks, side effects or experience of achieved low levels of landfill. • This paper provides insight into what works and what not. • Where strong gradients in regulations and tax occur between countries, waste will find its way to landfills across borders. • Strong landfill reduction can create a fierce competition over the remaining waste to be landfilled resulting in losses. • At some point a public organisation should take responsibility for the operation of a ‘safety net’ in waste management. - Abstract: Modern waste legislation aims at resource efficiency and landfill reduction. This paper analyses more than 20 years of landfill reduction in the Netherlands. The combination of landfill regulations, landfill tax and landfill bans resulted in the desired landfill reduction, but also had negative effects. A fierce competition developed over the remaining waste to be landfilled. In 2013 the Dutch landfill industry generated €40 million of annual revenue, had €58 million annual costs and therefore incurred an annual loss of €18 million. It is not an attractive option to prematurely end business. There is a risk that Dutch landfill operators will not be able to fulfil the financial obligations for closure and aftercare. Contrary to the polluter pays principle the burden may end up with society. EU regulations prohibiting export of waste for disposal are in place. Strong differentials in landfill tax rate between nations have nevertheless resulted in transboundary shipment of waste and in non-compliance with the self-sufficiency and proximity principles. During the transformation from a disposal society to a recycling society, it is important to carefully plan required capacity and to guide the reorganisation of the landfill sector. At some point, it is no longer profitable to provide landfill services. It may be necessary for public organisations or the state to take responsibility for the

  2. Pronurturance Plus at birth: A risk reduction strategy for preventing postpartum haemorrhage.

    Science.gov (United States)

    Saxton, A; Fahy, K; Hastie, C

    2016-06-01

    Postpartum haemorrhage (PPH) rates continue to rise in the developed world. A recent study found that any skin-to-skin contact and breastfeeding within 30min of birth was associated with an almost 50% reduction in PPH rates. Improved oxytocin release is the biological reason proposed to explain this. The combination of skin-to-skin contact and breastfeeding within 30min of birth is termed 'Pronurturance'. Midwifery theory and research claims that optimal third stage care is more holistic than simple Pronurturnace which suggests that further reductions in PPH rates may be possible. What can midwives and women do to minimise blood loss in the third and fourth stages of labour? We present a new theory that describes and explains how to optimise the woman's reproductive psychophysiology in the third and fourth stages of labour to ensure a well contracted uterus which inhibits excessive bleeding regardless of risk status or whether active management was used. In developing the Pronurturance Plus theory we expand upon what is already known about oxytocin in relation to simple pronurturance to integrate concepts from birth territory theory, cognitive neuroscience, mindfulness psychology and the autonomic nervous system to develop an holistic understanding of how to optimise care and minimise PPH. Pronurturance Plus is a psycho-biologically grounded theory which is consistent with existing evidence. It is free, natural and socially desirable. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. 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.

  4. 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.

  5. Geology for Global Development: Training young geoscientists to communicate and do effective disaster risk reduction in the developing world

    Science.gov (United States)

    Gill, J. C.

    2012-04-01

    Geoscientists have a crucial role to play in improving disaster risk reduction and supporting communities to build resilience and reduce vulnerability. Across the world millions live in severe poverty, without access to many of the basic needs that are often taken for granted - a clean water supply, a reliable food source, safe shelter and suitable infrastructure. This lack of basic needs results in communities being particularly vulnerable to devastating natural hazards, such as floods, earthquakes, volcanic eruptions and landslides. Here we discuss two major gaps which can limit the engagement of geoscience students and recent graduates in the serious debates surrounding resilience and effective disaster risk reduction: (i) Geoscience undergraduate and postgraduate courses rarely give students the opportunity to engage with issues such as vulnerability, sustainability, knowledge exchange and cross-cultural communication. (ii) There are very few opportunities for geoscience students to gain experience in this sector through UK or overseas placements. Geology for Global Development (GfGD), established in 2011, is starting to work with UK students and recent graduates to fill these gaps. GfGD aims to inspire and engage young geoscientists, supporting them to apply their interdisciplinary knowledge and skills to generate solutions and resources which support NGOs, empower communities and help build resilience to natural hazards. This is being and will be done through: (i) active university groups hosting seminars and discussion groups; (ii) blog articles; (iii) opportunities to contribute to technical papers; (iv) workshops and conferences; and (v) UK and overseas placements. GfGD seeks to play a key role in the training and development of geoscience graduates with the necessary 'soft-skills' and opportunities to make an important contribution to improving disaster risk reduction, fighting poverty and improving people's lives.

  6. A study on the effect of flaw detection probability assumptions on risk reduction achieved by non-destructive inspection

    International Nuclear Information System (INIS)

    Cronvall, O.; Simola, K.; Männistö, I.; Gunnars, J.; Alverlind, L.; Dillström, P.; Gandossi, L.

    2012-01-01

    Leakages and ruptures of piping components lead to reduction or loss of the pressure retaining capability of the system, and thus contribute to the overall risk associated with nuclear power plants. In-service inspection (ISI) aims at verifying that defects are not present in components of the pressure boundary or, if defects are present, ensuring that these are detected before they affect the safe operation of the plant. Reliability estimates of piping are needed e.g., in probabilistic safety assessment (PSA) studies, risk-informed ISI (RI-ISI) applications, and other structural reliability assessments. Probabilistic fracture mechanics models can account for ISI reliability, but a quantitative estimate for the latter is needed. This is normally expressed in terms of probability of detection (POD) curves, which correlate the probability of detecting a flaw with flaw size. A detailed POD curve is often difficult (or practically impossible) to obtain. If sufficient risk reduction can be shown by using simplified (but reasonably conservative) POD estimates, more complex PODs are not needed. This paper summarises the results of a study on the effect of piping inspection reliability assumptions on failure probability using structural reliability models. The main interest was to investigate whether it is justifiable to use a simplified POD curve. Further, the study compared various structural reliability calculation approaches for a set of analysis cases. The results indicate that the use of a simplified POD could be justifiable in RI-ISI applications.

  7. 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.

  8. Risk uncertainty analysis methods for NUREG-1150

    International Nuclear Information System (INIS)

    Benjamin, A.S.; Boyd, G.J.

    1987-01-01

    Evaluation and display of risk uncertainties for NUREG-1150 constitute a principal focus of the Severe Accident Risk Rebaselining/Risk Reduction Program (SARRP). Some of the principal objectives of the uncertainty evaluation are: (1) to provide a quantitative estimate that reflects, for those areas considered, a credible and realistic range of uncertainty in risk; (2) to rank the various sources of uncertainty with respect to their importance for various measures of risk; and (3) to characterize the state of understanding of each aspect of the risk assessment for which major uncertainties exist. This paper describes the methods developed to fulfill these objectives

  9. The roles of exercise and fall risk reduction in the prevention of osteoporosis.

    Science.gov (United States)

    Henderson, N K; White, C P; Eisman, J A

    1998-06-01

    In summary, the optimal model for the prevention of osteoporotic fractures includes maximization and maintenance of bone strength and minimization of trauma. Numerous determinants of each have been identified, but further work to develop preventative strategies based on these determinants remains to be undertaken. Physical activity is a determinant of peak BMD. There also is evidence that activity during growth modulates the external geometry and trabecular architecture, potentially enhancing skeletal strength, while during the adult years activity may reduce age-related bone loss. The magnitude of the effect of a 7% to 8% increase in peak BMD, if maintained through the adult years, could translate to a 1.5-fold reduction in fracture risk. Moreover, in the older population, appropriate forms of exercise could reduce the risk of falling and, thus, further reduce fracture risk. These data must be considered as preliminary in view of the paucity of long-term fracture outcome data from randomized clinical trials. However, current information suggests that the optimal form of exercise to achieve these objectives may vary through life. Vigorous physical activity (including weight-bearing, resistance, and impact components) during childhood may maximize peak BMD. This type of activity seems optimal through the young adult years, but as inevitable age-related degeneration occurs, activity modification to limit the impact component of exercise may become necessary. In the elderly, progressive strength training has been demonstrated to be a safe and effective form of exercise that reduces risk factors for falling and may also enhance BMD. In the frail elderly, activity to improve balance and confidence also may be valuable. Group activities such as Tai Chi may be cost-effective. Precise prescriptions must await the outcome of well-designed, controlled longitudinal studies that include fracture as an outcome. However, increased physical activity seems to be a sensible

  10. Effect of providing risk information on undergoing cervical cancer screening: a randomized controlled trial.

    Science.gov (United States)

    Fujiwara, Hiroyuki; Shimoda, Akihiro; Ishikawa, Yoshiki; Taneichi, Akiyo; Ohashi, Mai; Takahashi, Yoshifumi; Koyanagi, Takahiro; Morisawa, Hiroyuki; Takahashi, Suzuyo; Sato, Naoto; Machida, Shizuo; Takei, Yuji; Saga, Yasushi; Suzuki, Mitsuaki

    2015-01-01

    In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.

  11. 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.

  12. [Risk reduction and drug use in detention: study about the detainees of Liancourt Penitentiary].

    Science.gov (United States)

    Sannier, Olivier; Verfaillie, Florent; Lavielle, Dorothée

    2012-07-01

    The prison population is drug users. Recent debates around the provision of devices to reduce the risks associated with drug use (syringe exchange programs and snort kit) lead us to question local practices of the prison population. An anonymous questionnaire was offered to the prison population of the Liancourt penitentiary. The questions addressed the use of drugs before and during incarceration, knowledge of HIV and B and C hepatitis status, taking an opiate substitution treatment and advice on the implementation of syringe exchange programs and snort kit. A percentage of 54.4 of the prisoners responded to the questionnaire. An amount of 60.1 % of respondents consumed at least one drug before incarceration and 43.6 % of respondents consumed at least one drug during their incarceration. Cannabis was the most consumed drug before and during incarceration. Barely half of respondents reported knowing their HIV and hepatitis B and C status. Over 10 % of respondents said they were interesting in establishing needle exchange programs or snort kit. The prison concentrate drug users and is not a repressive tool of efficient risk reduction. The strategies implemented by the medical unit of Liancourt prison require adaptations that warrant development of health resources. Then, only new tools to reduce risks associated with drug use can be established. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  13. Cost effective snubber reduction program for nuclear power plants

    International Nuclear Information System (INIS)

    Adams, T.M.; Antaki, G.A.; Chang, K.C.

    1985-01-01

    Due to the stringent seismic requirements imposed on nuclear power plants, piping engineers have resorted to the extensive use of snubbers to support nuclear piping systems. The advantage of snubbers is that they provide dynamic restraint while allowing free thermal growth of the pipe. Unfortunately, as more plants go into operation, utilities have to face the costs of strict in-service inspection requirements and risks of unscheduled or extended plant outages associated with snubber failures. The snubber inspection requirements, defined in plant Technical Specifications, require periodic visual inspections of all snubbers and functional tests of a percentage of the plant snubbers, during refueling outages. For a typical 1000 Mw unit this represents from 50 to several hundred snubbers to be functionally tested at each refueling outage. Should failures occur during testing, the sample size must be further increased. Very quickly the costs and risks of extended shutdowns have led the industry to consider, and in many cases implement, snubber reduction programs. At the same time several changes in seismic design criteria have greatly facilitated the reduction of snubbers, making snubber elimination economically and technically attractive. In this paper we examine the costs and benefits of snubber reduction programs and propose a method for evaluating their cost benefits

  14. Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

    Science.gov (United States)

    Balcazar, H; Alvarado, M; Ortiz, G

    2011-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

  15. Assessing urban potential flooding risk and identifying effective risk-reduction measures.

    Science.gov (United States)

    Cherqui, Frédéric; Belmeziti, Ali; Granger, Damien; Sourdril, Antoine; Le Gauffre, Pascal

    2015-05-01

    Flood protection is one of the traditional functions of any drainage system, and it remains a major issue in many cities because of economic and health impact. Heavy rain flooding has been well studied and existing simulation software can be used to predict and improve level of protection. However, simulating minor flooding remains highly complex, due to the numerous possible causes related to operational deficiencies or negligent behaviour. According to the literature, causes of blockages vary widely from one case to another: it is impossible to provide utility managers with effective recommendations on how to improve the level of protection. It is therefore vital to analyse each context in order to define an appropriate strategy. Here we propose a method to represent and assess the flooding risk, using GIS and data gathered during operation and maintenance. Our method also identifies potential management responses. The approach proposed aims to provide decision makers with clear and comprehensible information. Our method has been successfully applied to the Urban Community of Bordeaux (France) on 4895 interventions related to flooding recorded during the 2009-2011 period. Results have shown the relative importance of different issues, such as human behaviour (grease, etc.) or operational deficiencies (roots, etc.), and lead to identify corrective and proactive. This study also confirms that blockages are not always directly due to the network itself and its deterioration. Many causes depend on environmental and operating conditions on the network and often require collaboration between municipal departments in charge of roads, green spaces, etc. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Vulnerability assessments, identity and spatial scale challenges in disaster-risk reduction

    Directory of Open Access Journals (Sweden)

    Edward R. Carr

    2015-11-01

    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.

  17. Atorvastatin reduces the risk of cardiovascular events in patients with carotid atherosclerosis: a secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Sillesen, H.; Amarenco, P.; Hennerici, M.G.

    2008-01-01

    BACKGROUND AND PURPOSE: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial found that treatment with atorvastatin 80 mg per day reduced the risk of stroke and cardiovascular events in patients with a recent transient ischemic attack (TIA) or stroke. We hypothesized...... this benefit would be greatest in the subgroup of patients with carotid stenosis. METHODS: The SPARCL trial randomized patients with TIA or stroke within 1 to 6 months without known coronary heart disease (CHD) and low-density lipoprotein cholesterol 100 to 190 mg/dL to treatment with atorvastatin 80 mg per...... artery stenosis, treatment with atorvastatin was associated with a 33% reduction in the risk of any stroke (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.47, 0.94; P=0.02), and a 43% reduction in risk of major coronary events (HR 0.57, 95% CI 0.32, 1.00; P=0.05). Later carotid revascularization...

  18. Decreased Risk of Squamous Cell Carcinoma of the Head and Neck in Users of Nonsteroidal Anti-Inflammatory Drugs

    Directory of Open Access Journals (Sweden)

    Neda Ahmadi

    2010-01-01

    Full Text Available We evaluated the chemopreventive effect of nonsteroidal anti-inflammatory drug (NSAID use in head and neck squamous cell carcinomas (HNSCC by conducting a case-control study based on the administration of a standardized questionnaire to 71 incident HNSCC cases and same number of healthy controls. NSAID use was associated with a 75% reduction in risk of developing HNSCC. A significant risk reduction was noted in association with frequency of NSAID use. Restricting the analysis to aspirin users revealed a significant 90% reduction in risk of developing HNSCC. This study provides evidence for a significant reduction in the risk of developing HNSCC in users of NSAIDs, and specifically aspirin users.

  19. A positive risk approach when clients choose to live at risk: a palliative case discussion.

    Science.gov (United States)

    De Bono, Christopher E; Henry, Blair

    2016-09-01

    The article discusses recent approaches in the literature about clients who chose to live at risk in their homes. It argues for a positive risk-based approach and a tool to help manage risk in the home, and applies these to a hypothetical end-of-life scenario. Historically, safety plans to consider risk management involved a culture of risk aversion supported by sometimes paternalistic motives intended to protect vulnerable clients. New findings in the literature engage in a process that respects the ethical principles underlying harm reduction philosophies. The literature also argues for a perspective that moves away from viewing risk as only harmful, to one that supports a positive understanding of risk as part of a client's informed choice. A risk support management plan, based on a positive approach, can provide a way to both support a client's choice to live at risk, anticipate for expected complications, and inform the creation of a contingency plan to address concerns as they may arise. The added value of a structured approach like the one proposed here for risk support management plans is that it provides adequate due diligence and informed decision-making when planning for risk-taking in complex situations.

  20. Cost and risk reduction using upfront licensing in Canada. Annex 15

    International Nuclear Information System (INIS)

    Snell, V.G.

    2002-01-01

    The paper summarizes the use of 'up-front' licensing in Canada - how licensing requirements are defined, and met - in advance of a project commitment. The approach to licensing in Canada has allowed flexibility in development of new designs. Since licensing was originally risk-based, and current regulatory policy allows cost-benefit considerations as part of the decision making, risk can be and should be used in novel circumstances as a licensing tool. Since the licensing framework is non-prescriptive, innovative approaches to design can be introduced and dispositioned without changing the legal structure. This flexibility has been used in several up-front licensing reviews: a small urban heating reactor, repeat CANDU 6 generating station units, and the single unit CANDU 9 generating station. In the future we expect to apply it to advanced designs, as an essential part of risk reduction and customer confidence in the product. The important lessons learned in Canada include: Up-front licensing is essential to reduce the risk of licensing-related delays once a project has been committed. It requires a significant investment in time and effort from both the designer and the regulator; The most effective scope for up-front licensing is for the regulator to thoroughly assess novel concepts, test the design against changed domestic requirements, and follow-up on known difficult areas; and for the designer to ensure foreign requirements are incorporated. There is little benefit in certifying the design in detail; Although it would be satisfying to have legally-binding certification, in the end there can be no legal obligation on the regulator, and agreement is pursued on the basis of good faith that the regulator will not make arbitrary decisions and that the designer will meet agreed targets or requirements; In almost all circumstances, issues will arise that are beyond the current 'rules', however expressed. Rather than rushing to create new rules, one reaches a

  1. Anticoagulation Bridge Therapy in Patients with Atrial Fibrillation: Recent Updates Providing a Rebalance of Risk and Benefit.

    Science.gov (United States)

    Garwood, Candice L; Korkis, Bianca; Grande, Domenico; Hanni, Claudia; Morin, Amy; Moser, Lynette R

    2017-06-01

    In 2011 we reviewed clinical updates and controversies surrounding anticoagulation bridge therapy in patients with atrial fibrillation (AF). Since then, options for oral anticoagulation have expanded with the addition of four direct oral anticoagulant (DOAC) agents available in the United States. Nonetheless, vitamin K antagonist (VKA) therapy continues to be the treatment of choice for patients who are poor candidates for a DOAC and for whom bridge therapy remains a therapeutic dilemma. This literature review identifies evidence and guideline and consensus statements from the last 5 years to provide updated recommendations and insight into bridge therapy for patients using a VKA for AF. Since our last review, at least four major international guidelines have been updated plus a new consensus document addressing bridge therapy was released. Prospective trials and one randomized controlled trial have provided guidance for perioperative bridge therapy. The clinical trial data showed that bridging with heparin is associated with a significant bleeding risk compared with not bridging; furthermore, data suggested that actual perioperative thromboembolic risk may be lower than previously estimated. Notably, patients at high risk for stroke have not been adequately represented. These findings highlight the importance of assessing thrombosis and bleeding risk before making bridging decisions. Thrombosis and bleeding risk tools have emerged to facilitate this assessment and have been incorporated into guideline recommendations. Results from ongoing trials are expected to provide more guidance on safe and effective perioperative management approaches for patients at high risk for stroke. © 2017 Pharmacotherapy Publications, Inc.

  2. Brief Communication: CATALYST - a multi-regional stakeholder Think Tank for fostering capacity development in disaster risk reduction and climate change adaptation

    NARCIS (Netherlands)

    Terwisscha van Scheltinga, C.T.H.M.; Hare, M.P.; Bers, van C.; Keur, van der P.

    2014-01-01

    This brief communication presents the work and objectives of the CATALYST project on "Capacity Development for Hazard Risk Reduction and Adaptation" funded by the European Commission (October 2011–September 2013). CATALYST set up a multi-regional think tank covering four regions (Central America and

  3. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

    Science.gov (United States)

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

  4. 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

  5. A Framework for the Identification of Men at Increased Risk for Prostate Cancer

    NARCIS (Netherlands)

    Roobol, Monique J.; Schroder, Fritz H.; Crawford, E. David; Freedland, Stephen J.; Sartor, A. Oliver; Fleshner, Neil; Andriole, Gerald L.

    2009-01-01

    Purpose: We assessed the risk of prostate cancer over time, and the implications for screening strategies and potential risk reduction approaches to provide a framework for clinical use of this approach concordant with the use of prostate specific antigen as a marker of current prostate cancer risk.

  6. A Framework for the Identification of Men at Increased Risk for Prostate Cancer

    NARCIS (Netherlands)

    Roobol, Monique J.; Schroder, Fritz H.; Crawford, E. David; Freedland, Stephen J.; Sartor, A. Oliver; Fleshner, Neil; Andriole, Gerald L.

    Purpose: We assessed the risk of prostate cancer over time, and the implications for screening strategies and potential risk reduction approaches to provide a framework for clinical use of this approach concordant with the use of prostate specific antigen as a marker of current prostate cancer risk.

  7. Applying the Heuristic to the Risk Assessment within the Automotive Industry Supply Chain

    Directory of Open Access Journals (Sweden)

    Marasova Daniela

    2017-03-01

    Full Text Available Risk management facilitates risk identification, evaluation, control, and by means of appropriate set of measures, risk reduction or complete elimination. Therefore, the risk management becomes a strategic factor for a company’s success. Properly implemented risk management system does not represent a tool to avoid the risk; it is used to understand the risk and provide the bases for strategic decision-making.

  8. Climate change air toxic co-reduction in the context of macroeconomic modelling.

    Science.gov (United States)

    Crawford-Brown, Douglas; Chen, Pi-Cheng; Shi, Hsiu-Ching; Chao, Chia-Wei

    2013-08-15

    This paper examines the health implications of global PM reduction accompanying greenhouse gas emissions reductions in the 180 national economies of the global macroeconomy. A human health effects module based on empirical data on GHG emissions, PM emissions, background PM concentrations, source apportionment and human health risk coefficients is used to estimate reductions in morbidity and mortality from PM exposures globally as co-reduction of GHG reductions. These results are compared against the "fuzzy bright line" that often underlies regulatory decisions for environmental toxics, and demonstrate that the risk reduction through PM reduction would usually be considered justified in traditional risk-based decisions for environmental toxics. It is shown that this risk reduction can be on the order of more than 4 × 10(-3) excess lifetime mortality risk, with global annual cost savings of slightly more than $10B, when uniform GHG reduction measures across all sectors of the economy form the basis for climate policy ($2.2B if only Annex I nations reduce). Consideration of co-reduction of PM-10 within a climate policy framework harmonized with other environmental policies can therefore be an effective driver of climate policy. An error analysis comparing results of the current model against those of significantly more spatially resolved models at city and national scales indicates errors caused by the low spatial resolution of the global model used here may be on the order of a factor of 2. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. The Community – Based Flood Disaster Risk Reduction (CBDRR in Beringin Watershed in Semarang City

    Directory of Open Access Journals (Sweden)

    Tiara Sartika Worowirasmi

    2015-08-01

    Full Text Available Population growth in Semarang city is certainly increasing land demand for settlement. Limited land and weak regulation enforcement of land control trigger the land use change including the watershed area. Semarang City Spatial Plan 2011-2031 has determined Beringin as a buffer area with limited physical development allocation but the citizens utilized the watershed area for settlement. Settlement developments in the area reduce the watershed ability to catch water and river capacity due to increased sedimentation. These two reasons are the main cause of the flash flood disaster (regularly in rainy season in seven villages of Beringin watershed. The condition is exacerbated by the tidal flood occurred in two village lies in coastal. In 2012, Semarang City government developed Flood Forecasting and Warning System as one of Climate Change Adaptation Measures known as Flood Early Warning System (FEWS. One of important output of FEWS is community-based disaster risk reduction. Community participation process in the FEWS has made it possible for the community to identify disaster risk characteristics, to propose solution for reducing flood risk which is suitable to the local wisdom, to increase the community capacity and to organize one of themselves in a disaster preparedness group which run quite independently.

  10. 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…

  11. System Risk Balancing Profiles: Software Component

    Science.gov (United States)

    Kelly, John C.; Sigal, Burton C.; Gindorf, Tom

    2000-01-01

    The Software QA / V&V guide will be reviewed and updated based on feedback from NASA organizations and others with a vested interest in this area. Hardware, EEE Parts, Reliability, and Systems Safety are a sample of the future guides that will be developed. Cost Estimates, Lessons Learned, Probability of Failure and PACTS (Prevention, Avoidance, Control or Test) are needed to provide a more complete risk management strategy. This approach to risk management is designed to help balance the resources and program content for risk reduction for NASA's changing environment.

  12. Traditional and Local Knowledge Practices for Disaster Risk Reduction in Northern Ghana

    Directory of Open Access Journals (Sweden)

    Nsioh Macnight Ngwese

    2018-03-01

    Full Text Available In order to deal with recurrent disasters, like floods and droughts coupled with the limited adaptive capacity, in the semiarid regions of Northern Ghana, local communities have no choice but to apply traditional and local knowledge practices. This study seeks to identify such practices employed in selected rural communities in Northern Ghana and to investigate their effectiveness. Data were collected through key informant interviews, household questionnaire surveys, focus group discussions, and participant observations. The findings indicated that although diverse practices were applied to predict and manage local disaster events, skepticism prevailed among locals toward these practices regarding their effectiveness. Due to the lack of science-based tools and systems for disaster prediction and management, local communities continually depended on these knowledge systems and practices. Integrating local and traditional disaster risk reduction (DRR efforts into modern scientific knowledge should be encouraged in order to reduce the vulnerability of local communities to disasters with thorough effectiveness evaluation protocols.

  13. 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.

  14. Pathogen reduction of blood components.

    Science.gov (United States)

    Solheim, Bjarte G

    2008-08-01

    Thanks to many blood safety interventions introduced in developed countries the risk of transfusion transmitted infections has become exceedingly small in these countries. However, emerging pathogens still represent a serious challenge, as demonstrated by West Nile virus in the US and more recently by Chikungunya virus in the Indian Ocean. In addition bacterial contamination, particularly in platelets, and protozoa transmitted by blood components still represent sizeable risks in developed countries. In developing countries the risk of all transfusion transmitted infections is still high due to insufficient funding and organisation of the health service. Pathogen reduction of pooled plasma products has virtually eliminated the risk of transfusion transmitted infections, without compromising the quality of the products significantly. Pathogen reduction of blood components has been much more challenging. Solvent detergent treatment which has been so successfully applied for plasma products dissolves cell membranes, and can, therefore, only be applied for plasma and not for cellular blood components. Targeting of nucleic acids has been another method for pathogen inactivation of plasma and the only approach possible for cellular blood products. As documented in more than 15 year's track record, solvent detergent treatment of pooled plasma can yield high quality plasma. The increased risk for contamination by unknown viruses due to pooling is out weighed by elimination of TRALI, significant reduction in allergic reactions and standardisation of the product. Recently, a promising method for solvent detergent treatment of single donor plasma units has been published. Methylene blue light treatment of single donor plasma units has a similar long track record as pooled solvent detergent treated plasma; but the method is less well documented and affects coagulation factor activity more. Psoralen light treated plasma has only recently been introduced (CE marked in Europe

  15. Cleaner fuels for ships provide public health benefits with climate tradeoffs.

    Science.gov (United States)

    Sofiev, Mikhail; Winebrake, James J; Johansson, Lasse; Carr, Edward W; Prank, Marje; Soares, Joana; Vira, Julius; Kouznetsov, Rostislav; Jalkanen, Jukka-Pekka; Corbett, James J

    2018-02-06

    We evaluate public health and climate impacts of low-sulphur fuels in global shipping. Using high-resolution emissions inventories, integrated atmospheric models, and health risk functions, we assess ship-related PM 2.5 pollution impacts in 2020 with and without the use of low-sulphur fuels. Cleaner marine fuels will reduce ship-related premature mortality and morbidity by 34 and 54%, respectively, representing a ~ 2.6% global reduction in PM 2.5 cardiovascular and lung cancer deaths and a ~3.6% global reduction in childhood asthma. Despite these reductions, low-sulphur marine fuels will still account for ~250k deaths and ~6.4 M childhood asthma cases annually, and more stringent standards beyond 2020 may provide additional health benefits. Lower sulphur fuels also reduce radiative cooling from ship aerosols by ~80%, equating to a ~3% increase in current estimates of total anthropogenic forcing. Therefore, stronger international shipping policies may need to achieve climate and health targets by jointly reducing greenhouse gases and air pollution.

  16. Reduction of regulatory risk: a network economic approach

    OpenAIRE

    Knieps, Günter; Weiß, Hans-Jörg

    2007-01-01

    Several definitions of regulatory risk are known from the literature. From the perspective of regulatory reform it is important to differentiate between the impact of a given regulatory scheme on the firm's risk exposure and the risk arising from discretionary behavior of regulatory agencies. Whereas the conse-quences of effective regulation in principle are known and accepted, excessive regulatory discretion may cause a strong need for regulatory reform. Regulatory reform focussing on the re...

  17. A human immunodeficiency virus risk reduction intervention for incarcerated youth: a randomized controlled trial.

    Science.gov (United States)

    Goldberg, Eudice; Millson, Peggy; Rivers, Stephen; Manning, Stephanie Jeanneret; Leslie, Karen; Read, Stanley; Shipley, Caitlin; Victor, J Charles

    2009-02-01

    To evaluate, by gender, the impact of a structured, comprehensive risk reduction intervention with and without boosters on human immunodeficiency virus (HIV) knowledge, attitudes and behaviors in incarcerated youth; and to determine predictors of increasing HIV knowledge and reducing high-risk attitudes and behaviors. This randomized controlled trial involved participants completing structured interviews at 1, 3, and 6 months. Repeated measures analysis of variance was used to analyze changes over time. The study was conducted in secure custody facilities and in the community. The study sample comprising 391 incarcerated youth, 102 female and 289 male aged 12-18, formed the voluntary sample. Participants were randomly assigned to one of three conditions: education intervention; education intervention with booster; or no systematic intervention. The outcome and predictor measures included the Rosenberg Self-Esteem Scale, Youth Self Report, Drug Use Inventory, and HIV Knowledge, Attitudes and Behavior Scale. The 6-month retention rate was 59.6%. At 6 months, males in the education and booster groups sustained increases in knowledge scores (p variations by gender underline the importance of gender issues in prevention interventions. Predictors of success were identified to inform future HIV education interventions.

  18. 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.

  19. Carbon recovery rates following different wildfire risk mitigation treatments

    Science.gov (United States)

    M. Hurteau; M. North

    2010-01-01

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

  20. Provider and systems factors in diabetes quality of care.

    Science.gov (United States)

    Ghaznavi, Kimia; Malik, Shaista

    2012-02-01

    A gap exists in knowledge and the observed frequency with which patients with diabetes actually receive treatment for optimal cardiovascular risk reduction. Many interventions to improve quality of care have been targeted at the health systems level and provider organizations. Changes in several domains of care and investment in quality by organizational leaders are needed to make long-lasting improvements. In the studies reviewed, the most effective strategies often have multiple components, whereas the use of one single strategy, such as reminders only or an educational intervention, is less effective. More studies are needed to examine the effect of several care management strategies simultaneously, such as use of clinical information systems, provider financial incentives, and organizational model on processes of care and outcomes.

  1. RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

    Science.gov (United States)

    Wiedemann, Peter M; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J

    2017-06-08

    An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study's multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the

  2. RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

    Science.gov (United States)

    Wiedemann, Peter M.; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J.

    2017-01-01

    An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study’s multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the

  3. RAMS (Risk Analysis - Modular System) methodology

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, R.D.; Strenge, D.L.; Buck, J.W. [and others

    1996-10-01

    The Risk Analysis - Modular System (RAMS) was developed to serve as a broad scope risk analysis tool for the Risk Assessment of the Hanford Mission (RAHM) studies. The RAHM element provides risk analysis support for Hanford Strategic Analysis and Mission Planning activities. The RAHM also provides risk analysis support for the Hanford 10-Year Plan development activities. The RAMS tool draws from a collection of specifically designed databases and modular risk analysis methodologies and models. RAMS is a flexible modular system that can be focused on targeted risk analysis needs. It is specifically designed to address risks associated with overall strategy, technical alternative, and `what if` questions regarding the Hanford cleanup mission. RAMS is set up to address both near-term and long-term risk issues. Consistency is very important for any comparative risk analysis, and RAMS is designed to efficiently and consistently compare risks and produce risk reduction estimates. There is a wide range of output information that can be generated by RAMS. These outputs can be detailed by individual contaminants, waste forms, transport pathways, exposure scenarios, individuals, populations, etc. However, they can also be in rolled-up form to support high-level strategy decisions.

  4. Characterizing the Benefits of Seismic Isolation for Nuclear Structures: A Framework for Risk-Based Decision Making

    Energy Technology Data Exchange (ETDEWEB)

    Bolisetti, Chandrakanth [Idaho National Lab. (INL), Idaho Falls, ID (United States); Yu, Chingching [Idaho National Lab. (INL), Idaho Falls, ID (United States); Coleman, Justin [Idaho National Lab. (INL), Idaho Falls, ID (United States); Whittaker, Andrew [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kosbab, Ben [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-11-01

    This report provides a framework for assessing the benefits of seismic isolation and exercises the framework on a Generic Department of Energy Nuclear Facility (GDNF). These benefits are (1) reduction in the risk of unacceptable seismic performance and a dramatic reduction in the probability of unacceptable performance at beyond-design basis shaking, and (2) a reduction in capital cost at sites with moderate to high seismic hazard. The framework includes probabilistic risk assessment and estimates of overnight capital cost for the GDNF.

  5. 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

  6. Early Primary Care Provider Follow-up and Readmission After High-Risk Surgery

    Science.gov (United States)

    Brooke, Benjamin S.; Stone, David H.; Cronenwett, Jack L.; Nolan, Brian; DeMartino, Randall R.; MacKenzie, Todd A.; Goodman, David C.; Goodney, Philip P.

    2014-01-01

    IMPORTANCE Follow-up with a primary care provider (PCP) in addition to the surgical team is routinely recommended to patients discharged after major surgery despite no clear evidence that it improves outcomes. OBJECTIVE To test whether PCP follow-up is associated with lower 30-day readmission rates after open thoracic aortic aneurysm (TAA) repair and ventral hernia repair (VHR), surgical procedures known to have a high and low risk of readmission, respectively. DESIGN, SETTING, AND PARTICIPANTS In a cohort of Medicare beneficiaries discharged to home after open TAA repair (n = 12 679) and VHR (n = 52 807) between 2003 to 2010, we compared 30-day readmission rates between patients seen and not seen by a PCP within 30 days of discharge and across tertiles of regional primary care use. We stratified our analysis by the presence of complications during the surgical (index) admission. MAIN OUTCOMES AND MEASURES Thirty-day readmission rate. RESULTS Overall, 2619 patients (20.6%) undergoing open TAA repair and 4927 patients (9.3%) undergoing VHR were readmitted within 30 days after surgery. Complications occurred in 4649 patients (36.6%) undergoing open TAA repair and 4528 patients (8.6%) undergoing VHR during their surgical admission. Early follow-up with a PCP significantly reduced the risk of readmission among open TAA patients who experienced perioperative complications, from 35.0% (without follow-up) to 20.4% (with follow-up) (P < .001). However, PCP follow-up made no significant difference in patients whose hospital course was uncomplicated (19.4% with follow-up vs 21.9% without follow-up; P = .31). In comparison, early follow-up with a PCP after VHR did not reduce the risk of readmission, regardless of complications. In adjusted regional analyses, undergoing open TAA repair in regions with high compared with low primary care use was associated with an 18% lower likelihood of 30-day readmission (odds ratio, 0.82; 95% CI, 0.71–0.96; P = .02), whereas no significant

  7. 75 FR 76345 - Risk Reduction Program

    Science.gov (United States)

    2010-12-08

    ... application of engineering and management principles, criteria, and techniques to optimize safety. Like risk.../deficiencies, using statistical models that compare the railroad's performance to the industry average or an... and implementation of its RRP utilizing valid mathematical tests or methods that conform to the...

  8. Testing the efficacy of a brief sexual risk reduction intervention among high-risk American Indian adults: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rachel Chambers

    2016-04-01

    Full Text Available Abstract Background American Indian adults are more likely to experience co-occurring mental health and substance use disorders than adults of other racial/ethnic groups and are disproportionately burdened by the most common sexually transmitted infections, namely chlamydia and gonorrhea. Several behavioral interventions are proven efficacious in lowering risk for sexually transmitted infection in various populations and, if adapted to address barriers experienced by American Indian adults who suffer from mental health and substance use problems, may be useful for dissemination in American Indian communities. The proposed study aims to examine the efficacy of an adapted evidence-based intervention to increase condom use and decrease sexual risk-taking and substance use among American Indian adults living in a reservation-based community in the Southwestern United States. Methods/Design The proposed study is a randomized controlled trial to test the efficacy of an adapted evidence-based intervention compared to a control condition. Participants will be American Indian adults ages 18–49 years old who had a recent episode of binge substance use and/or suicide ideation. Participants will be randomized to the intervention, a two-session risk-reduction counseling intervention or the control condition, optimized standard care. All participants will be offered a self-administered sexually transmitted infection test. Participants will complete assessments at baseline, 3 and 6 months follow-up. The primary outcome measure is condom use at last sex. Discussion This is one of the first randomized controlled trials to assess the efficacy of an adapted evidence-based intervention for reducing sexual risk behaviors among AI adults with substance use and mental health problems. If proven successful, there will be an efficacious program for reducing risk behaviors among high-risk adults that can be disseminated in American Indian communities as well as other

  9. Anterior disc displacement with reduction and symptomatic hypermobility in the human temporomandibular joint : Prevalence rates and risk factors in children and teenagers

    NARCIS (Netherlands)

    Slater, James J. R. Huddleston; Lobbezoo, Frank; Onland-Moret, N. Charlotte; Naeije, Machiel

    2007-01-01

    Aims: To assess the prevalence rates and risk factors of anterior disc displacement with reduction (ADDR) and symptomatic hypermobility in a large sample of children and teenagers. Prevalence rates were also established in samples of young adults and adults. Methods: Children from 7 Dutch primary

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Risk measures in practical use: risk reduction has its price, but is it known?

    International Nuclear Information System (INIS)

    Reinertsen, Rune

    1995-01-01

    Different risk measures are discussed in order to decide which to use to best express the risk workers are exposed to. A new risk measure is introduced and advantages and disadvantages are presented. The need for a new risk measure (Expected Number of Fatalities Rate ENFR), is discussed and explained with the help of an example. The example also contains a comparison with the well-known FAR-value. Also some problems and benefits of introducing a measure of the kind: ΔRISK/Δ$ are discussed and conclusions made. The question of what amount of money should be used on risk reducing activities is also addressed

  13. Methodology and applications for the benefit cost analysis of the seismic risk reduction in building portfolios at broadscale

    OpenAIRE

    Valcarcel, Jairo A.; Mora, Miguel G.; Cardona, Omar D.; Pujades, Lluis G.; Barbat, Alex H.; Bernal, Gabriel A.

    2013-01-01

    This article presents a methodology for an estimate of the benefit cost ratio of the seismic risk reduction in buildings portfolio at broadscale, for a world region, allowing comparing the results obtained for the countries belonging to that region. This methodology encompasses (1) the generation of a set of random seismic events and the evaluation of the spectral accelerations at the buildings location; (2) the estimation of the buildings built area, the economic value, as well as the cla...

  14. Substance Use Among Adolescents with Attention-Deficit/Hyperactivity Disorder: Reasons for Use, Knowledge of Risks, and Provider Messaging/Education.

    Science.gov (United States)

    Harstad, Elizabeth; Wisk, Lauren E; Ziemnik, Rosemary; Huang, Qian; Salimian, Parissa; Weitzman, Elissa R; Levy, Sharon

    Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for alcohol and marijuana use. This study's objective is to describe adolescents' ADHD-specific reasons for marijuana use, knowledge of ADHD-specific alcohol risks, and reported subspecialty provider messaging/education regarding alcohol use among adolescents with ADHD. Youths with ADHD aged 12 to 18 years completed a survey about alcohol and marijuana use, ADHD-specific reasons for marijuana use, knowledge of ADHD-specific alcohol risks, and reported provider messaging/education regarding alcohol use. We assessed knowledge toward substance use using descriptive statistics. We used χ and t tests to determine whether knowledge or provider messaging/education differed by sociodemographic characteristics. Of the 96 participants, 61.5% were male, average age was 15.7 years; 31.3% reported past-year alcohol use and 20.8% reported past-year marijuana use. The majority (65.2%) said "no/don't know" to both "Can alcohol make ADHD symptoms worse?" and "Can alcohol interfere or get in the way of the medications you take?" Older participants were more likely to correctly answer the medication question "yes." Despite most (74%) participants reporting that their provider asked about alcohol use, few youth reported that their providers gave specific messages/education that alcohol could make ADHD symptoms worse (9.4%) or interfere with ADHD medications (14.6%); older participants and past-year alcohol users were more likely to have received these alcohol-specific messages. Many youth with ADHD are unaware of the risks of alcohol use in relation to ADHD and providers are not consistently discussing these risks in the context of clinical ADHD care.

  15. Centrality as a Method for the Evaluation of Semantic Resources for Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    Otakar Čerba

    2017-08-01

    Full Text Available Clear and straightforward communication is a key aspect of all human activities related to crisis management. Since crisis management activities involve professionals from various disciplines using different terminology, clear and straightforward communication is difficult to achieve. Semantics as a broad science can help to overcome communication difficulties. This research focuses on the evaluation of available semantic resources including ontologies, thesauri, and controlled vocabularies for disaster risk reduction as part of crisis management. The main idea of the study is that the most appropriate source of broadly understandable terminology is such a semantic resource, which is accepted by—or at least connected to the majority of other resources. Important is not only the number of interconnected resources, but also the concrete position of the resource in the complex network of Linked Data resources. Although this is usually done by user experience, objective methods of resource semantic centrality can be applied. This can be described by centrality methods used mainly in graph theory. This article describes the calculation of four types of centrality methods (Outdegree, Indegree, Closeness, and Betweenness applied to 160 geographic concepts published as Linked Data and related to disaster risk reduction. Centralities were calculated for graph structures containing particular semantic resources as nodes and identity links as edges. The results show that (with some discussed exceptions the datasets with high values of centrality serve as important information resources, but they also include more concepts from preselected 160 geographic concepts. Therefore, they could be considered as the most suitable resources of terminology to make communication in the domain easier. The main research goal is to automate the semantic resources evaluation and to apply a well-known theoretical method (centrality to the semantic issues of Linked Data. It

  16. 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.

  17. Risk reduction by use of a buffer zone

    NARCIS (Netherlands)

    Wijnant-Timmerman, S.L.; Wiersma, T.

    2008-01-01

    In situations where chemical industries and residential areas are situated close to each other, the population runs a safety risk associated with the accidental release of toxic gases. TNO has investigated the possibilities to reduce this risk by integrating safety measures in the area between the

  18. No compelling evidence that sibutramine prolongs life in rodents despite providing a dose-dependent reduction in body weight

    Science.gov (United States)

    Smith, Daniel L.; Robertson, Henry; Desmond, Renee; Nagy, Tim R.; Allison, David B.

    2010-01-01

    Objective The health and longevity effects of body weight reduction resulting from exercise and caloric restriction in rodents are well known, but less is known about whether similar effects occur with weight reduction from the use of a pharmaceutical agent such as sibutramine, a serotonin-norepinephrine reuptake inhibitor. Results & Conclusion Using data from a two-year toxicology study of sibutramine in CD rats and CD-1 mice, despite a dose-dependent reduction in food intake and body weight in rats compared to controls, and a body weight reduction in mice at the highest dose, there was no compelling evidence for reductions in mortality rate. PMID:21079617

  19. Solar radon reduction at six homes in northeast Iowa

    International Nuclear Information System (INIS)

    Rhoads, H.E.; Hoekje, P.L.

    1995-01-01

    Growing concern about radon lung cancer risks, carbon monoxide poisoning, and the sick building syndrome have increased demand for improved indoor air quality. Through solar pre-heating of ventilation air, the Solar Radon Reduction System (SRRS) provides energy benefits with lower installation costs than conventional air-to-air heat exchangers and sub-slab suction approaches. Indoor air quality is improved through dilution, combustion appliance make-up air, pressurization, and reduced radon infiltration through induced-draft solar air collectors drawing supply air from outdoors. Installed at six homes in Waterloo and Cedar Falls, Iowa, the SRRS was found to significantly reduce radon concentrations in all houses with energy benefits and improved overall indoor comfort. Up to 73% reductions from closed house levels as high as 20.9 pCi/L were achieved

  20. Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK

    OpenAIRE

    Kimergård, Andreas; McVeigh, Jim

    2014-01-01

    Objectives The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how ‘risk environments’ produce harm. Methods Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Re...