The 'polypill' to reduce cardiovascular risk

DEFF Research Database (Denmark)

Patel, Vinod; Pedersen, Oluf; Morrissey, John

2004-01-01

This article considers data from the Steno-2 multifactorial intervention study in type 2 diabetes to which are applied the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Mathematical analyses support the use of a 'polypill' to reduce cardiovascular risk in type 2 diabetes. It is s...

Benefits from reducing risk of death

Energy Technology Data Exchange (ETDEWEB)

Krupnick, A

1994-07-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States.

Benefits from reducing risk of death

International Nuclear Information System (INIS)

Krupnick, A.

1994-01-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States

Design of Work Facilities for Reducing Musculoskeletal Disorders Risk in Paper Pallet Assembly Station

Science.gov (United States)

Mardi Safitri, Dian; Arfi Nabila, Zahra; Azmi, Nora

2018-03-01

Musculoskeletal Disorders (MSD) is one of the ergonomic risks due to manual activity, non-neutral posture and repetitive motion. The purpose of this study is to measure risk and implement ergonomic interventions to reduce the risk of MSD on the paper pallet assembly work station. Measurements to work posture are done by Ovako Working Posture Analysis (OWAS) methods and Rapid Entire Body Assessment (REBA) method, while the measurement of work repetitiveness was using Strain Index (SI) method. Assembly processes operators are identified has the highest risk level. OWAS score, Strain Index, and REBA values are 4, 20.25, and 11. Ergonomic improvements are needed to reduce that level of risk. Proposed improvements will be developed using the Quality Function Deployment (QFD) method applied with Axiomatic House of Quality (AHOQ) and Morphological Chart. As the result, risk level based on OWAS score & REBA score turn out from 4 & 11 to be 1 & 2. Biomechanics analysis of the operator also shows the decreasing values for L4-L5 moment, compression, joint shear, and joint moment strength.

Distance factor on reducing scattered radiation risk during interventional fluoroscopy

International Nuclear Information System (INIS)

Husaini Salleh; Mohd Khalid Matori; Muhammad Jamal Mat Isa; Zainal Jamaluddin; Mohd Firdaus Abdul Rahman; Mohd Khairusalih Mohd Zin

2012-01-01

Interventional Radiology (IR) is subspecialty of diagnostic radiology where minimally invasive procedures are performed using an x-ray as a guidance. This procedure can deliver high radiation doses to patient and medical staff compared with other radiological method due to long screening time. The use of proper shielding, shorten the exposure time and keep the distance are the practices to reduce scattered radiation risks to staff involve in this procedure. This project is to study the distance factor on reducing the scattered radiation effect to the medical staff. It also may provide the useful information which can be use to establish the scattered radiation profile during the IR for the sake of radiation protection and safety to the medical staff involved. (author)

Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits.

Science.gov (United States)

Rimm, E. B.; Klatsky, A.; Grobbee, D.; Stampfer, M. J.

1996-01-01

OBJECTIVES: To review the effect of specific types of alcoholic drink on coronary risk. DESIGN: Systematic review of ecological, case-control, and cohort studies in which specific associations were available for consumption of beer, wine, and spirits and risk of coronary heart disease. SUBJECTS: 12 ecological, three case-control, and 10 separate prospective cohort studies. MAIN OUTCOME MEASURES: Alcohol consumption and relative risk of morbidity and mortality from coronary heart disease. RESULTS: Most ecological studies suggested that wine was more effective in reducing risk of mortality from heart disease than beer or spirits. Taken together, the three case-control studies did not suggest that one type of drink was more cardioprotective than the others. Of the 10 prospective cohort studies, four found a significant inverse association between risk of heart disease and moderate wine drinking, four found an association for beer, and four for spirits. CONCLUSIONS: Results from observational studies, where alcohol consumption can be linked directly to an individual's risk of coronary heart disease, provide strong evidence that all alcoholic drinks are linked with lower risk. Thus, a substantial portion of the benefit is from alcohol rather than other components of each type of drink. PMID:8605457

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

Science.gov (United States)

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Functional neural correlates of reduced physiological falls risk

Directory of Open Access Journals (Sweden)

Hsu Chun

2011-08-01

Full Text Available Abstract Background It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. Methods We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA. Results After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Conclusions Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

Reduced risk avoidance and altered neural correlates of feedback processing in patients with borderline personality disorder.

Science.gov (United States)

Endrass, Tanja; Schuermann, Beate; Roepke, Stefan; Kessler-Scheil, Sonia; Kathmann, Norbert

2016-09-30

Patients with borderline personality disorder (BPD) show deficits in reward-guided decision making and learning. The present study examined risk-taking behavior in combination with feedback processing. Eighteen BPD patients and 18 healthy controls performed a probabilistic two-choice gambling task, while an electroencephalogram was recorded. Options differed in risk, but were identical in expected value and outcome probability. The feedback-related negativity (FRN) and the feedback-related P300 were analyzed. Healthy controls preferred low-risk over high-risk options, whereas BPD patients chose both option with equal probability. FRN amplitudes were reduced in BPD, but effects of feedback valence and risk did not differ between groups. This suggests attenuated outcome processing in the anterior cingulate cortex, but intact reward prediction error signaling. Furthermore, the modulation of the feedback-related P300 with feedback valence and risk was smaller in BPD patients, and decreased P300 amplitudes were associated with increased behavioral risk-taking behavior. These findings could relate to the reduced ability of BPD patients to learn and adequately adjust their behavior based on feedback information, possibly due to reduced significance of negative feedback. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Reducing cancer risk in rural communities through supermarket interventions.

Science.gov (United States)

McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

2013-09-01

Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

Nutritional strategies to reduce falls risk in older people.

Science.gov (United States)

Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Does retirement reduce the risk of myocardial infarction?

DEFF Research Database (Denmark)

Olesen, Kasper; Rugulies, Reiner; Rod, Naja Hulvej

2014-01-01

BACKGROUND: Recent studies have suggested that retirement may have beneficial effects on health outcomes. In this study we examined whether the risk of myocardial infarction (MI) was reduced following retirement in a Danish population sample. METHODS: Participants were 617 511 Danish workers, born...... of 1.11 (95% confidence interval: 1.06, 1.16) when comparing retirees with active workers of the same age. CONCLUSIONS: This study does not support the hypothesis that retirement reduces risk of MI. On the contrary, we find that retirement is associated with a modestly increased risk of MI....

Reducing the risk from radioactive sources

International Nuclear Information System (INIS)

MacKenzie, C.

2006-01-01

Each year the IAEA receives reports of serious injuries or deaths due to misuse or accidents involving sealed radioactive sources. Sealed radioactive sources are used widely in medicine, industry, and agriculture - by doctors to treat cancer, by radiographers to check welds in pipelines, or by specialists to irradiate food to prevent it from spoiling, for example. If these sources are lost or improperly discarded, a serious accident may result. In addition, the security of sealed sources has become a growing concern, particularly the potential that such a source could be used as a radioactive dispersal device or 'dirty bomb'. Preventing the loss or theft of sealed radioactive sources reduces both the risk of accidents and the risk that such sources could become an instrument of misuse. In most countries, radioactive materials and activities that produce radiation are regulated. Those working with sealed radioactive sources are required not just to have proper credentials, but also the needed training and support to deal with unexpected circumstances that may arise when a source is used. Despite these measures, accidents involving sealed sources continue to be reported to the IAEA. Among its many activities to improve the safety and security of sealed sources, the IAEA has been investigating the root causes of major accidents since the 1980s and publishing the findings so that others can learn from them. This information needs to be in the hands of those whose actions and decisions can reduce accidents by preventing a lost source from making it's way into scrap metal. The IAEA has also developed an international catalogue of sealed radioactive sources, and provides assistance to countries to safely contain sources no longer in use. To raise awareness, a Sealed Radioactive Sources Toolkit was issued that focuses on the long-term issues in safely and securely managing radioactive sealed sources. The target audiences are government agencies, radioactive sealed source

Environmental impact due to nuclear power plants

International Nuclear Information System (INIS)

Kellermann, O.; Balfanz, H.P.

1975-01-01

The environmental impact due to nuclear power plants is smaller than that due to fossil-fired power plants. The risks of the nuclear power plant operation are determined by the quantity and the probability of the release of radioactive materials. According to the value, the risks of normal operation can be compared to the accident risks. An attempt should be made to effectively reduce the remaining risk at unfavourable sites with the emphasis on accidents with larger effects than design basis accidents. (orig./LH) [de

Breast cancer after bilateral risk-reducing mastectomy

DEFF Research Database (Denmark)

Skytte, A-B; Crüger, Dorthe Gylling; Gerster, M

2011-01-01

This study aims to evaluate the incidence of breast cancer after risk-reducing mastectomy (RRM) in healthy BRCA mutation carriers. This study is a long-term follow-up of 307 BRCA mutation carriers of whom 96 chose RRM. None of the study participants had a previous history of breast or ovarian...... cancer nor had they undergone RRM or risk-reducing bilateral salpingo-oophorectomy (BSO) prior to the time of BRCA testing. The annual incidence of post-mastectomy breast cancer was 0.8% compared with 1.7% in the non-operated group. Implications of these findings in relation to genetic counseling...

Breastfeeding Reduces Childhood Obesity Risks.

Science.gov (United States)

Wang, Liang; Collins, Candice; Ratliff, Melanie; Xie, Bin; Wang, Youfa

2017-06-01

The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.

Risk factors for generally reduced productivity--a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms.

Science.gov (United States)

Boström, Maria; Dellve, Lotta; Thomée, Sara; Hagberg, Mats

2008-04-01

This study prospectively assessed the importance of individual conditions and computer use during school or work and leisure time as risk factors for self-reported generally reduced productivity due to musculoskeletal complaints among young adults with musculoskeletal symptoms in the neck or upper extremities. A cohort of 2914 young adults (18-25 years, vocational school and college or university students) responded to an internet-based questionnaire concerning musculoskeletal symptoms related to individual conditions and computer use during school or work and leisure time that possibly affected general productivity. Prevalence ratios (PR) were used to assess prospective risk factors for generally reduced productivity. The selected study sample (N=1051) had reported neck or upper-extremity symptoms. At baseline, 280 of them reported reduced productivity. A follow-up of the 771 who reported no reduced productivity was carried out after 1 year. Risk factors for self-reported generally reduced productivity for those followed-up were symptoms in two or three locations or dimensions for the upper back or neck and the shoulders, arms, wrists, or hands [PR 2.30, 95% confidence interval (95% CI) 1.40-3.78], symptoms persisting longer than 90 days in the shoulders, arms, wrists, or hands (PR 2.50, 95% CI 1.12-5.58), current symptoms in the shoulders, arms, wrists, or hands (PR 1.78, 95% CI 1.10-2.90) and computer use 8-14 hours/week during leisure time (PR 2.32, 95% CI 1.20-4.47). A stronger relationship was found if three or four risk factors were present. For women, a relationship was found between generally reduced productivity and widespread and current symptoms in the upper extremities. The main risk factors for generally reduced productivity due to musculoskeletal symptoms among young adults in this study were chronic symptoms in the upper extremities and widespread symptoms in the neck and upper extremities.

Reducing cardiovascular risk : protecting the kidney

NARCIS (Netherlands)

Dobre, Daniela; Lambers Heerspink, Hiddo J.; de Zeeuw, Dick

2009-01-01

Progressive decline of renal function in chronic kidney disease (CKD), measured by a reduced glomerular filtration rate or albuminuria, is linked to an increased risk of cardiovascular (CV) disease. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), most

Apparently conclusive meta-analyses may be inconclusive--Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta-analyses

DEFF Research Database (Denmark)

Brok, Jesper; Thorlund, Kristian; Wetterslev, Jørn

2008-01-01

BACKGROUND: Random error may cause misleading evidence in meta-analyses. The required number of participants in a meta-analysis (i.e. information size) should be at least as large as an adequately powered single trial. Trial sequential analysis (TSA) may reduce risk of random errors due to repeti......BACKGROUND: Random error may cause misleading evidence in meta-analyses. The required number of participants in a meta-analysis (i.e. information size) should be at least as large as an adequately powered single trial. Trial sequential analysis (TSA) may reduce risk of random errors due...

Risks due to fires at Big Rock Point

International Nuclear Information System (INIS)

Brinsfield, W.A.; Blanchard, D.P.

1983-01-01

The unique and older designs of the Big Rock Point nuclear plant is such that fires contribute significantly to the probability of core damage predicted in the probabilistic risk assessment performed for this plant. The methodology employed to determine this contribution reflects the unique, as constructed, plant design, while systematically and logically addressing the true effect of fires on the operation of the plant and the safety of the public. As a result of the methodology utilized in the PRA, recommendations are made which minimize the risk of core damage due to fires. Included in these recommendations is a proposal for equipment and controls to be included on the Big Rock Point alternate shutdown panel

A screening tool for the risk of disability retirement due to musculoskeletal disorders.

Science.gov (United States)

Shiri, Rahman; Heliövaara, Markku; Ahola, Kirsi; Kaila-Kangas, Leena; Haukka, Eija; Kausto, Johanna; Saastamoinen, Peppiina; Leino-Arjas, Päivi; Lallukka, Tea

2018-01-01

Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676) and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gönen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of 3 or higher out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.

Understanding your supply chain to reduce the risk of supply chain disruption.

Science.gov (United States)

Wildgoose, Nick; Brennan, Patrick; Thompson, Simon

2012-01-01

Supply chains are at the heart of the way in which organisations operate and compete today; they also play a critical role in overall organisation performance. In the context of increasingly complex and global supply chains, the actions taken to drive down costs are likely to drive risk into the supply chain. The frequency of supply chain disruptions is high and this paper offers practical advice to help reduce the frequency and cost associated with these. There is advice to help with the understanding of how to identify critical suppliers. The reader is guided through comprehensive risk assessment and mitigation approaches and a selection of practical risk solutions and tools that you can use is described. There is a section on the 'dos and don'ts' relating to supplier due diligence. For those organisations facing the challenge of drawing up a business case relating to investment in improving supply chain resiliency, there is also a section outlining some of the business benefits of improving supply chain resiliency.

Business risks, functions, methods of assessment and ways to reduce risk

Directory of Open Access Journals (Sweden)

A.V. Mihalchuk

2015-06-01

Full Text Available For successful existence in a market economy entrepreneur have to take bold actions, and this increases the risk. The article describes the concept of entrepreneurship and business risk, positive and negative aspects of functions of risk in business. Therefore, it is necessary to assess the risk properly and be able to manage it to achieve the most effective results in the market. In market conditions the problem of assessing and accounting market becomes independent theoretical and practical significance as an important component of the theory and practice of management. Risk - a key element of business activities. Development of risk situations can lead to both the occurrence of adverse effects (losses, lost profits, and positive results for a company in the form of increased profit. This article describes: the concept of entrepreneurship, risk and business risks, characteristic of positive and negative aspects of risk functions in business, methods of assessment and risk reduction, shows formulae and examples you can use to assess risk in an enterprise. Analyzing already established methods of risk assessment a number of rules were proposed in order to reduce business risk.

Estimate of the shielding effect on secondary cancer risk due to cone-beam CT in image-guided radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Sung, Jiwon; Baek, Taeseong; Yoon, Myonggeun [Korea University, Seoul (Korea, Republic of); Kim, Dongwook; Kim, Donghyun [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

2014-09-15

This study evaluated the effect of a simple shielding method using a thin lead sheet on the imaging dose caused by cone-beam computed tomography (CBCT) in image-guided radiation therapy (IGRT). Reduction of secondary doses from CBCT was measured using a radio-photoluminescence glass dosimeter (RPLGD) placed inside an anthropomorphic phantom. The entire body, except for the region scanned by using CBCT, was shielded by wrapping it with a 2-mm lead sheet. Changes in secondary cancer risk due to shielding were calculated using BEIR VII models. Doses to out-of-field organs for head-and-neck, chest, and pelvis scans were decreased 15 ∼ 100%, 23 ∼ 90%, and 23 ∼ 98%, respectively, and the average reductions in lifetime secondary cancer risk due to the 2-mm lead shielding were 1.6, 11.5, and 12.7 persons per 100,000, respectively. These findings suggest that a simple, thin-lead-sheet-based shielding method can effectively decrease secondary doses to out-of-field regions for CBCT, which reduces the lifetime cancer risk on average by 9 per 100,000 patients.

Periodontal disease with treatment reduces subsequent cancer risks.

Science.gov (United States)

Hwang, Ing-Ming; Sun, Li-Min; Lin, Cheng-Li; Lee, Chun-Feng; Kao, Chia-Hung

2014-10-01

The aim of our study was to evaluate the relationship between routine treatment of periodontal disease (PD) and the subsequent risks for cancers in Taiwan. Study participants were selected from the Taiwan National Health Insurance (NHI) system database. The PD with a routine treatment cohort contained 38 902 patients. For each treatment cohort participant, two age- and sex-matched comparison (control) cohort participants were randomly selected. Cox's proportional hazards regression analysis was used to estimate the effects of PD with treatment on the subsequent risk of cancer. The overall risk of developing cancer was significantly lower in the treatment cohort than in the patients without treatment (adjusted Hazard ratio = 0.72, 95% confidence interval = 0.68-0.76). The risks of developing most gastrointestinal tract, lung, gynecological and brain malignancies were significantly lower in the treatment cohort than in the comparison cohort. In contrast, the risks of prostate and thyroid cancers were significantly higher in the treatment cohort than in the comparison cohort. Our findings suggest that PD with treatment is associated with a significantly reduced overall risk of cancer and reduced risks of certain types of cancers. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Science.gov (United States)

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

2015-01-01

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

The efficiency of asset management strategies to reduce urban flood risk.

Science.gov (United States)

ten Veldhuis, J A E; Clemens, F H L R

2011-01-01

In this study, three asset management strategies were compared with respect to their efficiency to reduce flood risk. Data from call centres at two municipalities were used to quantify urban flood risks associated with three causes of urban flooding: gully pot blockage, sewer pipe blockage and sewer overloading. The efficiency of three flood reduction strategies was assessed based on their effect on the causes contributing to flood risk. The sensitivity of the results to uncertainty in the data source, citizens' calls, was analysed through incorporation of uncertainty ranges taken from customer complaint literature. Based on the available data it could be shown that increasing gully pot blockage is the most efficient action to reduce flood risk, given data uncertainty. If differences between cause incidences are large, as in the presented case study, call data are sufficient to decide how flood risk can be most efficiently reduced. According to the results of this analysis, enlargement of sewer pipes is not an efficient strategy to reduce flood risk, because flood risk associated with sewer overloading is small compared to other failure mechanisms.

Public Information Programmes on Risks Due to Radon. Annex V

International Nuclear Information System (INIS)

2015-01-01

Public concern about radon is generally lower than public concern about other comparable risks, or about much lower risks such as those associated with artificial radiation. The public tends to be most concerned about hazards that are: (a) Human made rather than natural; (b) Imposed by a human agency rather than arising by chance; (c) Able to cause harm to groups rather than individuals; (d) Obvious, immediate and ‘dread’ rather than covert, delayed and familiar. None of the four above mentioned factors that would increase concern apply to radon, and a study has found that householders often deny that a health risk exists. For this reason, public information programmes are necessary for the risks due to radon to be taken seriously

Evaluating shielding effectiveness for reducing space radiation cancer risks

International Nuclear Information System (INIS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; Ren, Lei

2006-01-01

We discuss calculations of probability distribution functions (PDF) representing uncertainties in projecting fatal cancer risk from galactic cosmic rays (GCR) and solar particle events (SPE). The PDFs are used in significance tests for evaluating the effectiveness of potential radiation shielding approaches. Uncertainties in risk coefficients determined from epidemiology data, dose and dose-rate reduction factors, quality factors, and physics models of radiation environments are considered in models of cancer risk PDFs. Competing mortality risks and functional correlations in radiation quality factor uncertainties are included in the calculations. We show that the cancer risk uncertainty, defined as the ratio of the upper value of 95% confidence interval (CI) to the point estimate is about 4-fold for lunar and Mars mission risk projections. For short-stay lunar missions ( 180d) or Mars missions, GCR risks may exceed radiation risk limits that are based on acceptable levels of risk. For example, the upper 95% CI exceeding 10% fatal risk for males and females on a Mars mission. For reducing GCR cancer risks, shielding materials are marginally effective because of the penetrating nature of GCR and secondary radiation produced in tissue by relativistic particles. At the present time, polyethylene or carbon composite shielding cannot be shown to significantly reduce risk compared to aluminum shielding based on a significance test that accounts for radiobiology uncertainties in GCR risk projection

Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

Directory of Open Access Journals (Sweden)

Stephanie L Sansom

Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

Risk analysis of the LHC underground area fire risk due to faulty electrical equipment

CERN Document Server

Harrison, A

2007-01-01

The European Organisation for Nuclear Research (CERN) in Geneva, Switzerland, is currently building the latest generation of particle accelerators, the LHC (Large Hadron Collider). The machine is housed in a circular tunnel of 27 km of circumference and is situated approximately 100 metres beneath the surface astride the Franco-Swiss border. Electrically induced fires in the LHC are a major concern, since an incident could present a threat to CERN personnel as well as the public. Moreover, the loss of equipment would result in significant costs and downtime. However, the amount of electrical equipment in the underground area required for operation, supervision and control of the machine is essential. Thus the present thesis is assessing the risk of fire due to faulty electrical equipment in both a qualitative as well as quantitative way. The recommendations following the qualitative analysis suggest the introduction of fire protection zones for the areas with the highest risk of fire due to a combination of p...

Economic impact of reduced mortality due to increased cycling.

Science.gov (United States)

Rutter, Harry; Cavill, Nick; Racioppi, Francesca; Dinsdale, Hywell; Oja, Pekka; Kahlmeier, Sonja

2013-01-01

Increasing regular physical activity is a key public health goal. One strategy is to change the physical environment to encourage walking and cycling, requiring partnerships with the transport and urban planning sectors. Economic evaluation is an important factor in the decision to fund any new transport scheme, but techniques for assessing the economic value of the health benefits of cycling and walking have tended to be less sophisticated than the approaches used for assessing other benefits. This study aimed to produce a practical tool for estimating the economic impact of reduced mortality due to increased cycling. The tool was intended to be transparent, easy to use, reliable, and based on conservative assumptions and default values, which can be used in the absence of local data. It addressed the question: For a given volume of cycling within a defined population, what is the economic value of the health benefits? The authors used published estimates of relative risk of all-cause mortality among regular cyclists and applied these to levels of cycling defined by the user to produce an estimate of the number of deaths potentially averted because of regular cycling. The tool then calculates the economic value of the deaths averted using the "value of a statistical life." The outputs of the tool support decision making on cycle infrastructure or policies, or can be used as part of an integrated economic appraisal. The tool's unique contribution is that it takes a public health approach to a transport problem, addresses it in epidemiologic terms, and places the results back into the transport context. Examples of its use include its adoption by the English and Swedish departments of transport as the recommended methodologic approach for estimating the health impact of walking and cycling. Copyright © 2013 World Health Organization. Published by Elsevier Inc. All rights reserved.

[Strategies for reducing risks in smoking: opportunity or threat].

Science.gov (United States)

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

Reducing the Risk of Methadone Overdose

Centers for Disease Control (CDC) Podcasts

2012-07-03

This podcast is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

Reducing Disaster Risk through Vulnerability Assessment: An Agricultural Perspective

Directory of Open Access Journals (Sweden)

Koos van Zyl

2006-04-01

Full Text Available A growing population, economic and environmental losses due to natural or human-made disasters, provides the need for a systematic approach to the management of risks. It is generally accepted that a multi-disciplinary understanding of disaster risk management is required.

Communication in reducing facility siting risk

International Nuclear Information System (INIS)

Bisconti, A.S.

1992-01-01

Today, social considerations are as important as technical ones in siting new nuclear facilities. Siting any industrial facility has become extremely difficult in this era of not in my backyard (NIMBY). Even if NIMBY does not arise locally, well-organized national opposition groups can be counted on to step in to fan the flames, especially when the industrial facility has to do with anything nuclear. It is now generally recognized that the greatest risk of failure for new nuclear facilities is not technical but social. Applying lessons gained from past experience and social science research can help reduce that risk. From these lessons, six principles for public interaction and communication stand out: (1) create goodwill now; (2) involve the community early; (3) establish the need; (4) communicate controls, not risk; (5) avoid jargon; (6) understand your public

Coupled analysis of building damage due to tunneling

NARCIS (Netherlands)

Giardina, G.; Hendriks, M.A.N.; Rots, J.G.

2009-01-01

Excavation works in urban areas require a preliminary risk damage assessment. In historical cities, the prediction of building response to settlements is necessary to reduce the risk of damage of the architectural heritage. The current method used to predict the building damage due to ground

A surety engineering framework to reduce cognitive systems risks.

Energy Technology Data Exchange (ETDEWEB)

Caudell, Thomas P. (University of New Mexico, Albuquerque, NM); Peercy, David Eugene; Caldera, Eva O. (University of New Mexico, Albuquerque, NM); Shaneyfelt, Wendy L.

2008-12-01

Cognitive science research investigates the advancement of human cognition and neuroscience capabilities. Addressing risks associated with these advancements can counter potential program failures, legal and ethical issues, constraints to scientific research, and product vulnerabilities. Survey results, focus group discussions, cognitive science experts, and surety researchers concur technical risks exist that could impact cognitive science research in areas such as medicine, privacy, human enhancement, law and policy, military applications, and national security (SAND2006-6895). This SAND report documents a surety engineering framework and a process for identifying cognitive system technical, ethical, legal and societal risks and applying appropriate surety methods to reduce such risks. The framework consists of several models: Specification, Design, Evaluation, Risk, and Maturity. Two detailed case studies are included to illustrate the use of the process and framework. Several Appendices provide detailed information on existing cognitive system architectures; ethical, legal, and societal risk research; surety methods and technologies; and educing information research with a case study vignette. The process and framework provide a model for how cognitive systems research and full-scale product development can apply surety engineering to reduce perceived and actual risks.

Should We Use PPAR Agonists to Reduce Cardiovascular Risk?

Directory of Open Access Journals (Sweden)

Jennifer G. Robinson

2008-01-01

Full Text Available Trials of peroxisome proliferator-activated receptor (PPAR agonists have shown mixed results for cardiovascular prevention. Fibrates are PPAR- agonists that act primarily to improve dyslipidemia. Based on low- and high-density lipoprotein cholesterol (LDL and HDL effects, gemfibrozil may be of greater cardiovascular benefit than expected, fenofibrate performed about as expected, and bezafibrate performed worse than expected. Increases in both cardiovascular and noncardiovascular serious adverse events have been observed with some fibrates. Thiazolidinediones (TZDs are PPAR- agonists used to improve impaired glucose metabolism but also influence lipids. Pioglitazone reduces atherosclerotic events in diabetic subjects, but has no net cardiovascular benefit due to increased congestive heart failure risk. Rosiglitazone may increase the risk of atherosclerotic events, and has a net harmful effect on the cardiovascular system when congestive heart failure is included. The primary benefit of TZDs appears to be the prevention of diabetic microvascular complications. Dual PPAR-/ agonists have had unacceptable adverse effects but more selective agents are in development. PPAR- and pan-agonists are also in development. It will be imperative to prove that future PPAR agonists not only prevent atherosclerotic events but also result in a net reduction on total cardiovascular events without significant noncardiovascular adverse effects with long-term use.

Risk factors associated with reduced work productivity among people with chronic knee pain.

Science.gov (United States)

Agaliotis, M; Fransen, M; Bridgett, L; Nairn, L; Votrubec, M; Jan, S; Heard, R; Mackey, M

2013-09-01

To determine the burden and risk factors associated with reduced work productivity among people with chronic knee pain. A longitudinal study, nested within a randomised controlled trial (RCT) evaluating the long-term effects of dietary supplements, was conducted among people with chronic knee pain in paid employment (n = 360). Participants recorded days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days every two months over a 12-month period in a study specific diary. Examined risk factors included knee pain severity, occupational group, radiographic disease severity, physical activity, body mass index (BMI), health-related quality of life (SF-12) and co-morbidity. Over the 12-month follow up period, 50 (14%) participants reported one or more days off work due to knee problems, while 283 (79%) reported reduced productivity while at work (presenteeism absenteeism was having an SF-12 Mental Component Summary (MCS) score labour (OR: 2.23 [1.09-4.59]) or manual labour (OR: 6.40 [1.44-28.35]) or a high maximum knee pain (4-6 out of 10) (OR: 2.29 [1.17-4.46]). This longitudinal study found that among this cohort of people with chronic knee pain, the burden of reduced work productivity is mainly attributable to presenteeism rather absenteeism. This study demonstrated that effective strategies to increase work productivity should focus on reducing knee pain or physical disability especially among workers in manual or semi-manual labour. © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Design of emergency plans due to the failure risk of hydraulic works - Theory and case study

International Nuclear Information System (INIS)

Ochoa Rivera, Juan Camilo

2006-01-01

Dams are built to be highly safe hydraulic works. Nevertheless, they are not exempt from a certain failure risk, which turns in a variable value along the time service of the dam. As the mentioned dam-failure risk can be a significant hazard, analysis on dam-break is becoming important, as same as the assessment of its consequences. This type of studies are intended to reduce the costs linked to dam-failure, which are mainly due to the losses of human beings and material goods. A suitable way to minimize such losses consists of designing emergency plans, which permit to prepare and implant appropriate protection measures. A methodological framework to carry out this kind of emergency plans is introduced in this paper, accompanied by a case study corresponding to an emergency plan of a Spanish dam

Reducing the Risks for Contrast-Induced Nephropathy

International Nuclear Information System (INIS)

Stacul, Fulvio

2005-01-01

Contrast-induced nephropathy (CIN) is one of the most serious adverse events associated with the use of contrast media (CM). Patients who develop this complication can have increased morbidity, higher rates of mortality, lengthy hospital stays, and poor long-term outcomes. Although CIN cannot be eliminated, the chances of developing this condition can be reduced by using appropriate prevention strategies. An important first step to reduce the chance of CIN is to identify risk factors associated with this condition. Patients with a previously elevated serum creatinine level, especially when secondary to diabetic nephropathy, are at great risk for developing CIN. Other patient-related risk factors include concurrent use of nephrotoxic medications, dehydration, congestive heart failure, age greater than 70 years, and probably the presence of diabetes mellitus even if serum creatinine is normal. Adequate hydration is widely accepted as an important prophylactic measure for preventing CIN, but the optimal hydration regimen is still debatable. The risk of CIN increases with greater doses of CM, as well as with the type of CM used. A high-osmolar CM poses a greater risk of CIN than does a low-osmolar CM and, as recent but limited data suggest, the use of an iso-osmolar CM is less nephrotoxic than a low-osmolar CM in patients with renal impairment following intra-arterial procedures, although this finding needs to be verified in future clinical studies. Pharmacologic agents such as calcium channel blockers, dopamine, atrial natriuretic peptide, fenoldopam, prostaglandin E1, and endothelin receptor antagonist have not been proven effective against CIN development. Controversies still exist on the possible effectiveness of theophylline and N-acetylcysteine. Simple strategies for the prevention of CIN in at-risk patients are reviewed and unproven interventions are discussed

Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery.

Science.gov (United States)

Salsano, Antonio; Giacobbe, Daniele Roberto; Sportelli, Elena; Olivieri, Guido Maria; Brega, Carlotta; Di Biase, Carlo; Coppo, Erika; Marchese, Anna; Del Bono, Valerio; Viscoli, Claudio; Santini, Francesco

2016-11-01

Patients undergoing major surgery are at increased risk of developing infections due to resistant organisms, including carbapenem-resistant Klebsiella pneumoniae (CR-Kp). In this study, we assessed risk factors for CR-Kp infections after open heart surgery in a teaching hospital in northern Italy. A retrospective study was conducted from January to December 2014. The primary outcome measure was postoperative CR-Kp infection, defined as a time-to-event end-point. The effect of potentially related variables was assessed by univariable and multivariable analyses. Secondary end-points were in-hospital mortality and 180-day postoperative mortality. Among 553 patients undergoing open heart surgery, 32 developed CR-Kp infections (6%). In the final multivariable model, CR-Kp colonization [hazard ratio (HR) 227.45, 95% confidence intervals (CI) 67.13-1225.20, P open heart surgery. CR-Kp infection after surgery significantly affected survival. Preventing colonization is conceivably the most effective current strategy to reduce the impact of CR-Kp. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Reducing the harms associated with risk assessments

International Nuclear Information System (INIS)

Montague, Peter

2004-01-01

Risk assessments are the intellectual products of dedicated public health and environmental professionals. Like many other products, risk assessments carry with them the potential for both good and harm. This paper briefly examines some of the harms to which risk assessments have contributed, and then suggests that the legal 'duty to warn' doctrine offers a logical and practical way to reduce some of these harms. The paper suggests concepts that could be incorporated into warnings accompanying every formal risk assessment as routine 'boiler plate' addenda, just as other potentially harmful products, such as lawn mowers and cook stoves, are accompanied by warnings. Finally, the paper briefly examines the 'Code of Ethics and Standards of Practice for Environmental Professionals' (promulgated by the National Association of Environmental Professionals) and shows that the suggested warnings are consistent with recommended practices for environmental professionals

Mitigating flood exposure: Reducing disaster risk and trauma signature.

Science.gov (United States)

Shultz, James M; McLean, Andrew; Herberman Mash, Holly B; Rosen, Alexa; Kelly, Fiona; Solo-Gabriele, Helena M; Youngs, Georgia A; Jensen, Jessica; Bernal, Oscar; Neria, Yuval

2013-01-01

Introduction. In 2011, following heavy winter snowfall, two cities bordering two rivers in North Dakota, USA faced major flood threats. Flooding was foreseeable and predictable although the extent of risk was uncertain. One community, Fargo, situated in a shallow river basin, successfully mitigated and prevented flooding. For the other community, Minot, located in a deep river valley, prevention was not possible and downtown businesses and one-quarter of the homes were inundated, in the city's worst flood on record. We aimed at contrasting the respective hazards, vulnerabilities, stressors, psychological risk factors, psychosocial consequences, and disaster risk reduction strategies under conditions where flood prevention was, and was not, possible. Methods . We applied the "trauma signature analysis" (TSIG) approach to compare the hazard profiles, identify salient disaster stressors, document the key components of disaster risk reduction response, and examine indicators of community resilience. Results . Two demographically-comparable communities, Fargo and Minot, faced challenging river flood threats and exhibited effective coordination across community sectors. We examined the implementation of disaster risk reduction strategies in situations where coordinated citizen action was able to prevent disaster impact (hazard avoidance) compared to the more common scenario when unpreventable disaster strikes, causing destruction, harm, and distress. Across a range of indicators, it is clear that successful mitigation diminishes both physical and psychological impact, thereby reducing the trauma signature of the event. Conclusion . In contrast to experience of historic flooding in Minot, the city of Fargo succeeded in reducing the trauma signature by way of reducing risk through mitigation.

Y2K, embedded chips, casualty hazards and due diligence in healthcare risk management.

Science.gov (United States)

Childers, J R

1998-01-01

Y2K raises challenges for healthcare risk managers that go beyond information technology issues. This article explains that (1) too little public attention is being paid to equipment which may well have Y2K faults and (2) few standards have been articulated for dealing with problems. Healthcare risk managers therefore must return to basic due diligence principles and develop their own standards and protocols. The article explains how to do due diligence and outlines suggested steps for dealing with the non-information technology side of compliance due diligence.

Estimation of wildfire size and risk changes due to fuels treatments

Science.gov (United States)

Cochrane, M.A.; Moran, C.J.; Wimberly, M.C.; Baer, A.D.; Finney, M.A.; Beckendorf, K.L.; Eidenshink, J.; Zhu, Z.

2012-01-01

Human land use practices, altered climates, and shifting forest and fire management policies have increased the frequency of large wildfires several-fold. Mitigation of potential fire behaviour and fire severity have increasingly been attempted through pre-fire alteration of wildland fuels using mechanical treatments and prescribed fires. Despite annual treatment of more than a million hectares of land, quantitative assessments of the effectiveness of existing fuel treatments at reducing the size of actual wildfires or how they might alter the risk of burning across landscapes are currently lacking. Here, we present a method for estimating spatial probabilities of burning as a function of extant fuels treatments for any wildland fire-affected landscape. We examined the landscape effects of more than 72 000 ha of wildland fuel treatments involved in 14 large wildfires that burned 314 000 ha of forests in nine US states between 2002 and 2010. Fuels treatments altered the probability of fire occurrence both positively and negatively across landscapes, effectively redistributing fire risk by changing surface fire spread rates and reducing the likelihood of crowning behaviour. Trade offs are created between formation of large areas with low probabilities of increased burning and smaller, well-defined regions with reduced fire risk.

Increasing stress on disaster-risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen C. J. H.; Mechler, Reinhard; Botzen, W. J. Wouter; Bouwer, Laurens M.; Pflug, Georg; Rojas, Rodrigo; Ward, Philip J.

2014-04-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. So far, little is known about such flood hazard interdependencies across regions and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins. We present probabilistic trends in continental flood risk, and demonstrate that observed extreme flood losses could more than double in frequency by 2050 under future climate change and socio-economic development. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Reducing risks, protecting people. A harmonized approach

International Nuclear Information System (INIS)

Foster, R.B.

2000-01-01

Risk training, education and communication usually refer to the responsibilities of those who generate risk (e.g. operators of nuclear power plants) towards those who are exposed to the risk (e.g. employees working in the plants and those living in the vicinity). In this context training, education and communication are intended to transfer information from risk professionals to a largely uninformed audience, with a view to improving standards or providing reassurance. However, with the growth of media such as the Internet those to whom such training, education and communication have traditionally been directed are now much better informed. In addition, increasing prosperity affects expectations and prompts questions, not only about the adequacy of the control measures intended to address specific hazards, but also about whether the hazardous activity is justified at all. Within the UK (and Europe) this is very evident for nuclear power, other applications of ionizing radiation, and in other areas such as genetically modified food. In consequence regulators of hazardous activities face considerable new challenges. Of course, regulators still have to formulate standards, communicate them to those responsible for risk reduction and see that the necessary controls are in place. But in addition regulators also have to be able to answer questions such as: - why is this hazardous activity (e.g. a nuclear power plant) allowed at all? - what level of risk is unacceptable? - is the approach to risk reduction sufficiently precautionary? - why shouldn't the risk be reduced further? - why are the risks from certain activities (e.g. those from ionizing radiation) controlled to much lower levels than those from other work activities? - how are decisions made, what criteria are applied and how are the stake holders involves? All this does not make life easy for regulators! The full paper will describe how the Health and Safety Executive (HSE) has responded to these challenges by

Health Risks Due to the Use of Clenbuterol Hydrochloride: a Review

Directory of Open Access Journals (Sweden)

Benjamín Valladares-Carranza

2015-09-01

Full Text Available This paper analyzes and evaluates information about the characteristics and risks of using Clenbuterol hydrochloride (CCL for their potential toxic effects, due to its inclusion in animal food (cattle, pigs, sheep and poultry to improve productive-reproductive parameters, but neglecting food safety. Therefore, it is necessary to reassess the potential dangers that may result when used in both human and veterinary medicine. The β-adrenergic synthetic CCL, white powder, anhydrous, highly water soluble and highly stable at room temperature is used in a clandestine manner to fatten animals for human consumption. Therapeutically, it is used as a bronchodilator drug (asthma patients; its illegal use (doping has been detected in sports competitions, and it is used for bodybuilding due to its anabolic effect. Its use in cattle for slaughter modifies and increases the growth of muscle mass and reduces fat accumulation, which accumulates in different organs. In people with a history of bovine liver consumption contaminated with CCL, there has been registration of: tremor, muscle pain, dizziness, headache, and tachycardia. In Mexico, in an illegal and clandestine manner, there is distribution, marketing and use of CCL; however, the work of livestock organizations in registering production units free of this substance will ensure the consumption of meat products. Moreover, to propose the use of other substances which so far have no signs of toxicity will lead to a sustainable, secure and safe productivity in livestock units.

Managing Risk, Reducing Vulnerability and Enhancing Productivity ...

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

Managing Risk, Reducing Vulnerability and Enhancing Productivity under a Changing Climate. The countries of the Greater Horn of Africa are particularly vulnerable to drought, exacerbated by widespread poverty and dependence on rainfed agriculture. Even with normal rainfall, the region does not produce enough food to ...

Simulating Pelletization Strategies to Reduce the Biomass Supply Risk at America’s Biorefineries

Energy Technology Data Exchange (ETDEWEB)

Jacob J. Jacobson; Shane Carnohan; Andrew Ford; Allyson Beall

2014-07-01

Demand for cellulosic ethanol and other advanced biofuels has been on the rise, due in part to federal targets enacted in 2005 and extended in 2007. The industry faces major challenges in meeting these worthwhile and ambitious targets. The challenges are especially severe in the logistics of timely feedstock delivery to biorefineries. Logistical difficulties arise from seasonal production that forces the biomass to be stored in uncontrolled field-side environments. In this storage format physical difficulties arise; transportation is hindered by the low bulk density of baled biomass and the unprotected material can decay leading to unpredictable losses. Additionally, uncertain yields and contractual difficulties can exacerbate these challenges making biorefineries a high-risk venture. Investors’ risk could limit business entry and prevent America from reaching the targets. This paper explores pelletizer strategies to convert the lignocellulosic biomass into a denser form more suitable for storage. The densification of biomass would reduce supply risks, and the new system would outperform conventional biorefinery supply systems. Pelletizer strategies exhibit somewhat higher costs, but the reduction in risk is well worth the extra cost if America is to grow the advanced biofuels industry in a sustainable manner.

Reducing Risk for the Next Generation Nuclear Plant

Energy Technology Data Exchange (ETDEWEB)

John M. Beck II; Harold J. Heydt; Emmanuel O. Opare; Kyle B. Oswald

2010-07-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

Reducing Risk for the Next Generation Nuclear Plant

International Nuclear Information System (INIS)

Beck, John M. II; Heydt, Harold J.; Opare, Emmanuel O.; Oswald, Kyle B.

2010-01-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

Blocking Surgically Induced Lysyl Oxidase Activity Reduces the Risk of Lung Metastases

Directory of Open Access Journals (Sweden)

Chen Rachman-Tzemah

2017-04-01

Full Text Available Surgery remains the most successful curative treatment for cancer. However, some patients with early-stage disease who undergo surgery eventually succumb to distant metastasis. Here, we show that in response to surgery, the lungs become more vulnerable to metastasis due to extracellular matrix remodeling. Mice that undergo surgery or that are preconditioned with plasma from donor mice that underwent surgery succumb to lung metastases earlier than controls. Increased lysyl oxidase (LOX activity and expression, fibrillary collagen crosslinking, and focal adhesion signaling contribute to this effect, with the hypoxic surgical site serving as the source of LOX. Furthermore, the lungs of recipient mice injected with plasma from post-surgical colorectal cancer patients are more prone to metastatic seeding than mice injected with baseline plasma. Downregulation of LOX activity or levels reduces lung metastasis after surgery and increases survival, highlighting the potential of LOX inhibition in reducing the risk of metastasis following surgery.

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer

Science.gov (United States)

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-01-01

Abstract Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD). This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated. The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group. Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD. PMID:27977613

Increasing stress on disaster risk finance due to large floods

Science.gov (United States)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen; Mechler, Reinhard; Botzen, Wouter; Bouwer, Laurens; Pflug, Georg; Rojas, Rodrigo; Ward, Philip

2014-05-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. To date, little is known about such flood hazard interdependencies across regions, and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins and that these correlations can, or should, be used in national to continental scale risk assessment. We present probabilistic trends in continental flood risk, and demonstrate that currently observed extreme flood losses could more than double in frequency by 2050 under future climate change and socioeconomic development. The results demonstrate that accounting for tail dependencies leads to higher estimates of extreme losses than estimates based on the traditional assumption of independence between basins. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Leukocyte-depletion of blood components does not significantly reduce the risk of infectious complications. Results of a double-blinded, randomized study

DEFF Research Database (Denmark)

Titlestad, I. L.; Ebbesen, L. S.; Ainsworth, A. P.

2001-01-01

Allogeneic blood transfusions are claimed to be an independent risk factor for postoperative infections in open colorectal surgery due to immunomodulation. Leukocyte-depletion of erythrocyte suspensions has been shown in some open randomized studies to reduce the rate of postoperative infection t...

Reducing risk of spinal haematoma from spinal and epidural pain procedures.

Science.gov (United States)

Breivik, Harald; Norum, Hilde; Fenger-Eriksen, Christian; Alahuhta, Seppo; Vigfússon, Gísli; Thomas, Owain; Lagerkranser, Michael

2018-04-25

Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory. We searched recent guidelines, PubMed (MEDLINE), SCOPUS and EMBASE for new and relevant randomised controlled trials (RCT), case-reports and original articles concerning benefits of neuraxial blocks, risks of SH due to anti-haemostatic drugs, patient-related risk factors, especially renal impairment with delayed excretion of antihaemostatic drugs, and specific risk factors related to the neuraxial pain procedures. Epidural and spinal analgesic techniques, as well as their combination provide superior analgesia and reduce the risk of postoperative and obstetric morbidity and mortality. Spinal pain procedure can be highly effective for cancer patients, less so for chronic non-cancer patients. We did not identify any RCT with SH as outcome. We evaluated risks and recommend precautions for SH when patients are treated with antiplatelet, anticoagulant, or fibrinolytic drugs, when patients' comorbidities may increase risks, and when procedure-specific risk factors are present. Inserting and withdrawing epidural catheters appear to have similar risks for initiating a SH. Invasive neuraxial pain procedures, e.g. spinal cord stimulation, have higher risks of bleeding than traditional neuraxial blocks. We recommend robust monitoring routines and treatment protocol to ensure early diagnosis and effective treatment of SH should this rare but potentially serious complication occur. When neuraxial analgesia is considered for a patient on anti

Hybrid methodology for risk assessment due to uranium in drinking water

International Nuclear Information System (INIS)

Pandey, M.; Kumar, Brij; Datta, D.

2015-01-01

Uranium is found in ground and surface waters due to its natural occurrence in geological formations. One microgram (μg) of natural uranium has an activity of 0.67 pCi. The average uranium concentrations in surface, ground, and domestic water are 1, 3, and 2 pCi/l respectively. The uranium intake from water is about equal to the total from other dietary components. Although radioactivity of natural uranium is low, and is not likely to cause cancer, yet chances of cancer resulting from an exposure to a radioactive material like uranium cannot be completely ruled out. Numerous studies have reported Sarcomas (disease) in rats injected with metallic uranium in the femoral marrow and in the chest wall. This paper proposes a hybrid method for combining probability and possibility distributions in the estimation of cancer induction risk. The method is first explained, and then applied to estimate the human cancer risk due to Uranium in drinking water (taken from 15 villages of Kullu district of Himachal Pradesh). The hybrid method is a simple answer, from an intuitive viewpoint, to the problem of combining variability and partial ignorance in the estimation of risk. It simply combines random Monte Carlo sampling with fuzzy calculus. For the proposition 'Probability that Excess risk is lower than 3 x 10 -6 per year', the study obtained a probability comprised between 0.945 (Belief value) and 1 (Plausibility value). The proposed risk level i.e. 3 x 10 -6 per year is considered negligible by major toxicological agencies in the field such as EPA, WHO etc. The belief of 94.5 is the minimum credible probability level for the above proposition and suggests that the risk level is definitely minimal. (author)

CULTURAL DUE DILIGENCE IN M&A. IMPORTANCE OF SOFT RISKS FACTORS

Directory of Open Access Journals (Sweden)

Iulian Walter

2017-07-01

Full Text Available During the last decades, the corporate world has witnessed a significant rise in the number of cross border mergers and acquisitions (M&As. In cross border M&As, not only different corporate cultures collide, but also different professional and national cultures. The purpose of Cultural Due Diligence (CDD is to get a coherent image of the intercultural challenges of the M&A in order to be aware of the intercultural risks and opportunities. This article aims to reveal the perception of managers involved in the pre-M&A stage on the soft risks factors that need to be investigated during CDD. This study proposes an appraisal of the most important intercultural issues that need to be considered in M&A. Our contribution to the intercultural aspects of M&A literature consists in improving the current understanding of Cultural Due Diligence content.

CULTURAL DUE DILIGENCE IN M&A. IMPORTANCE OF SOFT RISKS FACTORS

Directory of Open Access Journals (Sweden)

Iulian Warter

2017-06-01

Full Text Available During the last decades, the corporate world has witnessed a significant rise in the number of cross border mergers and acquisitions (M&As. In cross border M&As, not only different corporate cultures collide, but also different professional and national cultures. The purpose of Cultural Due Diligence (CDD is to get a coherent image of the intercultural challenges of the M&A in order to be aware of the intercultural risks and opportunities. This article aims to reveal the perception of managers involved in the pre-M&A stage on the soft risks factors that need to be investigated during CDD. This study proposes an appraisal of the most important intercultural issues that need to be considered in M&A. Our contribution to the intercultural aspects of M&A literature consists in improving the current understanding of Cultural Due Diligence content.

Evaluation of organ dose and estimation of risk due to the abdominal region radiography in Indian adults

International Nuclear Information System (INIS)

Kumaresan, M.; Chaubey, Ajay; Kantharia, Surita; Karira, V.; Kumar, Rajesh; Biju, K.; Rao, B.S.

2006-01-01

Organ dose, risk of carcinogenesis and genetic effect due to the abdominal region radiography in Indian adult with the help of Monte-Carlo MCNP code by measuring the entrance skin dose by LiF: Mg, Cu, P TL phosphor and the risk coefficients provided by ICRP 60 were estimated. The entrance skin dose for abdominal region radiography was ranges from 2.75 mSv to 18.88 mSv while average entrance skin dose was 8.3 mSv. The bladder, testes and ovary are the important organ those are getting higher dose. The maximum dose for testes, ovary and bladder is 5.37 mSv, 1.45 mSv and 4.74 mSv respectively. The frequency of occurrence of fatal cancers and serious genetic disorders as a consequence of abdominal region radiography ranges from 0.1 to 38.8 risk/10 6 of fatal cancer. Although the estimated risks are small but cannot be neglected. It is important to avoid unnecessary repetitions and also to carry out proper quality assurance tests on the equipment and in the long run it will help reduce the risks and maximize the benefits of radiodiagnosis. These studies may lead to setting up of national reference levels for the diagnostic procedures India. (author)

Meta-analysis: Does garlic intake reduce risk of gastric cancer?

Science.gov (United States)

Kodali, R T; Eslick, Guy D

2015-01-01

In the past 2 decades, various epidemiological studies investigated whether garlic can positively modify the risk of gastric cancer. Garlic contains numerous sulfide compounds, including diallyl trisulfide, which have anticarcinogenic properties. We conducted a meta-analysis to determine if garlic intake reduces the risk of gastric cancer. An electronic search of MEDLINE, PubMed, and EMBASE to June 2014 was completed. There were 14 case control studies, 2 randomized controlled studies, and 1 cohort study that fulfilled our inclusion criteria. We used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs) for risk of gastric cancer with garlic consumption. Meta-analysis of a total of 8,621 cases and 14,889 controls was conducted. Significant variability in duration of garlic intake and reference categories for amount of intake was noted. High, low, and any garlic intake were all associated with reduced risk of gastric cancer. High intake had the most significant risk reduction, OR = 0.49 (95% CI: 0.38-0.62). Heterogeneity was low (I² = 30.85, P = 0.17). A more modest risk reduction was associated with low intake, OR = 0.75 (95% CI: 0.58-0.97). Half of the studies did not separate garlic intake into high or low amounts, intake was only noted as consumption vs. non-consumption. Any amount of consumption still showed a risk reduction similar to low intake, OR = 0.77 (95% CI: 0.60-1.00). Low and any amount of consumption showed moderate heterogeneity (58% and 45%, respectively). Garlic intake appears to be associated with reduced risk of gastric cancer. Further high quality studies are required to confirm this finding and to assess the amount of garlic that needs to be consumed for protective effect.

A methodological frame for assessing benzene induced leukemia risk mitigation due to policy measures

International Nuclear Information System (INIS)

Karakitsios, Spyros P.; Sarigiannis, Dimosthenis A.; Gotti, Alberto; Kassomenos, Pavlos A.; Pilidis, Georgios A.

2013-01-01

The study relies on the development of a methodology for assessing the determinants that comprise the overall leukemia risk due to benzene exposure and how these are affected by outdoor and indoor air quality regulation. An integrated modeling environment was constructed comprising traffic emissions, dispersion models, human exposure models and a coupled internal dose/biology-based dose–response risk assessment model, in order to assess the benzene imposed leukemia risk, as much as the impact of traffic fleet renewal and smoking banning to these levels. Regarding traffic fleet renewal, several “what if” scenarios were tested. The detailed full-chain methodology was applied in a South-Eastern European urban setting in Greece and a limited version of the methodology in Helsinki. Non-smoking population runs an average risk equal to 4.1 · 10 −5 compared to 23.4 · 10 −5 for smokers. The estimated lifetime risk for the examined occupational groups was higher than the one estimated for the general public by 10–20%. Active smoking constitutes a dominant parameter for benzene-attributable leukemia risk, much stronger than any related activity, occupational or not. From the assessment of mitigation policies it was found that the associated leukemia risk in the optimum traffic fleet scenario could be reduced by up to 85% for non-smokers and up to 8% for smokers. On the contrary, smoking banning provided smaller gains for (7% for non-smokers, 1% for smokers), while for Helsinki, smoking policies were found to be more efficient than traffic fleet renewal. The methodology proposed above provides a general framework for assessing aggregated exposure and the consequent leukemia risk from benzene (incorporating mechanistic data), capturing exposure and internal dosimetry dynamics, translating changes in exposure determinants to actual changes in population risk, providing a valuable tool for risk management evaluation and consequently to policy support. - Highlights

A methodological frame for assessing benzene induced leukemia risk mitigation due to policy measures

Energy Technology Data Exchange (ETDEWEB)

Karakitsios, Spyros P. [Aristotle University of Thessaloniki, Department of Chemical Engineering, 54124 Thessaloniki (Greece); Sarigiannis, Dimosthenis A., E-mail: denis@eng.auth.gr [Aristotle University of Thessaloniki, Department of Chemical Engineering, 54124 Thessaloniki (Greece); Centre for Research and Technology Hellas (CE.R.T.H.), 57001, Thessaloniki (Greece); Gotti, Alberto [Centre for Research and Technology Hellas (CE.R.T.H.), 57001, Thessaloniki (Greece); Kassomenos, Pavlos A. [University of Ioannina, Department of Physics, Laboratory of Meteorology, GR-45110 Ioannina (Greece); Pilidis, Georgios A. [University of Ioannina, Department of Biological Appl. and Technologies, GR-45110 Ioannina (Greece)

2013-01-15

The study relies on the development of a methodology for assessing the determinants that comprise the overall leukemia risk due to benzene exposure and how these are affected by outdoor and indoor air quality regulation. An integrated modeling environment was constructed comprising traffic emissions, dispersion models, human exposure models and a coupled internal dose/biology-based dose–response risk assessment model, in order to assess the benzene imposed leukemia risk, as much as the impact of traffic fleet renewal and smoking banning to these levels. Regarding traffic fleet renewal, several “what if” scenarios were tested. The detailed full-chain methodology was applied in a South-Eastern European urban setting in Greece and a limited version of the methodology in Helsinki. Non-smoking population runs an average risk equal to 4.1 · 10{sup −5} compared to 23.4 · 10{sup −5} for smokers. The estimated lifetime risk for the examined occupational groups was higher than the one estimated for the general public by 10–20%. Active smoking constitutes a dominant parameter for benzene-attributable leukemia risk, much stronger than any related activity, occupational or not. From the assessment of mitigation policies it was found that the associated leukemia risk in the optimum traffic fleet scenario could be reduced by up to 85% for non-smokers and up to 8% for smokers. On the contrary, smoking banning provided smaller gains for (7% for non-smokers, 1% for smokers), while for Helsinki, smoking policies were found to be more efficient than traffic fleet renewal. The methodology proposed above provides a general framework for assessing aggregated exposure and the consequent leukemia risk from benzene (incorporating mechanistic data), capturing exposure and internal dosimetry dynamics, translating changes in exposure determinants to actual changes in population risk, providing a valuable tool for risk management evaluation and consequently to policy support

Reducing sequence risk using trend following and the CAPE ratio

OpenAIRE

Clare, A.; Thomas, S.; Smith, P. N.; Seaton, J.

2017-01-01

The risk of experiencing bad investment outcomes at the wrong time, or sequence risk, is a poorly understood, but crucial aspect of the risk faced by investors, in particular those in the decumulation phase of their savings journey, typically over the period of retirement financed by a defined contributions pension scheme. Using US equity return data from 1872-2014 we show how this risk can be significantly reduced by applying trend-following investment strategies. We also demonstrate that kn...

Cities at risk: status of Italian planning system in reducing seismic and hydrogeological risks

Directory of Open Access Journals (Sweden)

Grazia Di Giovanni

2016-03-01

Full Text Available Italy and its urban systems are under high seismic and hydrogeological risks. The awareness about the role of human activities in the genesis of disasters is achieved in the scientific debate, as well as the role of urban and regional planning in reducing risks. The paper reviews the state of Italian major cities referred to hydrogeological and seismic risk by: 1 extrapolating data and maps about seismic hazard and landslide risk concerning cities with more than 50.000 inhabitants and metropolitan contexts, and 2 outlining how risk reduction is framed in Italian planning system (at national and regional levels. The analyses of available data and the review of the normative framework highlight the existing gaps in addressing risk reduction: nevertheless a wide knowledge about natural risks afflicting Italian territory and an articulated regulatory framework, the available data about risks are not exhaustive, and risk reduction policies and multidisciplinary pro-active approaches are only partially fostered and applied.

Reduced risk of UC in families affected by appendicitis

DEFF Research Database (Denmark)

Nyboe Andersen, Nynne; Gørtz, Sanne; Frisch, Morten

2017-01-01

OBJECTIVE: The possible aetiological link between appendicitis and UC remains unclear. In order to investigate the hereditary component of the association, we studied the risk of UC in family members of individuals with appendicitis. DESIGN: A cohort of 7.1 million individuals was established...... million person-years of follow-up between 1977 and 2011, a total of 190 004 cohort members developed appendicitis and 45 202 developed UC. Individuals having a first-degree relative with appendicitis before age 20 years had significantly reduced risk of UC (RR 0.90; 95% CI 0.86 to 0.95); this association...... was stronger in individuals with a family predisposition to UC (RR 0.66; 95% CI 0.51 to 0.83). CONCLUSIONS: Individuals with a first-degree relative diagnosed with appendicitis before age 20 years are at reduced risk of UC, particularly when there is a family predisposition to UC. Our findings question...

Indirect risk effects reduce feeding efficiency of ducks during spring.

Science.gov (United States)

Behney, Adam C; O'Shaughnessy, Ryan; Eichholz, Michael W; Stafford, Joshua D

2018-01-01

Indirect risk effects of predators on prey behavior can have more of an impact on prey populations than direct consumptive effects. Predation risk can elicit more vigilance behavior in prey, reducing the amount of time available for other activities, such as foraging, which could potentially reduce foraging efficiency. Understanding the conditions associated with predation risk and the specific effects predation risk have on prey behavior is important because it has direct influences on the profitability of food items found under various conditions and states of the forager. The goals of this study were to assess how ducks perceived predation risk in various habitat types and how strongly perceived risk versus energetic demand affected foraging behavior. We manipulated food abundance in different wetland types in Illinois, USA to reduce confounding between food abundance and vegetation structure. We conducted focal-animal behavioral samples on five duck species in treatment and control plots and used generalized linear mixed-effects models to compare the effects of vegetation structure versus other factors on the intensity with which ducks fed and the duration of feeding stints. Mallards fed more intensively and, along with blue-winged teal, used longer feeding stints in open habitats, consistent with the hypothesis that limited visibility was perceived to have a greater predation risk than unlimited visibility. The species temporally nearest to nesting, wood ducks, were willing to take more risks for a greater food reward, consistent with an increase in a marginal value of energy as they approached nesting. Our results indicate that some duck species value energy differently based on the surrounding vegetation structure and density. Furthermore, increases in the marginal value of energy can be more influential than perceived risk in shaping foraging behavior patterns. Based on these findings, we conclude that the value of various food items is not solely

Cigarette smoking risk-reducing beliefs: Findings from the United States Health Information National Trends Survey.

Science.gov (United States)

Kaufman, Annette R; Coa, Kisha I; Nguyen, Anh B

2017-09-01

Cigarette smoking risk-reducing beliefs are ideas that certain health promoting behaviors (e.g., exercise) may mitigate the risks associated with smoking. The objective of this study was to describe smoking risk-reducing beliefs and the belief that quitting can reduce the harmful effects of smoking among the U.S. adult population and the associations between these beliefs, current smoking status, and sociodemographics. Data were from the Health Information National Trends Survey 4 (HINTS 4) Cycles 3 and 4 (2013-2014; N=6862). Descriptive analyses were conducted to examine bivariate associations among the quit smoking belief, smoking risk-reducing beliefs, and covariates. Weighted ordinal logistic regression models examined the adjusted associations between smoking status and sociodemographics, with quit smoking belief and risk-reducing beliefs. Eighty-two percent of the population reported that quitting cigarette smoking can help reduce the harmful effects of smoking a lot: former smokers and individuals with higher educational attainment were more likely to endorse this belief than never smokers and those with lower educational attainment. Many people endorsed smoking risk-reducing beliefs about exercise (79.3%), fruits and vegetables (71.8%), vitamins (67.2%), and sleep (68.5%). Former smokers were less likely to subscribe to these beliefs than never smokers. Vulnerable populations who may be most at risk of smoking attributable morbidity and mortality were more likely to endorse risk-reducing beliefs. Future studies are needed to better understand how risk-reducing beliefs are formed and if modifying these beliefs may help to reduce cigarette smoking in the U.S. Published by Elsevier Inc.

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.

Risk due assessment of the intake of uranium isotopes in mineral spring waters

International Nuclear Information System (INIS)

Camargo, Iara M.C.; Mazzilli, Barbara

1998-01-01

To complement the data of a previous research concerning the evaluation of the lifetime risk of radiation-induced cancer due to the injection of 226 Ra, 228 Ra and 222 Rn in mineral spring waters from a natural highly radioactive region of Brazil. The study was performed to evaluate the lifetime risk of radiation-induced cancer due to the ingestion of 238 U and 234 U in the same spring waters. It is assumed that the risk coefficient for natural U isotopes is the same as for the 226 Ra-induced bone sarcomas and that the equilibrium for skeletal content is 25 times the daily ingestion of 226 Ra, but 11 times the daily ingestion of long-lived uranium isotopes. Waters samples were collected seasonally over a period of one year at all the spring sites used by the local population of Aguas da Prata, Sao Paulo State, Brazil. Concentrations ranging from 2.0 to 28.4 mBq/L and from 4.7 to 143 mBq/L were observed for 238 U and 234 U, respectively. Based upon the measured concentrations the lifetime risk due to the ingestion of uranium isotopes was estimated. A total of 0.3 uranium-induced cancers for 10 6 exposed persons was predicted, suggesting that chronic ingestion of uranium at the levels observed at these springs will result in an incremental increase of fatal cancers of 0.1%. (author)

Risks and radiation doses due to residential radon in Germany

International Nuclear Information System (INIS)

Beck, T.R.

2017-01-01

The population-averaged risk rate and the annual average effective dose due to residential radon in Germany were calculated. The calculations were based on an epidemiological approach taking into account the age- and gender-specific lung cancer incidence rates for the German population and the excess relative risk of 0.16 per 100 Bq.m"-"3 for residential radon. In addition, the risk estimates adjusted for the smoking habits were determined. The population-averaged risk rate for the whole population was estimated with 4.1.10"-"5 y"-"1 (95% confidence interval (CI) 1.4.10"-"5 - 7.6.10"-"5 y"-"1). Residential radon causes a detriment per year of 3.3.10"-"5 y"-"1 (95% CI 1.1.10"-"5 - 6.0.10"-"5 y"-"1), which corresponds to an annual average effective dose of 0.6 mSv (95% CI 0.2-1.1 mSv). Annually, ∼3400 lung cancer incidences are attributed to residential radon. The results from the epidemiological approach exercised in this study are considerably lower than the effective dose, which would be obtained from the dose conversion coefficient calculated using biokinetic and dosimetric models. (author)

Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China

Directory of Open Access Journals (Sweden)

Guo-Fu Wang

2017-09-01

Full Text Available Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP and Geographic International System (GIS. Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring.

Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China.

Science.gov (United States)

Wang, Guo-Fu; Lyu, Hai-Min; Shen, Jack Shuilong; Lu, Lin-Hai; Li, Gang; Arulrajah, Arul

2017-09-25

Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring.

Medical interventional procedures--reducing the radiation risks

International Nuclear Information System (INIS)

Cousins, C.; Sharp, C.

2004-01-01

Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up

Medical interventional procedures--reducing the radiation risks

Energy Technology Data Exchange (ETDEWEB)

Cousins, C. E-mail: claire.cousins@addenbrookes.nhs.uk; Sharp, C

2004-06-01

Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up.

Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

Science.gov (United States)

Laman, David M; Weiler, B Douglas; Skeen, Rodney S

2013-03-01

Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

The risk of musculoskeletal disorders due to repetitive movements of upper limbs for workers employed in hazelnut sorting

Directory of Open Access Journals (Sweden)

Andrea Colantoni

2013-09-01

Full Text Available In the agro-industrial sector there are many activities whose urgent rhythms can cause a considerable exposure to bio-mechanical risk factors. In the hazelnut sorting, the workers are subject to several biomechanical risks, with repetitive movements, and operations that require a remarkable degree of strength. A thorough study of the workers’ exposure to repetitive manual movements has been carried out, with the aim of setting up the necessary measures to reduce the risk factors. The aim of the research is to assess the risk of work-related musculo-skeletal disorders (WMSDs due to repetitive work, for workers employed to hazelnut shells sorting. The research was carried out in an agricultural cooperative in the Viterbo’s area. For risk assessment authors used a method (Occupational Repetitive Actions “OCRA” index according to ISO 11228- 3:2009, Ergonomics - Manual handling - Part 3: Handling of low loads at high frequency which keeps into consideration several risk factors (such as repetitiveness, prehension force, posture. The risk was assessed for 16 female workers (in eight workplaces and in two different shifts through this classification: workers with experience less than 1 year, from 1 to 10 years and more than 10 years. This classification is very important for knowing if the professional experience could be considered a “prevention measure” for the risk reduction. The results show a high risk level for the right and left limb. The factors which more have contributed to reach such risk level are the great number of movements and the lack of recovering time.

Life history and spatial traits predict extinction risk due to climate change

Science.gov (United States)

Pearson, Richard G.; Stanton, Jessica C.; Shoemaker, Kevin T.; Aiello-Lammens, Matthew E.; Ersts, Peter J.; Horning, Ned; Fordham, Damien A.; Raxworthy, Christopher J.; Ryu, Hae Yeong; McNees, Jason; Akçakaya, H. Reşit

2014-03-01

There is an urgent need to develop effective vulnerability assessments for evaluating the conservation status of species in a changing climate. Several new assessment approaches have been proposed for evaluating the vulnerability of species to climate change based on the expectation that established assessments such as the IUCN Red List need revising or superseding in light of the threat that climate change brings. However, although previous studies have identified ecological and life history attributes that characterize declining species or those listed as threatened, no study so far has undertaken a quantitative analysis of the attributes that cause species to be at high risk of extinction specifically due to climate change. We developed a simulation approach based on generic life history types to show here that extinction risk due to climate change can be predicted using a mixture of spatial and demographic variables that can be measured in the present day without the need for complex forecasting models. Most of the variables we found to be important for predicting extinction risk, including occupied area and population size, are already used in species conservation assessments, indicating that present systems may be better able to identify species vulnerable to climate change than previously thought. Therefore, although climate change brings many new conservation challenges, we find that it may not be fundamentally different from other threats in terms of assessing extinction risks.

A comparison of risks due to HLW and SURF repositories in bedded salt

International Nuclear Information System (INIS)

Chu, M.S.Y.; Ortiz, N.R.; Wahi, K.K.

1983-01-01

A methodology was developed to analyze risks from geologic disposal of nuclear wastes. It was applied to estimate the risk due to spent fuel and high-level waste hypothetical repositories in bedded salt. A number of disruptive scenarios were analyzed for each waste type. A comparison between the spent fuel and high-level waste results is presented. The methodology enables one to identify important radionuclides, parameters, and scenarios in terms of their relative contribution to the overall risk or compliance with the proposed EPA Standard

Neurodevelopmental toxicity risks due to occupational exposure to industrial chemicals during pregnancy

DEFF Research Database (Denmark)

Julvez, Jordi; Grandjean, Philippe

2009-01-01

Exposure to neurotoxic chemicals is of particular concern when it occurs during early development. The immature brain is highly vulnerable prenatally and is therefore at risk due to occupational exposures incurred by pregnant women. A systematic search of the literature has been performed...... by occupational health researchers and practitioners from the need to protect pregnant workers. Due to the vulnerability of the brain during early development, a precautionary approach to neurodevelopmental toxicity needs to be applied in occupational health....

Reduced cancer risk in vegetarians: an analysis of recent reports.

Science.gov (United States)

Lanou, Amy Joy; Svenson, Barbara

2010-12-20

This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%-12% reduction in overall cancer risk) although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.

Reducing the risk of Legionnaires' disease associated with cooling towers

Energy Technology Data Exchange (ETDEWEB)

Freije, M.R. [HC Information Resources Inc., Carlsbad, CA (United States)

2008-08-15

To reduce the health and legal risks associated with Legionnaires' disease, facility managers should take steps to minimize Legionella bacteria in plumbing systems, open industrial equipment, water features, cooling towers, and other aerosolizing water systems. The risk of Legionnaires' disease associated with cooling towers can be reduced by controlling Legionella bacteria in cooling water and preventing transmission of the bacteria from towers to people. This paper presents nine reasonable ways to accomplish these goals. (orig.)

Assessment of the risk of failure of high voltage substations due to environmental conditions and pollution on insulators.

Science.gov (United States)

Castillo Sierra, Rafael; Oviedo-Trespalacios, Oscar; Candelo, John E; Soto, Jose D

2015-07-01

Pollution on electrical insulators is one of the greatest causes of failure of substations subjected to high levels of salinity and environmental pollution. Considering leakage current as the main indicator of pollution on insulators, this paper focuses on establishing the effect of the environmental conditions on the risk of failure due to pollution on insulators and determining the significant change in the magnitude of the pollution on the insulators during dry and humid periods. Hierarchical segmentation analysis was used to establish the effect of environmental conditions on the risk of failure due to pollution on insulators. The Kruskal-Wallis test was utilized to determine the significant changes in the magnitude of the pollution due to climate periods. An important result was the discovery that leakage current was more common on insulators during dry periods than humid ones. There was also a higher risk of failure due to pollution during dry periods. During the humid period, various temperatures and wind directions produced a small change in the risk of failure. As a technical result, operators of electrical substations can now identify the cause of an increase in risk of failure due to pollution in the area. The research provides a contribution towards the behaviour of the leakage current under conditions similar to those of the Colombian Caribbean coast and how they affect the risk of failure of the substation due to pollution.

Assessing the transfer of risk due to transportation of agricultural products.

Science.gov (United States)

Li, Pei-Chiun; Shih, Hsiu-Ching; Ma, Hwong-Wen

2015-02-01

Health risk assessment (HRA) is the process used to estimate adverse health effects on humans. The importance and sensitivity of food chains to HRA have been observed, but the impact of the transportation of food has generally been ignored. This study developed an exposure assessment to demonstrate the significance of the transportation of agricultural products in HRA. The associated case study estimated the health risks derived from various sources of arsenic emissions in Taiwan. Two assessment scenarios, self-sufficiency and transportation of agricultural products, were compared to calculate risk transfer ratios that show the impact of agriculture transportation. The risk transfer ratios found by the study range from 0.22 to 42.10, indicating that the quantity of transportation of agricultural products is the critical factor. High air deposition and high agricultural production are the two main contributors to the effect of the transportation of agricultural products on HRA. Risk reduction measures could be applied to high-pollution areas as well as to areas with high agricultural productivity to reduce ingestion risks to residents. Certain areas that are sensitive to the transportation of agricultural products may incur more risks if emissions increase in agriculturally productive counties. Copyright © 2014 Elsevier Ltd. All rights reserved.

Potential Future Risk of Cholera Due to Climate Change in Northern ...

African Journals Online (AJOL)

Prof

Cholera is one of the infectious diseases that remains a major health burden in ... this is because many factors that influence are these diseases (both climatic ... condition, education, and poverty reduction may reduce the risk of contracting cholera ... Research Organization in collaboration .... The dots on top represent the.

The 5 key questions coping with risks due to natural hazards, answered by a case study

Science.gov (United States)

Hardegger, P.; Sausgruber, J. T.; Schiegg, H. O.

2009-04-01

" compatibility. 100% protection against the 100 year event shows to be the optimal degree of protection. Consequently, impacts statistically less frequent than once in 100 year are accepted as the remaining risk. Such floods and debris flows respectively cause a fan of propagation which is substantially reduced due to the protection measures against the 100 year event. III) The "triple loss distribution" shows the monetized triple damage, dependent on its probability. The monetization is performed by the social process of participation of the impacted interests, if not, by official experts in representation. The triple loss distribution rises in time mainly due to the rise in density and value of precious goods. A comparison of the distributions of the triple loss and the triple risk, behaving in opposite direction, is shown and explained within the project. IV) The recommended yearly reserves to be stocked for restoration and compensation of losses, caused by debris flows, amount to € 70'000.- according to the approach of the "technical risk premium". The discrepancy in comparison with the much higher amounts according to the common approaches of natural hazards engineering are discussed. V) The sustainable mix of hydraulic and forestry measures with the highest return on investment at lowest risk is performed according to the portfolio theory (Markowitz), based on the triple value curves, generated by the method of TripelBudgetierung®. Accordingly, the optimum mix of measures to protect the community of Inzing against the natural hazard of debris flow, thus, the most efficient allocation of resources equals to 2/3 for hydraulic, 1/3 for forestry measures. In detail, the results of the research pilot project "Nachhaltiges Risikomanagement - Enterbach / Inzing / Tirol / Austria" may be consulted under www.ibu.hsr.ch/inzing.

Breast-feeding reduces the risk for childhood eczema.

Science.gov (United States)

Kull, Inger; Böhme, Maria; Wahlgren, Carl-Fredrik; Nordvall, Lennart; Pershagen, Göran; Wickman, Magnus

2005-09-01

The evidence for a preventive effect of breast-feeding on the development of eczema in childhood remains controversial. To investigate the effect of breast-feeding in various phenotypes of eczema to 4 years. A birth cohort of 4089 children made up the study base. Data on breast-feeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood specific IgE was analyzed. Children with symptoms of eczema and asthma during the period of breast-feeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure. Exclusive breast-feeding for >or=4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR], 0.78; 95% CI, 0.63--0.96) irrespective of combination with asthma, sensitization to common allergens, or parental allergic disease. This decreased risk was most evident for children with onset of eczema during the first 2 years persisting to 4 years (OR, 0.59; 95% CI, 0.45--0.77). Among children with early-onset eczema, irrespective of persistency, followed by late onset of asthma or early-onset asthma irrespective of persistency, followed by late-onset eczema to 4 years, a protective effect of breast-feeding was also seen (OR, 0.48; 95% CI, 0.30--0.76). Breast-feeding 4 months or more reduces the risk for eczema and onset of the allergy march to age 4.

Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

Science.gov (United States)

Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

Comparison of human exposure pathways in an urban brownfield: reduced risk from paving roads.

Science.gov (United States)

James, Kyle; Farrell, Richard E; Siciliano, Steven D

2012-10-01

Risk assessments often do not quantify the risk associated with soil inhalation. This pathway generally makes a negligible contribution to the cumulative risk, because soil ingestion is typically the dominant exposure pathway. Conditions in northern or rural centers in Canada characterized by large areas of exposed soil, including unpaved roads, favor the resuspension of soil particles, making soil inhalation a relevant risk pathway. The authors determined and compared human exposure to metals and polycyclic aromatic hydrocarbons (PAHs) from soil ingestion and inhalation and analyzed the carcinogenic and noncarcinogenic risks before and after roads were paved in a northern community. To determine the inhalation exposure, three size fractions of airborne particulate matter were collected (total suspended particulates [TSP], particulate matter with an aerodynamic diameter less than 10 µm [PM10], and particulate matter with an aerodynamic diameter less than 2.5 µm [PM2.5]) before and after roads were paved. Road paving reduced the concentration of many airborne contaminants by 25 to 75%, thus reducing risk. For example, before paving, the carcinogenic risk associated with inhalation of Cr was 3.4 excess cancers per 100,000 people exposed, whereas after paving, this risk was reduced to 1.6 in 100,000. Paving roads reduced the concentrations of total suspended particulates (TSP; p roads is an effective method of reducing risk from the inhalation of soil particles. Copyright © 2012 SETAC.

Natural disturbance reduces disease risk in endangered rainforest frog populations.

Science.gov (United States)

Roznik, Elizabeth A; Sapsford, Sarah J; Pike, David A; Schwarzkopf, Lin; Alford, Ross A

2015-08-21

Natural disturbances can drive disease dynamics in animal populations by altering the microclimates experienced by hosts and their pathogens. Many pathogens are highly sensitive to temperature and moisture, and therefore small changes in habitat structure can alter the microclimate in ways that increase or decrease infection prevalence and intensity in host populations. Here we show that a reduction of rainforest canopy cover caused by a severe tropical cyclone decreased the risk of endangered rainforest frogs (Litoria rheocola) becoming infected by a fungal pathogen (Batrachochytrium dendrobatidis). Reductions in canopy cover increased the temperatures and rates of evaporative water loss in frog microhabitats, which reduced B. dendrobatidis infection risk in frogs by an average of 11-28% in cyclone-damaged areas, relative to unaffected areas. Natural disturbances to the rainforest canopy can therefore provide an immediate benefit to frogs by altering the microclimate in ways that reduce infection risk. This could increase host survival and reduce the probability of epidemic disease outbreaks. For amphibian populations under immediate threat from this pathogen, targeted manipulation of canopy cover could increase the availability of warmer, drier microclimates and therefore tip the balance from host extinction to coexistence.

Cereal fiber intake may reduce risk of gastric adenocarcinomas : The EPIC-EURGAST study

NARCIS (Netherlands)

Mendez, M. A.; Pera, Guillem; Aguclo, Antonio; Bueno-de-Mesquita, H. Bas; Palli, Domenico; Boeing, Heiner; Carneiro, Ftima; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Goeran; Manjer, Jonas; Johansson, Ingegerd; Stenling, Roger; Martinez, Carmen; Dorronsoro, Miren; Barricarte, Aurelio; Tormo, Maria J.; Quiros, Jose R.; Allen, Naomi; Key, Timothy J.; Bingham, Sheila; Linseisen, Jakob; Kaaks, Rudolf; Overvad, Kim; Jensen, Majken; Olsen, Anja; Tjonneland, Anne; Peeters, Petra H. M.; Numans, Mattijs E.; Ocke, Marga C.; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Lund, Eiliv; Slimani, Nadia; Jenab, Mazda; Ferrari, Pietro; Riboli, Elio; Gonzalez, Carlos A.

2007-01-01

Numerous case-control studies suggest dietary fiber may reduce risk of gastric cancer, but this has not been confirmed prospectively. A previous case-control study reported reduced risk of gastric cardia adenocarcinomas associated with cereal fiber, but not with fruit or vegetable fiber. To date,

Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing

DEFF Research Database (Denmark)

Skytte, A-B; Gerdes, Anne-Marie Axø; Andersen, M K

2010-01-01

from 306 healthy BRCA carriers with no personal history of ovarian or breast cancer. We found a 10-year uptake of 75% for risk-reducing salpingo-oophorectomy and 50% for risk-reducing mastectomy by time to event analysis. Age and childbirth influenced this decision. The uptake rate has not changed......Once female carriers of a BRCA mutation are identified they have to make decisions on risk management. The aim of this study is to outline the uptake of risk-reducing surgery in the Danish population of BRCA mutation positive women and to search for factors affecting this decision. We analysed data...

Opportunities to reduce risk associated with nuclear logging techniques

International Nuclear Information System (INIS)

Wraight, P.D.; Robinson, E.; de Fleurieu, R.

1991-01-01

Nuclear logging provides petroleum exploration and production companies with data that are critical to their decisions and operations. Because this type data is so important, environmentally conscious well-logging and service companies are constantly reviewing the risks to people and environment associated with nuclear sources with the ALARA (as low as reasonably achievable) principle in mind. Opportunities to additionally reduce risks, which can be accomplished only with the active involvement of oil companies, are proposed in this paper

Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review.

Science.gov (United States)

Meiser, B; Wong, W K T; Peate, M; Julian-Reynier, C; Kirk, J; Mitchell, G

2017-01-01

Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women. Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.

ATWS: a reappraisal, part II, evaluation of societal risks due to reactor protection systems failure. Vol. 3. Pwr risk analysis. Phase report

International Nuclear Information System (INIS)

Lellouche, G.S.

1976-08-01

This document is the third volume of part 2 in a series of studies which will examine the basis for the problem of Anticipated Transients Without Scram (ATWS). The purpose of part 2 is an evaluation of societal risks due to RPS failure based on more current data and methodology than used in WASH-1270. This volume examines and documents the potential contribution to societal risk due to ATWS in the PWR. Volumes 1 and 2 described a similar analysis for the BWR

Reducing risk where tectonic plates collide

Science.gov (United States)

Gomberg, Joan S.; Ludwig, Kristin A.

2017-06-19

Most of the world’s earthquakes, tsunamis, landslides, and volcanic eruptions are caused by the continuous motions of the many tectonic plates that make up the Earth’s outer shell. The most powerful of these natural hazards occur in subduction zones, where two plates collide and one is thrust beneath another. The U.S. Geological Survey’s (USGS) “Reducing Risk Where Tectonic Plates Collide—A USGS Plan to Advance Subduction Zone Science” is a blueprint for building the crucial scientific foundation needed to inform the policies and practices that can make our Nation more resilient to subduction zone-related hazards.

[Dehydration due to "mouth broken"].

Science.gov (United States)

Meijler, D P M; van Mossevelde, P W J; van Beek, R H T

2012-09-01

Two children were admitted to a medical centre due to dehydration after an oral injury and the extraction of a tooth. One child complained of "mouth broken". Dehydration is the most common water-electrolyte imbalance in children. Babies and young children are prone to dehydration due to their relatively large body surface area, the high percentage extracellular fluid, and the limited ability of the kidneys to conserve water. After the removal ofa tooth, after an oral trauma or in case of oral discomfort, a child is at greater risk of dehydration by reduced fluid and food intake due to oral pain and/or discomfort and anxiety to drink. In those cases, extra attention needs to be devoted to the intake of fluids.

What can individuals do to reduce personal health risks from air pollution?

Science.gov (United States)

Laumbach, Robert; Meng, Qingyu; Kipen, Howard

2015-01-01

In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure and health risks. Personal exposure to ambient air pollution can be reduced on high air pollution days by staying indoors, reducing outdoor air infiltration to indoors, cleaning indoor air with air filters, and limiting physical exertion, especially outdoors and near air pollution sources. Limited evidence suggests that the use of respirators may be effective in some circumstances. Awareness of air pollution levels is facilitated by a growing number of public air quality alert systems. Avoiding exposure to air pollutants is especially important for susceptible individuals with chronic cardiovascular or pulmonary disease, children, and the elderly. Research on mechanisms underlying the adverse health effects of air pollution have suggested potential pharmaceutical or chemopreventive interventions, such as antioxidant or antithrombotic agents, but in the absence of data on health outcomes, no sound recommendations can be made for primary prevention. Health care providers and their patients should carefully consider individual circumstances related to outdoor and indoor air pollutant exposure levels and susceptibility to those air pollutants when deciding on a course of action to reduce personal exposure and health risks from ambient air pollutants. Careful consideration is especially warranted when interventions may have unintended negative consequences, such as when efforts to avoid exposure to air pollutants lead to reduced physical activity or when there is evidence that dietary supplements, such as antioxidants, have potential adverse health effects. These potential complications of partially effective personal interventions to reduce exposure or

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

Science.gov (United States)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would 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. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

Warehouse receipts functioning to reduce market risk

Directory of Open Access Journals (Sweden)

Jovičić Daliborka

2014-01-01

Full Text Available Cereal production underlies the market risk to a great extent due to its elastic demand. Prices of grain have cyclic movements and significant decline in the harvest periods as a result of insufficient supply and high demand. The very specificity of agricultural production leads to the fact that agricultures are forced to sell their products at unfavorable conditions in order to resume production. The Public Warehouses System allows the agriculturers, who were previously unable to use the bank loans to finance the continuation of their production, to efficiently acquire the necessary funds, by the support of the warehouse receipts which serve as collaterals. Based on the results obtained by applying statistical methods (variance and standard deviation, as a measure of market risk under the assumption that warehouse receipts' prices will approximately follow the overall consumer price index, it can be concluded that the warehouse receipts trade will have a significant impact on risk reduction in cereal production. Positive effects can be manifested through the stabilization of prices, reduction of cyclic movements in the production of basic grains and, in the final stage, on the country's food security.

Reducing the Risk of Methadone Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

2012-07-03

This 60 second PSA is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

Accelerating Net Terrestrial Carbon Uptake During the Warming Hiatus Due to Reduced Respiration

Science.gov (United States)

Ballantyne, Ashley; Smith, William; Anderegg, William; Kauppi, Pekka; Sarmiento, Jorge; Tans, Pieter; Shevliakova, Elena; Pan, Yude; Poulter, Benjamin; Anav, Alessandro;

Definition of the risk grounding fatalities due to unintentional airplane crashes by calculates

Directory of Open Access Journals (Sweden)

І.Л. Государська

2005-04-01

Full Text Available  Estimates of the expected number of grounding fatalities, are given which probably will arise due to accident of air carriers, air taxi and general aviation. Measures regulation of the risk is considered.

Assessment of risk due to vehicle accident for the plutonium solution transfer from H-area to F-area

International Nuclear Information System (INIS)

Sarrack, A.G.

1996-09-01

Transporting radioactive material onsite (intrasite transfers) via truck or train must be performed in a safe manner. Adequate safety is assured for each transfer, as documented in the corresponding Onsite Safety Assessment (OSA). One aspect of the OSA is to show that the package to be used for the transfer meets onsite acceptance criteria. The activity being analyzed in this report is the movement of plutonium solution with greater than 20 curies, all reasonable mitigative controls will be implemented to minimize the likelihood of an accidental release, and a probabilistic analysis will be used to evaluate the risk associated with the move. The purpose of this report is to document the evaluation of risk due to vehicle accident associated with transporting plutonium solution from H-area to F-area. Included in the report is a list of the required mitigative controls which reduce the predicted accident and release frequencies to those reported in the summary

Active fans and grizzly bears: Reducing risks for wilderness campers

Science.gov (United States)

Sakals, M. E.; Wilford, D. J.; Wellwood, D. W.; MacDougall, S. A.

2010-03-01

Active geomorphic fans experience debris flows, debris floods and/or floods (hydrogeomorphic processes) that can be hazards to humans. Grizzly bears ( Ursus arctos) can also be a hazard to humans. This paper presents the results of a cross-disciplinary study that analyzed both hydrogeomorphic and grizzly bear hazards to wilderness campers on geomorphic fans along a popular hiking trail in Kluane National Park and Reserve in southwestern Yukon Territory, Canada. Based on the results, a method is proposed to reduce the risks to campers associated with camping on fans. The method includes both landscape and site scales and is based on easily understood and readily available information regarding weather, vegetation, stream bank conditions, and bear ecology and behaviour. Educating wilderness campers and providing a method of decision-making to reduce risk supports Parks Canada's public safety program; a program based on the principle of user self-sufficiency. Reducing grizzly bear-human conflicts complements the efforts of Parks Canada to ensure a healthy grizzly bear population.

Using detection and deterrence to reduce insider risk

International Nuclear Information System (INIS)

Eggers, R.F.; Carlson, R.L.; Udell, C.J.

1988-01-01

This paper addresses a new concept of interaction between adversary detection and deterrence. It provides an initial evaluation of the effects of these variables on the risk of theft of special nuclear material by an insider adversary and can be extended to the sabotage threat. A steady-state risk equation is used. Exercises with this equation show that deterrence, resulting from the prospect of detection, has a greater ability to reduce the risk than the detection exercise itself. This is true for all cases except those in which the probabilty of detection is 1. Cases were developed for three different types of adversaries that can be distinguished from one another by the level of detection they are willing to tolerate before they are deterred from attempting a theft. By considering the effects of detection, deterrence, and adversary type, the ground work is laid for designing cost-effective insider threat-protection systems

Reduced cancer risk in vegetarians: an analysis of recent reports

Directory of Open Access Journals (Sweden)

Amy Joy Lanou

2010-12-01

Full Text Available Amy Joy Lanou1, Barbara Svenson21Department of Health and Wellness, 2Ramsey Library, University of North Carolina Asheville, Asheville, NC, USAAbstract: This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%–12% reduction in overall cancer risk although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.Keywords: diet, vegan, prevention

Increasing fluid intake and reducing dehydration risk in older people living in long-term care: a systematic review.

Science.gov (United States)

Bunn, Diane; Jimoh, Florence; Wilsher, Stephanie Howard; Hooper, Lee

2015-02-01

To assess the efficacy of interventions and environmental factors on increasing fluid intake or reducing dehydration risk in older people living in long-term care facilities. Systematic review of intervention and observational studies. Thirteen electronic databases were searched from inception until September 2013 in all languages. References of included papers and reviews were checked. Intervention and observational studies investigating modifiable factors to increase fluid intake and/or reduce dehydration risk in older people (≥65 years) living in long-term care facilities who could drink orally. Two reviewers independently screened, selected, abstracted data, and assessed risk of bias from included studies; narrative synthesis was performed. A total of 4328 titles and abstracts were identified, 325 full-text articles were obtained and 23 were included in the review. Nineteen intervention and 4 observational studies from 7 countries investigated factors at the resident, institutional, or policy level. Overall, the studies were at high risk of bias due to selection and attrition bias and lack of valid outcome measures of fluid intake and dehydration assessment. Reported findings from 6 of the 9 intervention studies investigating the effect of multicomponent strategies on fluid intake or dehydration described a positive effect. Components included greater choice and availability of beverages, increased staff awareness, and increased staff assistance with drinking and toileting. Implementation of the US Resident Assessment Instrument reduced dehydration prevalence from 3% to 1%, P = .01. Two smaller studies reported positive effects: one on fluid intake in 9 men with Alzheimer disease using high-contrast red cups, the other involved supplementing 13 mildly dehydrated residents with oral hydration solution over 5 days to reduce dehydration. Modifications to the dining environment, advice to residents, presentation of beverages, and mode of delivery (straw vs beaker

Innovative Corporate Initiatives to Reduce Climate Risk: Lessons from East Asia

Directory of Open Access Journals (Sweden)

Edward B. Barbier

2017-12-01

Full Text Available Businesses, investors, and insurers are requiring better quantitative assessments of their exposure to climate risks and their impact on climate change. They are incorporating these assessments in their day-to-day management and long-term investment decisions. Already, there are efforts to develop international guidelines, common policies and legal frameworks for such assessments, as well as the desire to foster climate financing. We examine recent progress in East Asia and the rest of the world in setting targets, pricing policies, and other mechanisms to reduce climate risks. We develop a model that demonstrates how reduced climate risk management may lower the total cost of capital of firms, thus making them more attractive to investors. We discuss the additional policies needed to support improved climate risk management in investment decisions, private investments in climate science, technology and innovation (STI expansion, and more widespread adoption of climate financing and principles. Central banks, financial authorities, and governments can advance this objective by creating financial incentives to support investment decision-making. This would take into account factors such as improving climate performance, establishing better climate risk management and reporting requirements to foster green STI, and developing international guidelines and common policy and legal frameworks to support better climate risk management, assessments and reporting.

Novel J stents reduce the risk of embolic stroke in vitro

International Nuclear Information System (INIS)

Bartoli, Carlo R.; Spence, Paul A.; Giridharan, Guruprasad A.

2010-01-01

Two and a half million Americans with atrial fibrillation are at an elevated risk for embolic stroke. Warfarin therapy is standard treatment for high-risk patients, yet 40-65% of elderly patients do not receive anticoagulation therapy due to bleeding complications. To address this clinical need, we are evaluating a minimally invasive stent-based stroke prevention device to divert emboli from entering the arterial supply of the brain. The feasibility of a J-shaped stroke prevention device was tested in a mock circulatory loop. Sixteen sets of 100 simulated emboli (1-5 mm 3 ) were injected into the left atrium with and without J stents protecting the aortic arch vessels. To determine efficacy, emboli were trapped in filters in the aortic arch vessels and distal aorta for manual counting. J stents decreased the number of emboli that entered the brachiocephalic trunk by 93.7% (p<0.0001), left common carotid artery by 79.8% (p<0.0001), and left subclavian artery by 89.7% (p<0.0001). In a mock circulation, J stents positioned in the aortic arch vessels and oriented downstream of aortic flow significantly decreased the number of emboli that entered the aortic arch vessels. These results warrant further investigation to determine the safety and efficacy of this prophylactic intervention to reduce embolic events, and chronic large animal studies are underway. (orig.)

Novel J stents reduce the risk of embolic stroke in vitro

Energy Technology Data Exchange (ETDEWEB)

Bartoli, Carlo R. [University of Louisville, M.D./Ph.D. Program, Louisville, KY (United States); Spence, Paul A. [SCR Inc., Louisville, KY (United States); Giridharan, Guruprasad A. [Cardiovascular Innovation Institute, University of Louisville, Department of Bioengineering, Louisville, KY (United States)

2010-05-15

Two and a half million Americans with atrial fibrillation are at an elevated risk for embolic stroke. Warfarin therapy is standard treatment for high-risk patients, yet 40-65% of elderly patients do not receive anticoagulation therapy due to bleeding complications. To address this clinical need, we are evaluating a minimally invasive stent-based stroke prevention device to divert emboli from entering the arterial supply of the brain. The feasibility of a J-shaped stroke prevention device was tested in a mock circulatory loop. Sixteen sets of 100 simulated emboli (1-5 mm{sup 3}) were injected into the left atrium with and without J stents protecting the aortic arch vessels. To determine efficacy, emboli were trapped in filters in the aortic arch vessels and distal aorta for manual counting. J stents decreased the number of emboli that entered the brachiocephalic trunk by 93.7% (p<0.0001), left common carotid artery by 79.8% (p<0.0001), and left subclavian artery by 89.7% (p<0.0001). In a mock circulation, J stents positioned in the aortic arch vessels and oriented downstream of aortic flow significantly decreased the number of emboli that entered the aortic arch vessels. These results warrant further investigation to determine the safety and efficacy of this prophylactic intervention to reduce embolic events, and chronic large animal studies are underway. (orig.)

Initiatives to Reduce Earthquake Risk of Developing Countries

Science.gov (United States)

Tucker, B. E.

2008-12-01

The seventeen-year-and-counting history of the Palo Alto-based nonprofit organization GeoHazards International (GHI) is the story of many initiatives within a larger initiative to increase the societal impact of geophysics and civil engineering. GHI's mission is to reduce death and suffering due to earthquakes and other natural hazards in the world's most vulnerable communities through preparedness, mitigation and advocacy. GHI works by raising awareness in these communities about their risk and about affordable methods to manage it, identifying and strengthening institutions in these communities to manage their risk, and advocating improvement in natural disaster management. Some of GHI's successful initiatives include: (1) creating an earthquake scenario for Quito, Ecuador that describes in lay terms the consequences for that city of a probable earthquake; (2) improving the curricula of Pakistani university courses about seismic retrofitting; (3) training employees of the Public Works Department of Delhi, India on assessing the seismic vulnerability of critical facilities such as a school, a hospital, a police headquarters, and city hall; (4) assessing the vulnerability of the Library of Tibetan Works and Archives in Dharamsala, India; (5) developing a seismic hazard reduction plan for a nonprofit organization in Kathmandu, Nepal that works to manage Nepal's seismic risk; and (6) assisting in the formulation of a resolution by the Council of the Organization for Economic Cooperation and Development (OECD) to promote school earthquake safety among OECD member countries. GHI's most important resource, in addition to its staff and Board of Trustees, is its members and volunteer advisors, who include some of the world's leading earth scientists, earthquake engineers, urban planners and architects, from the academic, public, private and nonprofit sectors. GHI is planning several exciting initiatives in the near future. One would oversee the design and construction of

Financial costs due to excess health risks among active employees of a utility company.

Science.gov (United States)

Yen, Louis; Schultz, Alyssa; Schnueringer, Elaine; Edington, Dee W

2006-09-01

The objective of this study was to examine the health risk-related excess costs of time away from work, medical claims, pharmacy claims, and total costs with and without considering the prevalence of health risks. A total of 2082 of 4266 employees of a Midwest utility participated in a health risk appraisal (HRA). Individuals were classified by their HRA participation status and also by 15 health risks. Total and excess costs were analyzed for all employees. There were significant excess costs due to individual risks and overall excess health risks in all cost measures. Both excess cost per risk and prevalence of the risk were important factors in determining the excess costs in the population. As compared with low-risk participants, HRA nonparticipants and the medium- and high-risk participants were 1.99, 2.22, and 3.97 times more likely to be high cost status. Approximately one third of corporate costs in medical claims, pharmacy claims, and time away from work could be defined as excess costs associated with excess health risks.

Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

Science.gov (United States)

Haghighat, Roxanna; Cluver, Lucie

2017-01-01

Background Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Methods Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10–24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. Results 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one

Effectiveness of a multifactorial handwashing program to reduce school absenteeism due to acute gastroenteritis.

Science.gov (United States)

Azor-Martínez, Ernestina; Cobos-Carrascosa, Elena; Gimenez-Sanchez, Francisco; Martínez-López, Jose Miguel; Garrido-Fernández, Pablo; Santisteban-Martínez, Joaquin; Seijas-Vazquez, Maria Luisa; Campos-Fernandez, Maria Amparo; Bonillo-Perales, Antonio

2014-02-01

Acute gastroenteritis (AGE) is one of the most common diseases among children and an important cause of school absenteeism. The aim of this study was to assess the effectiveness of a handwashing program using hand sanitizers for the prevention of school absenteeism due to AGE. A randomized, controlled and open study of a sample of 1341 children between 4 and 12 years of age, attending 5 state schools in Almería (Spain), with an 8-month follow up (academic year). The experimental group (EG) washed their hands with soap and water, complementing this with the use of a hand sanitizer, and the control group (CG) followed the usual handwashing procedure. Absenteeism rates due GI were compared between the 2 groups through the multivariate Poisson regression analysis. Percent days absent in both groups were compared with a Z-test. 446 cases of school absenteeism due to AGE were registered. The school children from the EG had a 36% lower risk of absenteeism due to AGE (IRR: 0.64, 95% confidence interval: 0.52-0.78) and a decrease in absenteeism of 0.13 episodes/child/academic year (0.27 of EG vs 0.40 CG/episodes/child/academic year, P absenteeism cases due to AGE.

Using detection and deterrence to reduce insider risk

Energy Technology Data Exchange (ETDEWEB)

Eggers, R F; Carlson, R L; Udell, C J

1988-06-01

This paper addresses a new concept of interaction between adversary detection and deterrence. It provides an initial evaluation of the effects of these variables on the risk of theft of special nuclear material by an insider adversary and can be extended to the sabotage threat. A steady-state risk equation is used. Exercises with this equation show that deterrence, resulting from the prospect of detection, has a greater ability to reduce the risk than the detection exercise itself. This is true for all cases except those in which the probability of detection is 1. Cases were developed for three different types of adversaries that can be distinguished from one another by the level of detection they are willing to tolerate before they are deterred from attempting a theft. By considering the effects of detection, deterrence, and adversary type, the ground work is laid for designing cost-effective insider threat-protection systems. 2 refs., 6 figs.

Reduced 25-hydroxyvitamin D and risk of Alzheimer's disease and vascular dementia

DEFF Research Database (Denmark)

Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G

2014-01-01

BACKGROUND: Vitamin D deficiency has been implicated as a risk factor for dementia in several cross-sectional studies. We tested the hypothesis that reduced plasma 25-hydroxyvitamin D (25[OH]D) is associated with increased risk of Alzheimer's disease (AD) and vascular dementia in the general.......28 (95% CI, 1.00-1.64) for 25(OH)D less than 25 nmol/L vs. greater than or equal to 50 nmol/L, and 1.27 (95% CI, 1.01-1.60) for less than the 25th vs. more than the 50th seasonally adjusted 25(OH)D. CONCLUSIONS: We observed an association of reduced plasma 25(OH)D with increased risk of the combined end...

Study of epidemiological risk of lung cancer in Mexico due indoor radon exposure

Science.gov (United States)

Ángeles, A.; Espinosa, G.

2014-07-01

In this work the lifetime relative risks (LRR) of lung cancer due to exposure to indoor 222Rn on the Mexican population is calculated. Cigarette smoking is the number one risk factor for lung cancer (LC), because that, to calculate the number of cases of LC due to exposure to 222Rn is necessary considers the number of cases of LC for smoking cigarette. The lung cancer mortality rates published by the "Secretaría de Salud" (SSA), the mexican population data published by the "Consejo Nacional de Población" (CONAPO), smoking data in the mexican population, published by the "Comisión Nacional Contra las Adicciones" (CONADIC), the "Organización Panamericana de la Salud" (OPS) and indoor 222Rn concentrations in Mexico published in several recent studies are used. To calculate the lifetime relative risks (LRR) for different segments of the Mexican population, firstly the Excess Relative Risk (ERR) is calculated using the method developed by the BEIR VI committee and subsequently modified by the USEPA and published in the report "EPA Assessment of Risks from Radon in Homes". The excess relative risks were then used to calculate the corresponding lifetime relative risks, again using the method developed by the BEIR VI committee. The lifetime relative risks for Mexican male and female eversmokers and Mexican male and female never-smokers were calculated for radon concentrations spanning the range found in recent studies of indoor radon concentrations in Mexico. The lifetime relative risks of lung cancer induced by lifetime exposure to the mexican average indoor radon concentration were estimated to be 1.44 and 1.40 for never-smokers mexican females and males respectively, and 1.19 and 1.17 for ever-smokers Mexican females and males respectively. The Mexican population LRR values obtained in relation to the USA and Canada LRR published values in ever-smokers for both gender are similar with differences less than 4%, in case of never-smokers in relation with Canada

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death--a nationwide prospective cohort study.

Science.gov (United States)

Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

2014-02-08

It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.

Reduced risk HTGR concept for industrial heat application

International Nuclear Information System (INIS)

Boardman, C.E.; Lipps, A.J.

1982-01-01

The industrial process heat market has been identified as major market for the High Temperature Gas-Cooled Reactor (HTGR), however, this market introduces stringent availability requirements on the reactor system relative to electric plants which feed a large existing grid. The characteristics and requirements of the industrial heat markets are summarized; the risks associated with serving this market with a single large HTGR will be discussed; and the modular concept, which has the potential to reduce both safety and investment risks, will be described. The reference modular concept described consists of several small, relatively benign nuclear heat sources linked together to supply heat energy to a balance-of-plant incorporating a process gas train/thermochemical pipe line system and a normal steam-electric plant

Reducing exposure to trust-related risks to avoid self-blame.

Science.gov (United States)

Effron, Daniel A; Miller, Dale T

2011-02-01

Three studies demonstrated that anticipated self-blame elicits more conservative decisions about risks that require trust than about otherwise economically identical risks that do not. Participants were more reluctant to invest money in a company when it risked failure due to fraud versus low consumer demand (Study 1), and to risk points in an economic game when its outcome ostensibly depended on another participant versus chance (Studies 2 and 3). These effects were mediated by anticipated self-blame (Studies 1 and 2). Additionally, participants who actually experienced a loss felt more self-blame when the loss violated their trust and became even more conservative in subsequent risk decisions relative to participants whose loss did not violate their trust (Study 3). No support emerged for alternative explanations based on either the perceived probability of incurring a loss or an aversion to losses that profit others. The motivational power of trust violations is discussed.

Reducing e-commerce risks using digital certificates

Directory of Open Access Journals (Sweden)

Piščević Miloš

2009-01-01

Full Text Available E-commerce means buying and selling goods and services across the Internet. Secured communication in e-commerce, across unsecured medium, such as the Internet, represents one of the major components in a domain of providing necessary security- critical demands, so the flow of information could go in a secure way. The Internet, as a global computer network must provide five major security services: confidentiality, data integrity, authentication, availability, and non-repudiation of information. Without guaranteeing aformentioned security goals, risks may be very high in e-commerce systems. A possible way to reduce these risks is to use digital certificates. Digital certificates provide a means of proving identity in electronic transactions, and from the point of view of computer communication they are irreplacable, but nevertheless they provide a good mechanism for implementing the major part of this security goal, and therefore, their usage in e-commerce is the major topic of this paper.

Reducing the health risks from radon in the UK overground workplace

International Nuclear Information System (INIS)

Denman, A.R.

2008-01-01

In response to the potential health risk from radon in workplaces in the United Kingdom (UK), the Ionising Radiations Regulations 1999 include the protection of workers from excessive radon levels. Under the Management of Health and Safety at Work Regulations 1999, employers are required to make risk assessments for potential hazards in the workplace. This is taken to apply to the risk from radon in premises in areas where over 1% of domestic housing properties have average annual radon levels over the Action Level. Whilst the UK Action Level in domestic housing has been set at 200 Bq·m -3 , the workplace limit is 400 Bq·m -3 . The Regulations require that this limit be compared to a 24-hour winter maximum, while in domestic properties the annual average radon level is compared to the Action Level. This paper discusses the application of the Regulations in the UK to ensure compliance and reduce risk from radon in the workplace, include use of short-term measurements, and the consideration of seasonal variation. Reduction of radon levels can be achieved by methods similar to those in domestic properties, but, in large buildings, several sump/pump systems may be required. Case studies have shown that the sump/pump system preferentially reduces radon levels at night, when workers are not usually present. Thus to achieve a significant health benefit the average radon level should be reduced below 325 Bq·m -3 . (author)

Reducing the risks of delegation: use of procedure skills checklists for unlicensed assistive personnel in schools, Part 2.

Science.gov (United States)

Shannon, Robin Adair; Kubelka, Suzanne

2013-09-01

School nurses are challenged by Federal Civil Rights Laws and the Standards of School Nursing Practice to care for a burgeoning population of students with special healthcare needs. Due to the realities of current school nurse-to-student ratios, school nurses are frequently responsible for directing unlicensed assistive personnel (UAPs) to support the health and safety needs of students, where State Nurse Practice Acts, state legislation, and local policy mandates allow. The delegation of health care tasks to UAPs poses many professional, ethical, and legal dilemmas for school nurses. One strategy to reduce the risks of delegation is through the use of procedure skills checklists, as highlighted by the experience of one large urban school district. Part 1 of this two-part article (Shannon & Kubelka, 2013) explored the scope of the problem and the principles of delegation, including legal and ethical considerations. Part 2 discusses the use of procedure skills checklists by school nurses as a strategy to reduce the risks of delegation of student special health care tasks to UAPs.

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer: An Asian population study.

Science.gov (United States)

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-12-01

Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD).This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated.The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group.Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD.

Increase plant safety and reduce cost by implementing risk-informed in-service inspection programs

International Nuclear Information System (INIS)

Billington, A.; Monette, P.

2001-01-01

The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less that 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used to improve the effectiveness of inspecting safety-significant piping components, to reduce inspection requirements on other piping components, to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure, and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits from past projects is presented, since the methodology is applicable for WWER plant design. (author)

Increase plant safety and reduce cost by implementing risk-informed In-Service Inspection programs

International Nuclear Information System (INIS)

Billington, A.; Monette, P.; Doumont, C.

2000-01-01

The idea behind the program is that it is possible to 'inspect less, but inspect better'. In other words, the risk-informed In-Service Inspection (ISI) process is used to improve the effectiveness of examination of piping components, i.e. concentrate inspection resources and enhance inspection strategies on high safety significant locations, and reduce inspection requirements on others. The Westinghouse Owners Group (WOG) risk-informed ISI process has already been applied for full scope (Millstone 3, Surry 1) and limited scope (Beznau, Ringhals 4, Asco, Turkey Point 3). By examining the high safety significant piping segments for the different fluid piping systems, the total piping core damage frequency is reduced. In addition, more than 80% of the risk associated with potential pressure boundary failures is addressed with the WOG risk-informed ISI process, while typically less than 50% of this same risk is addressed by the current inspection programs. The risk-informed ISI processes are used: to improve the effectiveness of inspecting safety-significant piping components; to reduce inspection requirements on other piping components; to evaluate improvements to plant availability and enhanced safety measures, including reduction of personnel radiation exposure; and to reduce overall Operation and Maintenance (O and M) costs while maintaining regulatory compliance. A description of the process as well as benefits of past projects is presented, since the methodology is applicable for VVER plant design. (author)

The Physician Attrition Crisis: A Cross-Sectional Survey of the Risk Factors for Reduced Job Satisfaction Among US Surgeons.

Science.gov (United States)

Jackson, Theresa N; Pearcy, Chris P; Khorgami, Zhamak; Agrawal, Vaidehi; Taubman, Kevin E; Truitt, Michael S

2018-05-01

A physician shortage is on the horizon, and surgeons are particularly vulnerable due to attrition. Reduced job satisfaction leads to increased job turnover and earlier retirement. The purpose of this study is to delineate the risk factors that contribute to reduced job satisfaction. A cross-sectional survey of US surgeons was conducted from September 2016 to May 2017. Screening for job satisfaction was performed using the abridged Job in General scale. Respondents were grouped into more and less satisfied using the median split. Twenty-five potential risk factors were examined that included demographic, occupational, psychological, wellness, and work-environment variables. Overall, 993 respondents were grouped into more satisfied (n = 502) and less satisfied (n = 491) cohorts. Of the demographic variables, female gender and younger age were associated with decreased job satisfaction (p = 0.003 and p = 0.008). Most occupational variables (specialty, experience, academics, practice size, payment model) were not significant. However, increased average hours worked correlated with less satisfaction (p = 0.008). Posttraumatic stress disorder, burnout, wellness, all eight work-environment variables, and unhappiness with career choice were linked to reduced job satisfaction (p = 0.001). A surgeon shortage has serious implications for health care. Job satisfaction is associated with physician retention. Our results suggest women and younger surgeons may be at increased risk for job dissatisfaction. Targeted work-environment interventions to reduce work-hours, improve hospital culture, and provide adequate financial reimbursement may promote job satisfaction and wellness.

Metabolic profile and cardiovascular risk factors in adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Directory of Open Access Journals (Sweden)

Mouna Feki Mnif

2012-01-01

Full Text Available Background: In congenital adrenal hyperplasia (CAH, long-term glucocorticoid treatment coupled with increased androgens may lead to undesirable metabolic effects. The aim of our report was to determine the prevalence of metabolic abnormalities and cardiovascular risk factors in a population of adult patients with CAH due to 21 hydroxylase deficiency. Materials and Methods: Twenty-six patients (11 males and 15 females, mean age ± SD=27.4±8.2 years were recruited. Anthropometry, body composition, metabolic parameters and cardiovascular risk factors were studied. Results: Obesity (overweight included was noted in 16 patients (61.5%, with android distribution in all cases. Bioelectrical impedance showed increased body fat mass in 12 patients (46.1%. Lipid profile alterations and carbohydrate metabolism disorders were detected in seven (26.9% and five (19.2% patients respectively. Moderate hepatic cytolysis, associated with hepatic steatosis, was found in one patient. Seven patients (27% had insulin resistance. Ambulatory blood pressure monitoring showed abnormalities in six patients (23%. Increased carotid intima media thickness was found in 14 patients (53.8%. Conclusion: Adult CAH patients tend to have altered metabolic parameters and a higher prevalence of cardiovascular risk factors. Lifelong follow-up, lifestyle modifications, and attempts to adjust and reduce the glucocorticoid doses seem important.

Reduced Risk of Importing Ebola Virus Disease because of Travel Restrictions in 2014: A Retrospective Epidemiological Modeling Study

Science.gov (United States)

Otsuki, Shiori

2016-01-01

Background An epidemic of Ebola virus disease (EVD) from 2013–16 posed a serious risk of global spread during its early growth phase. A post-epidemic evaluation of the effectiveness of travel restrictions has yet to be conducted. The present study aimed to estimate the effectiveness of travel restrictions in reducing the risk of importation from mid-August to September, 2014, using a simple hazard-based statistical model. Methodology/Principal Findings The hazard rate was modeled as an inverse function of the effective distance, an excellent predictor of disease spread, which was calculated from the airline transportation network. By analyzing datasets of the date of EVD case importation from the 15th of July to the 15th of September 2014, and assuming that the network structure changed from the 8th of August 2014 because of travel restrictions, parameters that characterized the hazard rate were estimated. The absolute risk reduction and relative risk reductions due to travel restrictions were estimated to be less than 1% and about 20%, respectively, for all models tested. Effectiveness estimates among African countries were greater than those for other countries outside Africa. Conclusions The travel restrictions were not effective enough to expect the prevention of global spread of Ebola virus disease. It is more efficient to control the spread of disease locally during an early phase of an epidemic than to attempt to control the epidemic at international borders. Capacity building for local containment and coordinated and expedited international cooperation are essential to reduce the risk of global transmission. PMID:27657544

CULTURAL DUE DILIGENCE IN M&A. IMPORTANCE OF SOFT RISKS FACTORS

OpenAIRE

Iulian Walter; Liviu Walter

2017-01-01

During the last decades, the corporate world has witnessed a significant rise in the number of cross border mergers and acquisitions (M&As). In cross border M&As, not only different corporate cultures collide, but also different professional and national cultures. The purpose of Cultural Due Diligence (CDD) is to get a coherent image of the intercultural challenges of the M&A in order to be aware of the intercultural risks and opportunities. This article aims to reveal the percept...

Risk factors for hospital-acquired bacteremia due to carbapenem-resistant Pseudomonas aeruginosa in a Colombian hospital.

Science.gov (United States)

Valderrama, Sandra Liliana; González, Pedro Felipe; Caro, María Alejandra; Ardila, Natalia; Ariza, Beatriz; Gil, Fabián; Álvarez, Carlos

2016-02-23

Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality.  To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014.  This was a case control study in which the case patients presented bacteremia due to P. aeruginosa resistant to carbapenems and the control group included patients with P. aeruginosa susceptible to this group of antibiotics. Variables such as the previous use of meropenem and ertapenem, immunosuppression and neoplasia were measured. Mortality and duration of hospital were also described.  In all, 168 patients were evaluated, of which 42 were cases and 126 controls. Using a multivariate model, the risk factors related to bacteremia due to carbapenem-resistant P. aeruginosa acquired in hospital were the following: use of parenteral nutrition (OR=8.28; 95% CI: 2.56-26.79; p=0); use of meropenem (OR=1.15; 95% CI: 1.03-1.28; p=0.01); and use of ciprofloxacin (OR=81.99; 95% CI: 1.14-5884; p=0.043).  In order to prevent the emergence of carbapenem-resistant P. aeruginosa, antimicrobial control programs should be strengthened by promoting the prudent administration of carbapenems and quinolones. The correct use of parenteral nutrition should also be monitored.

Risk Reduction Effects Due to the Start Time Extension of EDGs in OPR-1000

International Nuclear Information System (INIS)

Lim, Ho-Gon; Yang, Joon-Eon; Hwang, Mee-Jeong

2006-01-01

Under the condition that the ECCS rule in Korea will be revised based on the new U.S. 10 CFR 50.46, the risk impact due to the EDG start time extension is analyzed in the present study. This paper is composed of 6 sections. In the section 2, the LOCA break size that cannot be mitigable under the condition of extended EDG start time is obtained from the thermal hydraulic analysis. The section 3 discusses the frequency of the immitigable LOCA and the probability of the LOOP given a LOCA. In the section 4, the effect of the EDG start time extension on its failure probability is discussed with a qualitative manner. Finally, the whole risk change due to the EDG start time extension is calculated in the section 5 with the conclusions given in the section 6

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

Science.gov (United States)

Ingersoll, Karen S; Ceperich, Sherry D; Hettema, Jennifer E; Farrell-Carnahan, Leah; Penberthy, J Kim

2013-04-01

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized to motivational interviewing+assessment feedback (EARLY), informational video, or informational brochure conditions. Outcomes were drinks per drinking day (DDD), ineffective contraception rate, and AEP risk at 3 and 6 months. All interventions were associated with decreased DDD, ineffective contraception rate, and AEP risk. Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk, but not DDD. Effect sizes were compared to previous RCTs. The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women, but may provide a new option in a continuum of preventive care. Copyright © 2013 Elsevier Inc. All rights reserved.

Risk management.

Science.gov (United States)

Chambers, David W

2010-01-01

Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

Science.gov (United States)

Crucian, Brian; Sams, Clarence F.

2013-01-01

The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in- and post-flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep-space exploration missions.

A quantitative method for risk assessment of agriculture due to climate change

Science.gov (United States)

Dong, Zhiqiang; Pan, Zhihua; An, Pingli; Zhang, Jingting; Zhang, Jun; Pan, Yuying; Huang, Lei; Zhao, Hui; Han, Guolin; Wu, Dong; Wang, Jialin; Fan, Dongliang; Gao, Lin; Pan, Xuebiao

2018-01-01

Climate change has greatly affected agriculture. Agriculture is facing increasing risks as its sensitivity and vulnerability to climate change. Scientific assessment of climate change-induced agricultural risks could help to actively deal with climate change and ensure food security. However, quantitative assessment of risk is a difficult issue. Here, based on the IPCC assessment reports, a quantitative method for risk assessment of agriculture due to climate change is proposed. Risk is described as the product of the degree of loss and its probability of occurrence. The degree of loss can be expressed by the yield change amplitude. The probability of occurrence can be calculated by the new concept of climate change effect-accumulated frequency (CCEAF). Specific steps of this assessment method are suggested. This method is determined feasible and practical by using the spring wheat in Wuchuan County of Inner Mongolia as a test example. The results show that the fluctuation of spring wheat yield increased with the warming and drying climatic trend in Wuchuan County. The maximum yield decrease and its probability were 3.5 and 64.6%, respectively, for the temperature maximum increase 88.3%, and its risk was 2.2%. The maximum yield decrease and its probability were 14.1 and 56.1%, respectively, for the precipitation maximum decrease 35.2%, and its risk was 7.9%. For the comprehensive impacts of temperature and precipitation, the maximum yield decrease and its probability were 17.6 and 53.4%, respectively, and its risk increased to 9.4%. If we do not adopt appropriate adaptation strategies, the degree of loss from the negative impacts of multiclimatic factors and its probability of occurrence will both increase accordingly, and the risk will also grow obviously.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death – a nationwide prospective cohort study

Science.gov (United States)

2014-01-01

Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data, including all 5 248 672 individuals living in Sweden in 2005, aged 20–64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. Results In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). Conclusion This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses. PMID:24507477

Meta-analyses on behavioral interventions to reduce the risk of transmission of HIV.

Science.gov (United States)

Vergidis, Paschalis I; Falagas, Matthew E

2009-06-01

Different behavioral interventions have found to be efficacious in reducing high-risk sexual activity. Interventions have been evaluated in both original research and meta-analytic reviews. Most of the studies have shown that interventions are efficacious among different study populations. In adolescents, both in- and out-of-the classroom interventions showed a decrease in the risk of unprotected sex. In African Americans, greater efficacy was found for interventions including peer education. For Latinos, effect was larger in interventions with segmentation in the same gender. Geographic and social isolation are barriers in approaching MSM. For IDUs, interventions provided within a treatment program have an impact on risk reduction above that produced by drug treatment alone. Finally, people diagnosed with HIV tend to reduce their sexual risk behavior. However, adherence to safe sex practices for life can be challenging. Relentless efforts for implementation of behavioral interventions to decrease high-risk behavior are necessary to decrease HIV transmission.

Reducing The Risk Of Fires In Conveyor Transport

Science.gov (United States)

Cheremushkina, M. S.; Poddubniy, D. A.

2017-01-01

The paper deals with the actual problem of increasing the safety of operation of belt conveyors in mines. Was developed the control algorithm that meets the technical requirements of the mine belt conveyors, reduces the risk of fires of conveyors belt, and enables energy and resource savings taking into account random sort of traffic. The most effective method of decision such tasks is the construction of control systems with the use of variable speed drives for asynchronous motors. Was designed the mathematical model of the system "variable speed multiengine drive - conveyor - control system of conveyors", that takes into account the dynamic processes occurring in the elements of the transport system, provides an assessment of the energy efficiency of application the developed algorithms, which allows to reduce the dynamic overload in the belt to (15-20)%.

EPA'S strategy to reduce risk of radon

International Nuclear Information System (INIS)

Page, S.

1993-01-01

The Indoor Radon Abatement Act of 1988 (IRAA) directed EPA to undertake a variety of activities to address the growing public concern over dangers posed by exposure to indoor radon. Among other requirements, the law directed the Agency to study radon levels, evaluate mitigation methods, establish proficiency programs, assist states with program development, develop training centers, and provide public information. EPA has developed and implemented programs to address each of the key provisions of this statute. This paper presents EPA's broad national strategy to reduce radon risks. It combines and reinforces EPA's basic foundation, including its guiding policies and cooperative partnerships, with an overall management approach and focus for the future. The paper starts with an overview that introduces the strategy's four key elements: underlying policies and scientific principles, a decentralized system of states and other partners for targeting the public, multiple strategies for achieving radon risk reduction, and a strong focus on five key program priorities. This paper then discusses each of these elements in more detail and describes how they interact to guide future efforts and directions of the Agency

Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk.

Science.gov (United States)

Robinson, June K; Friedewald, John; Gordon, Elisa J

2016-03-01

Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun protection program and suggested refinements. The sequence of content presentation prepared the participant to accept the credibility, accuracy, and relevance of the message. Beginning with informing participants that using sun protection reduces the chance of developing skin cancer made the information credible to KTRs. Showing skin cancer on all skin types and patient testimonials enhanced participants' awareness of their susceptibility to develop skin cancer and primed patients to receive their personal risk of developing skin cancer. Coupling presentation of knowledge about the benefits of sun protection in reducing the risk of developing skin cancer with the personal risk of getting the disease was essential to KTRs believing that they could influence their health outcome.

The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk?

Science.gov (United States)

Segev-Jacubovski, Orit; Herman, Talia; Yogev-Seligmann, Galit; Mirelman, Anat; Giladi, Nir; Hausdorff, Jeffrey M

2011-01-01

In this article, we briefly summarize the incidence and significant consequences of falls among older adults, the insufficient effectiveness of commonly used multifactorial interventions and the evidence linking falls and cognitive function. Recent pharmacologic and nonpharmacologic studies that evaluated the effects of cognitive therapy on fall risk are reviewed. The results of this article illustrate the potential utility of multiple, diverse forms of cognitive therapy for reducing fall risk. The article also indicates that large-scale, randomized controlled trials are warranted and that additional research is needed to better understand the pathophysiologic mechanisms underlying the interplay between human mobility, fall risk and cognitive function. Nonetheless, we suggest that multimodality interventions that combine motor and cognitive therapy should, eventually, be incorporated into clinical practice to enable older adults and patients to move safer and with a reduced fall risk. PMID:21721921

Are Chinese consumers at risk due to exposure to metals in crayfish? A bioaccessibility-adjusted probabilistic risk assessment.

Science.gov (United States)

Peng, Qian; Nunes, Luís M; Greenfield, Ben K; Dang, Fei; Zhong, Huan

2016-03-01

Freshwater crayfish, the world's third largest crustacean species, has been reported to accumulate high levels of metals, while the current knowledge of potential risk associated with crayfish consumption lags behind that of finfish. We provide the first estimate of human health risk associated with crayfish (Procambarus clarkii) consumption in China, the world's largest producer and consumer of crayfish. We performed Monte Carlo Simulation on a standard risk model parameterized with local data on metal concentrations, bioaccessibility (φ), crayfish consumption rate, and consumer body mass. Bioaccessibility of metals in crayfish was found to be variable (68-95%) and metal-specific, suggesting a potential influence of metal bioaccessibility on effective metal intake. However, sensitivity analysis suggested risk of metals via crayfish consumption was predominantly explained by consumption rate (explaining >92% of total risk estimate variability), rather than metals concentration, bioaccessibility, or body mass. Mean metal concentrations (As, Cd, Cu, Ni, Pb, Se and Zn) in surveyed crayfish samples from 12 provinces in China conformed to national safety standards. However, risk calculation of φ-modified hazard quotient (HQ) and hazard index (HI) suggested that crayfish metals may pose a health risk for very high rate consumers, with a HI of over 24 for the highest rate consumers. Additionally, the φ-modified increased lifetime risk (ILTR) for carcinogenic effects due to the presence of As was above the acceptable level (10(-5)) for both the median (ILTR=2.5×10(-5)) and 90th percentile (ILTR=1.8×10(-4)), highlighting the relatively high risk of As in crayfish. Our results suggest a need to consider crayfish when assessing human dietary exposure to metals and associated health risks, especially for high crayfish-consuming populations, such as in China, USA and Sweden. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hypotheses and fundamental study design characteristics for evaluating potential reduced-risk tobacco products. Part I: Heuristic.

Science.gov (United States)

Murrelle, Lenn; Coggins, Christopher R E; Gennings, Chris; Carchman, Richard A; Carter, Walter H; Davies, Bruce D; Krauss, Marc R; Lee, Peter N; Schleef, Raymond R; Zedler, Barbara K; Heidbreder, Christian

2010-06-01

The risk-reducing effect of a potential reduced-risk tobacco product (PRRP) can be investigated conceptually in a long-term, prospective study of disease risks among cigarette smokers who switch to a PRRP and in appropriate comparison groups. Our objective was to provide guidance for establishing the fundamental design characteristics of a study intended to (1) determine if switching to a PRRP reduces the risk of lung cancer (LC) compared with continued cigarette smoking, and (2) compare, using a non-inferiority approach, the reduction in LC risk among smokers who switched to a PRRP to the reduction in risk among smokers who quit smoking entirely. Using standard statistical methods applied to published data on LC incidence after smoking cessation, we show that the sample size and duration required for a study designed to evaluate the potential for LC risk reduction for an already marketed PRRP, compared with continued smoking, varies depending on the LC risk-reducing effectiveness of the PRRP, from a 5-year study with 8000-30,000 subjects to a 15-year study with <5000 to 10,000 subjects. To assess non-inferiority to quitting, the required sample size tends to be about 10 times greater, again depending on the effectiveness of the PRRP. (c) 2009 Elsevier Inc. All rights reserved.

Myocardial Infarction Risk Due to Aircraft, Road, and Rail Traffic Noise.

Science.gov (United States)

Seidler, Andreas; Wagner, Mandy; Schubert, Melanie; Dröge, Patrik; Pons-Kühnemann, Jörn; Swart, Enno; Zeeb, Hajo; Hegewald, Janice

2016-06-17

Traffic noise can induce stress reactions that have effects on the cardiovascular system. The exposure-risk relationship between aircraft, road, and rail traffic noise and myocardial infarction is currently unknown. 19 632 patients from the Rhine-Main region of Germany who were diagnosed with myocardial infarction in the years 2006-2010 were compared with 834 734 control subjects. The assignment of persons to groups was performed on the basis of billing and prescription data from three statutory health insurance carriers. The exposure of all insurees to aircraft, road, and rail traffic noise in 2005 was determined from their residence addresses. As estimators of risk, odds ratios (OR) were calculated by logistic regression analysis, with adjustment for age, sex, regional social status variables, and individual social status (if available). The evaluation was performed on the basis of the continuous 24-hour noise level and the categorized noise level (in 5 decibel classes). The linear model revealed a statistically significant risk increase due to road noise (2.8% per 10 dB rise, 95% confidence interval [1.2; 4.5]) and railroad noise (2.3% per 10 dB rise [0.5; 4.2]), but not airplane noise. Airplane noise levels of 60 dB and above were associated with a higher risk of myocardial infarction (OR 1.42 [0.62; 3.25]). This higher risk is statistically significant if the analysis is restricted to patients who had died of myocardial infarction by 2014/2015 (OR 2.70 [1.08; 6.74]. In this subgroup, the risk estimators for all three types of traffic noise were of comparable magnitude (3.2% to 3.9% per 10 dB rise in noise level). In this study, a substantial proportion of the population was exposed to traffic noise levels that were associated with an albeit small increase in the risk of myocardial infarction. These findings underscore the importance of effective traffic noise prevention.

Radiocontamination of agricultural workers due to nuclear accidents

International Nuclear Information System (INIS)

Petrovic, B.; Smelcerovic, M.; Djuric, G.; Popovic, D.

1989-01-01

In the radiocontamination of the environment due to nuclear accidents, agricultural workers should be considered as a critical group of population. The presented paper discusses this problem from the aspects of folder production. The values of the effective dose equivalent are estimated for different phases of the production process and certain procedures aimed to reduce the radiation risk are proposed (author)

Radiocontamination of agricultural workers due to nuclear accidents

Energy Technology Data Exchange (ETDEWEB)

Petrovic, B [Faculty of Veterinary Medicine, Beograd, (Serbia and Montenegro); Smelcerovic, M; Djuric, G; Popovic, D [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

1989-07-01

In the radiocontamination of the environment due to nuclear accidents, agricultural workers should be considered as a critical group of population. The presented paper discusses this problem from the aspects of folder production. The values of the effective dose equivalent are estimated for different phases of the production process and certain procedures aimed to reduce the radiation risk are proposed (author)

GIS-based assessment of cancer risk due to benzene in Tehran ambient air.

Science.gov (United States)

Atabi, Farideh; Mirzahosseini, Seyed Alireza Hajiseyed

2013-10-01

The present study aimed to assess the risk of cancer due to benzene in the ambient air of gas stations and traffic zones in the north of Tehran. The cancer risk was estimated using the population distribution data for benzene levels and the unit risk for benzene proposed by the United States Environmental Protection Agency (US EPA). Sixteen sampling locations were monitored, once every week, during 5 April 2010 to 25 March 2011. The results showed that the mean annual benzene concentration was 14.51±3.17 parts per billion (ppb) for traffic zones and 29.01±1.32 ppb for outside gas stations. The risk calculated was 1026×10(-6) for gas station 27 and 955×10(-6) for gas station 139. According to our results, the annual benzene level in Tehran ambient air is 2 to 20 times higher than the respective value specified in International Standard (1.56 ppb). Moreover, the results showed a notable increase of cancer risks, ranging from 10% to 56%, for the vicinity population close to the gas stations in comparison to the vicinity population in the traffic zones.

Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer.

Science.gov (United States)

Meiser, Bettina; Price, Melanie A; Butow, Phyllis N; Karatas, Janan; Wilson, Judy; Heiniger, Louise; Baylock, Brandi; Charles, Margaret; McLachlan, Sue-Anne; Phillips, Kelly-Anne

2013-03-01

Bilateral risk-reducing salpingo-oophorectomy (RRSO) has been shown to significantly reduce the risk of ovarian cancer. This study assessed factors predicting uptake of RRSO. Women participating in a large multiple-case breast cancer family cohort study who were at increased risk for ovarian and fallopian tube cancer (i.e. BRCA1 or BRCA2 mutation carrier or family history including at least one first- or second-degree relative with ovarian or fallopian tube cancer), with no personal history of cancer and with at least one ovary in situ at cohort enrolment, were eligible for this study. Women who knew they did not carry the BRCA1 or BRCA2 mutation segregating in their family (true negatives) were excluded. Sociodemographic, biological and psychosocial factors, including cancer-specific anxiety, perceived ovarian cancer risk, optimism and social support, were assessed using self-administered questionnaires and interviews at cohort enrolment. RRSO uptake was self-reported every three years during systematic follow-up. Of 2,859 women, 571 were eligible. Mean age was 43.3 years; 62 women (10.9 %) had RRSO a median of two years after cohort entry. Factors predicting RRSO were: being parous (OR 3.3, p = 0.015); knowing one's mutation positive status (OR 2.9, p cancer (OR 2.5, p = 0.013). Psychological variables measured at cohort entry were not associated with RRSO. These results suggest that women at high risk for ovarian cancer make decisions about RRSO based on risk and individual socio-demographic characteristics, rather than in response to psychological factors such as anxiety.

Epistemically Virtuous Risk Management: Financial Due Diligence and Uncovering the Madoff Fraud

OpenAIRE

de Bruin, Boudewijn; Luetge, Christoph; Jauernig, Johanna

2014-01-01

The chapter analyses how Bernard Madoff’s Ponzi scheme was uncovered by Harry Markopolos, an employee of Rampart Investment Management, LLC, and the contribution of so-called epistemic virtues to Markopolos’ success. After Rampart had informed the firm about an allegedly highly successful hedge fund run by Madoff, Markopolos used qualitative and quantitative methods from financial due diligence to examine Madoff’s risks, returns and strategy, ultimately to conclude that Madoff was running a l...

Clostridium Difficile Infection Due to Pneumonia Treatment: Mortality Risk Models.

Science.gov (United States)

Chmielewska, M; Zycinska, K; Lenartowicz, B; Hadzik-Błaszczyk, M; Cieplak, M; Kur, Z; Wardyn, K A

2017-01-01

One of the most common gastrointestinal infection after the antibiotic treatment of community or nosocomial pneumonia is caused by the anaerobic spore Clostridium difficile (C. difficile). The aim of this study was to retrospectively assess mortality due to C. difficile infection (CDI) in patients treated for pneumonia. We identified 94 cases of post-pneumonia CDI out of the 217 patients with CDI. The mortality issue was addressed by creating a mortality risk models using logistic regression and multivariate fractional polynomial analysis. The patients' demographics, clinical features, and laboratory results were taken into consideration. To estimate the influence of the preceding respiratory infection, a pneumonia severity scale was included in the analysis. The analysis showed two statistically significant and clinically relevant mortality models. The model with the highest prognostic strength entailed age, leukocyte count, serum creatinine and urea concentration, hematocrit, coexisting neoplasia or chronic obstructive pulmonary disease. In conclusion, we report on two prognostic models, based on clinically relevant factors, which can be of help in predicting mortality risk in C. difficile infection, secondary to the antibiotic treatment of pneumonia. These models could be useful in preventive tailoring of individual therapy.

Update on raloxifene: role in reducing the risk of invasive breast cancer in postmenopausal women

Directory of Open Access Journals (Sweden)

Vogel VG

2011-10-01

Full Text Available Victor G Vogel Cancer Institute, Geisinger Health System, Danville, PA, USA Abstract: Risk factors allow us to define women who are at increased lifetime risk for breast cancer, and the most important factor is age. Benign breast disease increases risk, and the most important histologies are atypical lobular or ductal hyperplasia and lobular carcinoma in situ. Family history of breast cancer among first-degree relatives (mother, sisters, daughters also increases risk. Quantitative measures of risk give accurate predictions of breast cancer incidence for groups of women but not for individual subjects. Multiple published, randomized controlled trials, which employed selective estrogen receptor (ER modulators (SERMs, have demonstrated consistent reductions of 35% or greater in the risk of ER-positive invasive and noninvasive breast cancer in postmenopausal women. Professional organizations in the US now recommend the use of SERMs to reduce the risk of breast cancer in high-risk, postmenopausal women. Raloxifene and tamoxifen reduce the risk of ER-positive invasive breast cancer with equal efficacy, but raloxifene is associated with a lower risk of thromboembolic disease, benign uterine conditions, and cataracts than tamoxifen in postmenopausal women. No evidence exists establishing whether a reduction in breast cancer risk from either agent translates into reduced breast cancer mortality. Overall quality of life is similar with raloxifene or tamoxifen, but the incidence of dyspareunia, weight gain, and musculoskeletal complaints is higher with raloxifene use, whereas vasomotor symptoms, bladder incontinence, gynecologic symptoms, and leg cramps were higher with tamoxifen use. Keywords: selective estrogen receptor modulators (SERMs, raloxifene, risk reduction, chemoprevention

The HEART score is useful to predict cardiovascular risks and reduces unnecessary cardiac imaging in low-risk patients with acute chest pain.

Science.gov (United States)

Dai, Siping; Huang, Bo; Zou, Yunliang; Guo, Jianbin; Liu, Ziyong; Pi, Dangyu; Qiu, Yunhong; Xiao, Chun

2018-06-01

The present study was to investigate whether the HEART score can be used to evaluate cardiovascular risks and reduce unnecessary cardiac imaging in China.Acute coronary syndrome patients with the thrombosis in myocardial infarction risk score risk HEART score group and 2 patients (1.5%) in the high risk HEART score group had cardiovascular events. The sensitivity of HEART score to predict cardiovascular events was 100% and the specificity was 46.7%. The potential unnecessary cardiac testing was 46.3%. Cox proportional hazards regression analysis showed that per one category increase of the HEART score was associated with nearly 1.3-fold risk of cardiovascular events.In the low-risk acute chest pain patients, the HEART score is useful to physicians in evaluating the risk of cardiovascular events within the first 30 days. In addition, the HEART score is also useful in reducing the unnecessary cardiac imaging.

Immediate Antiretroviral Therapy Reduces Risk of Infection-Related Cancer During Early HIV Infection

DEFF Research Database (Denmark)

Borges, Alvaro Humberto Diniz; Neuhaus, Jacqueline; Babiker, Abdel G

2016-01-01

BACKGROUND:  In the Strategic Timing of Antiretroviral Treatment (START) study, immediate combination antiretroviral therapy (cART) initiation reduced cancer risk by 64%. We hypothesized that risk reduction was higher for infection-related cancer and determined by differences in CD4 cell counts a...

Risk-reducing salpingectomy with delayed oophorectomy in BRCA1/2 mutation carriers: Patients' and professionals' perspectives

NARCIS (Netherlands)

Jong, M. de; Harmsen, M.G.; Hoogerbrugge, N.; Massuger, L.F.A.G.; Hermens, R.P.M.G.; Hullu, J.A. de

2015-01-01

OBJECTIVE: To identify influencing factors of BRCA1/2 mutation carriers and their professionals for risk-reducing salpingectomy (RRS) with delayed oophorectomy (RRO) as a substitute for risk-reducing salpingo-oophorectomy (RRSO) and for study participation on this concept. METHODS: A qualitative

Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial

Directory of Open Access Journals (Sweden)

Wells Jennie L

2009-08-01

Full Text Available Abstract Background Older adults with cognitive problems have a higher risk of falls, at least twice that of cognitively normal older adults. The consequences of falls in this population are very serious: fallers with cognitive problems suffer more injuries due to falls and are approximately five times more likely to be admitted to institutional care. Although the mechanisms of increased fall risk in cognitively impaired people are not completely understood, it is known that impaired cognitive abilities can reduce attentional resource allocation while walking. Since cognitive enhancers, such as cholinesterase inhibitors, improve attention and executive function, we hypothesise that cognitive enhancers may reduce fall risk in elderly people in the early stages of cognitive decline by improving their gait and balance performance due to an enhancement in attention and executive function. Method/Design Double blinded randomized controlled trial with 6 months follow-up in 140 older individuals with Mild Cognitive Impairment (MCI. Participants will be randomized to the intervention group, receiving donepezil, and to the control group, receiving placebo. A block randomization by four and stratification based on fall history will be performed. Primary outcomes are improvements in gait velocity and reduction in gait variability. Secondary outcomes are changes in the balance confidence, balance sway, attention, executive function, and number of falls. Discussion By characterizing and understanding the effects of cognitive enhancers on fall risk in older adults with cognitive impairments, we will be able to pave the way for a new approach to fall prevention in this population. This RCT study will provide, for the first time, information regarding the effect of a medication designed to augment cognitive functioning have on the risk of falls in older adults with Mild Cognitive Impairment. We expect a significant reduction in the risk of falls in this

Breastfeeding reduces the risk of obesity in childhood and adolescence

Directory of Open Access Journals (Sweden)

Eleni-Maria Papatesta

2013-06-01

Full Text Available Childhood obesity has increased dramatically over the last decades, representing one of the most serious public health hazards of the 21st century. Efforts must be made by healthcare professionals to prevent it, as it is associated with short- and long-term risks for physical and mental health and because of the increased possibility to persist during adulthood. From antiquity human breast milk was considered the ideal nourishment for the newborn. Breastfeeding is beneficial for the mother-child dyad. Among others, existing data suggest that it reduces the risk for childhood and adolescence obesity. The mechanisms for this are numerous and include the feeding behavior breastfeeding infants acquire, their growth rate, the ‘early protein hypothesis’, the role of leptin that is found in increased levels in human milk, the dietary choices the breastfed infants make during childhood and adolescence and finally the differences in their bowel flora. Meta-analyses provide sufficient evidence for this protective effect, with a dose-response effect as to the duration of breastfeeding. Healthcare professionals involved in the care of the mother-infant dyad must encourage and support mothers to breastfeed their infants for a long period of time, if obesity were to be prevented. Aim of this review is to provide an account of existing data on the association of breastfeeding and the reduced risk of obesity in childhood and adulthood.

Context dependency and consumer acceptance of risk reducing strategies - a choice experiment study on salmonella risks in pork

DEFF Research Database (Denmark)

Mørkbak, Morten Raun; Christensen, Tove; Gyrd-Hansen, Dorte

2012-01-01

The paper investigates to what extent context dependency is present, when consumers are introduced to different risk reducing technologies and how this will affect their preferences for reductions in food risks. In particular, choice experiments are used to elicit consumer preferences for reducin...... findings of bad news having greater effect than good news – now applied to context dependency of preferences for food safety technologies....

Reduced reward anticipation in youth at high-risk for unipolar depression: A preliminary study

Directory of Open Access Journals (Sweden)

Thomas M. Olino

2014-04-01

Full Text Available Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR relative to youth at low familial risk for depression (LR. Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed.

Analysis of risk factors for rebleeding after splenectomy and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis

Directory of Open Access Journals (Sweden)

ZHANG Lei

2015-03-01

Full Text Available ObjectiveTo investigate the possible risk factors for rebleeding after splenectomy and pericardial devascularization in the treatment of portal hypertension due to liver cirrhosis, and to provide a certain basis for reducing the incidence of digestive tract re-hemorrhage for these patients. MethodsA retrospective analysis was performed on 238 cirrhotic patients with portal hypertension who underwent splenectomy and pericardial devascularization in the First Hospital of Lanzhou University from December 2003 to December 2013. These patients were divided into postoperative rebleeding group (n=32 and non-bleeding group (n=206. Univariate analysis (t test or chi-square test and multivariate logistic regression analysis were performed to investigate the risk factors for rebleeding after splenectomy and pericardial devascularization. ResultsOf the 32 patients with postoperative rebleeding, 17 had esophagogastric variceal bleeding, 11 had bleeding due to portal hypertensive gastropathy, and 4 had stress ulcer bleeding. The univariate analysis showed that there were significant differences between the two groups in the following factors: Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, pathological changes of the gastric mucosa, platelet count, prothrombin time (PT, activated partial thromboplastin time (APTT, and presence of diabetes (all P<0.05. The multivariate logistic regression analysis suggested that the significant independent influential factors for postoperative rebleeding were presence of diabetes, Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, diffuse lesion of the gastric mucosa, PT, and APTT. ConclusionFor cirrhotic patients with portal hypertension, the appropriate methods for managing these risk factors are of great clinical significance for preventing rebleeding after splenectomy and pericardial devascularization.

Risk-reducing surgery on the uterine adnexa: timing and type of surgical treatment, and pathology report.

Science.gov (United States)

Signorelli, Mauro; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

2016-10-01

Inherited mutations in BRCA1 and BRCA2 increase significantly the risk of developing breast and ovarian cancers, and they have been associated with increased risks of developing other types of cancer. Although screening programs have been implemented in order to detect cancers at the early stage, they resulted ineffective. To date, risk-reducing bilateral salpingo-oophorectomy represents the only procedure allowing reducing the incidence of ovarian cancer and increasing survival among BRCA1 and -2 mutation carriers. In the present review we will discuss the advantages and disadvantages related to the execution of prophylactic surgery, thus underlying possible beneficial and detrimental effects of this kind of surgery in premenopausal women. Additionally, we will investigate further therapeutic strategies aimed to reduce the risk of developing ovarian cancer, without affected patients' hormonal status.

Underestimation of risk due to exposure misclassification

DEFF Research Database (Denmark)

Grandjean, Philippe; Budtz-Jørgensen, Esben; Keiding, Niels

2004-01-01

Exposure misclassification constitutes a major obstacle when developing dose-response relationships for risk assessment. A non-differentional error results in underestimation of the risk. If the degree of misclassification is known, adjustment may be achieved by sensitivity analysis. The purpose...

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

Assessments and applications to enhance human reliability and reduce risk during less-than-full-power operations

International Nuclear Information System (INIS)

Hannaman, G.W.; Singh, A.

1992-01-01

Study of events, interviews with plant personnel, and applications of risk studies indicate that the risk of a potential accident during less-than-full-power (LTFP) operation is becoming a greater fraction of the risk as improvements are made to the full-power operations. Industry efforts have been increased to reduce risk and the cost of shutdown operations. These efforts consider the development and application of advanced tools to help utilities proactively identify issues and develop contingencies and interventions to enhance reliability and reduce risk of low-power operations at nuclear power plants. The role for human reliability assessments is to help improve utility outage planning to better achieve schedule and risk control objectives. Improvements are expected to include intervention tools to identify and reduce human error, definition of new instructional modules, and prioritization of risk reduction issues for operators. The Electric Power Research Institute is sponsoring a project to address the identification and quantification of factors that affect human reliability during LTFP operation of nuclear power plants. The results of this project are expected to promote the development of proactively applied interventions and contingencies for enhanced human reliability during shutdown operations

Priorities for technology development and policy to reduce the risk from radioactive materials

International Nuclear Information System (INIS)

Duggan, Ruth Ann

2010-01-01

The Standing Committee on International Security of Radioactive and Nuclear Materials in the Nonproliferation and Arms Control Division conducted its fourth annual workshop in February 2010 on Reducing the Risk from Radioactive and Nuclear Materials. This workshop examined new technologies in real-time tracking of radioactive materials, new risks and policy issues in transportation security, the best practices and challenges found in addressing illicit radioactive materials trafficking, industry leadership in reducing proliferation risk, and verification of the Nuclear Nonproliferation Treaty, Article VI. Technology gaps, policy gaps, and prioritization for addressing the identified gaps were discussed. Participants included academia, policy makers, radioactive materials users, physical security and safeguards specialists, and vendors of radioactive sources and transportation services. This paper summarizes the results of this workshop with the recommendations and calls to action for the Institute of Nuclear Materials Management (INMM) membership community.

Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks

Science.gov (United States)

Zemp, Delphine Clara; Schleussner, Carl-Friedrich; Barbosa, Henrique M. J.; Hirota, Marina; Montade, Vincent; Sampaio, Gilvan; Staal, Arie; Wang-Erlandsson, Lan; Rammig, Anja

2017-03-01

Reduced rainfall increases the risk of forest dieback, while in return forest loss might intensify regional droughts. The consequences of this vegetation-atmosphere feedback for the stability of the Amazon forest are still unclear. Here we show that the risk of self-amplified Amazon forest loss increases nonlinearly with dry-season intensification. We apply a novel complex-network approach, in which Amazon forest patches are linked by observation-based atmospheric water fluxes. Our results suggest that the risk of self-amplified forest loss is reduced with increasing heterogeneity in the response of forest patches to reduced rainfall. Under dry-season Amazonian rainfall reductions, comparable to Last Glacial Maximum conditions, additional forest loss due to self-amplified effects occurs in 10-13% of the Amazon basin. Although our findings do not indicate that the projected rainfall changes for the end of the twenty-first century will lead to complete Amazon dieback, they suggest that frequent extreme drought events have the potential to destabilize large parts of the Amazon forest.

Assessing the Risk of Occult Cancer and 30-day Morbidity in Women Undergoing Risk-reducing Surgery: A Prospective Experience.

Science.gov (United States)

Bogani, Giorgio; Tagliabue, Elena; Signorelli, Mauro; Chiappa, Valentina; Carcangiu, Maria Luisa; Paolini, Biagio; Casarin, Jvan; Scaffa, Cono; Gennaro, Massimiliano; Martinelli, Fabio; Borghi, Chiara; Ditto, Antonino; Lorusso, Domenica; Raspagliesi, Francesco

To investigate the incidence and predictive factors of 30-day surgery-related morbidity and occult precancerous and cancerous conditions for women undergoing risk-reducing surgery. A prospective study (Canadian Task Force classification II-1). A gynecologic oncology referral center. Breast-related cancer antigen (BRCA) mutation carriers and BRCAX patients (those with a significant family history of breast and ovarian cancer). Minimally invasive risk-reduction surgery. Overall, 85 women underwent risk-reducing surgery: 30 (35%) and 55 (65%) had hysterectomy plus bilateral salpingo-oophorectomy (BSO) and BSO alone, respectively. Overall, in 6 (7%) patients, the final pathology revealed unexpected cancer: 3 early-stage ovarian/fallopian tube cancers, 2 advanced-stage ovarian cancers (stage IIIA and IIIB), and 1 serous endometrial carcinoma. Additionally, 3 (3.6%) patients had incidental finding of serous tubal intraepithelial carcinoma. Four (4.7%) postoperative complications within 30 days from surgery were registered, including fever (n = 3) and postoperative ileus (n = 1); no severe (grade 3 or more) complications were observed. All complications were managed conservatively. The presence of occult cancer was the only factor predicting the development of postoperative complications (p = .02). Minimally invasive risk-reducing surgery is a safe and effective strategy to manage BRCA mutation carriers. Patients should benefit from an appropriate counseling about the high prevalence of undiagnosed cancers observed at the time of surgery. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia.

Directory of Open Access Journals (Sweden)

Hans J Overgaard

2016-11-01

Full Text Available As many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Integrating improved water management and educational strategies for both diseases in the school environment can potentially improve the health situation for students and the larger community. The objective of this trial was to investigate whether interventions targeting diarrhea and dengue risk factors would significantly reduce absence due to diarrheal disease and dengue entomological risk factors in schools.A factorial cluster randomized controlled trial was carried out in 34 rural primary schools (1,301 pupils in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Schools were randomized to one of four study arms: diarrhea interventions (DIA, dengue interventions (DEN, combined diarrhea and dengue interventions (DIADEN, and control (CON. Interventions had no apparent effect on pupil school absence due to diarrheal disease (p = 0.45 or on adult female Aedes aegypti density (p = 0.32 (primary outcomes. However, the dengue interventions reduced the Breteau Index on average by 78% (p = 0.029, with Breteau indices of 10.8 and 6.2 in the DEN and DIADEN arms, respectively compared to 37.5 and 46.9 in the DIA and CON arms, respectively. The diarrhea interventions improved water quality as assessed by the amount of Escherichia coli colony forming units (CFU; the ratio of Williams mean E. coli CFU being 0.22, or 78% reduction (p = 0.008.Integrated control of dengue and diarrhea has never been conducted before

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia

Science.gov (United States)

Overgaard, Hans J.; Alexander, Neal; Matiz, Maria Ines; Jaramillo, Juan Felipe; Olano, Victor Alberto; Vargas, Sandra; Sarmiento, Diana; Lenhart, Audrey; Stenström, Thor Axel

2016-01-01

Background As many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Integrating improved water management and educational strategies for both diseases in the school environment can potentially improve the health situation for students and the larger community. The objective of this trial was to investigate whether interventions targeting diarrhea and dengue risk factors would significantly reduce absence due to diarrheal disease and dengue entomological risk factors in schools. Methodology/Principal Findings A factorial cluster randomized controlled trial was carried out in 34 rural primary schools (1,301 pupils) in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Schools were randomized to one of four study arms: diarrhea interventions (DIA), dengue interventions (DEN), combined diarrhea and dengue interventions (DIADEN), and control (CON). Interventions had no apparent effect on pupil school absence due to diarrheal disease (p = 0.45) or on adult female Aedes aegypti density (p = 0.32) (primary outcomes). However, the dengue interventions reduced the Breteau Index on average by 78% (p = 0.029), with Breteau indices of 10.8 and 6.2 in the DEN and DIADEN arms, respectively compared to 37.5 and 46.9 in the DIA and CON arms, respectively. The diarrhea interventions improved water quality as assessed by the amount of Escherichia coli colony forming units (CFU); the ratio of Williams mean E. coli CFU being 0.22, or 78% reduction (p = 0.008). Conclusions/Significance Integrated

Reducing drinking water supply chemical contamination: risks from underground storage tanks.

Science.gov (United States)

Enander, Richard T; Hanumara, R Choudary; Kobayashi, Hisanori; Gagnon, Ronald N; Park, Eugene; Vallot, Christopher; Genovesi, Richard

2012-12-01

Drinking water supplies are at risk of contamination from a variety of physical, chemical, and biological sources. Ranked among these threats are hazardous material releases from leaking or improperly managed underground storage tanks located at municipal, commercial, and industrial facilities. To reduce human health and environmental risks associated with the subsurface storage of hazardous materials, government agencies have taken a variety of legislative and regulatory actions--which date back more than 25 years and include the establishment of rigorous equipment/technology/operational requirements and facility-by-facility inspection and enforcement programs. Given a history of more than 470,000 underground storage tank releases nationwide, the U.S. Environmental Protection Agency continues to report that 7,300 new leaks were found in federal fiscal year 2008, while nearly 103,000 old leaks remain to be cleaned up. In this article, we report on an alternate evidence-based intervention approach for reducing potential releases from the storage of petroleum products (gasoline, diesel, kerosene, heating/fuel oil, and waste oil) in underground tanks at commercial facilities located in Rhode Island. The objective of this study was to evaluate whether a new regulatory model can be used as a cost-effective alternative to traditional facility-by-facility inspection and enforcement programs for underground storage tanks. We conclude that the alternative model, using an emphasis on technical assistance tools, can produce measurable improvements in compliance performance, is a cost-effective adjunct to traditional facility-by-facility inspection and enforcement programs, and has the potential to allow regulatory agencies to decrease their frequency of inspections among low risk facilities without sacrificing compliance performance or increasing public health risks. © 2012 Society for Risk Analysis.

Reduced reward anticipation in youth at high-risk for unipolar depression: a preliminary study.

Science.gov (United States)

Olino, Thomas M; McMakin, Dana L; Morgan, Judith K; Silk, Jennifer S; Birmaher, Boris; Axelson, David A; Williamson, Douglas E; Dahl, Ronald E; Ryan, Neal D; Forbes, Erika E

2014-04-01

Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA) may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR) relative to youth at low familial risk for depression (LR). Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for) disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

The determinants of quitting or reducing smoking due to the tobacco tax increase

Directory of Open Access Journals (Sweden)

Tigova, Olena

2011-05-01

Full Text Available BACKGROUND. Ukraine has adopted State targeted social program for reducing the harmful effects of tobacco on public health in Ukraine till 2012. One of the measures to be implemented is increasing excise tax on tobacco products; therefore, a highly important question is which groups of population are likely to benefit from tax increase through quitting or reducing smoking.METHODS. Data used for analysis were collected in a nationally representative survey of Ukrainian population conducted in 2010. An outcome measure was the anticipated keeping smoking versus quitting (reducing smoking due to tobacco tax increase. Independent variables included socio-demographic characteristics, experience of quitting smoking, exposure to different tobacco control measures, exposure to tobacco advertizing. Binary logistic regression was used to measure associations.RESULTS. Respondents were more likely to expect to keep smoking after the tobacco tax increase if they were dependent on tobacco (odds ratio 2.57, not interested in quitting, not in favor of tobacco tax increase, and exposed to tobacco advertising on TV and cigarette promotions. Respondents were more likely to expect to reduce or quit smoking if they had higher wealth status (OR=0.55, were aware of tobacco health hazard (OR=0.09, had earlier attempts of quitting smoking, were not exposed to secondhand smoke, observed tobacco-related information on television (OR=0.7 and in newspapers (OR=0.45, and observed advertizing of tobacco on radio (OR=0.33 and in public transport (OR=0.25.CONCLUSIONS. Several aspects are important while implementing taxation policy. It is more likely to result in quitting or reducing smoking among those who are less dependent, have tried quitting smoking earlier, and have higher wealth level. Concurrent smoke-free policies and awareness campaigns may potentiate the effect of taxation policies and are recommended to be developed further.

Does Chocolate Intake During Pregnancy Reduce the Risks of Preeclampsia and Gestational Hypertension?

Science.gov (United States)

Saftlas, Audrey F.; Triche, Elizabeth W.; Beydoun, Hind; Bracken, Michael B.

2010-01-01

Purpose Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine if regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Methods Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at Chocolate consumption (servings/week) during the 1st and 3rd trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of Chocolate intake was more frequent among normotensives (80.7%) than preeclamptics (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (1st trimester: aOR=0.55, 95% CI: 0.32-0.95; 3rd trimester: aOR=0.56, 95% CI: 0.32-0.97). Only 1st trimester intake was associated with reduced odds of GH (aOR=0.65, 95% CI: 0.45-0.87). Conclusions These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. PMID:20609337

Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial

Science.gov (United States)

Blocklin, Michelle; Layzer, Jean; Price, Cristofer; Juras, Randall; Freiman, Lesley

2016-01-01

Objectives. To test the effectiveness of Reducing the Risk, an evidence-based sexual health curriculum designed to help prevent adolescent pregnancy and sexually transmitted infections, on youth sexual behavior and intermediate outcomes thought to lead to these behaviors. Methods. Classes within schools in St. Louis, Missouri; Austin, Texas; and San Diego, California; were randomly assigned to receive Reducing the Risk or “business as usual.” Youths completed Web-based surveys at baseline (preintervention, August 2012–January 2014) and 12 months later (August 2013–January 2015). Intent-to-treat analyses were conducted across sites; we tested for differences in impacts between sites and other subgroups. Results. The program had no overall impact on sexual behaviors. However, at 1 site, program participants were significantly less likely to have engaged in recent sexual intercourse than were control group members. There were positive overall impacts on intermediate outcomes (e.g., knowledge, attitudes). Conclusions. After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term. PMID:27689492

Principles of resource-effectiveness and regulatory-effectiveness for risk-informed applications: Reducing burdens by improving effectiveness

International Nuclear Information System (INIS)

Vesely, W.E.

1999-01-01

Principles of resource-effectiveness and regulatory-effectiveness are presented which systematically compare the resources expended on a requirement or activity versus its risk importance. To evaluate resource-effectiveness and regulatory-effectiveness, cost-benefit analysis principles are generalized to resource versus risk importance principles. It is shown that by applying resource-importance analyses, current requirements and activities can be systematically evaluated for their resource-effectiveness and their risk-consistency. Strategies can then be developed to maximize both resource-effectiveness and risk-consistency which reduces unnecessary burdens while maintaining risk or reducing risk. The principles, approaches, and implementation schemes which are presented provide a systematic process for evaluating and optimizing resource-effectiveness and regulatory-effectiveness. The illustrations that are presented show that current NRC and industry actions are not resource-effective. By improving their resource-effectiveness and risk-consistency, significant burden reductions are achievable while risk, e.g. core damage frequency, is maintained or is reduced. The illustrations show that by optimizing industry resources and NRC resources with regard to their risk-effectiveness, significant burden reductions are achievable for both the industry and NRC. Algorithms and software exist for broad-scale implementations. Because of the burden reductions which are identified and the improvements in risk-consistency which result, resource-importance analysis should be the first step in risk-informed applications. Resource-importance analysis is so important and can provide such large benefits that it needs to be carried out on all current requirements that are addressed by risk-informed applications

Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis.

Science.gov (United States)

Manchanda, Ranjit; Legood, Rosa; Antoniou, Antonis C; Gordeev, Vladimir S; Menon, Usha

2016-09-01

Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model. RRSO was undertaken in premenopausal women >40 years. The model was evaluated at lifetime OC risk levels: 2%, 4%, 5%, 6%, 8% and 10%. Costs and outcomes are discounted at 3.5%. Uncertainty in the model was assessed using both deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Outcomes included in the analyses were OC, breast cancer (BC) and additional deaths from coronary heart disease. Total costs and effects were estimated in terms of quality-adjusted life-years (QALYs); incidence of OC and BC; as well as incremental cost-effectiveness ratio (ICER). Published literature, Nurses Health Study, British National Formulary, Cancer Research UK, National Institute for Health and Care Excellence guidelines and National Health Service reference costs. The time horizon is lifetime and perspective: payer. Premenopausal RRSO is cost-effective at 4% OC risk (life expectancy gained=42.7 days, ICER=£19 536/QALY) with benefits largely driven by reduction in BC risk. RRSO remains cost-effective at >8.2% OC risk without hormone replacement therapy (ICER=£29 071/QALY, life expectancy gained=21.8 days) or 6%if BC risk reduction=0 (ICER=£27 212/QALY, life expectancy gained=35.3 days). Sensitivity analysis indicated results are not impacted much by costs of surgical prevention or treatment of OC/ BC or cardiovascular disease. However, results were sensitive to RRSO utility scores. Additionally, 37%, 61%, 74%, 84%, 96% and 99.5% simulations on PSA are cost

Reducing risks and increasing safety in everyday life: the role of the public

International Nuclear Information System (INIS)

Enander, A.

1998-01-01

Full text of publication follows: in social science risk research more attention has been paid to examining how people in general perceive risks than to how they perceive possible measures to reduce risks and to increase their own safety. The latter area is, however, becoming increasingly important to understand, particularly in the light of current emphasis on individual responsibility in risk prevention and emergency preparedness. For example, in Sweden a major effort to increase safety awareness among the general public and to increase knowledge and skills in a number of safety-related areas is at present being planned. This effort is being undertaken as a cooperative effort between different authorities and institutions and is coordinated by the Swedish Rescue Services Agency. The intentions behind this and similar programmes raise a number of questions concerning how people view risks and safety measures in their own immediate environment. Knowledge of the factors affecting willingness to take precautions is important in the design of communication and information. The factors which are of significance may be risk-related and concern perceptions of personal risk, but may also be related to attitudes an beliefs concerning different precautionary measures, to perception of social norms and conventions as well as to personal experiences and values. This paper presents some data concerning views and actions among lay groups in relation to reducing risks and increasing safety. Factors affecting these views are discussed in the light of previous research and of empirical data from some recent studies. (author)

Probabilistic inhalation risk assessment due to radioactivity released from coal fired thermal power plants

International Nuclear Information System (INIS)

Tiwari, M.; Ajmal, P.Y.; Bhangare, R.C.; Sahu, S.K.; Pandit, G.G.

2014-01-01

This paper deals with assessment of radiological risk to the general public around in the neighborhood of a 1000 MWe coal-based thermal power plant. We have used Monte Carlo simulation for characterization of uncertainty in inhalation risk due to radionuclide escaping from the stack of thermal power plant. Monte Carlo simulation treats parameters as random variables bound to a given probabilistic distribution to evaluate the distribution of the resulting output. Risk assessment is the process that estimates the likelihood of occurrence of adverse effects to humans and ecological receptors as a result of exposure to hazardous chemical, radiation, and/or biological agents. Quantitative risk characterization involves evaluating exposure estimates against a benchmark of toxicity, such as a cancer slope factor. Risk is calculated by multiplying the carcinogenic slope factor (SF) of the radionuclide by the dose an individual receives. The collective effective doses to the population living in the neighborhood of coal-based thermal power plant were calculated using Gaussian plume dispersion model. Monte Carlo Analysis is the most widely used probabilistic method in risk assessment. The MCA technique treats any uncertain parameter as random variable that obeys a given probabilistic distribution. This technique is widely used for analyzing probabilistic uncertainty. In MCA computer simulation are used to combine multiple probability distributions associated with the dose and SF depicted in risk equation. Thus we get a probabilistic distribution for the risk

Surfactant Protein-B 121ins2 Heterozygosity, Reduced Pulmonary Function and COPD in Smokers

DEFF Research Database (Denmark)

Bækvad-Hansen, Marie; Dahl, Morten; Tybjærg-Hansen, Anne

2010-01-01

.2-4.8) for spirometry defined COPD and of 2.2(1.0-5.1) for hospitalization due to COPD. Among never smokers, 121ins2 heterozygotes did not differ from wildtypes in lung function or risk of COPD. CONCLUSIONS: Surfactant protein-B 121ins2 heterozygosity is associated with reduced lung function and increased risk for COPD......2 mutation have reduced lung function and increased risk for chronic obstructive pulmonary disease (COPD) among smokers. METHODS: We genotyped 47,600 individuals from the adult Danish general population and recorded smoking habits, spirometry and hospital admissions due to COPD. The study...... that the effect of genotype differ by smoking status. Among smokers, 121ins2 heterozygotes had 9% reduced FEV1%predicted(p=0.0008), 6% reduced FVC%predicted(p=0.01) and 6% reduced FEV1/FVC(p=0.00007), compared with wildtypes. Also among smokers, 121ins2 heterozygotes had odds ratios of 2.4(95%CI 1...

Reducing drug–herb interaction risk with a computerized reminder system

Science.gov (United States)

Lin, Sheng-Shing; Tsai, Chiu-Lin; Tu, Ching-Yeh; Hsieh, Ching-Liang

2015-01-01

Background Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. Methods Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. Results During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). Conclusion Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. PMID:25733840

Artistic occupations are associated with a reduced risk of Parkinson's disease.

Science.gov (United States)

Haaxma, Charlotte A; Borm, George F; van der Linden, Dimitri; Kappelle, Arnoud C; Bloem, Bastiaan R

2015-09-01

Parkinson's disease (PD) is preceded by a premotor phase of unknown duration. Dopaminergic degeneration during this phase may lead to subtle cognitive and behavioural changes, such as decreased novelty seeking. Consequently, premotor subjects might be most comfortable in jobs that do not require optimal dopamine levels, leading to an overrepresentation in structured and predictable occupations, or an underrepresentation in artistic occupations. In a case-control study, 750 men with PD (onset ≥40 years) and 1300 healthy men completed a validated questionnaire about their lifetime occupational status. Occupations were classified using the RIASEC model. Odds ratios (ORs) were calculated for the conventional and artistic categories, both for the most recent occupation before symptom onset, and for the very first occupation. Because farming has been associated with a PD risk, ORs were calculated separately for farming. A reduced risk of PD was found for men with an artistic occupation late in life (OR 0.14, 95% CI 0.04-0.53), while an artistic first occupation did not prevent PD (OR 0.72, CI 0.32-1.59). Conventional occupations showed no increased risk (recent: OR 1.07, CI 0.70-1.64; first: OR 1.14, CI 0.77-1.71). In support of previous reports, farming was associated with an increased risk of PD (recent: OR 2.6, CI 1.4-4.6; first: OR 2.7, CI 1.6-4.5). PD patients were older than controls, but various statistical corrections for age all lead to similar results. Artistic occupations late in life are associated with a reduced risk of subsequent PD, perhaps because this reflects a better preserved dopaminergic state. No initial occupation predicted PD, suggesting that the premotor phase starts later in life.

Reducing the Risk: Unemployed Migrant Youth and Labour Market Programs. Overview.

Science.gov (United States)

Australian Inst. of Multicultural Affairs, Melbourne (Australia).

This booklet is an overview and summary of the publication "Reducing the Risk: Unemployed Migrant Youth and Labour Market Programs" which reviews programs and services for migrant and refugee youth in Australia. The unemployment rate for this group is higher than for their Australian-born peers, and their participation in governmental…

Key Factors for Determining Risk of Groundwater Impacts Due to Leakage from Geologic Carbon Sequestration Reservoirs

Energy Technology Data Exchange (ETDEWEB)

Carroll, Susan [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Keating, Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mansoor, Kayyum [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dai, Zhenue [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sun, Yunwei [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Trainor-Guitton, Whitney [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Brown, Chris [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bacon, Diana [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2014-01-06

The National Risk Assessment Partnership (NRAP) is developing a science-based toolset for the analysis of potential impacts to groundwater chemistry from CO₂ injection (www.netldoe.gov/nrap). The toolset adopts a stochastic approach in which predictions address uncertainties in shallow underwater and leakage scenarios. It is derived from detailed physics and chemistry simulation results that are used to train more computationally efficient models,l referred to here as reduced-order models (ROMs), for each component system. In particular, these tools can be used to help regulators and operators understand the expected sizes and longevity of plumes in pH, TDS, and dissolved metals that could result from a leakage of brine and/or CO₂ from a storage reservoir into aquifers. This information can inform, for example, decisions on monitoring strategies that are both effective and efficient. We have used this approach to develop predictive reduced-order models for two common types of reservoirs, but the approach could be used to develop a model for a specific aquifer or other common types of aquifers. In this paper we describe potential impacts to groundwater quality due to CO₂ and brine leakage, discuss an approach to calculate thresholds under which "no impact" to groundwater occurs, describe the time scale for impact on groundwater, and discuss the probability of detecting a groundwater plume should leakage occur.

Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension?

Science.gov (United States)

Saftlas, Audrey F; Triche, Elizabeth W; Beydoun, Hind; Bracken, Michael B

2010-08-01

Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine whether regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at Chocolate consumption (servings/week) during the first and third trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of less than 1 serving/week comprised the referent group. Adjusted odds ratios (aORs) were estimated by the use of logistic regression. Chocolate intake was more frequent among normotensive (80.7%) than preeclamptic (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (first trimester: aOR, 0.55; 95% confidence interval [95% CI], 0.32-0.95; third trimester: aOR, 0.56; 95% CI, 0.32-0.97). Only first trimester intake was associated with reduced odds of GH (aOR,0.65; 95% CI, 0.45-0.87). These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. 2010 Elsevier Inc. All rights reserved.

Reducing the Risk of Type 2 Diabetes in Nonselected Outpatients With Schizophrenia

DEFF Research Database (Denmark)

Hjorth, Peter; Espensen, Caroline H; Madsen, Nikolaj J

2018-01-01

maintaining such a lifestyle because of factors related to their illness, such as cognitive disturbances, negative and positive symptoms, and side effects of psychotropic medications. OBJECTIVE: To measure and reduce risk factors for type 2 diabetes in patients with schizophrenia and examine characteristics...... and reduction in their risk factors for type 2 diabetes. The clinical intervention incorporated individual guidance, group sessions, and treatment as usual. RESULTS: Patients newly diagnosed with schizophrenia were found to have high consumption of soft drinks and low physical activity at their index evaluation......: The study found that positive outcomes were associated with female sex and a longer duration of illness. Negative outcomes with worsening of risk factors were associated with being newly diagnosed with schizophrenia and male sex. It was possible to produce improvements in some risk factors through...

Assessing Health Risk due to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam

Directory of Open Access Journals (Sweden)

Tung Bui Huy

2014-07-01

Full Text Available We assessed health risks related to Arsenic (As in contaminated drinking water in Hanam, applying the Australian Environmental Health Risk Assessment Framework, which promotes stakeholder involvement in risk assessments. As concentrations in 300 tube-well water samples, before and after filtration, were analyzed and the water consumption levels in 150 households were estimated. Skin cancer risk was characterized using Cancer Slope Factor index and lifetime average daily dose with a probabilistic approach. The results showed that arsenic concentrations in tube-well water ranged from 8–579 ppb (mean 301 ppb before filtration and current sand filters used by the households did not meet the standard for As removal. Arsenic daily consumption of 40% of the adults exceeded the level of TDI (Tolerable Daily Intake at 1 µg/kg/day. The average skin cancer risk in adults due to consuming filtered tube-well water for drinking purpose were 25.3 × 10−5 (using only well water and 7.6 × 10−5 (using both well and rain water. The skin cancer risk would be 11.5 times higher if the water was not filtered. Improvement of filtration measures or the replacement of the current drinking water sources to minimize the health risks to the local population is urgently needed.

Assessing Health Risk due to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam

Science.gov (United States)

Bui Huy, Tung; Tuyet-Hanh, Tran Thi; Johnston, Richard; Nguyen-Viet, Hung

2014-01-01

We assessed health risks related to Arsenic (As) in contaminated drinking water in Hanam, applying the Australian Environmental Health Risk Assessment Framework, which promotes stakeholder involvement in risk assessments. As concentrations in 300 tube-well water samples, before and after filtration, were analyzed and the water consumption levels in 150 households were estimated. Skin cancer risk was characterized using Cancer Slope Factor index and lifetime average daily dose with a probabilistic approach. The results showed that arsenic concentrations in tube-well water ranged from 8–579 ppb (mean 301 ppb) before filtration and current sand filters used by the households did not meet the standard for As removal. Arsenic daily consumption of 40% of the adults exceeded the level of TDI (Tolerable Daily Intake) at 1 µg/kg/day. The average skin cancer risk in adults due to consuming filtered tube-well water for drinking purpose were 25.3 × 10−5 (using only well water) and 7.6 × 10−5 (using both well and rain water). The skin cancer risk would be 11.5 times higher if the water was not filtered. Improvement of filtration measures or the replacement of the current drinking water sources to minimize the health risks to the local population is urgently needed. PMID:25062276

Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults

Directory of Open Access Journals (Sweden)

Chih-Hsiang Yang

2015-01-01

Full Text Available Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258 completed a brief web survey in October–November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction.

Do Antibiotics Reduce Production Risk for U.S. Pork Producers?

OpenAIRE

Liu, Xuanli; Miller, Gay Y.; McNamara, Paul E.

2005-01-01

Production risk from live weight variation of market pigs has become a more important concern in U.S. swine production. Packers are concerned about the variation in carcass size because of the demand for standardized cuts and the use of automation in the slaughter process. Swine producers care about standardized pigs because of revenue implications and possible links to animal health and productivity. Pig size variation can be due to various condition and inputs including antibiotics. However...

Shielding Studies for Reducing the associated Radiological Risks Due To Irradiated Low Enriched Uranium Foil

International Nuclear Information System (INIS)

Margeanu, C.A.

2011-01-01

Present work estimates the radiation dose rates corresponding to irradiated Low Enriched Uranium (20 wt % 235 U) foil as part of shielding studies for radiological risks reduction after irradiation inside TRIGA 14 MW Research Reactor in an investigation on 99 Mo production possibility. Post-Irradiation Examination Laboratory's cell shielding calculations have been performed; radiation source was obtained by using ORIGEN-S code with specific cross-sections libraries. Different post-irradiation cooling times have been considered, gamma dose rates being estimated by using MAVRIC module from Scale 6 programs package, for following exposure situations (relative to Pie cell): i) front side, ii) lateral side and iii) back side. Three different calculations were performed: a) without any protection shield between operator and cell, except for the cell stainless steel wall; b) with a Lead protection shield between operator and cell and c) with a depleted Uranium shield, located inside the cell in between the radiation source and cell window. Radiation dose rates to cell external wall surface and for other eight fixed distances from cell wall were estimated. To obtain a consistent set of solutions, the study was done for various Uranium foil weights and different Lead and depleted Uranium shields thicknesses. Calculations were focused to assure that the dose rate to an operator positioned at 60 cm working distance from the cell will not exceed 0.02 mSv/h, maximum allowed dose rate for professionally exposed personnel according to Romanian regulations.

Reducing the risk of cyber threats in utilities through log management

Energy Technology Data Exchange (ETDEWEB)

Patnaik, A. [ArcSight, Cupertino, CA (United States)

2010-01-15

Electrical blackouts caused by terrorists hacking into targeted control systems have already occurred in Brazil. A patchwork of security tools is needed to reduce potential threats. The continuous collection and analysis of data is also needed to detect cyber threats. The real time correlation of logs across all systems, applications and users is needed to ensure the reliability and security of the power grid. Solutions must also integrate well with identity management sources in order to prevent remote access account hijacking. Effective log management can be used to detect threats and reduce the risk of power outages. 1 fig.

Balance training reduces falls risk in older individuals with type 2 diabetes.

Science.gov (United States)

Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

Poor health as a potential risk factor for job loss due to automation: the case of Norway.

Science.gov (United States)

Hessel, Philipp; Christiansen, Solveig; Skirbekk, Vegard

2018-03-01

This study aimed to quantify the extent to which health characteristics of workers are related to the potential risk of experiencing job displacement due to automation. Linking the 2015 Norwegian Statistics on Income and Living Conditions survey (n=6393) with predicted probabilities of automation by occupation, we used Kruskal-Wallis tests and multivariate generalised linear models to assess the association between long-standing illnesses and risk of job automation. Individuals with long-standing illnesses face substantially greater risks of losing their job due to automation. Whereas the average risk of job automation is 57% for men and 49% for women with long-standing illnesses, the risk is only 50% for men and 44% for women with limitations (pjob automation among men (risk ratio (RR) 1.13, 95% CI 1.09 to 1.19), as well as women (RR 1.11, 95% CI 1.05 to 1.17). While, among men, the association between long-standing illness and risk of job automation remains significant when controlling for education and income, it becomes insignificant among women. Individuals with poor health are likely to carry the highest burden of technological change in terms of worsening employment prospects because of working in occupations disproportionally more likely to be automated. Although the extent of technology-related job displacement will depend on several factors, given the far-reaching negative consequences of job loss on health and well-being, this process represents a significant challenge for public health and social equity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study.

Science.gov (United States)

Cadarette, Suzanne M; Lévesque, Linda; Mamdani, Muhammad; Perreault, Sylvie; Juurlink, David N; Paterson, J Michael; Carney, Greg; Gunraj, Nadia; Hawker, Gillian A; Tadrous, Mina; Wong, Lindsay; Dormuth, Colin R

2013-09-01

Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to

A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents.

Science.gov (United States)

Kennedy, David P; Hunter, Sarah B; Chan Osilla, Karen; Maksabedian, Ervant; Golinelli, Daniela; Tucker, Joan S

2016-03-15

Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. NCT02140359.

Optimization (Alara) and probabilistic exposures: the application of optimization criteria to the control of risks due to exposures of a probabilistic nature

International Nuclear Information System (INIS)

Gonzalez, A.J.

1989-01-01

The paper described the application of the principles of optimization recommended by the International Commission on Radiological Protection (ICRP) to the restrain of radiation risks due to exposures that may or may not be incurred and to which a probability of occurrence can be assigned. After describing the concept of probabilistic exposures, it proposes a basis for a converging policy of control for both certain and probabilistic exposures, namely the dose-risk relationship adopted for radiation protection purposes. On that basis some coherent approaches for dealing with probabilistic exposures, such as the limitation of individual risks, are discussed. The optimization of safety for reducing all risks from probabilistic exposures to as-low-as-reasonably-achievable (ALARA) levels is reviewed in full. The principles of optimization of protection are used as a basic framework and the relevant factors to be taken into account when moving to probabilistic exposures are presented. The paper also reviews the decision-aiding techniques suitable for performing optimization with particular emphasis to the multi-attribute utility-analysis technique. Finally, there is a discussion on some practical application of decision-aiding multi-attribute utility analysis to probabilistic exposures including the use of probabilistic utilities. In its final outlook, the paper emphasizes the need for standardization and solutions to generic problems, if optimization of safety is to be successful

Risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia in a developing country

International Nuclear Information System (INIS)

Kalam, K.; Kumar, S.; Ali, S.; Baqi, S.; Qamar, F.

2014-01-01

Objective: To identify the risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia in a developing country. Methods: A prospective cohort study was conducted at the Sindh Institute of Urology and Transplantation (SIUT) from June to October 2012. Hospitalized patients > 15 years of age with gram negative bacteraemia were included and followed for a period of 2 weeks for in hospital mortality. Data was collected and analyzed for 243 subjects. Multivariate analysis was used to determine the risk factors for carbapenem resistant bacteraemia and mortality due to gram negative bacteraemia. Crude and adjusted odds ratio and 95% CI are reported. Results: A total of 729 out of 1535 (47.5%) cultures were positive for gram negative isolates. Out of 243 subjects, 117 (48%) had an MDR isolate. Having an MDR isolate on culture (AOR, 2.33; 95% CI, 1.35 -4.0), having multiple positive cultures (AOR, 1.8; 95% CI, 0.94 -3.4) and stay in ICU >48 hours (AOR, 2.0 ; 95% CI, 1.12 -3.78) were identified as significant risk factors for mortality due to gram negative organisms. Risk factors for carbapenem resistant bacteraemia were age >50 years (AOR, 1.83; 95% CI, 1.0-3.5), septic shock on presentation (AOR 2.53; 95% CI, 1.03 -6.2) , ICU stay of >72 hours (AOR 2.40; 95% CI, 1.14-5.0) and receiving immunosuppressant medications (AOR 2.23; 95% CI, 0.74 - 6.7). Conclusion: There is a high burden of MDR and carbapenem resistant gram negative bacteraemia, with a high mortality rate. (author)

Adherence to the USDA Food Guide, DASH Eating Plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma.

Science.gov (United States)

Dixon, L Beth; Subar, Amy F; Peters, Ulrike; Weissfeld, Joel L; Bresalier, Robert S; Risch, Adam; Schatzkin, Arthur; Hayes, Richard B

2007-11-01

The 2005 Dietary Guidelines for Americans include quantitative recommendations for 2 eating patterns, the USDA Food Guide and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, to promote optimal health and reduce disease risk. A Mediterranean dietary pattern has also been promoted for health benefits. Our objective was to determine whether adherence to the USDA Food Guide recommendations, the DASH Eating Plan, or a Mediterranean dietary pattern is associated with reduced risk of distal colorectal adenoma. In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, men and women aged 55-74 y were screened for colorectal cancer by sigmoidoscopy at 10 centers in the U.S. After adjusting for potential confounders, men who most complied with the USDA Food Guide recommendations had a 26% reduced risk of colorectal adenoma compared with men who least complied with the recommendations (OR USDA score >or= 5 vs. dietary pattern. Women who most complied with the USDA Food Guide recommendations had an 18% reduced risk for colorectal adenoma, but subgroup analyses revealed protective associations only for current smokers (OR USDA score >or= 5 vs. or= 5 vs. dietary recommendations or a Mediterranean dietary pattern is associated with reduced risk of colorectal adenoma, especially in men.

Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts

Science.gov (United States)

... the-Counter Medicines Safe Daily Use of Aspirin Aspirin for Reducing Your Risk of Heart Attack and ... any pharmacy, grocery or convenience store and buy aspirin without a prescription. The Drug Facts label on ...

Early growth characteristics and the risk of reduced lung function and asthma

DEFF Research Database (Denmark)

den Dekker, Herman T; Sonnenschein-van der Voort, Agnes M M; de Jongste, Johan C

2016-01-01

BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children fro...

Reduced risk of UC in families affected by appendicitis: a Danish national cohort study.

Science.gov (United States)

Nyboe Andersen, Nynne; Gørtz, Sanne; Frisch, Morten; Jess, Tine

2017-08-01

The possible aetiological link between appendicitis and UC remains unclear. In order to investigate the hereditary component of the association, we studied the risk of UC in family members of individuals with appendicitis. A cohort of 7.1 million individuals was established by linkage of national registers in Denmark with data on kinship and diagnoses of appendicitis and UC. Poisson regression models were used to calculate first hospital contact rate ratios (RR) for UC with 95% CIs between individuals with or without relatives with a history of appendicitis. During 174 million person-years of follow-up between 1977 and 2011, a total of 190 004 cohort members developed appendicitis and 45 202 developed UC. Individuals having a first-degree relative with appendicitis before age 20 years had significantly reduced risk of UC (RR 0.90; 95% CI 0.86 to 0.95); this association was stronger in individuals with a family predisposition to UC (RR 0.66; 95% CI 0.51 to 0.83). Individuals with a first-degree relative diagnosed with appendicitis before age 20 years are at reduced risk of UC, particularly when there is a family predisposition to UC. Our findings question a previously hypothesised direct protective influence of appendicitis on inflammation of the large bowel. Rather, genetic or environmental factors linked to an increased risk of appendicitis while being protective against UC may explain the repeatedly reported reduced relative risk of UC in individuals with a history of appendicitis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users.

Science.gov (United States)

Corsi, Karen F; Lehman, Wayne E; Min, Sung-Joon; Lance, Shannon P; Speer, Nicole; Booth, Robert E; Shoptaw, Steve

2012-06-04

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk.

Prepayment risk, impact on credit products

Directory of Open Access Journals (Sweden)

Dan Costin NIŢESCU

2012-08-01

Full Text Available Credit pricing is always an important aspect of operations of banks, as loans are generally two thirds of bank assets. Therefore, the study of factors influencing a bank customer behavior and their impact on early repayment of loans may have a significant influence in reducing the risk assumed by such unexpected operations.Objective analysis of prepayment risk is to estimate the probability of repayment to better manage its manifestation. The existence of potential customers that use this option exposes the bank to a number of risks, such as interest rate risk, the maturity mismatch risk and liquidity risk.Proper evaluation and forecasting the evolution of this risk can bring great benefits for a credit institution in the management of loan products and customer relationship: lower risk of over-ensure against fixed rate mortgage, a better management of short-term and long term liquidity needs (thus reducing the risk of over-financing can offer customers more competitive pricing (achieved by reducing funding costs due to better assessment and management of risks involved early repayment.

Renal function during pregnancy may predict risk of future hospitalization due to atherosclerotic-related morbidity.

Science.gov (United States)

Wolak, Talya; Shoham-Vardi, Ilana; Sergienko, Ruslan; Sheiner, Eyal

2016-02-01

This study aims to examine whether renal function during pregnancy can serve as a surrogate marker for the risk of developing atherosclerotic-related morbidity. A case-control study, including women who gave birth at a tertiary referral medical centre during 2000-2012. This population was divided into cases of women who were subsequently hospitalized for atherosclerotic morbidity during the study period and age-matched controls. From the study population, we retrieved two groups: the creatinine (Cr) group: women who had at least one Cr measurement (4945 women) and the urea group: women who had at least one urea measurement (4932 women) during their pregnancies. In the Cr and urea group, there were 572 and 571 cases and 4373 and 4361 controls, respectively. The mean follow-up period in the Cr and urea group was 61.7 ± 37.0 and 57.3 ± 36.0 months, respectively. Cox proportional hazards models (controlling for confounders: gestational hypertension, gestational diabetes, obesity, maternal age, creatinine level (for urea), and gestational week) were used to estimate the adjusted hazard ratios (HR) for hospitalizations. A significant association was documented between renal function during pregnancy and long-term atherosclerotic morbidity. Multivariate analysis, showed that Cr at pregnancy index of ≥89 μmol/L was associated with a significant increased risk for hospitalization due to cardiovascular (CVS) events (adjusted HR = 2.91 CI 1.37-6.19 P = 0.005) and urea level ≤7 mmol/L was independently associated with reduced prevalence of CVS hospitalization (adjusted HR = 0.62 CI 0.57-0.86 P = 0.001). Renal function abnormality during pregnancy may reveal occult predisposition to atherosclerotic morbidity years after childbirth. © 2015 Asian Pacific Society of Nephrology.

Reduced Arctic air pollution due to decreasing European and North American emissions

Science.gov (United States)

Mackie, Anna R.; Palmer, Paul I.; Barlow, James M.; Finch, Douglas P.; Novelli, Paul; Jaeglé, Lyatt

2016-07-01

Atmospheric transport of midlatitude pollutant emissions to the Arctic can result in disproportionate impacts on the receptor region. We use carbon monoxide (CO), a tracer of incomplete combustion, to study changes in pollutant transport to the Arctic. Using a wavelet transform, we spectrally decompose CO mole fraction measurements from three Arctic sites (Alert, Barrow, and Zeppelin) collected by NOAA over the past 20-25 years. We show that CO concentrations have decreased by -1.0 to -1.2 ppb/yr. We find that the dampened seasonal cycle (-1.2 to -2.3 ppb/yr) is mostly due to a reduction in peak concentrations (-1.5 to -2.4 ppb/yr), which we attribute to reduced source emissions. We find no evidence to support a persistent increase in hydroxyl radical concentration. Using the GEOS-Chem global 3-D chemistry transport model, we show that observed decreases are consistent with reductions in fossil fuel usage from Europe and North America.

Reducing the risk, managing safety.

Science.gov (United States)

Aldridge, Peter

2016-02-01

Fire safety in healthcare premises has always been a challenge to those that discharge this duty. Statutory compliance should be a matter of course, but in an ever increasingly challenged NHS, even this is not a given. While the NHS is driven by managing very complex risk to deliver cutting edge healthcare, providers cannot be risk averse. Which risk, however, takes priority? Here Peter Aldridge, fire and corporate services manager at Leeds Teaching Hospitals NHS Trust, and Secretary to the National Association of Healthcare Fire Officers (NAHFO)--which will this month and next jointly stage fire safety seminars with IHEEM; see page 8--considers the key issues, with input from a fire officer at a leading mental health and community Trust.

Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

Science.gov (United States)

Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

2017-03-01

Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

Comparison of risks due to bisphenol A and radiation with trad-MCN assay

International Nuclear Information System (INIS)

Shin, H. S.; Lee, J. H.; Kim, J. K.; Chon, K. J.; Lee, B. H.

2001-01-01

Many kinds of synthetic chemicals have been being used for various purposes. Some of them are called 'environmental hormones' because they can disturb the endocrine system of organisms. Presently no technique is established for the quantitative assessment of biological risk of the environmental hormones. The pollen mother cells (PMC) of Tradescantia are very sensitive to chemical toxicants or ionizing radiation, and thus can be used as a biological end-point assessing their effect. Micronucleus frequencies in PMC showed a good dose- and concentration-response relationship for radiation and bisphenol A. From the dose-response relationship, it is possible to estimate the equivalent bisphenol A concentration, or vice versa. One μM/ml of bisphenol A is equivalent to 1.8 cGy of radiation in the induction of micronuclei. It is known from the result that Trad-MCN assay can be an excellent tool for detection of biological risk due to environmental toxicants or synthetic chemicals

Improving material management to reduce greenhouse gas emissions

NARCIS (Netherlands)

Hekkert, Marko Peter

2000-01-01

Climate change due to greenhouse gas emissions caused by human actions is probably one of the major global environmental problems that we face today. In order to reduce the risk of climate change and the potential effects thereof, the emission of greenhouse gases like carbon dioxide (CO2) and

USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

Science.gov (United States)

Vantamay, Nottakrit

2015-09-01

This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth.

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

Support of the 'fallopian tube hypothesis' in a prospective series of risk-reducing salpingo-oophorectomy specimens

NARCIS (Netherlands)

Reitsma, Welmoed; de Bock, Geertruida H.; Oosterwijk, Jan C.; Bart, Joost; Hollema, Harry; Mourits, Marian J. E.

Objective: To determine the prevalence, localisation and type of occult (non) invasive cancer in risk-reducing salpingo-oophorectomy (RRSO) specimens in BRCA-mutation carriers and high-risk women from BRCA-negative families. Methods: A consecutive series of RRSO specimens of asymptomatic,

A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes.

Directory of Open Access Journals (Sweden)

Stuart J H Biddle

Full Text Available Type 2 diabetes mellitus (T2DM, a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time.Adults aged 18-40 years who were either overweight (with an additional risk factor for T2DM or obese were recruited for the Sedentary Time ANd Diabetes (STAND RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables.187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2 were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures.A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change

Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty

DEFF Research Database (Denmark)

Thune, Jens Jakob; Hoefsten, Dan Eik; Lindholm, Matias Greve

2005-01-01

BACKGROUND: Randomized trials comparing fibrinolysis with primary angioplasty for acute ST-elevation myocardial infarction have demonstrated a beneficial effect of primary angioplasty on the combined end point of death, reinfarction, and disabling stroke but not on all-cause death. Identifying...... a patient group with reduced mortality from an invasive strategy would be important for early triage. The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple validated integer score that makes it possible to identify high-risk patients on admission to hospital. We hypothesized that a high...... as high risk. There was a significant interaction between risk status and effect of primary angioplasty (P=0.008). In the low-risk group, there was no difference in mortality (primary angioplasty, 8.0%; fibrinolysis, 5.6%; P=0.11); in the high-risk group, there was a significant reduction in mortality...

Optimisation of a Swedish district heating system with reduced heat demand due to energy efficiency measures in residential buildings

International Nuclear Information System (INIS)

Åberg, M.; Henning, D.

2011-01-01

The development towards more energy efficient buildings, as well as the expansion of district heating (DH) networks, is generally considered to reduce environmental impact. But the combined effect of these two progressions is more controversial. A reduced heat demand (HD) due to higher energy efficiency in buildings might hamper co-production of electricity and DH. In Sweden, co-produced electricity is normally considered to displace electricity from less efficient European condensing power plants. In this study, a potential HD reduction due to energy efficiency measures in the existing building stock in the Swedish city Linköping is calculated. The impact of HD reduction on heat and electricity production in the Linköping DH system is investigated by using the energy system optimisation model MODEST. Energy efficiency measures in buildings reduce seasonal HD variations. Model results show that HD reductions primarily decrease heat-only production. The electricity-to-heat output ratio for the system is increased for HD reductions up to 30%. Local and global CO 2 emissions are reduced. If co-produced electricity replaces electricity from coal-fired condensing power plants, a 20% HD reduction is optimal for decreasing global CO 2 emissions in the analysed DH system. - Highlights: ► A MODEST optimisation model of the Linköping district heating system is used. ► The impact of heat demand reduction on heat and electricity production is examined. ► Model results show that heat demand reductions decrease heat-only production. ► Local and global CO 2 emissions are reduced. ► The system electricity-to-heat output increases for reduced heat demand up to 30%.

Trends in the risk of mortality due to cardiovascular diseases in five Brazilian geographic regions from 1979 to 1996

Directory of Open Access Journals (Sweden)

Maria de Fátima Marinho de Souza

2001-12-01

Full Text Available OBJECTIVE - To analyze the trends in risk of death due to cardiovascular diseases in the northern, northeastern, southern, southeastern, and central western Brazilian geographic regions from 1979 to 1996. METHODS - Data on mortality due to cardiovascular, cardiac ischemic, and cerebrovascular diseases in 5 Brazilian geographic regions were obtained from the Ministry of Health. Population estimates for the time period from 1978 to 1996 in the 5 Brazilian geographic regions were calculated by interpolation with the Lagrange method, based on the census data from 1970, 1980, 1991, and the population count of 1996, for each age bracket and sex. Trends were analyzed with the multiple linear regression model. RESULTS - Cardiovascular diseases showed a declining trend in the southern, southeastern, and northern Brazilian geographic regions in all age brackets and for both sexes. In the northeastern and central western regions, an increasing trend in the risk of death due to cardiovascular diseases occurred, except for the age bracket from 30 to 39 years, which showed a slight reduction. This resulted from the trends of cardiac ischemic and cerebrovascular diseases. The analysis of the trend in the northeastern and northern regions was impaired by the great proportion of poorly defined causes of death. CONCLUSION - The risk of death due to cardiovascular, cerebrovascular, and cardiac ischemic diseases decreased in the southern and southeastern regions, which are the most developed regions in the country, and increased in the least developed regions, mainly in the central western region.

Estimate of lifetime excess lung cancer risk due to indoor exposure to natural radon-222 daughters in Korea

International Nuclear Information System (INIS)

Si-Young Chang; Jeong-Ho Lee; Chung-Woo Ha

1993-01-01

Lifetime excess lung cancer risk due to indoor 222 Rn daughters exposure in Korea was quantitatively estimated by a modified relative risk projection model proposed by the U.S. National Academy of Science and the recent Korean life table data. The lifetime excess risk of lung cancer death attributable to annual constant exposure to Korean indoor radon daughters was estimated to be about 230/10 6 per WLM, which seemed to be nearly in the median of the range of 150-450/10 6 per WLM reported by the UNSCEAR in 1988. (1 fig., 2 tabs.)

SIMPLE DECISION RULES REDUCE REINJURY RISK AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Science.gov (United States)

Grindem, Hege; Snyder-Mackler, Lynn; Moksnes, Håvard; Engebretsen, Lars; Risberg, May Arna

2016-01-01

Background Knee reinjury after anterior cruciate ligament (ACL) reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population. Objectives To assess the relationship between knee reinjury after ACL reconstruction and 1) return to level I sports, 2) timing of return to sports, and 3) knee function prior to return. Methods 106 patients who participated in pivoting sports participated in this prospective two year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey–Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria was defined as scores >90 on all tests, failure as failing any. Results Patients who returned to level I sports had 4.32 (p=0.048) higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51 % for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2 % of those who failed RTS criteria suffered reinjuries versus 5.6 % of those who passed (HR: 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate. Conclusion Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. Return to sport 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduces the reinjury rate. PMID:27162233

Reduce the risk of stock trading by using technical analysis in iran's ...

African Journals Online (AJOL)

Reduce the risk of stock trading by using technical analysis in iran's stock market. ... In this research, efficiency of 50 active companies of Tehran Stock ... With this observation, this research suggest forming a portfolio with zero cost by purchasing ... FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

Insulin use increases risk of asthma but metformin use reduces the risk in patients with diabetes in a Taiwanese population cohort.

Science.gov (United States)

Chen, Chiung-Zuei; Hsu, Chih-Hui; Li, Chung-Yi; Hsiue, Tzuen-Ren

2017-12-01

Recent reports have suggested that insulin promotes airway smooth muscle contraction and enhances airway hyperresponsiveness, which are cardinal features of asthma. In contrast, metformin can reduce both airway inflammatory and remodeling properties. However, these results are all from in vitro and animal studies. This study investigated whether diabetes and various antidiabetic agents associate with the risk of asthma. We used a retrospective population-based cohort study using Taiwan's National Health Insurance claim database from 2000 to 2010 and a Cox proportional hazards regression model to compare the incidence of asthma between patients with diabetes (n = 19,428) and a matched non-diabetic group (n = 38,856). We also used a case-control study nested from the above cohort including 1,982 incident cases of asthma and 1,982 age- and sex-matched controls. A time density sampling technique was used to assess the effects of various antidiabetic agents on the risk of asthma. The incidence of asthma was significantly higher in the diabetic cohort than that in the non-diabetic cohort after adjustment for age, sex, and obesity, with a hazard ratio of 1.30 (95% confidence interval [CI]: 1.24-1.38). Insulin was found to increase the risk of asthma among diabetic patients (odds ratio [OR] 2.23; 95% CI: 1.52-3.58). In contrast, the use of metformin correlated with a decreased risk of asthma (OR 0.75; 95% CI: 0.60-0.95). Individuals with diabetes are at an increased risk of asthma. Insulin may further increase the risk of asthma, but the risk could possibly be reduced by using metformin.

Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

DEFF Research Database (Denmark)

Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A

2017-01-01

BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. OBJECTIVE: To perform......) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses...... of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry. RESULTS: The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women...

Can we reduce the risk of disease heart in treatments of left breast? bated breath

International Nuclear Information System (INIS)

Fuentemilla Urio, N.; Lozares Cordero, S.; Otal Palacin, A.; Olasolo Alonso, J.; Pellejero Pellejero, S.; Martin Albina, M. L.; Maneru Camara, F.; Miquelez Alonso, S.; Rubio Arroniz, T.; Soto Prados, P.

2013-01-01

In studies related to breast cancer and mortality, there has been an increase in the mortality of patients with survival greater than 10 years treated with radiotherapy. Subsequent studies it appears that the main cause is heart disease. Therefore, that the heart started to consider organ of risk in the treatment of breast cancer with radiation therapy (adjuvant). Reducing the doses both heart and coronary arteries leads to a reduction in the risk of heart disease. Currently are introducing new techniques, to reduce the dose in heart and in the left anterior descending coronary artery such as new positions or techniques of Breath bated breath hold... (Author)

Risk factors for readmission to hospital in adult patients with heart failure and reduced ejection fraction

DEFF Research Database (Denmark)

Schjødt, Inge; Larsen, Palle; Johnsen, Søren Paaske

2017-01-01

REVIEW QUESTION/OBJECTIVE:: The objective of this systematic review is to identify and synthesize the best available evidence on risk factors associated with hospital readmission at different time points within the first year after heart failure (HF) hospitalization in patients suffering from HF...... with reduced ejection fraction (EF).More specifically, the question is: what are the risk factors for the prediction of hospital readmission within seven, 15, 30, 60, 90, 180 and 365 days of discharge in hospitalized patients with HF with reduced EF aged 18 years or older?...

A Pilot RCT of an Internet Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy.

Science.gov (United States)

Ingersoll, Karen; Frederick, Christina; MacDonnell, Kirsten; Ritterband, Lee; Lord, Holly; Jones, Brogan; Truwit, Lauren

2018-06-01

Preventing alcohol-exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face-to-face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6-month (6-M) follow-up assessments. Seventy-one women completed online questionnaires and telephone interviews and were randomized to CARRII (n = 36) or PE (n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6-M follow-up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6-M follow-up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6-M follow-up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent-to-treat group-by-time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT. Copyright © 2018 by the Research Society on Alcoholism.

Reduced COPD Exacerbation Risk Correlates With Improved FEV1: A Meta-Regression Analysis.

Science.gov (United States)

Zider, Alexander D; Wang, Xiaoyan; Buhr, Russell G; Sirichana, Worawan; Barjaktarevic, Igor Z; Cooper, Christopher B

2017-09-01

The mechanism by which various classes of medication reduce COPD exacerbation risk remains unknown. We hypothesized a correlation between reduced exacerbation risk and improvement in airway patency as measured according to FEV 1 . By systematic review, COPD trials were identified that reported therapeutic changes in predose FEV 1 (dFEV 1 ) and occurrence of moderate to severe exacerbations. Using meta-regression analysis, a model was generated with dFEV 1 as the moderator variable and the absolute difference in exacerbation rate (RD), ratio of exacerbation rates (RRs), or hazard ratio (HR) as dependent variables. The analysis of RD and RR included 119,227 patients, and the HR analysis included 73,475 patients. For every 100-mL change in predose FEV 1 , the HR decreased by 21% (95% CI, 17-26; P < .001; R 2  = 0.85) and the absolute exacerbation rate decreased by 0.06 per patient per year (95% CI, 0.02-0.11; P = .009; R 2  = 0.05), which corresponded to an RR of 0.86 (95% CI, 0.81-0.91; P < .001; R 2  = 0.20). The relationship with exacerbation risk remained statistically significant across multiple subgroup analyses. A significant correlation between increased FEV 1 and lower COPD exacerbation risk suggests that airway patency is an important mechanism responsible for this effect. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Evaluating Process Effectiveness to Reduce Risk

Science.gov (United States)

Shepherd, Christena C.

2017-01-01

It is well documented that government agencies do not have the same incentive as the private sector to focus on process effectiveness and continual improvement of those processes. It is also well documented whenever government agencies fail to deliver efficient, effective, consistent, and fair services to the citizens. In spite of the various "reinventing government" and "effectiveness initiatives" of the past decades, and in spite of the efforts on the part of many agencies to improve, government in general still lags behind industry in creating a culture of effective processes and systems. While the tragic events that unfolded recently in Flint, Michigan, teach us that running government "like a business" does not always take the needs of the citizenry into account, there are many lessons and techniques from the private sector that government agencies can use to improve. The incentive to improve, while mandated by various administrations1, needs to come from within the workforce, in order to effectively take root. The best, most effective incentive is to reduce, control or eliminate risk. Government agencies face some of the same risks as the private sector, while some are unique. While ISO 310002 has been around since 2009, risk has taken on increased visibility within the private sector with the advent of the emphasis on risk-based thinking in ISO 9001:20153. The relationship between risk-based thinking and effective processes is simple and direct. Those processes that are well thought out and standardized (i.e. Plan-Do-Check-Act), will have taken into account the applicable policy, statutory, regulatory, safety, quality and technical parameters, which may not occur to someone performing the process with minimal experience or training; and thus protect the employees, the public and the agency from statutory and regulatory violations; delay in providing services; non-delivery of services; harm to public or employee safety and health; cost overruns; breaches in

MODELING CREDIT RISK THROUGH CREDIT SCORING

OpenAIRE

Adrian Cantemir CALIN; Oana Cristina POPOVICI

2014-01-01

Credit risk governs all financial transactions and it is defined as the risk of suffering a loss due to certain shifts in the credit quality of a counterpart. Credit risk literature gravitates around two main modeling approaches: the structural approach and the reduced form approach. In addition to these perspectives, credit risk assessment has been conducted through a series of techniques such as credit scoring models, which form the traditional approach. This paper examines the evolution of...

Assessment of cardiovascular risk factors in obese individual in ...

African Journals Online (AJOL)

Background: Risk factor modification can reduce clinical events and premature death in people with established cardiovascular disease (CVD) as well as in those who are at high cardiovascular risk due to one or more risk factors. Obesity, a common nutritional disorder in industrialized countries is associated with an ...

Potential mediating pathways through which sports participation relates to reduced risk of suicidal ideation.

Science.gov (United States)

Taliaferro, Lindsay A; Rienzo, Barbara A; Miller, M David; Pigg, R Morgan; Dodd, Virginia J

2010-09-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The participants were 450 undergraduate students. Measures assessed participants' involvement in university-run sports and other activities; frequency of physical activity; and perceived social support, self-esteem, depression, hopelessness, loneliness, and suicidal ideation. Regression analyses confirmed a path model and tested for mediation effects. Vigorous activity mediated relationships between sport participation and self-esteem and depression; and self-esteem and depression mediated the relationship between vigorous activity and suicidal ideation. Social support mediated relationships between sport participation and depression, hopelessness, and loneliness; and each of these risk factors partially mediated the relationship between social support and suicidal ideation. However no variable fully mediated the relationship between sport participation and suicidal ideation. This study provides a foundation for research designed to examine pathways through which sport participation relates to reduced risk of suicidal behavior.

Could inter-agency working reduce emergency department attendances due to alcohol consumption?

Science.gov (United States)

Benger, J; Carter, R

2008-06-01

Excess alcohol consumption and associated harms in terms of health, crime and disorder have been highlighted by the government and media, causing considerable public concern. This study quantified the number of patient attendances at an urban adult and children's emergency department (ED) directly attributable to alcohol intoxication, and investigated ways in which the inter-agency sharing of anonymised information could be used to design, implement and monitor interventions to reduce these harms. Intoxicated patients attending either the adult or children's ED were prospectively identified by qualified nursing staff and anonymised data collected by a dedicated researcher. Collaboration and data sharing between health, police, social services, university experts and local authorities was achieved through the establishment of steering and operational groups with agreed objectives and the formation of a shared anonymised database. The proportion of patients attending the ED as a result of alcohol intoxication was 4% in adults and <1% in children. 70% of patients were male, with a mean age of 30 years, and 72% attended between 20.00 and 08.00 h. The most common reason for ED attendance was accident (34%), followed closely by assault (30%). 27% of patients had done most of their drinking at home, 36% in a pub and 16% in a nightclub. Inter-agency collaboration proved highly successful: pooling of anonymised data created a much clearer picture of the extent of the problem and immediately suggested strategies for intervention. The initiative to achieve inter-agency collaboration and data sharing was highly successful, with clear potential for the development and implementation of interventions that will reduce ED attendance due to excess alcohol consumption.

Quantitative risk assessment of listeriosis-associated deaths due to Listeria monocytogenes contamination of deli meats originating from manufacture and retail.

Science.gov (United States)

Pradhan, Abani K; Ivanek, Renata; Gröhn, Yrjö T; Bukowski, Robert; Geornaras, Ifigenia; Sofos, John N; Wiedmann, Martin

2010-04-01

The objective of this study was to estimate the relative risk of listeriosis-associated deaths attributable to Listeria monocytogenes contamination in ham and turkey formulated without and with growth inhibitors (GIs). Two contamination scenarios were investigated: (i) prepackaged deli meats with contamination originating solely from manufacture at a frequency of 0.4% (based on reported data) and (ii) retail-sliced deli meats with contamination originating solely from retail at a frequency of 2.3% (based on reported data). Using a manufacture-to-consumption risk assessment with product-specific growth kinetic parameters (i.e., lag phase and exponential growth rate), reformulation with GIs was estimated to reduce human listeriosis deaths linked to ham and turkey by 2.8- and 9-fold, respectively, when contamination originated at manufacture and by 1.9- and 2.8-fold, respectively, for products contaminated at retail. Contamination originating at retail was estimated to account for 76 and 63% of listeriosis deaths caused by ham and turkey, respectively, when all products were formulated without GIs and for 83 and 84% of listeriosis deaths caused by ham and turkey, respectively, when all products were formulated with GIs. Sensitivity analyses indicated that storage temperature was the most important factor affecting the estimation of per annum relative risk. Scenario analyses suggested that reducing storage temperature in home refrigerators to consistently below 7 degrees C would greatly reduce the risk of human listeriosis deaths, whereas reducing storage time appeared to be less effective. Overall, our data indicate a critical need for further development and implementation of effective control strategies to reduce L. monocytogenes contamination at the retail level.

BCG vaccination reduces risk of tuberculosis infection in vaccinated badgers and unvaccinated badger cubs.

Directory of Open Access Journals (Sweden)

Stephen P Carter

Full Text Available Wildlife is a global source of endemic and emerging infectious diseases. The control of tuberculosis (TB in cattle in Britain and Ireland is hindered by persistent infection in wild badgers (Meles meles. Vaccination with Bacillus Calmette-Guérin (BCG has been shown to reduce the severity and progression of experimentally induced TB in captive badgers. Analysis of data from a four-year clinical field study, conducted at the social group level, suggested a similar, direct protective effect of BCG in a wild badger population. Here we present new evidence from the same study identifying both a direct beneficial effect of vaccination in individual badgers and an indirect protective effect in unvaccinated cubs. We show that intramuscular injection of BCG reduced by 76% (Odds ratio = 0.24, 95% confidence interval (CI 0.11-0.52 the risk of free-living vaccinated individuals testing positive to a diagnostic test combination to detect progressive infection. A more sensitive panel of tests for the detection of infection per se identified a reduction of 54% (Odds ratio = 0.46, 95% CI 0.26-0.88 in the risk of a positive result following vaccination. In addition, we show the risk of unvaccinated badger cubs, but not adults, testing positive to an even more sensitive panel of diagnostic tests decreased significantly as the proportion of vaccinated individuals in their social group increased (Odds ratio = 0.08, 95% CI 0.01-0.76; P = 0.03. When more than a third of their social group had been vaccinated, the risk to unvaccinated cubs was reduced by 79% (Odds ratio = 0.21, 95% CI 0.05-0.81; P = 0.02.

Reducing cardiovascular risk factors in non-selected outpatients with schizophrenia.

Science.gov (United States)

Hansen, Mette Vinther; Hjorth, Peter; Kristiansen, Christina Blanner; Vandborg, Kirsten; Gustafsson, Lea Nørgaard; Munk-Jørgensen, Povl

2016-06-01

Cardiovascular diseases are the most common causes of premature death in patients with schizophrenia. We aimed at reducing cardiovascular risk factors in non-selected outpatients with schizophrenia using methods proven effective in short-term trials. Furthermore, we examined whether any baseline characteristics were associated with positive outcomes. All outpatients treated for schizophrenia at two Danish hospitals were included in this 1-year follow-up study. The patients were offered health interventions both individually and in groups. Weight, waist circumference, blood glucose, serum lipids, and information on smoking and alcohol were obtained. On average, small significant increases in body mass index (BMI) and waist circumferences were observed while small non-significant improvements in other cardiovascular risk factors were seen. Patients with high baseline BMI and patients with duration of treated illness beyond 2 years had significantly better intervention outcomes. Our results show that it was difficult to improve physical health in a group of non-selected patients with schizophrenia as part of routine care. The patients were not easily motivated to participate in the interventions, and it was difficult to monitor the recommended metabolic risk measures in the patient group. Future research should focus on simple strategies in health promotion that can be integrated into routine care. © The Author(s) 2016.

Newly developed integrated model to reduce risks in the electricity market

International Nuclear Information System (INIS)

Mo, Birger

2001-01-01

A new model which integrates hydro-scheduling and financial hedging has been developed in cooperation with Norsk Hydro. We believe the new tool will be useful for owners of hydropower plants that want to reduce risks in the power market. The model development started in 1997 and was financed by Norsk Hydro. As of 1998, the main financial contributor has been the Research Council of Norway through a project in the Strategic Institute Programme. (author)

Reduced risk of axillary lymphatic spread in triple-negative breast cancer

DEFF Research Database (Denmark)

Holm-Rasmussen, Emil Villiam; Jensen, Maj-Britt; Balslev, Eva

2015-01-01

We examined the association between the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of women with primary breast cancer and the risk of axillary lymph node (ALN) involvement at the time of diagnosis. Information on 20,009 women diagnosed with primary breast...... cancer between 2008 and 2012 was retrieved from the Danish Breast Cancer Cooperative Group database. The associations between clinical and pathological variables and ALN involvement at the time of diagnosis were evaluated in univariate and multivariate regression analyses, as well as the significance......-negative breast cancer (TNBC) patients showed a significantly reduced risk of ALN involvement at the time of diagnosis compared to patients with HR-positive/HER2-negative tumors (OR 0.55; 95 % CI 0.49-0.62; P

Proactive information provision for reducing social construct risk of nuclear facility

International Nuclear Information System (INIS)

Kitamura, Masaharu; Takahashi, Makoto; Hashizume, Hidetoshi; Shiraishi, Natsuki; Yagi, Ekou

2006-01-01

Outlines of, and the empirical observations from, an action research project aiming at improvement of relationship between nuclear community and the public have been reported in this paper. Ultimate goal of the project is effective reduction of social construct risk of nuclear power plants. As an initial approach to the goal, a proactive information provision scheme has been designed based on the knowledge acquired during our previous attempt of public communication named repetitive dialogue forum. The information contents consistent with the actual need of local citizens has been derived from the previous experiences and provided in the present project. Although the project is in its incipient stage, the observations are informative enough to develop the project further to attain the ultimate purpose of reducing the social construct component of technological risk of nuclear facilities. (author)

Comparison of human health risks resulting from exposure to fungicides and mycotoxins via food

NARCIS (Netherlands)

Muri, S.D.; Voet, van der H.; Boon, P.E.; Klaveren, van J.D.; Bruschweiler, B.

2009-01-01

The interest in holistic considerations in the area of food safety is increasing. Risk managers may face the problem that reducing the risk of one compound may increase the risk of another compound. An example is the potential increase in mycotoxin levels due to a reduced use of fungicides in crop

Intake of Japanese and Chinese teas reduces risk of Parkinson's disease.

Science.gov (United States)

Tanaka, Keiko; Miyake, Yoshihiro; Fukushima, Wakaba; Sasaki, Satoshi; Kiyohara, Chikako; Tsuboi, Yoshio; Yamada, Tatsuo; Oeda, Tomoko; Miki, Takami; Kawamura, Nobutoshi; Sakae, Nobutaka; Fukuyama, Hidenao; Hirota, Yoshio; Nagai, Masaki

2011-07-01

Studies that have addressed the association between the intake of coffee or caffeine and Parkinson's disease (PD) were conducted mainly in Western countries. Little is known about this relationship in an Asian population. Therefore, we performed an assessment of the association of the intake of coffee, other caffeine-containing beverages, and caffeine with the risk of PD in Japan. The study involved 249 PD cases and 368 control subjects. Information on dietary factors was obtained through a self-administered diet history questionnaire. Adjustment was made for sex, age, region of residence, educational level, pack-years of smoking, body mass index, the dietary glycemic index, and intake of cholesterol, vitamin E, β-carotene, vitamin B(6,) alcohol, and iron. Intake of coffee, black tea, and Japanese and Chinese teas was significantly inversely associated with the risk of PD: the adjusted odds ratios in comparison of the highest with the lowest quartile were 0.52, 0.58, and 0.59, respectively (95% confidence intervals = 0.30-0.90, 0.35-0.97, and 0.35-0.995, respectively). A clear inverse dose-response relationship between total caffeine intake and PD risk was observed. We confirmed that the intake of coffee and caffeine reduced the risk of PD. Furthermore, this is the first study to show a significant inverse relationship between the intake of Japanese and Chinese teas and the risk of PD. Copyright © 2011 Elsevier Ltd. All rights reserved.

Polyurethane film dressings and ceramide 2-containing hydrocolloid dressing reduce the risk of pressure ulcer development in high-risk patients undergoing surgery: a matched case-control study

Directory of Open Access Journals (Sweden)

Kohta M

2015-02-01

Full Text Available Masushi Kohta,1 Kazumi Sakamoto,2 Tsunao Oh-i31Medical Engineering Laboratory, ALCARE Co, Ltd, Sumida-ku, Tokyo, 2Department of Nursing, 3Department of Dermatology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, JapanBackground: Numerous clinical challenges regarding adhesive dressings have shown that using an adhesive dressing could minimize or prevent superficial skin loss in patients at risk of developing pressure ulcers. However, evidence that polyurethane film dressings and ceramide 2-containing hydrocolloid dressing can reduce the risk of pressure ulcer development in high-risk patients undergoing surgery is limited. Therefore, we assessed the effects of application of these dressings for reducing the risk of pressure ulcer development in these patients and identified other risk factors.Methods: A matched case-control study was conducted involving 254 patients at high risk for pressure ulcer development at one acute care hospital in Japan. No patients in this study had a pressure ulcer at the start of the study. Thirty-one patients developed a pressure ulcer during surgery, and these patients were defined as cases. Controls were randomly matched for sex and age (±4 years, from which 62 patients were selected. Medical records were obtained for preoperative factors, including age, sex, body mass index, diabetes mellitus, albumin, total protein, C-reactive protein, white cell count, red cell count, and hemoglobin, and for intraoperative factors, including dressing application, operation time, body position, and surgery type. The odds ratio (OR and 95% confidence interval (CI were determined to identify risk factors for pressure ulcer development in patients undergoing surgery.Results: By multiple logistic regression analysis, there was a significantly reduced risk of pressure ulcer development for patients who had dressing applications as compared with those without dressing applications (OR 0.063; 95% CI 0.012–0.343; P=0

Breast cancer screening in BRCA1 and BRCA2 mutation carriers after risk reducing salpingo-oophorectomy

NARCIS (Netherlands)

Fakkert, I.E.; Jansen, L.; Meijer, K.; Kok, Theo; Oosterwijk, J.C.; Mourits, M.J.E.; de Bock, G.H.

Breast cancer screening is offered to BRCA1 and BRCA2 mutation carriers from the age of 25 years because of their increased risk of breast cancer. As ovarian cancer screening is not effective, risk-reducing salpingho-oophorectomy (RRSO) is offered after child bearing age. RRSO before menopause

A comprehensive Network Security Risk Model for process control networks.

Science.gov (United States)

Henry, Matthew H; Haimes, Yacov Y

2009-02-01

The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk management policies due to shortcomings in their structure or formulation, the NSRM provides model structure and an associated modeling methodology that captures the relevant dynamics of cyber attacks on PCN for risk analysis. This article develops the NSRM in detail in the context of an illustrative example.

Moisture Risk in Unvented Attics Due to Air Leakage Paths

Energy Technology Data Exchange (ETDEWEB)

Prahl, D.; Shaffer, M.

2014-11-01

IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Warme und Feuchte instationar Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated with this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.

Moisture Risk in Unvented Attics Due to Air Leakage Paths

Energy Technology Data Exchange (ETDEWEB)

Prahl, D. [IBACOS, Inc., Pittsburgh, PA (United States); Shaffer, M. [IBACOS, Inc., Pittsburgh, PA (United States)

2014-11-01

IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Wärme und Feuchte instationär Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated with this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.

The KnowRISK project: Tools and strategies to reduce non-structural damage

Science.gov (United States)

Sousa Oliveira, Carlos; Lopes, Mário; Mota de Sá, Francisco; Amaral Ferreia, Mónica; Candeias, Paulo; Campos Costa, Alfredo; Rupakhety, Rajesh; Meroni, Fabrizio; Azzaro, Raffaele; D'Amico, Salvatore; Langer, Horst; Musacchio, Gemma; Sousa Silva, Delta; Falsaperla, Susanna; Scarfì, Luciano; Tusa, Giuseppina; Tuvé, Tiziana

2016-04-01

The project KnowRISK (Know your city, Reduce seISmic risK through non-structural elements) is financed by the European Commission to develop prevention measures that may reduce non-structural damage in urban areas. Pilot areas of the project are within the three European participating countries, namely Portugal, Iceland and Italy. Non-structural components of a building include all those components that are not part of the structural system, more specifically the architectural, mechanical, electrical, and plumbing systems, as well as furniture, fixtures, equipment, and contents. Windows, partitions, granite veneer, piping, ceilings, air conditioning ducts and equipment, elevators, computer and hospital equipment, file cabinets, and retail merchandise are all examples of non-structural components that are vulnerable to earthquake damage. We will use the experience gained during past earthquakes, which struck in particular Iceland, Italy and Portugal (Azores). Securing the non-structural elements improves the safety during an earthquake and saves lives. This paper aims at identifying non-structural seismic protection measures in the pilot areas and to develop a portfolio of good practices for the most common and serious non-structural vulnerabilities. This systematic identification and the portfolio will be achieved through a "cross-knowledge" strategy based on previous researches, evidence of non-structural damage in past earthquakes. Shake table tests of a group of non-structural elements will be performed. These tests will be filmed and, jointly with portfolio, will serve as didactic supporting tools to be used in workshops with building construction stakeholders and in risk communication activities. A Practical Guide for non-structural risk reduction will be specifically prepared for citizens on the basis of the outputs of the project, taking into account the local culture and needs of each participating country.

Do differences in childhood diet explain the reduced overweight risk in breastfed children?

NARCIS (Netherlands)

Scholtens, Salome; Brunekreef, Bert; Smit, Henriette A; Gast, Gerrie-Cor M; Hoekstra, Maarten O; de Jongste, Johan C; Postma, Dirkje S; Gerritsen, Jorrit; Seidell, Jaap C; Wijga, Alet H

2008-01-01

Breastfeeding has been associated with a reduced risk of overweight later in life. This study investigates whether differences in diet and lifestyle at 7 years of age between breastfed and formula-fed children can explain the difference in overweight prevalence at 8 years of age. We studied 2,043

Do Differences in Childhood Diet Explain the Reduced Overweight Risk in Breastfed Children?

NARCIS (Netherlands)

Scholtens, Salome; Brunekreef, Bert; Smit, Henriette A.; Gast, Gerrie-Cor M.; Hoekstra, Maarten O.; De Jongste, Johan C.; Postma, Dirkje S.; Gerritsen, Jorrit; Seidell, Jaap C.; Wijga, Alet H.

2008-01-01

Breastfeeding has been associated with a reduced risk of overweight later in life. This study investigates whether differences in diet and lifestyle at 7 years of age between breastfed and formula-fed children can explain the difference in overweight prevalence at 8 years of age. We studied 2,043

Reducing the Risk of Tick-Borne Diseases through Smart, Safe and Sustainable Pest Control

Science.gov (United States)

Each year PestWise programs form new partnerships to address ongoing and emerging issues. Reducing the risk from ticks and tick-borne disease is an issue of importance and EPA is contributing to a larger federal effort.

A Proposed Set of Metrics to Reduce Patient Safety Risk From Within the Anatomic Pathology Laboratory.

Science.gov (United States)

Banks, Peter; Brown, Richard; Laslowski, Alex; Daniels, Yvonne; Branton, Phil; Carpenter, John; Zarbo, Richard; Forsyth, Ramses; Liu, Yan-Hui; Kohl, Shane; Diebold, Joachim; Masuda, Shinobu; Plummer, Tim; Dennis, Eslie

2017-05-01

Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes. : Our group developed a universal, comprehensive list of 47 metrics for patient specimen handling in the anatomic pathology laboratory. Steps within the specimen workflow sequence are categorized as high or low risk. In general, steps associated with the potential for specimen misidentification correspond to the high-risk grouping and merit greater focus within quality management systems. Primarily workflow measures related to operational efficiency can be considered low risk. Our group intends to advance the widespread use of these metrics in anatomic pathology laboratories to reduce patient safety risk and improve patient care with development of best practices and interlaboratory error reporting programs. © American Society for Clinical Pathology 2017.

Non-sedentary Lifestyle Can Reduce Hip Fracture Risk among Older Caucasians Adults: The Adventist Health Study-2.

Science.gov (United States)

Lousuebsakul-Matthews, Vichuda; Thorpe, Donna; Knutsen, Raymond; Beeson, W Larry; Fraser, Gary E; Knutsen, Synnove F

2015-01-01

The beneficial effect of physical activity on reducing hip fracture risk has been supported in many previous studies. The present cohort study explores the relationship between total daily physical activity expressed as MET-hour/day and hip fracture risk among men over 50 years of age and postmenopausal women (n=22,836). Associations between self-reported hip fracture incidence and total daily physical activity and selected lifestyle factors were assessed using Cox proportional hazard regression. In gender-specific multivariable models, total activity above average (≥ 51 MET-hours per day for men, ≥ 48 MET-hours per day for women) compared to those with sedentary lifestyle (sedentary lifestyle can reduce the risk of hip fracture among the elderly.

Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude?

DEFF Research Database (Denmark)

Hallqvist, J; Diderichsen, Finn; Theorell, T

1998-01-01

The objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic differences in risk of myocardial infarction. The material...

Reducing the risk of HIV infection among South African sex workers: socioeconomic and gender barriers.

Science.gov (United States)

Karim, Q A; Karim, S S; Soldan, K; Zondi, M

1995-11-01

The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides.

Method to reduce levitation force decay of the bulk HTSC above the NdFeB guideway due to lateral movement

Energy Technology Data Exchange (ETDEWEB)

Ma, G T; Lin, Q X; Wang, J S; Wang, S Y; Deng, Z G; Lu, Y Y; Liu, M X; Zheng, J [Applied Superconductivity Lab, Mail Stop 152 Southwestern Jiaotong University, Chengdu, Sichuan 610031 (China)], E-mail: asclab@asclab.cn

2008-06-15

A magnetic levitation vehicle using bulk high-T{sub c} superconductors (HTSC) is considered as a promising transportation type thanks to its lateral inherent stability, but previous studies have found that the levitation force (LF) decays due to lateral movement. In this paper, a pre-load method is presented to reduce the LF decay, and the experimental results indicate that this method is very applicable in supressing this decay in spite of the applied field and material property of the bulk HTSC, and this effect can be ascribed to the reduction of the hysteresis loss in the bulk HTSC, i.e. more trapped magnetic flux after the pre-load case. In the end, experimental results indicate that the Halbach PMG has an advantage to reduce the cost of the PMG, but its rate of LF decay is also larger due to lateral movement.

CAPRA - Comprehensive Approach to Probabilistic Risk Assessment: international initiative for risk management effectiveness

OpenAIRE

Cardona, Omar Darío; Ordaz, Mario G.; Reinoso, Eduardo; Yamín, Luis; Barbat Barbat, Horia Alejandro

2012-01-01

Understanding disaster risk due to hazard events, such as earthquakes, creates powerful incentives for countries to develop planning options and tools to reduce potential damages. This has been the reason why CAPRA, the risk evaluation model described in this paper, was developed with the technical and financial support of the World Bank, the Inter-American Development Bank (IDB) and the International Strategy of United Nations for Disaster Reduction (ISDR). CAPRA is a techno-scientific metho...

Reducing Environmental Risks by Information Disclosure: Evidence in Residential Lead Paint Disclosure Rule

Science.gov (United States)

Bae, Hyunhoe

2012-01-01

Recently, there has been a surge in environmental regulations that require information disclosure. However, existing empirical evidence is limited to certain applications and has yet to generalize the effectiveness of this approach as a policy strategy to reduce environmental risks. This study evaluates the disclosure rule of the residential lead…

Reducing the risks of delegation: use of procedure skills checklists for unlicensed assistive personnel in schools, Part 1.

Science.gov (United States)

Shannon, Robin Adair; Kubelka, Suzanne

2013-07-01

School nurses are challenged by federal civil rights laws and the standards of school nursing practice to care for a burgeoning population of students with special health care needs. Due to the realities of current school nurse-to-student ratios, school nurses are frequently responsible for directing unlicensed assistive personnel (UAPs) to support the health and safety needs of students, where State Nurse Practice Acts, state legislation, and local policy mandates allow. The delegation of health care tasks to UAPs poses many professional, ethical, and legal dilemmas for school nurses. One strategy to reduce the risks of delegation is through the use of procedure skills checklists, as highlighted by the experience of one large urban school district. Part 1 of this two-part article will explore the scope of the problem and the principles of delegation, including legal and ethical considerations.

Improving patient follow-up in interventional radiology and radiation-based acts. To reduce the risk of deterministic effects

International Nuclear Information System (INIS)

Etard, Cecile; Aubert, Bernard; Lafont, Marielle; Mougniot, Sandrine; Rousse, Carole; Bey, Eric; Cassagnes, Lucie; Guersen, Joel; Ducou Le Pointe, Hubert; Elhadad, Simon; Georges, Jean-Louis; Nonent, Michel; Paisant-Thouveny, Francine; Salvat, Cecile; Vidal, Vincent; Chauvet, Bruno; Riu, Jean-Luc; Voix, Fabien; Bar, Olivier; Le Du, Dominique; Maccia, Carlo; Lacombe, Pascal; Mertz, Luc; Valery, Charles

2014-04-01

After having presented an example of adverse reaction to interventional radiology (a case of a iatrogenic radiodermatitis), this report first presents the context which creates a risk situation. It describes risks related to the use of ionizing radiations, identifies risk factors and how to make procedures safer, and indicates actions aimed at reducing risks (in a preventive way, in recovery, by attenuation)

Reducing volcanic risk on Fogo Volcano, Cape Verde, through a participatory approach: which outcome?

Science.gov (United States)

Texier-Teixeira, P.; Chouraqui, F.; Perrillat-Collomb, A.; Lavigne, F.; Cadag, J. R.; Grancher, D.

2014-09-01

This research paper presents the outcomes of Work Package 5 (socio-economical vulnerability assessment and community-based disaster risk reduction) of the MIAVITA (MItigate and Assess risk from Volcanic Impact on Terrain and human Activities) research programme conducted on Fogo Volcano, Cape Verde. The study lasted for almost 3 years (May 2010 to January 2012), of which most of the time was spent in the village of Chã das Caldeiras, situated within the 9 km wide caldera of the volcano inside Fogo Natural Park. The objectives of the programme included assessment of the vulnerability of the community at risk in terms of livelihoods, access to resources, and power relations between the local people and the different public and private institutions. These are important factors that need to be investigated in order to understand the root causes of vulnerability of the local people. This case study shows that the voluntary exposure of people to volcanic threats is linked to daily access to sources of livelihood, especially agriculture and tourism. This is despite the perception of people of the risk to their lives and properties. In order to counter the factors of vulnerability, the study also aimed to identify and enhance local capacities. To achieve such an objective, a participatory three-dimensional mapping (P3DM) activity was conducted to facilitate the dialogue between the local people and the different stakeholders as well as to prepare plans and measures to reduce volcanic risk. The P3DM was a half success considering that it has not yet led to an operational plan which takes into account the local capacities. The main reasons included (1) the non-participatory aspect of the project at the beginning which should have identified priorities for people and let them lead the project to ensure the sustainability of (2) deep conflicts within the community which complicated the focus group discussions around the 3-D map, and the difficulties in involving more

Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

Science.gov (United States)

Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

2014-01-01

Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

Conditional economic incentives for reducing HIV risk behaviors: integration of psychology and behavioral economics.

Science.gov (United States)

Operario, Don; Kuo, Caroline; Sosa-Rubí, Sandra G; Gálarraga, Omar

2013-09-01

This article reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories and behavioral economics can be combined into new approaches for HIV prevention. Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and sexually transmitted infection (STI) prevalence, HIV testing, HIV medication adherence, and drug use. CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Risk assessment of atmospheric contamination due to combustion of fossil-fuels in Japan and possible application of fuzzy set

International Nuclear Information System (INIS)

Nishiwaki, Y.; Shah, S.M.; Kanoh, E.

1983-01-01

For risk assessment of atmospheric contamination due to fossil-fuel combustion in Japan, epidemiological studies have been conducted since 1961. Health effects of sulfur dioxide in industrial areas of Japan where fossil-fuel power stations are located have been investigated. The dose-response relationship between prevalence rates of chronic bronchitis and sulphur dioxide was established. Various efforts have been made to reduce the concentrations of sulfur dioxide in the atmosphere. However, the average concentration of NO 2 tended to increase gradually. It was therefore considered important to study the health effects of nitrogen dioxide. In different areas of Japan with varying atmospheric concentrations of nitrogen dioxide, an extensive epidemiological survey was conducted with over 10,000 school-children. The results of the survey indicate that the prevalence rates of asthma and wheezing were higher with the higher degree of air pollution, and that the indoor pollution is important. It is also attempted to compare hazard indices of the air-borne wastes from fossil-fuel power plants and those from nuclear power plants. The conventional pollutants seem to be much more important as compared with the radioactive releases under normal conditions of operation. The survey of stochastic effects with very small chances of occurrence was not attempted because of the great uncertainties and difficulties in identifying a small signal within a large noise. The possible application of the theory of Fuzzy Set for risk analysis is suggested

Maintenance strategies to reduce downtime due to machine positional errors

OpenAIRE

Shagluf, Abubaker; Longstaff, A.P.; Fletcher, S.

2014-01-01

Proceedings of Maintenance Performance Measurement and Management (MPMM) Conference 2014 Manufacturing strives to reduce waste and increase Overall Equipment Effectiveness (OEE). When managing machine tool maintenance a manufacturer must apply an appropriate decision technique in order to reveal hidden costs associated with production losses, reduce equipment downtime competentely and similiarly identify the machines performance. Total productive maintenance (TPM) is a maintenance progr...

Reducing Delay in Diagnosis: Multistage Recommendation Tracking.

Science.gov (United States)

Wandtke, Ben; Gallagher, Sarah

2017-11-01

The purpose of this study was to determine whether a multistage tracking system could improve communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. Unconditional recommendations for imaging follow-up of all diagnostic imaging modalities excluding mammography (n = 589) were entered into a database and tracked through a multistage tracking system for 13 months. Tracking interventions were performed for patients for whom completion of recommended follow-up imaging could not be identified 1 month after the recommendation due date. Postintervention compliance with the follow-up recommendation required examination completion or clinical closure (i.e., biopsy, limited life expectancy or death, or subspecialist referral). Baseline radiology information system checks performed 1 month after the recommendation due date revealed timely completion of 43.1% of recommended imaging studies at our institution before intervention. Three separate tracking interventions were studied, showing effectiveness between 29.0% and 57.8%. The multistage tracking system increased the examination completion rate to 70.5% (a 52% increase) and reduced the rate of unknown follow-up compliance and the associated risk of delay in diagnosis to 13.9% (a 74% decrease). Examinations completed after tracking intervention generated revenue of 4.1 times greater than the labor cost. Performing sequential radiology recommendation tracking interventions can substantially reduce the rate of unknown follow-up compliance and add value to the health system. Unknown follow-up compliance is a risk factor for delay in diagnosis, a form of preventable medical error commonly identified in malpractice claims involving radiologists and office-based practitioners.

Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

Science.gov (United States)

Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

2016-01-01

evidence for the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System and the gaps in relation to exploration, as identified by the NASA Human Research Program (HRP). The research reviewed here indicates strategies to establish methods, technologies, and requirements that increase food stability, support adequate nutrition, quality, and variety, enable supplementation with grow-pick-and-eat salad crops, ensure safety, and reduce resource use. Obtaining the evidence to establish an adequate food system is essential, as the resources allocated to the food system may be defined based on the data relating nutritional stability and food quality requirements to crew performance and health.

Zinc as an adjunct treatment for reducing case fatality due to clinical severe infection in young infants: study protocol for a randomized controlled trial.

Science.gov (United States)

Wadhwa, Nitya; Basnet, Sudha; Natchu, Uma Chandra Mouli; Shrestha, Laxman P; Bhatnagar, Shinjini; Sommerfelt, Halvor; Strand, Tor A; Ramji, Siddarth; Aggarwal, K C; Chellani, Harish; Govil, Anuradha; Jajoo, Mamta; Mathur, N B; Bhatt, Meenakshi; Mohta, Anup; Ansari, Imran; Basnet, Srijana; Chapagain, Ram H; Shah, Ganesh P; Shrestha, Binod M

2017-07-10

An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal. In a 1:1 ratio, we will randomly assign young infants to receive 10 mg of elemental zinc or placebo orally in addition to the standard therapy for a total of 14 days. The primary outcomes hospital case fatality, which is death due to any cause and at any time after enrolment while hospitalized for the illness episode, and extended case fatality, which encompasses the period until 12 weeks after enrolment. A previous study showed a beneficial effect of zinc in reducing the risk of treatment failure, as well as a non-significant effect on case fatality. This study was not powered to detect an effect on case fatality, which this current study is. If the results are consistent with this earlier trial, we would have provided strong evidence for recommending zinc as an adjunct to standard therapy for clinical severe infection in young infants. Universal Trial Number: U1111-1187-6479, Clinical Trials Registry - India: CTRI/2017/02/007966 : Registered on February 27, 2017.

Improving performance of HVAC systems to reduce exposure to aerosolized infectious agents in buildings; recommendations to reduce risks posed by biological attacks.

Science.gov (United States)

Hitchcock, Penny J; Mair, Michael; Inglesby, Thomas V; Gross, Jonathan; Henderson, D A; O'Toole, Tara; Ahern-Seronde, Joa; Bahnfleth, William P; Brennan, Terry; Burroughs, H E Barney; Davidson, Cliff; Delp, William; Ensor, David S; Gomory, Ralph; Olsiewski, Paula; Samet, Jonathan M; Smith, William M; Streifel, Andrew J; White, Ronald H; Woods, James E

2006-01-01

The prospect of biological attacks is a growing strategic threat. Covert aerosol attacks inside a building are of particular concern. In the summer of 2005, the Center for Biosecurity of the University of Pittsburgh Medical Center convened a Working Group to determine what steps could be taken to reduce the risk of exposure of building occupants after an aerosol release of a biological weapon. The Working Group was composed of subject matter experts in air filtration, building ventilation and pressurization, air conditioning and air distribution, biosecurity, building design and operation, building decontamination and restoration, economics, medicine, public health, and public policy. The group focused on functions of the heating, ventilation, and air conditioning systems in commercial or public buildings that could reduce the risk of exposure to deleterious aerosols following biological attacks. The Working Group's recommendations for building owners are based on the use of currently available, off-the-shelf technologies. These recommendations are modest in expense and could be implemented immediately. It is also the Working Group's judgment that the commitment and stewardship of a lead government agency is essential to secure the necessary financial and human resources and to plan and build a comprehensive, effective program to reduce exposure to aerosolized infectious agents in buildings.

Comprehensive approach for probabilistic risk assessment (CAPRA): international initiative for disaster risk management effectiveness

OpenAIRE

Cardona, Omar D.; Ordaz Schroder, Mario Gustavo; Reinoso, Eduardo; Yamín, Luis; Barbat Barbat, Horia Alejandro

2010-01-01

Understanding disaster risk due to hazard events, such as earthquakes, creates powerful incentives for countries to develop planning options and tools to reduce potential damages. This has been the reason why CAPRA, the risk evaluation model described in this paper, was developed with the technical and financial support of the World Bank, the Inter-American Development Bank (IDB) and the International Strategy of United Nations for Disaster Reduction (ISDR). CAPRA is a techno-scientific metho...

Reduced risk of uncomplicated malaria episodes in children with a+-thalassemia in northeastern Tanzania

DEFF Research Database (Denmark)

Enevold, Anders; Lusingu, John P; Mmbando, Bruno

2008-01-01

the susceptibility to uncomplicated malaria. We compared the risk of suffering from febrile, uncomplicated malaria between individuals carrying three common RBC polymorphisms (sickle cell trait, alpha(+)-thalassemia, and glucose-6-phosphate-dehydrogenase deficiency) and controls. The study was performed in an area...... measured with flow cytometry and ELISA assays, respectively. Regression analyses showed that alpha(+)-thalassemia was associated with a reduced risk of uncomplicated malaria episodes and that this advantageous effect seemed to be more predominant in children older than 5 years of age, but was independent...

Assessment of damage from reduction of expected lifespan due to cancer

Directory of Open Access Journals (Sweden)

Boris Alengordovich Korobitsyn

2013-09-01

Full Text Available This paper presents the theoretical and methodological approaches to the assessment of damage from premature mortality and reduction of life expectancy due to various reasons. The concepts measuring the price of a human life are analyzed: the evaluation from the standpoint of the theory of human capital; indirect estimation taking into account non-monetary social costs; evaluation of individuals’ willingness to pay for the elimination of the risk of death; estimation based on the determination of insurance premiums and compensations under court decision; evaluation of the social investments, aimed to reduce the risk of premature mortality of the individual. The following indexes were calculated for all subordinate entities of the Russian Federation: reduction of life expectancy, lost years of potential life in the working age, and gross regional product lost due to the reduction of years of potential life in the working-age population as a result of cancer

The KnowRISK project - Know your city, Reduce seISmic risK through non-structural elements

Science.gov (United States)

Sousa Oliveria, Carlos; Amaral Ferreira, Mónica; Lopez, Mário; Sousa Silva, Delta; Musacchio, Gemma; Rupakhety, Rajesh; Falsaperla, Susanna; Meroni, Fabrizio; Langer, Horst

2016-04-01

Historically, there is a tendency to focus on seismic structural performance of buildings, neglecting the potential for damage of non-structural elements. In particular, non-structural elements of buildings are their architectural parts (i.e. partitions, ceilings, cladding), electrical and mechanical components (i.e., distribution panels, piping, plumbing), and contents (e.g., furniture, bookcases, computers and desktop equipment). Damage of these elements often contributes significantly to earthquake impacts. In the 1999 Izmit Earthquake, Turkey, 50% of the injuries and 3% of human losses were caused by non-structural failures. In the 2010-2011 Christchurch Earthquakes (New Zealand), 40% of building damage was induced by non-structural malfunctions. Around 70%-85% of construction cost goes into these elements, and their damage can strongly influence the ability of communities to cope with and recover from earthquakes. The project Know your city, Reduce seISmic risK through non-structural elements (KnowRISK) aims at facilitating local communities' access to expert knowledge on non-structural seismic protection solutions. The project will study seismic scenarios critical for non-structural damage, produce a portfolio of non-structural protection measures and investigate the level of awareness in specific communities. We will implement risk communication strategies that will take into account the social and cultural background and a participatory approach to raise awareness in local communities. The paradox between the progress of scientific knowledge and the ongoing increase of losses from natural disasters worldwide is a well-identified gap in the UN Hyogo Framework for Action 2005-2015, in which one of the main priorities is the investment on "knowledge use, innovation and education to build a culture of safety and resilience". The KnowRISK is well aligned with these priorities and will contribute to participatory action aimed at: i) transferring expert knowledge

Reducing risk and accelerating delivery of a neutron source for fusion materials research

Energy Technology Data Exchange (ETDEWEB)

Surrey, E., E-mail: Elizabeth.Surrey@ccfe.ac.uk [EURATOM/CCFE, Abingdon OX14 3DB (United Kingdom); Porton, M. [EURATOM/CCFE, Abingdon OX14 3DB (United Kingdom); Davenne, T.; Findlay, D.; Letchford, A.; Thomason, J. [STFC Rutherford Appleton Laboratory, Harwell OX11 0QX (United Kingdom); Roberts, S.G.; Marrow, J.; Seryi, A. [University of Oxford, Oxford OX1 3DP (United Kingdom); Connolly, B. [University of Birmingham, Edgbaston B15 2TT (United Kingdom); Owen, H. [University of Manchester, Manchester M13 9PL (United Kingdom)

2014-04-15

Highlights: • Proposed neutron source for fusion materials – FAFNIR – n(d,C) stripping source. • Near term technology, reduces risk compared with IFMIF, timely data production. • Technical, economic and programme needs assessed, compatible with EU Roadmap proposals. • Safety case impacts regulatory role for source, now mainly stakeholder insurance. - Abstract: The materials engineering database relevant to fusion irradiation is poorly populated and it has long been recognized that a fusion spectrum neutron source will be required, the facility IFMIF being the present proposal. Re-evaluation of the regulatory approach for the EU proposed DEMO device shows that the purpose of the source can be changed from lifetime equivalent irradiation exposure to data generation at lower levels of exposure by adopting a defence in depth strategy and regular component surveillance. This reduces the specification of the source with respect to IFMIF allowing lower risk technology solutions to be considered. A description of such a source, the Facility for Fusion Neutron Irradiation Research, FAFNIR, is presented here along with project timescales and costs.

Patient protection in nuclear medicine due to optimization of the administered activity

International Nuclear Information System (INIS)

Perez Diaz, M.; Diaz Rizo, O.; Khouri, H. J.

2011-01-01

The possibility of a radiological risk reduction in Nuclear Medicine patients is studied through the reduced absorbed doses in organs and tissues, and whole-body effective dose due to optimization of the administered radionuclide activities. Activity values, optimized for equipments and radiopharmaceuticals available in Cuba, are compared with the IAEA recommended values and with the routinary activities in medical practice. All doses were calculated using MIRDOSE 3.0 code for each activity and medical assay. The activity optimization permits to reduce in a 50% the doses administered to patients of the major part of studied medical assays. (Author)

Reducing drug–herb interaction risk with a computerized reminder system

Directory of Open Access Journals (Sweden)

Lin SS

2015-02-01

Full Text Available Sheng-Shing Lin,1,2 Chiu-Lin Tsai,3 Ching-Yeh Tu,3 Ching-Liang Hsieh2,4,5 1Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, 2Department of Chinese Medicine, China Medical University Hospital, 3Division of Chinese Medicine, Department of Pharmacy, China Medical University Hospital, 4Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, 5Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan Background: Traditional Chinese medicine (TCM and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions.Methods: Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient.Results: During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL.Conclusion: Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. Keywords: Traditional Chinese medicine, Western medicine, adverse reaction

K-Anonymity Based Privacy Risk Budgeting System for Interactive Record Linkage

Directory of Open Access Journals (Sweden)

Hye-Chung Kum

2017-04-01

The k-anonymity based privacy risk budgeting system provides a mechanism where we can concretely reason about the tradeoff between the privacy risks due to information disclosed, accuracy gained, and biases reduced during interactive record linkage.

Interventions aiming to reduce early retirement due to rheumatic diseases

Directory of Open Access Journals (Sweden)

Pedro Almeida Laires

2017-07-01

Full Text Available Introduction: Aging of the population and early retirement translates into productivity losses to society. Persistence of working life is crucial to counteract this sustainability issue faced by western countries. Musculoskeletal and rheumatic diseases (RD may cause work disability and early exit from work, including early retirement. The objective of this article is to review the current knowledge about interventions aiming to reduce early retirement due to RD. Methods: We searched PubMed and The Cochrane Library for studies either in English or Portuguese between January 2000 and June 2016 that evaluated the impact of interventions targeting early retirement in RD patients still at work. We also searched for grey literature from Portuguese institutional repositories. Results: We identified several published studies testing pharmacologic and non-pharmacologic vocational rehabilitation interventions. None was specifically identified for Portugal. The general low quality of the literature and its inconsistency makes it unfeasible to draw definitive conclusions. However, some broad recommendations might be outlined. An effective intervention must: 1 act upon different levels (e.g. RD patient, workplace, involving several stakeholders (e.g. rheumatologists, occupational physicians, employers; 2 prioritize the right patients (e.g. more disabling RD; and 3 consider the patients’ role, for instance by including an element of patient education and support. Despite the lack of good quality evidence on this field, there seems to be a growing interest in the international scientific community with several ongoing studies promoting such interventions. This promising data will be very useful to set up effective policies. Conclusions: This article summarizes the current knowledge about the impact of interventions to avoid or mitigate early retirement in RD patients. It highlights the demand for further research and it also contributes to aware decision

Compassionate Love as a Predictor of Reduced HIV Disease Progression and Transmission Risk

Directory of Open Access Journals (Sweden)

Heidemarie Kremer

2013-01-01

Full Text Available Objectives. This study examined if compassionate love (CL predicts HIV disease progression and transmission risk. Scientific study of CL emerged with Underwood’s working model of other-centered CL, defining five criteria: free choice, cognitive understanding, valuing/empowering, openness/receptivity for spirituality, and response of the heart. Method. This 10-year cohort study collected 6-monthly interviews/essays on coping with HIV and trauma of 177 people with HIV in South Florida. Secondary qualitative content analysis on other-centered CL inductively added the component of CL towards self. Deductively, we coded the presence of the five criteria of CL and rated the benefit of CL for the recipient on a 6-point Likert scale. Growth-curve modeling (reduced to 4 years due to cohort effects investigated if CL predicts CD4 slope (HIV disease progression and cumulative viral load detection (transmission risk. Results. Valuing/empowering and cognitive understanding were the essential criteria for CL to confer long-term benefits. CL had a higher benefit for recipients if given out of free choice. High scores of CL towards self were reciprocal with receiving (93% and giving (77% other-centered CL. Conversely, those rated low on CL towards self were least likely to score high on receiving (38% and giving (49% other-centered CL. Growth-curve modeling showed that CL towards self predicted 4-year cumulative undetectable viral load (independent from sociocultural differences, substance use disorder, baseline CD4 and viral load. Those high versus low on CL self were 2.25 times more likely to have undetectable viral load at baseline and 1.49 times more likely to maintain undetectable viral load over time. CL towards self predicted CD4 preservation after controlling for differences in CL giving. Conclusions. CL towards self is potentially the seed of being expressive and receptive of CL. Health care professionals prepared to walk the extra mile for those who

Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review.

Science.gov (United States)

Mat, Sumaiyah; Tan, Maw Pin; Kamaruzzaman, Shahrul Bahyah; Ng, Chin Teck

2015-01-01

osteoarthritis (OA) of knee has been reported as a risk factor for falls and reduced balance in the elderly. This systematic review evaluated the effectiveness of physical therapies in improving balance and reducing falls risk among patients with knee OA. a computerised search was performed to identify relevant studies up to November 2013. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the PeDro score. a total of 15 randomised controlled trials involving 1482 patients were identified. The mean PeDro score was 7. The pooled standardised mean difference in balance outcome for strength training = 0.3346 (95% CI: 0.3207-0.60, P = 0.01 falls risk outcomes in, strength training, Tai chi and aerobics also showed a significant reduction in reduced risk of falls significantly with pooled result 0.55 (95% CI: 0.41-0.68, P balance and falls risk in older individuals with knee OA, while water-based exercises and light treatment did not significantly improve balance outcomes. Strength training, Tai Chi and aerobics exercises can therefore be recommended as falls prevention strategies for individuals with OA. However, a large randomised controlled study using actual falls outcomes is recommended to determine the appropriate dosage and to measure the potential benefits in falls reduction. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Directory of Open Access Journals (Sweden)

Lash Timothy L

2010-01-01

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

Risks of energy generation in perspective

International Nuclear Information System (INIS)

Cohen, B.L.

Life expectancy reduction (LER) figures due to various risks are given. The example, air pollution from coal burning gives an LER of 12 days, and nuclear power, by government estimates, gives an LER of 0.04 days. The 25-day LER from all our use of energy is placed in perspective by comparing equivalent risks from everday hazards. The logical assumsption that reducing energy consumption reduces the LER figure is shown to be false because lower energy consumption lowers per capita income, which in turn greatly reduces life expectancy of the population. Energy shortage also ultimately leads to greater unemployment which increases the rate of suicide and murder and so, again, decreases life expectancy. (J.T.A.)

Reducing the extinction risk of stochastic populations via nondemographic noise

Science.gov (United States)

Be'er, Shay; Assaf, Michael

2018-02-01

We consider nondemographic noise in the form of uncertainty in the reaction step size and reveal a dramatic effect this noise may have on the stability of self-regulating populations. Employing the reaction scheme m A →k A but allowing, e.g., the product number k to be a priori unknown and sampled from a given distribution, we show that such nondemographic noise can greatly reduce the population's extinction risk compared to the fixed k case. Our analysis is tested against numerical simulations, and by using empirical data of different species, we argue that certain distributions may be more evolutionary beneficial than others.

Finanční due diligence

OpenAIRE

Slonka, Tomáš

2015-01-01

Thesis on financial due diligence focuses on the use of due diligence in practice. The aim of this work is to determine the risk for the investor and the calculation of the target company with and without conducting due diligence, thus finding out the added value of due diligence.

Reducing Risks to Women Linked to Shift Work, Long Work Hours, and Related Workplace Sleep and Fatigue Issues.

Science.gov (United States)

Caruso, Claire C

2015-10-01

In the United States, an estimated 12% to 28% of working women are on shift work schedules, and 12% work more than 48 hours per week. Shift work and long work hours are associated with many health and safety risks, including obesity, injuries, and negative reproductive outcomes. Over time, the worker is at risk for developing a wide range of chronic diseases. These work schedules can also strain personal relationships, owing to fatigue and poor mood from sleep deprivation and reduced quality time to spend with family and friends. Worker errors from fatigue can lead to reduced quality of goods and services, negatively impacting the employer. In addition, mistakes by fatigued workers can have far-reaching negative effects on the community, ranging from medical care errors to motor vehicle crashes and industrial disasters that endanger others. To reduce the many risks that are linked to these demanding work hours, the National Institute for Occupational Safety and Health (NIOSH) conducts research, develops guidance and authoritative recommendations, and translates and disseminates scientific information to protect workers, their families, employers, and the community. The key message to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the worker's personal life. The NIOSH website has freely available online training programs with suggestions for workers and their managers to help them better cope with this workplace hazard.

Risk Due to Radiological Terror Attacks With Natural Radionuclides

International Nuclear Information System (INIS)

Friedrich, Steinhaeusler; Lyudmila, Zaitseva; Stan, Rydell

2008-01-01

The naturally occurring radionuclides radium (Ra-226) and polonium (Po-210) have the potential to be used for criminal acts. Analysis of international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (CSTO), operated at the University of Salzburg, shows that several acts of murder and terrorism with natural radionuclides have already been carried out in Europe and Russia. Five different modes of attack (T) are possible: (1) Covert irradiation of an individual in order to deliver a high individual dose; (2) Covert irradiation of a group of persons delivering a large collective dose; (3) Contamination of food or drink; (4) Generation of radioactive aerosols or solutions; (5) Combination of Ra-226 with conventional explosives (Dirty Bomb).This paper assesses the risk (R) of such criminal acts in terms of: (a) Probability of terrorist motivation deploying a certain attack mode T; (b) Probability of success by the terrorists for the selected attack mode T; (c) Primary damage consequence (C) to the attacked target (activity, dose); (d) Secondary damage consequence (C') to the attacked target (psychological and socio-economic effects); (e) Probability that the consequences (C, C') cannot be brought under control, resulting in a failure to manage successfully the emergency situation due to logistical and/or technical deficits in implementing adequate countermeasures. Extensive computer modelling is used to determine the potential impact of such a criminal attack on directly affected victims and on the environment

Risk Due to Radiological Terror Attacks With Natural Radionuclides

Science.gov (United States)

Friedrich, Steinhäusler; Stan, Rydell; Lyudmila, Zaitseva

2008-08-01

The naturally occurring radionuclides radium (Ra-226) and polonium (Po-210) have the potential to be used for criminal acts. Analysis of international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (CSTO), operated at the University of Salzburg, shows that several acts of murder and terrorism with natural radionuclides have already been carried out in Europe and Russia. Five different modes of attack (T) are possible: (1) Covert irradiation of an individual in order to deliver a high individual dose; (2) Covert irradiation of a group of persons delivering a large collective dose; (3) Contamination of food or drink; (4) Generation of radioactive aerosols or solutions; (5) Combination of Ra-226 with conventional explosives (Dirty Bomb). This paper assesses the risk (R) of such criminal acts in terms of: (a) Probability of terrorist motivation deploying a certain attack mode T; (b) Probability of success by the terrorists for the selected attack mode T; (c) Primary damage consequence (C) to the attacked target (activity, dose); (d) Secondary damage consequence (C') to the attacked target (psychological and socio-economic effects); (e) Probability that the consequences (C, C') cannot be brought under control, resulting in a failure to manage successfully the emergency situation due to logistical and/or technical deficits in implementing adequate countermeasures. Extensive computer modelling is used to determine the potential impact of such a criminal attack on directly affected victims and on the environment.

The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

Science.gov (United States)

Stivala, Adam; Hartley, Greg

2014-01-01

Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

Agricultural Technology, Risk, and Gender

DEFF Research Database (Denmark)

Arndt, Channing; Tarp, Finn

2000-01-01

Interactions between agricultural technology improvements, risk-reducing behavior, and gender roles in agricultural production in Mozambique are examined. The analysis employs a computable general equilibrium (CGE) model that explicitly incorporates key features of the economy. These include......: detailed accounting of marketing margins, home consumption, risk, and gender roles in agricultural production. Our results show that agricultural technology improvements benefit both male and female occupants of rural households. Due to economic interactions, agricultural technology improvements...

Dietary intake of carotenoids and risk of type 2 diabetes

NARCIS (Netherlands)

Sluijs, I.; Cadier, E.; Beulens, J. W J; van der A, D. L.; Spijkerman, A. M W; van der Schouw, Y. T.

Background and aims: Carotenoids may reduce diabetes risk, due to their antioxidant properties. However, the association between dietary carotenoids intake and type 2 diabetes risk is still unclear. Therefore, the objective of this study was to examine whether higher dietary carotenoid intakes

Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration.

Science.gov (United States)

Onozuka, Daisuke; Hagihara, Akihito

2017-03-15

Although several studies have reported the impacts of extremely high temperatures on cardiovascular diseases, no studies have examined whether variation in out-of-hospital cardiac arrest (OHCA) due to extremely long sunshine duration changes during the summer. We obtained daily data on all cases of OHCA and weather variations for all 47 prefectures of Japan during the summer (June to September) between 2005 and 2014. A distributed lag non-linear model combined with a quasi-Poisson regression model was used to estimate within-summer variation in OHCA due to extremely long sunshine duration for each prefecture. Then, multivariate random-effects meta-analysis was performed to derive overall effect estimates of sunshine duration at the national level. A total of 166,496 OHCAs of presumed cardiac origin met the inclusion criteria. The minimum morbidity percentile (MMP) was the 0th percentile of sunshine duration at the national level. The overall cumulative relative risk (RR) at the 99th percentile vs. the MMP was 1.15 (95% CI: 1.05-1.27) during the summer. The effect of extremely long sunshine duration on OHCA in early summer was acute and did not persist, whereas an identical effect was observed in late summer, but it was delayed and lasted for several days. During summer periods, excessive sunshine duration could increase the risk of OHCA. Timely preventive measures to reduce the OHCA risk due to extremely long sunshine duration are important in early summer, whereas these measures could include a wider time window of several days to reduce the risk in late summer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessment of factors that increase and reduce the risk of aggressive unlawful behavior among juveniles (a review of foreign literature

Directory of Open Access Journals (Sweden)

Nazarova N.G.

2016-10-01

Full Text Available The article is devoted to an overview of foreign researches about factors that increase the risk of aggressive unlawful behavior among juveniles and reduce the risk of such behavior. Such definitions as risk factor, protective factor (defensive, aggression and violence were examined. It is shown how the methods of assessment for both social and negative consequences of unlawful behavior, including aggressive one, have been developed, starting from discretionary approach based on unstructured clinical statement and ending with a method of structured risk assessment. The article contains the descriptions of researches about prognostic structured risk assessment of aggressive criminal behavior among adolescents. The results of contemporary foreign researches that were aimed at identifying factors that either increase or reduce the risk of aggressive unlawful behavior in childhood and adolescence, were outlined.

Physical therapy approaches to reduce fall and fracture risk among older adults.

Science.gov (United States)

Karinkanta, Saija; Piirtola, Maarit; Sievänen, Harri; Uusi-Rasi, Kirsti; Kannus, Pekka

2010-07-01

Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and excess health-care costs and mortality. These problems have led to a variety of single component or multicomponent intervention strategies to prevent falls and subsequent injuries. The most effective physical therapy approach for the prevention of falls and fractures in community-dwelling older adults is regular multicomponent exercise; a combination of balance and strength training has shown the most success. Home-hazard assessment and modification, as well as assistive devices, such as canes and walkers, might be useful for older people at a high risk of falls. Hip protectors are effective in nursing home residents and potentially among other high-risk individuals. In addition, use of anti-slip shoe devices in icy conditions seems beneficial for older people walking outdoors. To be effective, multifactorial preventive programs should include an exercise component accompanied by individually tailored measures focused on high-risk populations. In this Review, we focus on evidence-based physical therapy approaches, including exercise, vibration training and improvements of safety at home and during periods of mobility. Additionally, the benefits of multifaceted interventions, which include risk factor assessment, dietary supplements, elements of physical therapy and exercise, are addressed.

The analysis of activities and social campaigns aimed at reducing children’s risk of traffic incidents

Directory of Open Access Journals (Sweden)

Krzysztof Goniewicz

2017-08-01

Full Text Available Road traffic accidents and falls are the cause of over 80% of serious injuries in children. However, injuries resulting in road accidents are the leading cause of children’s death, more common than cancer and birth defects. The paper presents ways to reduce the risk of children in traffic. Various technical improvements were pointed out that could improve the safety of children. It highlighted the important role of parents and children tutors in education on road safety. It was found that injury prevention should be a systematic and organized action. This should include both the elimination of threats and actions to reduce the risk and improve the in-hospital and pre-hospital care.

Investing: reducing risks to enhance returns.

Science.gov (United States)

West, J; Glickman, S; Seidner, A G

1996-09-01

The financial assets of a healthcare organization can present many opportunities for investment. In order to develop a profitable investment program that avoids risky speculation, however, healthcare financial managers must fully understand the nature and risks of their organizations' investments. They must define and monitor their investment objectives, limitations, levels of acceptable risk and policies and conditions through a statement of investment policy and comprehensive investment guidelines.

Preeclampsia-Associated Hormonal Profiles and Reduced Breast Cancer Risk Among Older Mothers

Science.gov (United States)

2003-04-01

Preeclampsia has been linked to reduced breast cancer risk, and this reduction may be especially marked among women who bear their first child later...in life. In this ongoing case-control study, we examine the hormonal profiles of older Colorado mothers with and without a history of preeclampsia in...premenopausal, and are free of serious chronic disease. Cases are 14 Denver area women who experienced preeclampsia in their first pregnancy; controls are 13

A New Approach to Establish a Cell Line with Reduced Risk of Endogenous Retroviruses

Science.gov (United States)

Fukuma, Aiko; Yoshikawa, Rokusuke; Miyazawa, Takayuki; Yasuda, Jiro

2013-01-01

Endogenous retroviruses (ERVs) are integrated as DNA proviruses in the genomes of all mammalian species. Several ERVs are replication-competent and produced as fully infectious viruses from host cell. Thus, live-attenuated vaccines and biological substances have been prepared using the cell lines which may produce ERV. Indeed, we recently reported that several commercial live-attenuated vaccines for pets were contaminated with the infectious feline endogenous retrovirus, RD-114. In this study, to establish a cell line for vaccine manufacture with reduced risk of ERVs, we generated a cell line stably expressing human tetherin (Teth-CRFK cells). The release of infectious ERV from Teth-CRFK cells was suppressed to undetectable levels, while the production of parvovirus in Teth-CRFK cells was similar to that in parental CRFK cells. These observations suggest that Teth-CRFK cells will be useful as a cell line for the manufacture of live-attenuated vaccines or biological substances with reduced risk of ERV. PMID:23585909

A new approach to establish a cell line with reduced risk of endogenous retroviruses.

Directory of Open Access Journals (Sweden)

Aiko Fukuma

Full Text Available Endogenous retroviruses (ERVs are integrated as DNA proviruses in the genomes of all mammalian species. Several ERVs are replication-competent and produced as fully infectious viruses from host cell. Thus, live-attenuated vaccines and biological substances have been prepared using the cell lines which may produce ERV. Indeed, we recently reported that several commercial live-attenuated vaccines for pets were contaminated with the infectious feline endogenous retrovirus, RD-114. In this study, to establish a cell line for vaccine manufacture with reduced risk of ERVs, we generated a cell line stably expressing human tetherin (Teth-CRFK cells. The release of infectious ERV from Teth-CRFK cells was suppressed to undetectable levels, while the production of parvovirus in Teth-CRFK cells was similar to that in parental CRFK cells. These observations suggest that Teth-CRFK cells will be useful as a cell line for the manufacture of live-attenuated vaccines or biological substances with reduced risk of ERV.

A new approach to establish a cell line with reduced risk of endogenous retroviruses.

Science.gov (United States)

Fukuma, Aiko; Yoshikawa, Rokusuke; Miyazawa, Takayuki; Yasuda, Jiro

2013-01-01

Endogenous retroviruses (ERVs) are integrated as DNA proviruses in the genomes of all mammalian species. Several ERVs are replication-competent and produced as fully infectious viruses from host cell. Thus, live-attenuated vaccines and biological substances have been prepared using the cell lines which may produce ERV. Indeed, we recently reported that several commercial live-attenuated vaccines for pets were contaminated with the infectious feline endogenous retrovirus, RD-114. In this study, to establish a cell line for vaccine manufacture with reduced risk of ERVs, we generated a cell line stably expressing human tetherin (Teth-CRFK cells). The release of infectious ERV from Teth-CRFK cells was suppressed to undetectable levels, while the production of parvovirus in Teth-CRFK cells was similar to that in parental CRFK cells. These observations suggest that Teth-CRFK cells will be useful as a cell line for the manufacture of live-attenuated vaccines or biological substances with reduced risk of ERV.

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

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Antonsen,Erik

2017-01-01

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

Red wine consumption not associated with reduced risk of colorectal cancer.

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Chao, Chun; Haque, Reina; Caan, Bette J; Poon, Kwun-Yee T; Tseng, Hung-Fu; Quinn, Virginia P

2010-01-01

Red wine contains polyphenol antioxidants that inhibit colorectal cancer (CRC) development in animal studies. We investigated the effect of red wine intake on risk of CRC in the California Men's Health Study (CMHS). CMHS is a prospective, multiethnic cohort of middle-aged men who were members of the Kaiser Permanente (KP) California Health Plans and completed study questionnaires between 2002-2003. Incident CRC were identified from the health plan cancer registries through the end of 2007 (n = 287). To properly account for potential confounding by previous endoscopy screening, we restricted the primary analyses to CMHS men continuously enrolled in KP between 1998-2002 (n = 43,483 and CRC = 176). We used multivariable Cox regression to adjust for important confounders. We did not find an inverse association between moderate red wine intake and risk of CRC. The hazard ratio for consuming >/=1 drink/day (average = 2 drinks/day) was 1.16, 95% confidence intervals 0.56-2.40. There was no linear dose-response. The lack of clear association for red wine intake was consistently observed when we stratified the analyses by CRC stage at diagnosis and cancer site (colon or rectum). Moderate red wine consumption was not associated with reduced risk of colorectal cancer in this population of middle-aged men.

Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

Directory of Open Access Journals (Sweden)

K. M. Friddle

2017-01-01

Full Text Available Objective. Current American retinopathy of prematurity (ROP screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP. Study Design. We performed a 13-year review from Intermountain Health Care (IHC data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP. Results. We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61% were included in the study. Overall, severe ROP occurred in 260 (9.3%, but only 11/1601 ≥ 29 weeks (0.7%. All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601 of the screened population. Conclusions. Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.

Perioperative Statin Therapy Is Not Associated With Reduced Risk of Anastomotic Leakage After Colorectal Resection

DEFF Research Database (Denmark)

Bisgård, Anne Sofie; Noack, Morten Westergaard; Klein, Mads

2013-01-01

Anastomotic leakage is a serious complication of colorectal surgery. Several studies have demonstrated the beneficial pleiotropic effects of statins, and preliminary studies have suggested that perioperative statin treatment may be associated with reduced risk of anastomotic leakage....

A new approach to reduce uncertainties in space radiation cancer risk predictions.

Directory of Open Access Journals (Sweden)

Francis A Cucinotta

Full Text Available The prediction of space radiation induced cancer risk carries large uncertainties with two of the largest uncertainties being radiation quality and dose-rate effects. In risk models the ratio of the quality factor (QF to the dose and dose-rate reduction effectiveness factor (DDREF parameter is used to scale organ doses for cosmic ray proton and high charge and energy (HZE particles to a hazard rate for γ-rays derived from human epidemiology data. In previous work, particle track structure concepts were used to formulate a space radiation QF function that is dependent on particle charge number Z, and kinetic energy per atomic mass unit, E. QF uncertainties where represented by subjective probability distribution functions (PDF for the three QF parameters that described its maximum value and shape parameters for Z and E dependences. Here I report on an analysis of a maximum QF parameter and its uncertainty using mouse tumor induction data. Because experimental data for risks at low doses of γ-rays are highly uncertain which impacts estimates of maximum values of relative biological effectiveness (RBEmax, I developed an alternate QF model, denoted QFγAcute where QFs are defined relative to higher acute γ-ray doses (0.5 to 3 Gy. The alternate model reduces the dependence of risk projections on the DDREF, however a DDREF is still needed for risk estimates for high-energy protons and other primary or secondary sparsely ionizing space radiation components. Risk projections (upper confidence levels (CL for space missions show a reduction of about 40% (CL∼50% using the QFγAcute model compared the QFs based on RBEmax and about 25% (CL∼35% compared to previous estimates. In addition, I discuss how a possible qualitative difference leading to increased tumor lethality for HZE particles compared to low LET radiation and background tumors remains a large uncertainty in risk estimates.

Potential Mediating Pathways through Which Sports Participation Relates to Reduced Risk of Suicidal Ideation

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Taliaferro, Lindsay A.; Rienzo, Barbara A.; Miller, M. David; Pigg, R. Morgan; Dodd, Virginia J.

2010-01-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The…

Reduced Risk of Barrett's Esophagus in Statin Users: Case-Control Study and Meta-Analysis.

Science.gov (United States)

Beales, Ian L P; Dearman, Leanne; Vardi, Inna; Loke, Yoon

2016-01-01

Use of statins has been associated with a reduced incidence of esophageal adenocarcinoma in population-based studies. However there are few studies examining statin use and the development of Barrett's esophagus. The purpose of this study was to examine the association between statin use and the presence of Barrett's esophagus in patients having their first gastroscopy. We have performed a case-control study comparing statin use between patients with, and without, an incident diagnosis of non-dysplastic Barrett's esophagus. Male Barrett's cases (134) were compared to 268 male age-matched controls in each of two control groups (erosive gastro-esophageal reflux and dyspepsia without significant upper gastrointestinal disease). Risk factor and drug exposure were established using standardised interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. We performed a meta-analysis pooling our results with three other case-control studies. Regular statin use was associated with a significantly lower incidence of Barrett's esophagus compared to the combined control groups [adjusted OR 0.62 (95 % confidence intervals 0.37-0.93)]. This effect was more marked in combined statin plus aspirin users [adjusted OR 0.43 (95 % CI 0.21-0.89)]. The inverse association between statin or statin plus aspirin use and risk of Barrett's was significantly greater with longer duration of use. Meta-analysis of pooled data (1098 Barrett's, 2085 controls) showed that statin use was significantly associated with a reduced risk of Barrett's esophagus [pooled adjusted OR 0.63 (95 % CI 0.51-0.77)]. Statin use is associated with a reduced incidence of a new diagnosis of Barrett's esophagus.

Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income.

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Bennett, Kevin J; Dismuke, Clara E

2010-05-01

High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden. The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics. Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios. Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

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

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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.

NADiA® ProsVue™ PSA Slope Is an Independent Prognostic Marker for Identifying Men at Reduced Risk for Clinical Recurrence of Prostate Cancer after Radical Prostatectomy

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Moul, Judd W.; Lilja, Hans; Semmes, O. John; Lance, Raymond S.; Vessella, Robert L.; Fleisher, Martin; Mazzola, Clarisse; Sarno, Mark J.; Stevens, Barbara; Klem, Robert E.; McDermed, Jonathan E.; Triebell, Melissa T.; Adams, Thomas H.

2015-01-01

Objectives To validate the hypothesis that men displaying serum PSA slopes ≤2.0 pg/mL/month postprostatectomy, measured with a new immuno-PCR diagnostic test (NADiA® ProsVue™) were at a reduced risk of clinical recurrence as determined by positive biopsy, imaging or death due to prostate cancer. Methods From 4 clinical sites, we selected a cohort of 304 men followed up to 17.6 years postprostatectomy for clinical recurrence. We assessed the prognostic value of a PSA slope cutpoint of 2.0 pg/mL/month against established risk factors to identify men at very low risk of clinical recurrence using uni- and multivariate Cox proportional hazards regression and Kaplan-Meier analysis. Results The univariate HR (95% CI) of a PSA slope >2.0 pg/mL/month was 18.3 (10.6–31.8), compared to a slope ≤2.0 pg/mL/month (P free survival was 4.8 years versus >10 years in the 2 groups (P <0.0001). Multivariate HR for PSA slope with the covariates of preprostatectomy PSA, pathologic stage and Gleason score was 9.8 (5.4–17.8), an 89.8% risk reduction, for men with PSA slopes ≤2.0 pg/mL/month (P <0.0001). Gleason Score (<7 vs. ≥7) was the only other significant predictor (HR 5.4, 2.1–13.8, P = 0.0004). Conclusions Clinical recurrence following radical prostatectomy is often difficult to predict since established factors do not reliably stratify risk. We demonstrate that a NADiA ProsVue slope ≤2.0 pg/mL/month postprostatectomy is prognostic for reduced risk of prostate cancer recurrence and adds predictive power to established risk factors. PMID:23107099

Letter to Editor: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

Directory of Open Access Journals (Sweden)

Caliandro Pietro

2008-02-01

Full Text Available Abstract A response to Chalidis et al: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement. World J Surg Oncol 2007, 5:92.

Sociocultural tailoring of a healthy lifestyle intervention to reduce cardiovascular disease and type 2 diabetes risk among Latinos.

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Mudd-Martin, Gia; Martinez, Maria C; Rayens, Mary Kay; Gokun, Yevgeniya; Meininger, Janet C

2013-11-27

Suboptimal lifestyle factors in combination with genetic susceptibility contribute to cardiovascular disease and type 2 diabetes risk among Latinos. We describe a community-academic collaboration that developed and explored the feasibility of implementing a socioculturally tailored, healthy lifestyle intervention integrating genomics and family history education to reduce risk of cardiovascular disease and type 2 diabetes among Latinos. The community-based participatory research was conducted with communities in Kentucky, which has a rapidly growing Latino population. This growth underscores the need for socioculturally appropriate health resources. Su Corazon, Su Vida (Your Heart, Your Life) is a Spanish-language, healthy lifestyle educational program to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Twenty natural leaders from an urban Latino community in Kentucky participated in sociocultural tailoring of the program and development of a genomics and family history module. The tailored program was presented to 22 participants to explore implementation feasibility and assess appropriateness for community use. Preintervention and postintervention assessments of genomic knowledge and lifestyle behaviors and qualitative postintervention evaluations were conducted. Postintervention improvements in health-promoting lifestyle choices and genomic knowledge specific to cardiovascular disease and type 2 diabetes suggested that the program may be effective in reducing risk. Feedback indicated the program was socioculturally acceptable and responsive to community needs. These findings indicated that a tailored healthy lifestyle program integrating genomics and family history education was socioculturally appropriate and may feasibly be implemented to reduce cardiovascular disease and type 2 diabetes risk in a Latino community with limited health care resources. The project highlights contributions of community-based processes in tailoring

Exploiting Science: Enhancing the Safety Training of Pilots to Reduce the Risk of Bird Strikes

Science.gov (United States)

Mendonca, Flavio A. C.

Analysis of bird strikes to aviation in the U.S. from 1990 to 2015 indicate that the successful mitigation efforts at airports, which must be sustained, have reduced incidents with damage and a negative effect-on-flight since 2000. However, such efforts have done little to reduce strikes outside the airport jurisdiction, such as occurred with US Airways Flight 1549 in 2009. There are basically three strategies to mitigate the risk of bird strikes: standards set by aviation authorities, technology, and actions by crewmembers. Pilots play an important role as stakeholders in the prevention of bird strikes, especially outside the airport environment. Thus, safety efforts require enhanced risk management and aeronautical decision-making training for flight crews. The purpose of this study was to determine if a safety training protocol could effectively enhance CFR Part 141 general aviation pilots' knowledge and skills to reduce the risk of bird strikes to aviation. Participants were recruited from the Purdue University professional flight program and from Purdue Aviation. The researcher of this study used a pretest posttest experimental design. Additionally, qualitative data were collected through open-ended questions in the pretest, posttest, and a follow-up survey questionnaire. The participants' pretest and posttest scores were analyzed using parametric and nonparametric tests. Results indicated a significant increase in the posttest scores of the experimental group. An investigation of qualitative data showed that the topic "safety management of bird hazards by pilots" is barely covered during the ground and flight training of pilots. Furthermore, qualitative data suggest a misperception of the safety culture tenets and a poor familiarity with the safety risk management process regarding bird hazards. Finally, the researcher presented recommendations for practice and future research.

Reducing overheating risk using ventilative cooling

DEFF Research Database (Denmark)

Heiselberg, Per Kvols

2014-01-01

The current trend towards nearly-zero energy buildings has led to an increased risk of overheating throughout the year. Use of the cooling potential of outdoor air can be an energy efficient passive solution to this.......The current trend towards nearly-zero energy buildings has led to an increased risk of overheating throughout the year. Use of the cooling potential of outdoor air can be an energy efficient passive solution to this....

Statin Adherence Is Associated With Reduced Recurrent Stroke Risk in Patients With or Without Atrial Fibrillation.

Science.gov (United States)

Flint, Alexander C; Conell, Carol; Ren, Xiushui; Kamel, Hooman; Chan, Sheila L; Rao, Vivek A; Johnston, S Claiborne

2017-07-01

Outpatient statin use reduces the risk of recurrent ischemic stroke among patients with stroke of atherothrombotic cause. It is not known whether statins have similar effects in ischemic stroke caused by atrial fibrillation (AFib). We studied outpatient statin adherence, measured by percentage of days covered, and the risk of recurrent ischemic stroke in patients with or without AFib in a 21-hospital integrated healthcare delivery system. Among 6116 patients with ischemic stroke discharged on a statin over a 5-year period, 1446 (23.6%) had a diagnosis of AFib at discharge. The mean statin adherence rate (percentage of days covered) was 85, and higher levels of percentage of days covered correlated with greater degrees of low-density lipoprotein suppression. In multivariable survival models of recurrent ischemic stroke over 3 years, after controlling for age, sex, race/ethnicity, medical comorbidities, and hospital center, higher statin adherence predicted reduced stroke risk both in patients without AFib (hazard ratio, 0.78; 95% confidence interval, 0.63-0.97) and in patients with AFib (hazard ratio, 0.59; 95% confidence interval, 0.43-0.81). This association was robust to adjustment for the time in the therapeutic range for international normalized ratio among AFib subjects taking warfarin (hazard ratio, 0.61; 95% confidence interval, 0.41-0.89). The relationship between statin adherence and reduced recurrent stroke risk is as strong among patients with AFib as it is among patients without AFib, suggesting that AFib status should not be a reason to exclude patients from secondary stroke prevention with a statin. © 2017 American Heart Association, Inc.

The role of color sorting machine in reducing food safety risks

Directory of Open Access Journals (Sweden)

Eleonora Kecskes-Nagy

2016-07-01

Full Text Available It is the very difficult problem how we can decrease food safety risks in the product, which was polluted in process of cropping. According to professional literature almost the prevention is considered as an exclusive method to keep below safe level the content of DON toxin. The source of food safety in food chain is that the primary products suit the food safety requirements. It is a very difficult or sometimes it is not possible to correct food safety risk factors - which got into the products during cultivation - in the course of processing. Such factor is fusariotoxin in fodder and bread wheat. DON toxin is the most frequent toxin in cereals. The objective of the searching was to investigate, if it is possible to decrease DON toxin content of durum wheat and to minimize the food safety risk by application milling technology with good production practice and technological conditions. The samples were taken in the first phase of milling technology just before and after color sorting. According to measuring results Sortex Z+ optical sorting decreased DON toxin content of wheat. This mean that the food safety risks can be reduced by Sortex Z+ optical sorting machine. Our experiments proved if there is color sorting in the cleaning process preceding the milling of wheat then a part of the grain of wheat infected by Fusarium sp. can be selected. This improves the food safety parameters of given lot of wheat and decrease the toxin content. The flour made from contaminated grains of wheat can be a serious food safety risk. We would like to support scientifically the technical development of milling technology with our experimental data. Normal 0 21 false false false HU X-NONE X-NONE MicrosoftInternetExplorer4

Aerobic exercise training reduces arterial stiffness in metabolic syndrome.

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Donley, David A; Fournier, Sara B; Reger, Brian L; DeVallance, Evan; Bonner, Daniel E; Olfert, I Mark; Frisbee, Jefferson C; Chantler, Paul D

2014-06-01

The metabolic syndrome (MetS) is associated with a threefold increase risk of cardiovascular disease (CVD) mortality partly due to increased arterial stiffening. We compared the effects of aerobic exercise training on arterial stiffening/mechanics in MetS subjects without overt CVD or type 2 diabetes. MetS and healthy control (Con) subjects underwent 8 wk of exercise training (ExT; 11 MetS and 11 Con) or remained inactive (11 MetS and 10 Con). The following measures were performed pre- and postintervention: radial pulse wave analysis (applanation tonometry) was used to measure augmentation pressure and index, central pressures, and an estimate of myocardial efficiency; arterial stiffness was assessed from carotid-femoral pulse-wave velocity (cfPWV, applanation tonometry); carotid thickness was assessed from B-mode ultrasound; and peak aerobic capacity (gas exchange) was performed in the seated position. Plasma matrix metalloproteinases (MMP) and CVD risk (Framingham risk score) were also assessed. cfPWV was reduced (P Exercise training reduced (P exercise training, thereby lowering their cardiovascular risk. Copyright © 2014 the American Physiological Society.

Cerebrospinal fluid leakage during transsphenoidal surgery: postoperative external lumbar drainage reduces the risk for meningitis

NARCIS (Netherlands)

van Aken, M. O.; Feelders, R. A.; de Marie, S.; van de Berge, J. H.; Dallenga, A. H. G.; Delwel, E. J.; Poublon, R. M. L.; Romijn, J. A.; van der Lely, A. J.; Lamberts, S. W. J.; de Herder, W. W.

2004-01-01

Postoperative meningitis is a well known complication of transsphenoidal surgery (TSS). The objective of this study was to evaluate whether postoperative external cerobrospinal fluid (CSF) drainage in case of intraoperative CSF-leakage, reduces the risk of postoperative meningitis. We

Setting Priorities in Behavioral Interventions: An Application to Reducing Phishing Risk.

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Canfield, Casey Inez; Fischhoff, Baruch

2018-04-01

Phishing risk is a growing area of concern for corporations, governments, and individuals. Given the evidence that users vary widely in their vulnerability to phishing attacks, we demonstrate an approach for assessing the benefits and costs of interventions that target the most vulnerable users. Our approach uses Monte Carlo simulation to (1) identify which users were most vulnerable, in signal detection theory terms; (2) assess the proportion of system-level risk attributable to the most vulnerable users; (3) estimate the monetary benefit and cost of behavioral interventions targeting different vulnerability levels; and (4) evaluate the sensitivity of these results to whether the attacks involve random or spear phishing. Using parameter estimates from previous research, we find that the most vulnerable users were less cautious and less able to distinguish between phishing and legitimate emails (positive response bias and low sensitivity, in signal detection theory terms). They also accounted for a large share of phishing risk for both random and spear phishing attacks. Under these conditions, our analysis estimates much greater net benefit for behavioral interventions that target these vulnerable users. Within the range of the model's assumptions, there was generally net benefit even for the least vulnerable users. However, the differences in the return on investment for interventions with users with different degrees of vulnerability indicate the importance of measuring that performance, and letting it guide interventions. This study suggests that interventions to reduce response bias, rather than to increase sensitivity, have greater net benefit. © 2017 Society for Risk Analysis.

Reducing volcanic risk on Fogo Volcano, Cape-Verde, through a participatory approach: which out coming?

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Texier-Teixeira, P.; Chouraqui, F.; Perrillat-Collomb, A.; Lavigne, F.; Cadag, J. R.; Grancher, D.

2013-11-01

This research paper presents the outcomes of the Work Package 5 (Socio-economical Vulnerability Assessment and Community-Based Disaster Risk Reduction) of the MIAVITA Research Program (MItigate and Assess risk from Volcanic Impact on Terrain and human Activities) conducted in Fogo Volcano, Cape-Verde. The study lasted for almost 3 yr (May 2010-January 2012) of which most of the time was spent in the village of Chã das Caldeiras, situated within the 9 km-wide caldera of the volcano inside the Fogo Natural Park. The objectives of the program included assessment of the vulnerability of the community at risk in terms of livelihoods, access to resources, and power relations between the local people and the different public and private institutions. These are important factors that need to be investigated in order to understand the root causes of vulnerability of the local people. This case study shows that the voluntary exposure of people at volcanic threats is linked with daily access to sources of livelihood specially agriculture and tourism. This is despite the perception of people of the risk on their lives and properties. In order to counter the factors of vulnerability, the study also aimed to identify and enhance local capacities. To achieve such objective, a Participatory 3-Dimensional Mapping (P3DM) activity was conducted to facilitate the dialogue between the local people and the different stakeholders as well as to prepare plans and measures to reduce volcanic risk. The P3DM was a half success considering that it has not yet led to an operational plan which takes into account the local capacities. The main reasons included (1) the non-participative aspect of the project at the beginning which should have identified priorities for people and let them lead the project to ensure the sustainability (2) deep conflicts within the community which complicated the focus group discussions around the 3-D map, and the difficulties to involve more marginalized people

Perturbation Training Can Reduce Community-Dwelling Older Adults’ Annual Fall Risk: A Randomized Controlled Trial

Science.gov (United States)

Bhatt, Tanvi; Yang, Feng; Wang, Edward

2014-01-01

Background. Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults’ annual falls risk in their everyday living. Methods. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). Results. With this single session of repeated-slip exposure, training cut older adults’ annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. Conclusion. A single session of repeated-slip exposure could improve community-dwelling older adults’ resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. PMID:24966227

Governance of Land Use Planning to Reduce Fire Risk to Homes Mediterranean France and California

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Susan D. Kocher

2017-03-01

Full Text Available Wildfire is a natural part of forested Mediterranean systems. As humans continue to live and build housing in these areas, wildfire is a constant threat to homes and lives. The goal of this paper is to describe aspects of land-use planning that are used to reduce wildfire risk in institutionally divergent regions; southern France and California. By reviewing relevant legislation and planning documents and conducting in person interviews with fire and planning professionals, we identify the institutions which participate in land use planning to reduce fire risk and the key laws and regulations that guide planning decisions. Our results indicate that France has a more centralized system for planning for fire, with national level entities heavily involved in local land use planning. California, on the other hand sees almost no federal oversite, and, while state law requires local plans to include wildfire risk, most fine grain decisions are left to local planners and decision makers. In both regions, however, we see a reliance on technical support provided from outside local jurisdictions. Increased coordination between local, regional, and national governments could improve land use planning in both locations.

Corporate risk and external sourcing: A study of Scandinavian multinational firms

DEFF Research Database (Denmark)

Aabo, Tom; Pantzalis, Christos; Sørensen, Helle

2016-01-01

data by surveying Scandinavian non-financial firms. We find that highly international firms reduce corporate risk by externally sourcing from foreign suppliers both compared to sourcing from own production facilities abroad (due to superior flexibility) and compared to domestic sourcing (due...

An assessment of adult risks of paresthesia due to mercury from coal combustion

Energy Technology Data Exchange (ETDEWEB)

Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.; Dephillips, M.; Viren, J.; Saroff, L. [Brookhaven National Laboratory, Upton, NY (United States). Dept. of Applied Science

1995-02-01

This paper presents a probabilistic assessment of the risks of transient adult paresthesia (tingling of the extremities) resulting from ingestion of methylmercury (MeHg) in fish and shellfish. Two scenarios are evaluated: the baseline, in which the MeHg dose results from the combined effects of eating canned tuna fish, various marine seafood, and freshwater sportfish, and an impact scenario in which the Hg content of the freshwater sportfish is increased due to local deposition from a hypothetical 1000 Mw{sub e} coal-fired power plant. Measurements from the literature are used to establish the parameters of the baseline, including atmospheric rates of Hg deposition and the distributions of MeHg in fish. The Hg intake for the impact scenario is then based on linear scaling of the additional annual Hg deposition as estimated from a Guassian plume dispersion model. Human health responses are based on a logistic fit to the frequencies of paresthesia observed during a grain poisoning incident in Iraq 1971-2. Based on a background prevalence rate of 2.2% for adult paresthesia, the assessment predicts a 5% chance that the increase in paresthesia prevalence due to either baseline or incremental MeHg doses might approach about 1% of the background prevalence rate. 15 refs., 3 figs., 3 tabs.

Mandatory high-risk pooling: an approach to reducing incentives for cream skimming.

Science.gov (United States)

van Barneveld, E M; van Vliet, R C; van de Ven, W P

1996-01-01

Risk-adjusted capitation payments (RACPs) to competing health insurers are an essential element of market-oriented health care reforms in The Netherlands. Crude RACPs are inadequate, especially because they encourage insurers to select against people expected to be unprofitable--a practice called cream skimming. However, implementing improved RACPs does not appear to be straightforward. This paper analyzes an approach that, given a system of crude RACPs, reduces insurers' incentives for cream skimming in the market for individual health insurance, while preserving incentives for efficiency and cost containment. Under the proposed system of Mandatory High-Risk Pooling (MHRP), each insurer would be allowed to periodically predetermine a small fraction of its members whose costs would be (partially) pooled. The pool would be financed with mandatory, flat-rate contributions. The results suggest that MHRP is a promising supplement to RACPs.

The risk of sequelae due to pneumococcal meningitis in high-income countries: a systematic review and meta-analysis.

Science.gov (United States)

Jit, Mark

2010-07-01

To determine the risk of various kinds of sequelae in survivors of meningitis due to Streptococcus pneumoniae, as well as the influence of co-factors such as study design, study population and treatment on this risk. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 September 1991 to 18 June 2009 for original articles on pneumococcal meningitis sequelae. Prevalence of sequelae was pooled using random effects meta-analysis. Studies were appraised for the influence of referral bias, external validity of study populations, testing procedure and publication bias. Data were extracted from 63 studies involving 3408 pneumococcal meningitis survivors. The pooled prevalence of any reported sequelae from 48 studies was 31.7% (95% confidence interval 27.2-36.3%) using a random effects model (Cochran-Q = 277, p < 0.01). Differences in studies due to design, study population and treatment were not significant. The pooled prevalence of hearing loss, seizures, hydrocephalus, spasticity/paresis, cranial nerve palsies and visual impairment was 20.9% (17.1-24.7%), 6.5% (3.3-9.7%), 6.8% (3.3-10.2%), 8.7% (6.4-11.0%), 12.2% (5.3-19.1%) and 2.4% (0-5.7%) respectively. The burden of sequelae due to pneumococcal meningitis remains high in the reviewed studies.

Reducing health risk in family members of patients with type 2 diabetes: views of first degree relatives

Directory of Open Access Journals (Sweden)

O'Sullivan Bernadette

2009-12-01

Full Text Available Abstract Background Patients with type 2 diabetes can have an important role in discussing health risk within families. This study aimed to establish the acceptability to first degree relatives towards their relative with type 2 diabetes intervening as health promoters in their own families, using the Health Belief Model as a theoretical framework for evaluation. Methods Cross-sectional questionnaire design. Survey questionnaire for first degree relative (sibling or child mailed to a random sample of patients with type 2 diabetes registered with an urban hospital diabetes clinic (n = 607 eligible patients. Patients were asked to pass on questionnaires to one to two first degree relatives. Results Questionnaires were returned from 257 families (42% response rate with two responses provided by 107 families (a total of 364 questionnaires. The majority (94% of first degree relatives of patients with type 2 diabetes would like to be informed about reducing their risk. Half (48% of respondents reported being spoken to by a relative with type 2 diabetes about their risk of diabetes. Those spoken to were more likely to see themselves at risk of diabetes, to worry about developing diabetes and to view diabetes as a serious condition. Conclusions A role for patients with type 2 diabetes in discussing health risk in their family appears to be acceptable to many relatives. Discussion of risk and interventions to reduce health risk with their relatives should be encouraged in patients with type 2 diabetes.

Reducing health risk in family members of patients with type 2 diabetes: views of first degree relatives.

LENUS (Irish Health Repository)

Whitford, David L

2009-01-01

BACKGROUND: Patients with type 2 diabetes can have an important role in discussing health risk within families. This study aimed to establish the acceptability to first degree relatives towards their relative with type 2 diabetes intervening as health promoters in their own families, using the Health Belief Model as a theoretical framework for evaluation. METHODS: Cross-sectional questionnaire design. Survey questionnaire for first degree relative (sibling or child) mailed to a random sample of patients with type 2 diabetes registered with an urban hospital diabetes clinic (n = 607 eligible patients). Patients were asked to pass on questionnaires to one to two first degree relatives. RESULTS: Questionnaires were returned from 257 families (42% response rate) with two responses provided by 107 families (a total of 364 questionnaires). The majority (94%) of first degree relatives of patients with type 2 diabetes would like to be informed about reducing their risk. Half (48%) of respondents reported being spoken to by a relative with type 2 diabetes about their risk of diabetes. Those spoken to were more likely to see themselves at risk of diabetes, to worry about developing diabetes and to view diabetes as a serious condition. CONCLUSIONS: A role for patients with type 2 diabetes in discussing health risk in their family appears to be acceptable to many relatives. Discussion of risk and interventions to reduce health risk with their relatives should be encouraged in patients with type 2 diabetes.

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.

Accident Precursor Analysis and Management: Reducing Technological Risk Through Diligence

Science.gov (United States)

Phimister, James R. (Editor); Bier, Vicki M. (Editor); Kunreuther, Howard C. (Editor)

2004-01-01

Almost every year there is at least one technological disaster that highlights the challenge of managing technological risk. On February 1, 2003, the space shuttle Columbia and her crew were lost during reentry into the atmosphere. In the summer of 2003, there was a blackout that left millions of people in the northeast United States without electricity. Forensic analyses, congressional hearings, investigations by scientific boards and panels, and journalistic and academic research have yielded a wealth of information about the events that led up to each disaster, and questions have arisen. Why were the events that led to the accident not recognized as harbingers? Why were risk-reducing steps not taken? This line of questioning is based on the assumption that signals before an accident can and should be recognized. To examine the validity of this assumption, the National Academy of Engineering (NAE) undertook the Accident Precursors Project in February 2003. The project was overseen by a committee of experts from the safety and risk-sciences communities. Rather than examining a single accident or incident, the committee decided to investigate how different organizations anticipate and assess the likelihood of accidents from accident precursors. The project culminated in a workshop held in Washington, D.C., in July 2003. This report includes the papers presented at the workshop, as well as findings and recommendations based on the workshop results and committee discussions. The papers describe precursor strategies in aviation, the chemical industry, health care, nuclear power and security operations. In addition to current practices, they also address some areas for future research.

Vitamin Intake Reduce the Risk of Gastric Cancer: Meta-Analysis and Systematic Review of Randomized and Observational Studies

Science.gov (United States)

Geng, Qirong; Wang, Jing; Lan, Yadong; Zhan, Youqing; Xu, Dazhi

2014-01-01

Aim The association between vitamin intake and gastric cancer (GC) has been widely debated due to the relatively weak evidence. In this study, a meta-analysis of prospective and well designed observational studies were performed to explore this association. Methods MEDLINE, Cochrane Library, and Sciencedirect were searched for studies of vitamin consumption and gastric cancer. This produced 47 relevant studies covering 1,221,392 human subjects. Random effects models were used to estimate summary relative risk (RR). Dose-response, subgroup, sensitivity, meta-regression, and publication bias analyses were conducted. Results The RR of gastric cancer in the group with the highest vitamin intake was compared to that of the lowest intake group. Total vitamin intake was 0.78 (95% CI, 0.71−0.83). In 9 studies that individuals were given doses at least 4 times above the tolerable upper intake (UL) vitamins, the RR was 1.20 (95% CI, 0.99−1.44). However, in 17 studies that individuals received doses below the UL, the RR was 0.76 (95% CI, 0.68−0.86). Dose-response analysis was conducted on different increments in different types of vitamins (vitamin A: 1.5 mg/day, vitamin C: 100 mg/day, vitamin E: 10 mg/day) intake with a significant reduction in the risk of gastric cancer, respectively, 29% in vitamin A, 26% in vitamin C, and 24% in vitamin E. Conclusion This meta-analysis clearly demonstrated that low doses of vitamins can significantly reduce the risk of GC, especially vitamin A, vitamin C, vitamin E. PMID:25549091

Platelet concentrates: reducing the risk of transfusion-transmitted bacterial infections

Directory of Open Access Journals (Sweden)

de Korte D

2014-06-01

Full Text Available Dirk de Korte,1 Jan H Marcelis2 1Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, 2Department of Microbiology, St Elisabeth Hospital, Tilburg, the Netherlands Abstract: The introduction of a combination of interventions during collection of whole-blood or platelet concentrates has been successful in lowering the degree of bacterial contamination in the final product, the platelet concentrate, by 50%–75%. These interventions were improved donor questionnaires, best-practice skin disinfection, and diversion of first blood volume. These interventions have reduced the number of bacteria present in the platelet concentrates. In combination with screening for bacterial contamination of platelet concentrates with a culture method, the degree of transfusion-transmitted bacterial infection has been reduced significantly. Due to the very low initial bacteria counts upon collection of the products, the need for improved sensitivity of early screenings tests or highly selective point-of-issue tests remains. The latter should be rapid and easy to perform. An alternative approach might be the implementation of pathogen-inactivation methods for cellular blood products to reduce the amount of pathogens. However, these methods are costly, and so far not proved to be cost-effective, especially in countries with an already-low incidence of transfusion-transmitted infections by viruses, parasites, or bacteria. Keywords: blood products, bacterial contamination, screening, point of issue, pathogen inactivation

High-speed running and sprinting as an injury risk factor in soccer: Can well-developed physical qualities reduce the risk?

Science.gov (United States)

Malone, Shane; Owen, Adam; Mendes, Bruno; Hughes, Brian; Collins, Kieran; Gabbett, Tim J

2018-03-01

This study investigated the association between high-speed running (HSR) and sprint running (SR) and injuries within elite soccer players. The impact of intermittent aerobic fitness as measured by the end speed of the 30-15 intermittent fitness test (30-15V IFT ) and high chronic workloads (average 21-day) as potential mediators of injury risk were also investigated. Observational Cohort Study. 37 elite soccer players from one elite squad were involved in a one-season study. Training and game workloads (session-RPE×duration) were recorded in conjunction with external training loads (using global positioning system technology) to measure the HSR (>14.4kmh -1 ) and SR (>19.8kmh -1 ) distance covered across weekly periods during the season. Lower limb injuries were also recorded. Training load and GPS data were modelled against injury data using logistic regression. Odds ratios (OR) were calculated with 90% confidence intervals based on 21-day chronic training load status (sRPE), aerobic fitness, HSR and SR distance with these reported against a reference group. Players who completed moderate HSR (701-750-m: OR: 0.12, 90%CI: 0.08-0.94) and SR distances (201-350-m: OR: 0.54, 90%CI: 0.41-0.85) were at reduced injury risk compared to low HSR (≤674-m) and SR (≤165-m) reference groups. Injury risk was higher for players who experienced large weekly changes in HSR (351-455-m; OR: 3.02; 90%CI: 2.03-5.18) and SR distances (between 75-105-m; OR: 6.12, 90%CI: 4.66-8.29). Players who exerted higher chronic training loads (≥2584 AU) were at significantly reduced risk of injury when they covered 1-weekly HSR distances of 701-750m compared to the reference group of soccer players. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Human Exposure Risk Assessment Due to Heavy Metals in Groundwater by Pollution Index and Multivariate Statistical Methods: A Case Study from South Africa

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Vetrimurugan Elumalai

2017-04-01

Full Text Available Heavy metals in surface and groundwater were analysed and their sources were identified using multivariate statistical tools for two towns in South Africa. Human exposure risk through the drinking water pathway was also assessed. Electrical conductivity values showed that groundwater is desirable to permissible for drinking except for six locations. Concentration of aluminium, lead and nickel were above the permissible limit for drinking at all locations. Boron, cadmium, iron and manganese exceeded the limit at few locations. Heavy metal pollution index based on ten heavy metals indicated that 85% of the area had good quality water, but 15% was unsuitable. Human exposure dose through the drinking water pathway indicated no risk due to boron, nickel and zinc, moderate risk due to cadmium and lithium and high risk due to silver, copper, manganese and lead. Hazard quotients were high in all sampling locations for humans of all age groups, indicating that groundwater is unsuitable for drinking purposes. Highly polluted areas were located near the coast, close to industrial operations and at a landfill site representing human-induced pollution. Factor analysis identified the four major pollution sources as: (1 industries; (2 mining and related activities; (3 mixed sources- geogenic and anthropogenic and (4 fertilizer application.

Reduced Risk-Taking After Prior Losses in Pathological Gamblers Under Treatment and Healthy Control Group but not in Problem Gamblers.

Science.gov (United States)

Bonini, Nicolao; Grecucci, Alessandro; Nicolè, Manuel; Savadori, Lucia

2018-06-01

A group of pathological gamblers and a group of problem gamblers (i.e., gamblers at risk of becoming pathological) were compared to healthy controls on their risk-taking propensity after prior losses. Each participant played both the Balloon Analogue Risk Taking task (BART) and a modified version of the same task, where individuals face five repeated predetermined early losses at the onset of the game. No significant difference in risk-taking was found between groups on the standard BART task, while significant differences emerged when comparing behaviors in the two tasks: both pathological gamblers and controls reduced their risk-taking tendency after prior losses in the modified BART compared to the standard BART, whereas problem gamblers showed no reduction in risk-taking after prior losses. We interpret these results as a sign of a reduced sensitivity to negative feedback in problem gamblers which might contribute to explain their loss-chasing tendency.

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

Estimation of the burden of cardiovascular disease attributable to modifiable risk factors and cost-effectiveness analysis of preventative interventions to reduce this burden in Argentina

Directory of Open Access Journals (Sweden)

Martí Sebastián

2010-10-01

Full Text Available Abstract Background Cardiovascular disease (CVD is the primary cause of mortality and morbidity in Argentina representing 34.2% of deaths and 12.6% of potential years of life lost (PYLL. The aim of the study was to estimate the burden of acute coronary heart disease (CHD and stroke and the cost-effectiveness of preventative population-based and clinical interventions. Methods An epidemiological model was built incorporating prevalence and distribution of high blood pressure, high cholesterol, hyperglycemia, overweight and obesity, smoking, and physical inactivity, obtained from the Argentine Survey of Risk Factors dataset. Population Attributable Fraction (PAF of each risk factor was estimated using relative risks from international sources. Total fatal and non-fatal events, PYLL and Disability Adjusted Life Years (DALY were estimated. Costs of event were calculated from local utilization databases and expressed in international dollars (I$. Incremental cost-effectiveness ratios (ICER were estimated for six interventions: reducing salt in bread, mass media campaign to promote tobacco cessation, pharmacological therapy of high blood pressure, pharmacological therapy of high cholesterol, tobacco cessation therapy with bupropion, and a multidrug strategy for people with an estimated absolute risk > 20% in 10 years. Results An estimated total of 611,635 DALY was lost due to acute CHD and stroke for 2005. Modifiable risk factors explained 71.1% of DALY and more than 80% of events. Two interventions were cost-saving: lowering salt intake in the population through reducing salt in bread and multidrug therapy targeted to persons with an absolute risk above 20% in 10 years; three interventions had very acceptable ICERs: drug therapy for high blood pressure in hypertensive patients not yet undergoing treatment (I$ 2,908 per DALY saved, mass media campaign to promote tobacco cessation amongst smokers (I$ 3,186 per DALY saved, and lowering cholesterol with

An experiential program to reduce AIDS risk among female sex partners of injection-drug users.

Science.gov (United States)

Rhodes, F; Wolitski, R J; Thornton-Johnson, S

1992-11-01

This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.

Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

Science.gov (United States)

Goldenberg, Shira M; Engstrom, David; Rolon, Maria Luisa; Silverman, Jay G; Strathdee, Steffanie A

2013-01-01

Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1) reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2) mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3) provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

Natural radiation dose due to 210Po and associated risk to certain fishes of Kudankulam Waters, Gulf of Mannar

International Nuclear Information System (INIS)

Praveen Pole, R.P.; Godwin Wesley, S.; Vijayakumar, B.

2014-01-01

With increasing emphasis on environmental protection, concern has switched over from the earlier target human being to non-human species regarding possible radiation risk. Alpha-emitter 210 Po (t 1/2 = 138.4 d) is the most important radionuclide, considering it as a potential natural source of internal radiation dose to marine organisms. Fishes are known to accumulate 210 Po to a large extent through food chains and certain marine fishes are potential bioindicators as they bioaccumulate the target radionuclide from surrounding waters. Hence it is imperative to assess the level of 210 Po and the radiological risk (risk quotient) due to the radiation dose received by different fish species collected from the coastal areas around the nuclear installation at Kudankulam

Evidence Theory Based Uncertainty Quantification in Radiological Risk due to Accidental Release of Radioactivity from a Nuclear Power Plant

International Nuclear Information System (INIS)

Ingale, S. V.; Datta, D.

2010-01-01

Consequence of the accidental release of radioactivity from a nuclear power plant is assessed in terms of exposure or dose to the members of the public. Assessment of risk is routed through this dose computation. Dose computation basically depends on the basic dose assessment model and exposure pathways. One of the exposure pathways is the ingestion of contaminated food. The aim of the present paper is to compute the uncertainty associated with the risk to the members of the public due to the ingestion of contaminated food. The governing parameters of the ingestion dose assessment model being imprecise, we have approached evidence theory to compute the bound of the risk. The uncertainty is addressed by the belief and plausibility fuzzy measures.

Risk estimates of stochastic effects due to exposure to radiation - a stochastic harm index

International Nuclear Information System (INIS)

Gonen, Y.G.

1980-01-01

The effects of exposure to low level radiation on the survival probability and life expectancy were investigated. The 1977 vital statistics of Jewish males in Israel were used as a baseline, mainly the data on normalized survival probability and life expectation as functions of age. Assumed effects of exposure were superposed on these data and the net differences calculated. It was found that the realistic rate effects of exposure to radiation are generally less than calculated by multiplying the collective dose by the risk factor. The effects are strongly age-dependent, decreasing sharply with age at exposure. The assumed harm due to exposure can be more than offset by improvements in medical care and safety. (H.K.)

PRN 97-3: Guidelines for Expedited Review of Conventional Pesticides under the Reduced-Risk Initiative and for Biological Pesticides

Science.gov (United States)

EPA encourages the development, registration and use of lower-risk pesticide products which would result in reduced risks to human health and the environment. This Pesticide Registration notice and the related web page explain the process and criteria.

Risk factors associated with sick leave due to work-related injuries in Dutch farmers: an exploratory case-control study

NARCIS (Netherlands)

Hartman, E.; Frankena, K.; Oude Vrielink, H.H.E.; Nielen, M.; Metz, J.H.M.; Huirne, R.B.M.

2004-01-01

Using data from an insurance company, the occurrence of sick leave among Dutch farmers due to work-related injuries, and the epidemiological risk factors were investigated. In this case-control study the cases had filed a sick leave claim for work-related injury from 19982001 and the controls had

Addressing the issue of falls off playground equipment: an empirically-based intervention to reduce fall-risk behaviors on playgrounds.

Science.gov (United States)

Morrongiello, Barbara A; Matheis, Shawn

2007-08-01

The present study evaluated the impact of an intervention to reduce fall-risk behaviors on playgrounds among children 6-11 years of age. Children completed posters indicating risky playground behaviors they would and would not do. In the intervention group, video and audio presentations were used to expose children to injury occurrences so that injury vulnerability was communicated in a fear-evoking way. In the control group, children only completed the pre- and post-intervention measures. Significant decreases in intentions to risk-take were obtained in the intervention, but not the control group. Effectiveness did not vary with children's age or sex, but was greater for those scoring high in sensation-seeking. A fear-appeals approach proved successful to reduce intended fall-risk behaviors, particularly for children high in sensation-seeking whose risk-taking is motivated by affect arousal.

Low-Dose Aspirin Reduces Breast Cancer Risk in Women with Diabetes: A Nationwide Retrospective Cohort Study in Taiwan.

Science.gov (United States)

Yang, Yi-Sun; Kornelius, Edy; Chiou, Jeng-Yuan; Lai, Yung-Rung; Lo, Shih-Chang; Peng, Chiung-Huei; Huang, Chien-Ning

2017-12-01

Low-dose aspirin is commonly used for preventing cardiovascular disease in people with diabetes, but its association with cancer remains controversial. This study used a nationwide population-based reimbursement database to investigate the relationship between low-dose aspirin use and breast cancer incidence in women with diabetes. This retrospective cohort study was conducted using data retrieved from the National Health Insurance Research Database in Taiwan from January 1, 1998 to December 31, 2011. Women diagnosed as having diabetes with low-dose aspirin use (75-165 mg daily) were identified as the study population, whereas those without low-dose aspirin use were selected as the comparison group. We analyzed 148,739 patients with diabetes. Their mean age (standard deviation) was 63.3 (12.8) years. A total of 27,378 patients were taking aspirin. Overall, the use of aspirin in patients with diabetes reduced the risk of breast cancer by 18% (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.71-0.94) after adjustment for potential confounders, namely age and comorbidities. Specifically, a cumulative dose of aspirin exceeding 88,900 mg was observed to reduce the risk of breast cancer by 47% (HR, 0.53, 95% CI, 0.43-0.67); however, low (aspirin did not reduce the risk of breast cancer. Our findings suggest that a cumulative aspirin dosage of more than 88,900 mg daily was associated with a reduced risk of breast cancer in women with diabetes. However, additional studies are necessary to confirm these findings.

Automatic and consistent registration framework for temporal pairs of mammograms in application to breast cancer risk assessment due to hormone replacement therapy (HRT)

DEFF Research Database (Denmark)

Karemore, Gopal Raghunath; Carreras, I. Arganda; Nielsen, Mads

2009-01-01

 Purpose: Mammographic density is a strong risk factor for breast cancer. However, whether changes in mammographic density due to HRT are associated with risk remains unclear. The aim of this study is to provide a framework for accurate interval change analysis in temporal pairs of mammograms of ...

Risk reducation of nuclear energy and its role in energy mix

International Nuclear Information System (INIS)

Tanaka, Satoru

2013-01-01

This article was newly written for useful discussion on energy policy based on the lecture at the Japan Science Council symposium 'How to amend energy policy after the Fukushima nuclear accident' held in July 2012. Basic standpoints of energy policy and positioning of nuclear power according to the 2010 energy basic program were reviewed. Nuclear power capacity was expected to increase from 49.5 GWe in 2007 to 68 GWe in 2030 to assure energy security. The accident forced energy policy to be amended starting with nuclear power zero base. The accident actualized the safety risks of nuclear power utilization, which were discussed from fragilities of three areas: (1) design basis, (2) emergency preparedness/response and (3) regulation system. Concrete measures to reduce risks of nuclear disaster were proposed. Role and responsibility of scientists was commented. Trend of energy policy based on basic philosophy selection for three scenarios in 2030 at the lecture time was confirmed and significance of nuclear power utilization was summarized from many-sided view points. (T. Tanaka)

Limit lines for risk

International Nuclear Information System (INIS)

Cox, D.C.; Baybutt, P.

1982-01-01

Approaches to the regulation of risk from technological systems, such as nuclear power plants or chemical process plants, in which potential accidents may result in a broad range of adverse consequences must take into account several different aspects of risk. These include overall or average risk, accidents posing high relative risks, the rate at which accident probability decreases with increasing accident consequences, and the impact of high frequency, low consequence accidents. A hypothetical complementary cumulative distribution function (CCDF), with appropriately chosen parametric form, meets all these requirements. The Farmer limit line, by contrast, places limits on the risks due to individual accident sequences, and cannot adequately account for overall risk. This reduces its usefulness as a regulatory tool. In practice, the CCDF is used in the Canadian nuclear licensing process, while the Farmer limit line approach, supplemented by separate qualitative limits on overall risk, is employed in the United Kingdom

Impact of a Genetic Risk Score for Coronary Artery Disease on Reducing Cardiovascular Risk: A Pilot Randomized Controlled Study

Directory of Open Access Journals (Sweden)

Joshua W. Knowles

2017-08-01

Full Text Available PurposeWe tested whether providing a genetic risk score (GRS for coronary artery disease (CAD would serve as a motivator to improve adherence to risk-reducing strategies.MethodsWe randomized 94 participants with at least moderate risk of CAD to receive standard-of-care with (N = 49 or without (N = 45 their GRS at a subsequent 3-month follow-up visit. Our primary outcome was change in low density lipoprotein cholesterol (LDL-C between the 3- and 6-month follow-up visits (ΔLDL-C. Secondary outcomes included other CAD risk factors, weight loss, diet, physical activity, risk perceptions, and psychological outcomes. In pre-specified analyses, we examined whether there was a greater motivational effect in participants with a higher GRS.ResultsSixty-five participants completed the protocol including 30 participants in the GRS arm. We found no change in the primary outcome between participants receiving their GRS and standard-of-care participants (ΔLDL-C: −13 vs. −9 mg/dl. Among participants with a higher GRS, we observed modest effects on weight loss and physical activity. All other secondary outcomes were not significantly different, including anxiety and worry.ConclusionAdding GRS to standard-of-care did not change lipids, adherence, or psychological outcomes. Potential modest benefits in weight loss and physical activity for participants with high GRS need to be validated in larger trials.

Bringing life course home: a pilot to reduce pregnancy risk through housing access and family support.

Science.gov (United States)

Allen, Deborah; Feinberg, Emily; Mitchell, Heavenly

2014-02-01

Proponents of life course comment that while the theory is persuasive, translating theory to practice is daunting. This paper speaks to the challenges and possibilities of intervention based on life course theory. It describes Healthy Start in Housing (HSiH), a partnership between the Boston Public Health Commission (BPHC) and the Boston Housing Authority (BHA) to reduce stress due to housing insecurity among low-income, pregnant women. HSiH seeks improved birth outcomes and long term health of mothers and infants. BHA goals are improved quality of life for participants, greater public housing stability and enhanced impact of housing on community well-being. HSiH is a 1 year pilot offering 75 housing units to pregnant women at risk of adverse birth outcomes and homelessness. BHA provides housing and expedites processing of HSiH applications; BPHC staff oversee enrollment, guide women through the application process, and provide enhanced, long-term case management. Of 130 women referred to HSiH to date, 53 were ineligible, 59 have submitted applications, 13 are preparing applications and 5 dropped out. Nineteen women have been housed. Among eligible women, 58 % had medical conditions, 56 % mental health conditions, and 14 % prior adverse outcomes; 30 % had multiple risks. Standardized assessments reflected high levels of depressive symptoms; 41 % had symptoms consistent with post-traumatic stress disorder. Life course theory provides both the framework and the rationale for HSiH. HSiH experience confirms the salience of daily social experience to women's health and the importance of addressing stressors and stress in women's lives.

Assessing radiologic risk for population due to human activities

International Nuclear Information System (INIS)

Toma, Al.; Dulama, C.; Dobrin, R.; Hirica, O.

2002-01-01

The most important factor in assessing radiologic risk is ensuring scientific means for evaluation of the radioactive release impact upon humans and organisms. To evaluate quantitatively this impact not only knowledge of radioactivity distribution in these dynamical systems is necessary but also understanding the transfer mechanisms between ecosystem components is needed. Thus a complete radioecologic study appear to be very complex and needs defining the source term, dynamic description of radionuclides behavior in the ecosystem, estimation of radiation doses in the major components of the ecosystem and finally the effects of radiation doses upon different parts of the systems. A diagram of the steps implied in evaluation of the effects due to radioactive effluent release in the environment is presented and discussed. The following steps are described: - identification of radioactive sources, as well as their input rate. Presence of noxious materials such as heavy metals or some organic compounds should be taken into account to assess the synergetic or antagonistic interactions; - determination of space-time distribution of release radionuclides; - estimation of dose rates and radiation exposure of population; - estimation of radiation dose effects upon individuals, population and ecosystems. This fourth step implies: experimental field or laboratory studies to determine the somatic/genetic response to radiation as a function of the exposure dose; following-up and interpretation of the organism response to dose or dose rates in terms of radiation-induce changes in the population life cycles; forecasting the irradiation effects upon population or communities within environment. Finally, this evaluation is completed by the decision making process implying a society acceptance of the forecast and/or observed effects

Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

Science.gov (United States)

Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

2015-12-10

The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

Integrating Research to Reduce Risk and Gain the Benefits for Development

Science.gov (United States)

Mcbean, G. A.

2015-12-01

Across all countries there are challenges due to the increasing numbers of hazards creating disasters and impacting on people and property and limiting development. These impacts, in a relative sense relative to population and economy, are larger in developing countries and small island states. The issues of disaster risk reduction, sustainable development goals and climate change mitigation and adaptation are key global issues being addressed through international processes in 2015. Internationally coordinated research, through programs such as Integrated Research on Disaster Risk, Future Earth: Research for Global Sustainability and Health and Wellbeing in the Changing Urban Environment, needs to be supported and their research coordinated so the outputs are effective in policy development and can be used by all countries. A particular challenge is with regard to those extreme and relatively rare events that have huge impacts but societies are not yet effective in "making timely decisions and implementation of the hazard-associated preparedness measures to mitigate humanitarian and economic losses". The challenge for the scientific community is to work with stakeholder communities through a co-design, co-produce and co-deliver approach to enhance the relevance and effectiveness of our science.

Risk analysis for renewable energy projects due to constraints arising

Science.gov (United States)

Prostean, G.; Vasar, C.; Prostean, O.; Vartosu, A.

2016-02-01

Starting from the target of the European Union (EU) to use renewable energy in the area that aims a binding target of 20% renewable energy in final energy consumption by 2020, this article illustrates the identification of risks for implementation of wind energy projects in Romania, which could lead to complex technical implications, social and administrative. In specific projects analyzed in this paper were identified critical bottlenecks in the future wind power supply chain and reasonable time periods that may arise. Renewable energy technologies have to face a number of constraints that delayed scaling-up their production process, their transport process, the equipment reliability, etc. so implementing these types of projects requiring complex specialized team, the coordination of which also involve specific risks. The research team applied an analytical risk approach to identify major risks encountered within a wind farm project developed in Romania in isolated regions with different particularities, configured for different geographical areas (hill and mountain locations in Romania). Identification of major risks was based on the conceptual model set up for the entire project implementation process. Throughout this conceptual model there were identified specific constraints of such process. Integration risks were examined by an empirical study based on the method HAZOP (Hazard and Operability). The discussion describes the analysis of our results implementation context of renewable energy projects in Romania and creates a framework for assessing energy supply to any entity from renewable sources.

How to reduce avoidable admissions due to acute diabetes complications?: interrelation between primary and specialized attention in a diabetes unit.

Science.gov (United States)

García-Talavera Espín, N V; López-Ruiz, A; Nuñez Sánchez, Ma Á; Meoro Avilés, A; Sánchez Cañizares, C; Romero López-Reinoso, H; López Olivar, Ma D; Lapaz Jorge, Ma Á; Guirao Sastre, J Ma; San Eustaquio Tudanca, F; Soriano Palao, J

2012-01-01

Type 2 Diabetes Mellitus is a serious health problem. In the year 2030 it will affect 366 million people around the world. Evaluate the effectiveness of a mixed intervention and reducing the amount and seriousness of acute complications in diabetics from our Health Area. Protocols of action as well as information documents were produced. Diabetes Unit coordinated educational activities in the different support levels of the Area VII of Murcia. Information talks were provided for the people in charge of the Diabetes Unit in every Care Center and Service of the Health Area. Personalized training was provided for patients treated in the different Care levels. The study comprised three stages. Information leaflets were spread and talks offered to the patient regarding in house handling of hypo and hyper glycemia. A reduction of 39% of the emergencies due to acute non complicated diabetes was achieved, as well as a reduction of 47.6% of hospital admissions. There was a reduction of 67.8% of the amount of total hospital stays for the group of patients under 35 years who were admitted into the hospital due to type 1 or 2 diabetes mellitus that didn't show any complications (GRD295). There was a reduction of more than thirty percent in the emergencies due to acute decompensations in the disease and a significant reduction in the avoidable hospital stays in the young adult, thus improving the patients' life quality and reducing the social cost of the diabetic patient.

2014 Bone and Muscle Risks Standing Review Panel

Science.gov (United States)

Steinberg, Susan; Glowacki, Julie; Gregor, Robert; Cullen, Diane; Drake, Almond; Enoka, Roger; Hanley, Edward, Jr.; Kraemer, William; Raven, Peter; Sumner, D. Rick

2015-01-01

The 2014 Bone and Muscle Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on December 17 - 18, 2014. The SRP reviewed the updated Evidence Reports for the Risk of Impaired Performance Due to Reduced Muscle Mass, Strength and Endurance and (from here on referred to as the 2014 Muscle Evidence Report) and the Risk of Reduced Physical Performance Capabilities Due to Reduced Aerobic Capacity (from here on referred to as the 2014 Aerobic Evidence Report), as well as the Research Plans for these Risks. The SRP agreed the Evidence Reports were comprehensive and described a logical sequence of steps taken by NASA and the scientific community to address the risk of impaired performance as a result of muscle atrophy, i.e., reduced muscle mass, loss of strength and loss of endurance in a microgravity environment. The interdependence of the three physiological systems represented by this SRP (i.e., skeletal, muscular and cardiovascular) supports a level of discussion on system integration that is now appreciated by the Chief Scientist of the Human Research Program (HRP). The Evidence Reports cover the effects of microgravity on muscle, ranging from the cellular and molecular levels to whole muscle function. The reports also addressed other factors related to muscle (e.g., neural influences, insulin resistance, heat stress, and nutrition) that will serve as a basis for future discussions on the integration of physiological systems and the response to microgravity. The SRP agreed the Evidence Reports were balanced, provided insight to muscle function, and laid the foundation for the integrated approach now taken by the SRP.

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.

Life time fatality risk assessment due to variation of indoor radon concentration in dwellings in western Haryana, India

International Nuclear Information System (INIS)

Kansal, Sandeep; Mehra, Rohit; Singh, N.P.

2012-01-01

Indoor radon measurements in 60 dwellings belonging to 12 villages of Sirsa, Fatehbad and Hisar districts of western Haryana, India, have been carried out, using LR-115 type II cellulose nitrate films in the bare mode. The annual average indoor radon value in the studied area varies from 76.00 to 115.46 Bq m −3 , which is well within the recommended action level 200–300 Bq m −3 (). The winter/summer ratio of indoor radon ranges from 0.78 to 2.99 with an average of 1.52. The values of annual average dose received by the residents and Life time fatality risk assessment due to variation of indoor radon concentration in dwellings of studied area suggests that there is no significance threat to the human beings due to the presence of natural radon in the dwellings. - Highlights: ► The radon concentration values in the dwellings are 2–3 times more than the world average of 40 Bq m −3 . ► These values are lower than the recommended action level of 200–300 Bq m −3 (). ► The annual effective dose is less than the recommended action level of 3–10 mSv per year (). ► The values of life time fatality risk determined for the studied area are within safe standards. ► There is no significant threat to the human beings due to the presence of natural radon in the dwellings.

Analysis of an Underground Structure Settlement Risk due to Tunneling

DEFF Research Database (Denmark)

Vahdatirad, Mohammad Javad; Ghodrat, Hadi; Firouzianbandpey, Sarah

2010-01-01

of the underground commercial center structure settlement is estimated using both empirical and numerical methods. The settlement risk level of the commercial center structure is determined based on presented definitions about risk classification of various types of structures. Consequently, tunneling processes...

Reduced face aftereffects in autism are not due to poor attention.

Directory of Open Access Journals (Sweden)

Louise Ewing

Full Text Available This study aimed to determine why face identity aftereffects are diminished in children with autism, relative to typical children. To address the possibility that reduced face aftereffects might reflect reduced attention to adapting stimuli, we investigated the consequence of controlling attention to adapting faces during a face identity aftereffect task in children with autism and typical children. We also included a size-change between adaptation and test stimuli to determine whether the reduced aftereffects reflect atypical adaptation to low- or higher-level stimulus properties. Results indicated that when attention was controlled and directed towards adapting stimuli, face identity aftereffects in children with autism were significantly reduced relative to typical children. This finding challenges the notion that atypicalities in the quality and/or quantity of children's attention during adaptation might account for group differences previously observed in this paradigm. Additionally, evidence of diminished face identity aftereffects despite a stimulus size change supports an adaptive processing atypicality in autism that extends beyond low-level, retinotopically coded stimulus properties. These findings support the notion that diminished face aftereffects in autism reflect atypicalities in adaptive norm-based coding, which could also contribute to face processing difficulties in this group.

Normal obstetric ultrasound reduces the risk of down syndrome in fetuses of older mothers

International Nuclear Information System (INIS)

Anderson, N. G.; Luehr, B.; Ng, R.

2006-01-01

The objective of this study is to determine whether a normal fetal morphology ultrasound scan in women older than 35 years reduces the risk of aneuploidy. We reviewed the results of amniocentesis and second trimester sonogram in all women older than 35 years from 1991 to 1995. None had prior screening. We excluded fetuses with structural anomalies. We determined the sensitivity and specificity of minor markers in detecting Down syndrome and also determined the reduction in risk of a normal sonogram. Among the 2060 women older than 35 years giving birth during the study period, 16 (0.78%) delivered an infant with Down syndrome. Of the 16 fetuses, two had no prenatal testing or ultrasound, two had invasive testing but no second trimester sonogram, five had a normal sonogram and seven had one or more sonographic markers of Down syndrome. At least 17% of women older than 35 years did not participate in prenatal testing or ultrasound. Ultrasound detected Down syndrome with a sensitivity of 59% (95% confidence interval: 45-72%), a false-positive rate of 10.6% (9.4-11.8%) and a positive predictor value of 1 in 9. The likelihood of having normal karyotype if the sonogram was normal was 0.46 (0.31-0.61). In women older than 35 years, a normal second trimester sonogram reduces the risk of Down syndrome by more than 50%. At least 17% of women older than 35 years do not participate in prenatal testing or ultrasound

Relaxin reduces susceptibility to post-infarct atrial fibrillation in mice due to anti-fibrotic and anti-inflammatory properties.

Science.gov (United States)

Beiert, Thomas; Tiyerili, Vedat; Knappe, Vincent; Effelsberg, Verena; Linhart, Markus; Stöckigt, Florian; Klein, Sabine; Schierwagen, Robert; Trebicka, Jonel; Nickenig, Georg; Schrickel, Jan W; Andrié, René P

2017-08-26

Relaxin-2 (RLX) is a peptide hormone that exerts beneficial anti-fibrotic and anti-inflammatory effects in diverse models of cardiovascular disease. The goal of this study was to determine the effects of RLX treatment on the susceptibility to atrial fibrillation (AF) after myocardial infarction (MI). Mice with cryoinfarction of the left anterior ventricular wall were treated for two weeks with either RLX (75 μg/kg/d) or vehicle (sodium acetate) delivered via subcutaneously implanted osmotic minipumps. RLX treatment significantly attenuated the increase in AF-inducibility following cryoinfarction and reduced the mean duration of AF episodes. Furthermore, epicardial mapping of both atria revealed an increase in conduction velocity. In addition to an attenuation of atrial hypertrophy, chronic application of RLX reduced atrial fibrosis, which was linked to a significant reduction in atrial mRNA expression of connective tissue growth factor. Transcript levels of the pro-inflammatory cytokines interleukin-6 and interleukin-1β were reduced in RLX treated mice, but macrophage infiltration into atrial myocardium was similar in the vehicle and RLX treated groups. Treatment with RLX in mice after MI reduces susceptibility to AF due to anti-inflammatory and anti-fibrotic properties. Because to these favorable actions, RLX may become a new therapeutic option in the treatment of AF, even when complicating MI. Copyright © 2017 Elsevier Inc. All rights reserved.

Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

Directory of Open Access Journals (Sweden)

Shira M Goldenberg

Full Text Available Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31 in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1 reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2 mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3 provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

Inulin Supplementation Does Not Reduce Plasma Trimethylamine N-Oxide Concentrations in Individuals at Risk for Type 2 Diabetes

Directory of Open Access Journals (Sweden)

Mary Elizabeth Baugh

2018-06-01

Full Text Available Trimethylamine N-oxide (TMAO is associated with type 2 diabetes (T2DM and increased risk of adverse cardiovascular events. Prebiotic supplementation has been purported to reduce TMAO production, but whether prebiotics reduce fasting or postprandial TMAO levels is unclear. Sedentary, overweight/obese adults at risk for T2DM (n = 18 were randomized to consume a standardized diet (55% carbohydrate, 30% fat with 10 g/day of either an inulin supplement or maltodextrin placebo for 6 weeks. Blood samples were obtained in the fasting state and hourly during a 4-h high-fat challenge meal (820 kcal; 25% carbohydrate, 63% fat; 317.4 mg choline, 62.5 mg betaine, 8.1 mg l-carnitine before and after the diet. Plasma TMAO and trimethylamine (TMA moieties (choline, l-carnitine, betaine, and γ-butyrobetaine were measured using isocratic ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS. There were no differences in fasting or postprandial TMAO or TMA moieties between the inulin and placebo groups at baseline (all p > 0.05. There were no significant changes in fasting or postprandial plasma TMAO or TMA moiety concentrations following inulin or placebo. These findings suggest that inulin supplementation for 6 weeks did not reduce fasting or postprandial TMAO in individuals at risk for T2DM. Future studies are needed to identify efficacious interventions that reduce plasma TMAO concentrations.

Modelling the ability of source control measures to reduce inundation risk in a community-scale urban drainage system

Science.gov (United States)

Mei, Chao; Liu, Jiahong; Wang, Hao; Shao, Weiwei; Xia, Lin; Xiang, Chenyao; Zhou, Jinjun

2018-06-01

Urban inundation is a serious challenge that increasingly confronts the residents of many cities, as well as policymakers, in the context of rapid urbanization and climate change worldwide. In recent years, source control measures (SCMs) such as green roofs, permeable pavements, rain gardens, and vegetative swales have been implemented to address flood inundation in urban settings, and proven to be cost-effective and sustainable. In order to investigate the ability of SCMs on reducing inundation in a community-scale urban drainage system, a dynamic rainfall-runoff model of a community-scale urban drainage system was developed based on SWMM. SCMs implementing scenarios were modelled under six design rainstorm events with return period ranging from 2 to 100 years, and inundation risks of the drainage system were evaluated before and after the proposed implementation of SCMs, with a risk-evaluation method based on SWMM and analytic hierarchy process (AHP). Results show that, SCMs implementation resulting in significantly reduction of hydrological indexes that related to inundation risks, range of reduction rates of average flow, peak flow, and total flooded volume of the drainage system were 28.1-72.1, 19.0-69.2, and 33.9-56.0 %, respectively, under six rainfall events with return periods ranging from 2 to 100 years. Corresponding, the inundation risks of the drainage system were significantly reduced after SCMs implementation, the risk values falling below 0.2 when the rainfall return period was less than 10 years. Simulation results confirm the effectiveness of SCMs on mitigating inundation, and quantified the potential of SCMs on reducing inundation risks in the urban drainage system, which provided scientific references for implementing SCMs for inundation control of the study area.

Statins Reduces the Risk of Dementia in Patients with Late-Onset Depression: A Retrospective Cohort Study.

Science.gov (United States)

Yang, Ya-Hsu; Teng, Hao-Wei; Lai, Yen-Ting; Li, Szu-Yuan; Lin, Chih-Ching; Yang, Albert C; Chan, Hsiang-Lin; Hsieh, Yi-Hsuan; Lin, Chiao-Fan; Hsu, Fu-Ying; Liu, Chih-Kuang; Liu, Wen-Sheng

2015-01-01

Patients with late-onset depression (LOD) have been reported to run a higher risk of subsequent dementia. The present study was conducted to assess whether statins can reduce the risk of dementia in these patients. We used the data from National Health Insurance of Taiwan during 1996-2009. Standardized Incidence Ratios (SIRs) were calculated for LOD and subsequent dementia. The criteria for LOD diagnoses included age ≥65 years, diagnosis of depression after 65 years of age, at least three service claims, and treatment with antidepressants. The time-dependent Cox proportional hazards model was applied for multivariate analyses. Propensity scores with the one-to-one nearest-neighbor matching model were used to select matching patients for validation studies. Kaplan-Meier curve estimate was used to measure the group of patients with dementia living after diagnosis of LOD. Totally 45,973 patients aged ≥65 years were enrolled. The prevalence of LOD was 12.9% (5,952/45,973). Patients with LOD showed to have a higher incidence of subsequent dementia compared with those without LOD (Odds Ratio: 2.785; 95% CI 2.619-2.958). Among patients with LOD, lipid lowering agent (LLA) users (for at least 3 months) had lower incidence of subsequent dementia than non-users (Hazard Ratio = 0.781, 95% CI 0.685-0.891). Nevertheless, only statins users showed to have reduced risk of dementia (Hazard Ratio = 0.674, 95% CI 0.547-0.832) while other LLAs did not, which was further validated by Kaplan-Meier estimates after we used the propensity scores with the one-to-one nearest-neighbor matching model to control the confounding factors. Statins may reduce the risk of subsequent dementia in patients with LOD.

Development, oviposition, and mortality of Neoseiulus fallacis (Acari: Phytoseiidae) in response to reduced-risk insecticides.

Science.gov (United States)

Villanueva, Raul T; Walgenbach, James F

2005-12-01

Eight reduced-risk insecticides (acetamiprid, thiamethoxam, imidacloprid, thiacloprid, methoxyfenozide, pyriproxyfen, indoxacarb, and spinosad) and three conventional insecticides (azinphosmethyl, fenpropathrin, and esfenvalerate) were tested against Neoseiulus fallacis (Garman) (Acari: Phytoseiidae), the most abundant predacious mite in North Carolina apple (Malus spp.) orchards. To assess the effect of insecticides on development and mortality of N. fallacis immatures, 12-h-old eggs were individually placed on bean leaf disks previously dipped in insecticide solutions. Tetranychus urticae Koch (Acari: Tetranychidae) females were added as a food source. None of the reduced-risk insecticides significantly affected immature N. fallacis compared with the control; however, the pyrethroids esfenvalerate and fenpropathrin were highly toxic to immatures. To evaluate the effect of insecticides on mortality and oviposition of adult N. fallacis, 7- to 8-d-old females were confined on insecticide-treated bean leaves with Malephora crocea (Aizoaceae) pollen added as a food source. Spinosad resulted in the highest mortality, whereas azinphosmethyl, acetamiprid, fenpropathrin, and imidacloprid were moderately toxic, and mortality from esfenvalerate, indoxacarb, thiacloprid, methoxyfenozide, pyriproxyfen, and thiamethoxam did not differ significantly from the control. Oviposition was affected in a similar manner, with the exception of acetamiprid that did not affect oviposition, and thiamethoxam that reduced oviposition.

Programmatic Considerations to Reduce the Risk of Adverse Renal Stone Events in Spaceflight

Science.gov (United States)

Antonsen, Erik; Pietrzyk, Robert

2017-01-01

Introduction: Microgravity exposure may alter the likelihood that astronauts will experience renal stones. The potential risk includes both acute and chronic health issues, with the potential for significant impact on mission objectives. Methods: To understand the role of the NASA's Human Research Program (HRP) research agenda in both preventing and addressing renal stones in spaceflight, current astronaut epidemiologic data and a summary of programmatic considerations are reviewed. Results: Although there has never been a symptomatic renal stone event in a U.S. crewmember during spaceflight, urine chemistry has been altered - likely due to induced changes in renal physiology as a result of exposure to microgravity. This may predispose astronauts to stone formation, leading the HRP to conduct and sponsor research to: 1) understand the risk of stone formation in space; 2) prevent stones from forming; and 3) address stones that may form by providing novel diagnostic and therapeutic approaches. Discussion: The development of a renal stone during spaceflight is a significant medical concern that requires the HRP to minimize this risk by providing the ability to prevent, diagnose, monitor and treat the condition during spaceflight. A discussion of the risk as NASA understands it is followed by an overview of the multiple mitigations currently under study, including novel ultrasound techniques for stone detection and manipulation, and how they may function as part of a larger exploration medical system.

Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

International Nuclear Information System (INIS)

Andrianov, A.; Kuptsov, I.

2013-01-01

This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure

Solution of resource allocation problem for identification of cost-effective measures to reduce nuclear proliferation risks

Energy Technology Data Exchange (ETDEWEB)

Andrianov, A.; Kuptsov, I. [Obninsk Institute for Nuclear Power Engineering, Studgorodok 1, Obninsk, Kaluga region 249030 (Russian Federation)

2013-07-01

This report presents a methodology of selection of cost-effective measures to reduce nuclear proliferation risks. The methodology relies on a graded security model used in practice in different applications. The method is based on the controlled finite Markov chain approach set in combination with discrete dynamic programming and MCDM (Multi Criteria Decision Making) techniques that enables the expert to select the cost-effective measures to reduce nuclear proliferation risks depending on availability of resources. The analysis performed with different number of possible measures confirms the conclusions that the implementation of extra-large costs may not produce the required effect, and the increase in resources above a certain level does not appear sensitive. Diversification in improving the effectiveness of other measures seems more rational and efficient for the whole system than the unlimited improvement of the effectiveness of only one measure.

Counterfeit Parts: DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk

Science.gov (United States)

2016-02-01

agencies and contractors we met with stated that they have encountered counterfeit parts less frequently in the DOD supply chain , in part, because...the DOD supply chain as a method to prevent further counterfeiting.22 DOD and industry officials noted that timely reporting of...COUNTERFEIT PARTS DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk Report to Congressional Committees

Maintenance Strategies to Reduce Downtime Due to\\ud Machine Positional Errors

OpenAIRE

Shagluf, Abubaker; Longstaff, Andrew P.; Fletcher, Simon

2014-01-01

Manufacturing strives to reduce waste and increase\\ud Overall Equipment Effectiveness (OEE). When managing machine tool maintenance a manufacturer must apply an appropriate decision technique in order to reveal hidden costs associated with production losses, reduce equipment downtime\\ud competently and similarly identify the machines’ performance.\\ud Total productive maintenance (TPM) is a maintenance program that involves concepts for maintaining plant and equipment effectively. OEE is a pow...

'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications

Directory of Open Access Journals (Sweden)

Sarah L. Goff

2018-04-01

Full Text Available Purpose: Atypical hyperplasia (AH is associated with a nearly 4-fold elevation of lifetime risk for breast cancer, and lobular carcinoma in situ (LCIS is associated with a 7- to 8-fold risk. Women with AH/LCIS make numerous decisions in the course of treatment, including whether to take a risk-reducing medication, an option relatively few women pursue. We explored women’s decision-making processes through patient narratives in an effort to inform decision supports for AH/LCIS. Methods: We conducted in-depth interviews with 20 English-speaking women with AH/LCIS and no subsequent diagnosis of invasive breast cancer who had enrolled in the Rays of Hope Center for Breast Cancer Research patient registry between April 5, 2012, and March 31, 2016. Interviews were audiotaped, professionally transcribed, and qualitatively analyzed using thematic qualitative content analysis. Results: We identified three major narrative themes: 1 experiences with medical care; 2 decision-making; and 3 making sense of AH/LCIS. Each major theme had several subthemes, many of which map onto existing decisional theories and heuristics. Subthemes included the impact of life context on diagnosis meaning, emotional responses, changes in self-concept and body image, and understanding of the risk-benefit of risk-reducing medications. Conclusions: This narrative analysis offers important insights into how lived experience may influence decision-making for women with AH/LCIS. Decision supports that focus not only on analytic decisional processes, but also patients’ subjectivities and decisional heuristics, could prove useful for women and their health care providers.

HSE risks assessment in urban high-rise construction using Fuzzy Approach

Directory of Open Access Journals (Sweden)

A. Ardeshir

2015-07-01

Conclusion: Findings in this research indicated that HSE risks are very critical and they should be controlled before start of the project. Moreover, many of HSE risk are due to lack of appropriate HSE culture in the organization and projects that can be reduced by culture-building practices.

Risk factors for premature birth in French Guiana: the importance of reducing health inequalities.

Science.gov (United States)

Leneuve-Dorilas, Malika; Favre, Anne; Carles, Gabriel; Louis, Alphonse; Nacher, Mathieu

2017-11-27

French Guiana has the highest birth rate in South America. This French territory also has the highest premature birth rate and perinatal mortality rate of all French territories. The objective was to determine the premature birth rate and to identify the prevalence of risk factors of premature birth in French Guiana. A retrospective study of all births in French Guiana was conducted between January 2013 and December 2014 using the computerized registry compiling all live births over 22 weeks of gestation on the territory. During this period 12 983 live births were reported on the territory. 13.5% of newborns were born before 37 (1755/12 983). The study of the registry revealed that common sociodemographic risk factors of prematurity were present. In addition, past obstetrical history was also important: a scarred uterus increased the risk of prematurity adjusted odds ratio =1.4, 95%CI (1.2-1.6). Similarly, obstetrical surveillance, the absence of preparation for birth or of prenatal interview increased the risk of prematurity by 2.4 and 2.3, the excess fraction in the population was 69% and 72.2%, respectively. Known classical risk factors are important. In the present study excess fractions were calculated in order to prioritize interventions to reduce the prematurity rate.

Association of Proton Pump Inhibitors with Reduced Risk of Warfarin-related Serious Upper Gastrointestinal Bleeding

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Ray, Wayne A.; Chung, Cecilia P.; Murray, Katherine T.; Smalley, Walter E.; Daugherty, James R.; Dupont, William D.; Stein, C. Michael

2016-01-01

Background & Aims Proton-pump inhibitors (PPIs) might reduce the risk of serious warfarin-related upper gastrointestinal bleeding, but the evidence of their efficacy for this indication is limited. A gastroprotective effect of PPIs would be particularly important for patients who take warfarin with antiplatelet drugs or nonselective non-steroidal anti-inflammatory drugs (NSAIDs), which further increase the risk of gastrointestinal bleeding. Methods This retrospective cohort study of patients beginning warfarin treatment in Tennessee Medicaid and the 5% National Medicare Sample identified 97,430 new episodes of warfarin treatment with 75,720 person-years of follow up. The study endpoints were hospitalizations for upper gastrointestinal bleeding potentially preventable by PPIs and for bleeding at other sites. Results Patients who took warfarin without PPI co-therapy had 119 hospitalizations for upper gastrointestinal bleeding per 10,000 person-years of treatment. The risk decreased by 24% among patients who received PPI co-therapy (adjusted hazard ratio [HR], 0.76; 95% CI, 0.63–0.91). There was no significant reduction in the risk of other gastrointestinal bleeding hospitalizations (HR, 1.07; 95% CI, 0.94–1.22) or non-gastrointestinal bleeding hospitalizations (HR, 0.98; 95% CI, 0.84–1.15) in this group. Among patients concurrently using antiplatelet drugs or NSAIDs, those without PPI co-therapy had 284 upper gastrointestinal bleeding hospitalizations per 10,000 person-years of warfarin treatment. The risk decreased by 45% (HR, 0.55; 95% CI, 0.39–0.77) with PPI co-therapy. PPI co-therapy had no significant protective effect for warfarin patients not using antiplatelet drugs or NSAIDs (HR, 0.86; 95% CI, 0.70-1.06). Findings were similar in both study populations. Conclusions In an analysis of patients beginning warfarin treatment in Tennessee Medicaid and the 5% National Medicare Sample, PPI co-therapy was associated with reduced risk of warfarin-related upper

Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities.

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Vanos, Jennifer K; Hebbern, Christopher; Cakmak, Sabit

2014-02-01

Synoptic weather and ambient air quality synergistically influence human health. We report the relative risk of mortality from all non-accidental, respiratory-, and cardiovascular-related causes, associated with exposure to four air pollutants, by weather type and season, in 10 major Canadian cities for 1981 through 1999. We conducted this multi-city time-series study using Poisson generalized linear models stratified by season and each of six distinctive synoptic weather types. Statistically significant relationships of mortality due to short-term exposure to carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were found, with significant modifications of risk by weather type, season, and mortality cause. In total, 61% of the respiratory-related mortality relative risk estimates were significantly higher than for cardiovascular-related mortality. The combined effect of weather and air pollution is greatest when tropical-type weather is present in the spring or summer. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Impact of climate change and population growth on a risk assessment for endocrine disruption in fish due to steroid estrogens in England and Wales

International Nuclear Information System (INIS)

Keller, V.D.J.; Lloyd, P.; Terry, J.A.; Williams, R.J.

2015-01-01

In England and Wales, steroid estrogens: estrone, estradiol and ethinylestradiol have previously been identified as the main chemicals causing endocrine disruption in male fish. A national risk assessment is already available for intersex in fish arising from estrogens under current flow conditions. This study presents, to our knowledge, the first set of national catchment-based risk assessments for steroid estrogen under future scenarios. The river flows and temperatures were perturbed using three climate change scenarios (ranging from relatively dry to wet). The effects of demographic changes on estrogen consumption and human population served by sewage treatment works were also included. Compared to the current situation, the results indicated increased future risk:the percentage of high risk category sites, where endocrine disruption is more likely to occur, increased. These increases were mainly caused by changes in human population. This study provides regulators with valuable information to prepare for this potential increased risk. - Highlights: • Risk assessment for the 2050's including climate change and population changes. • Three climate scenarios considered (changes in river flow and river temperature). • Increased risk from fish intersex across all scenarios in England and Wales. • Population is the main factor causing the risk increase for the 2050's. - The predicted increase in risk of endocrine disruption in fish due to steroid estrogens in England and Wales in the 2050's is mainly due to human population increase rather than climate change

Hazard Identification, Risk Assessment and Risk Control (HIRARC Accidents at Power Plant

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Ahmad Asmalia Che

2016-01-01

Full Text Available Power plant had a reputation of being one of the most hazardous workplace environments. Workers in the power plant face many safety risks due to the nature of the job. Although power plants are safer nowadays since the industry has urged the employer to improve their employees’ safety, the employees still stumble upon many hazards thus accidents at workplace. The aim of the present study is to investigate work related accidents at power plants based on HIRARC (Hazard Identification, Risk Assessment and Risk Control process. The data were collected at two coal-fired power plant located in Malaysia. The finding of the study identified hazards and assess risk relate to accidents occurred at the power plants. The finding of the study suggested the possible control measures and corrective actions to reduce or eliminate the risk that can be used by power plant in preventing accidents from occurred

Collapse risk of buildings in the Pacific Northwest region due to subduction earthquakes

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Raghunandan, Meera; Liel, Abbie B.; Luco, Nicolas

2015-01-01

Subduction earthquakes similar to the 2011 Japan and 2010 Chile events will occur in the future in the Cascadia subduction zone in the Pacific Northwest. In this paper, nonlinear dynamic analyses are carried out on 24 buildings designed according to outdated and modern building codes for the cities of Seattle, Washington, and Portland, Oregon. The results indicate that the median collapse capacity of the ductile (post-1970) buildings is approximately 40% less when subjected to ground motions from subduction, as compared to crustal earthquakes. Buildings are more susceptible to earthquake-induced collapse when shaken by subduction records (as compared to crustal records of the same intensity) because the subduction motions tend to be longer in duration due to their larger magnitude and the greater source-to-site distance. As a result, subduction earthquakes are shown to contribute to the majority of the collapse risk of the buildings analyzed.

Increased ecological risk due to the hyperaccumulation of As in Pteris cretica during the phytoremediation of an As-contaminated site.

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Jeong, Seulki; Moon, Hee Sun; Nam, Kyoungphile

2015-03-01

Ecological risk due to the hyperaccumulation of As in Pteris cretica during phytoremediation was evaluated at an abandoned As-contaminated site. Five receptor groups representing terrestrial invertebrates, avian insectivores, small mammals, herbivores, and omnivores were selected as potentially affected ecological receptors. Soil and food ingestion were considered as major exposure pathways. Phytoremediation was performed with P.cretica only and with both P.cretica and siderophores to enhance plant uptake of As. Ecological hazard index (EHI) values for the small mammal greatly exceeded 1.0 even after three weeks of growth regardless of siderophore application, probably due to its limited home range. For the mammalian herbivore, which mainly consumes plant foliage, the EHI values were greater than 5.73 after seven weeks without siderophore application, but the value increased sharply to 29.3 at seven weeks when siderophores were applied. This increased risk could be attributed to the facilitated translocation of As from roots to stems and leaves in P.cretica. Our results suggest that, when a phytoremediation strategy is considered for metals remediation, its ecological consequences should be taken into account to prevent the spread of hyperaccumulated heavy metals throughout the food chain of ecological receptors. Uncertainties involved in the ecological risk assessment process were also discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reducing O and M risks

International Nuclear Information System (INIS)

Patton, D.; LeMaster, D.

1991-01-01

This article examines the increasing requirement by investors and financiers of the use of an independent engineer for monitoring the performance of an independent energy project from the conceptual stage through the life span for the term of the loan. The topics include managing the risks from all perspectives, setting expectations, attention to detail. The article also includes a sidebar on loan agreement principles for operational facilities

DLP: REDUCED RISK OF LEAKAGE OF CONFIDENTIAL INFORMATION OF THE BANK

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T. A. Andryianava

2017-01-01

Full Text Available Research application of DLP-system for protection of confidential information, a methodology for adapting the DLP-system to the specific activities of the organization, comparative analysis of the results of standard and adapted DLP-systems in the Bank. Developed: a technique for analyzing information security events, algorithm for responding to identified events, methodology and procedures for adapting the standard DLP-system to the specifics of the Bank’s activities. The methodology for adapting a standard DLP-system to the specifics of the Bank’s work consists of the following activities: identification of critical corporate information categories, audit of information systems, description of current risks and their assessment, introduction of rules for Bank’s critical information and setting up a DLP system in accordance with the specifics of the Bank’s work. Modernization of the configuration of a standard DLP-system includes the following procedures: selection of confidential information of the Bank based on membership criteria, setting up detection, creating perimeters and developing an algorithm for responding to identified information security events in the Bank. The algorithm is designed to improve the efficiency of the response of information security officers in cases of incident detection and describes the stages of the subsequent actions. The results of the research prove that using an adapted DLP-system significantly reduces the number of false positives, increasing the accuracy of detecting confidential information and reducing the risk of leakage of critical information outside the corporate network. The application of the adapted DLP-system in the Bank allowed to increase the speed of response of information security specialists to the information security events detected by the DLP-system adapted to the Bank, and also allowed the DLP-system to transition from the copy mode to the blocking mode of illegitimate transfer

Regulatory risk assessments: Is there a need to reduce uncertainty and enhance robustness?

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Snodin, D J

2015-12-01

A critical evaluation of several recent regulatory risk assessments has been undertaken. These relate to propyl paraben (as a food additive, cosmetic ingredient or pharmaceutical excipient), cobalt (in terms of a safety-based limit for pharmaceuticals) and the cancer Threshold of Toxicological Concern as applied to food contaminants and pharmaceutical impurities. In all cases, a number of concerns can be raised regarding the reliability of the current assessments, some examples being absence of data audits, use of single-dose and/or non-good laboratory practice studies to determine safety metrics, use of a biased data set and questionable methodology and lack of consistency with precedents and regulatory guidance. Drawing on these findings, a set of recommendations is provided to reduce uncertainty and improve the quality and robustness of future regulatory risk assessments. © The Author(s) 2015.

Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial.

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Pai, Yi-Chung; Bhatt, Tanvi; Yang, Feng; Wang, Edward

2014-12-01

Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Healthy Dietary Pattern Reduces Lung Cancer Risk: A Systematic Review and Meta-Analysis.

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Sun, Yanlai; Li, Zhenxiang; Li, Jianning; Li, Zengjun; Han, Jianjun

2016-03-04

Diet and nutrients play an important role in cancer development and progress; a healthy dietary pattern has been found to be associated with several types of cancer. However, the association between a healthy eating pattern and lung cancer risk is still unclear. Therefore, we conducted a systematic review with meta-analysis to evaluate whether a healthy eating pattern might reduce lung cancer risk. We identified relevant studies from the PubMed and Embase databases up to October 2015, and the relative risks were extracted and combined by the fixed-effects model when no substantial heterogeneity was observed; otherwise, the random-effects model was employed. Subgroup and publication bias analyses were also performed. Finally, eight observational studies were included in the meta-analysis. The pooled relative risk of lung cancer for the highest vs. lowest category of healthy dietary pattern was 0.81 (95% confidence interval, CI: 0.75-0.86), and no significant heterogeneity was detected. The relative risks (RRs) for non-smokers, former smokers and current smokers were 0.89 (95% CI: 0.63-1.27), 0.74 (95% CI: 0.62-0.89) and 0.86 (95% CI: 0.79-0.93), respectively. The results remained stable in subgroup analyses by other confounders and sensitivity analysis. The results of our meta-analysis suggest that a healthy dietary pattern is associated with a lower lung cancer risk, and they provide more beneficial evidence for changing the diet pattern in the general population.

An Integrated Risk Index Model Based on Hierarchical Fuzzy Logic for Underground Risk Assessment

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Muhammad Fayaz

2017-10-01

Full Text Available Available space in congested cities is getting scarce due to growing urbanization in the recent past. The utilization of underground space is considered as a solution to the limited space in smart cities. The numbers of underground facilities are growing day by day in the developing world. Typical underground facilities include the transit subway, parking lots, electric lines, water supply and sewer lines. The likelihood of the occurrence of accidents due to underground facilities is a random phenomenon. To avoid any accidental loss, a risk assessment method is required to conduct the continuous risk assessment and report any abnormality before it happens. In this paper, we have proposed a hierarchical fuzzy inference based model for under-ground risk assessment. The proposed hierarchical fuzzy inference architecture reduces the total number of rules from the rule base. Rule reduction is important because the curse of dimensionality damages the transparency and interpretation as it is very tough to understand and justify hundreds or thousands of fuzzy rules. The computation time also increases as rules increase. The proposed model takes 175 rules having eight input parameters to compute the risk index, and the conventional fuzzy logic requires 390,625 rules, having the same number of input parameters to compute risk index. Hence, the proposed model significantly reduces the curse of dimensionality. Rule design for fuzzy logic is also a tedious task. In this paper, we have also introduced new rule schemes, namely maximum rule-based and average rule-based; both schemes can be used interchangeably according to the logic needed for rule design. The experimental results show that the proposed method is a virtuous choice for risk index calculation where the numbers of variables are greater.

Report: EPA’s Information Systems and Data Are at Risk Due to Insufficient Training of Personnel With Significant Information Security Responsibilities

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Report #14-P-0142, March 21, 2014. The EPA places its information systems and data at risk due to an organizational structure that has not specified required duties and responsibilities to ensure personnel are trained on key information security roles.

Study on the evaluation of radiation doses in dental radiography. Doses and risks due to dental full mouth examination

Energy Technology Data Exchange (ETDEWEB)

Sugimoto, K [Kanagawa Dental Coll., Yokosuka (Japan)

1980-09-01

Radiation doses and possible biological risks due to dental full mouth examination (adult: 10-film technique, child: 6-film technique) were evaluated based on preliminary experiments and statistical surveillance of patients' records. Dosimetrical studies were performed by using head and neck phantoms and a dental x-ray tube. Radiation doses were measured by x-ray films and thermoluminescence dosimeters. For the obtained doses of skin, eyes, thyroid gland and bone marrow, the biological risk of leukemia and thyroid cancer was discussed on the statistical basis of patients at Kanagawa Dental College Hospital. The major findings were as follows: The total number of patients who recieved full mouth x-ray examination at Kanagawa Dental College Hospital in 1978 was 1,099. The number of male patients was 382 (3,804 films) and that of female patients was 717 (7,138 films). In both sexes, the number of patients was the greatest in the group of 8 - 14 years of age. The collective doses of bone marrow due to full mouth 10-film examination performed at Kanagawa Dental College Hospital in 1978 were approximately 6.0 rad, which could induce leukemia with a probability of 1/8,000. The collective doses of thyroid gland were approximately 13 rad, which could induce lethal thyroid cancer with a probability of 1/15,000. The radiation dose due to the dental radiography for examination at Kanagawa Dental College Hospital was proved to be apparently below the level that could actually induce radiation injuries. But the collective radiation doses due to dental examination in Japan as a whole were approximately 8,000 times greater than that in Kanagawa Dental College Hospital.

Top 9 Ways to Reduce the Risk of Pneumonia If You or a Loved One Is Hospitalized

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... You website Home > Consumers > Monthly alerts for consumers Top 9 ways to reduce the risk of pneumonia ... is used on the patient, whether or not gloves are worn. In fact, healthcare providers should clean ...

Uterovaginal Anastomosis for Cases of Cryptomenorrhea Due to Cervical Atresia with Vaginal Aplasia: Benefits and Risks.

Science.gov (United States)

Zayed, M; Fouad, R; Elsetohy, K A; Hashem, A T; AbdAllah, A A; Fathi, A I

2017-12-01

The objective of this study was to assess short-term benefits and risks of utero-vaginal anastomosis done for cases of cryptomenorrhea due to cervical atresia with vaginal aplasia. Prospective study. Surgical procedures were done between December 2013 and September 2015 at the department of Obstetrics and Gynecology, Cairo University Hospital. Five patients who had cryptomenorrhea due to cervical atresia associated with vaginal aplasia were included. Utero-vaginal anastomoses were performed in 2 stages; a stage of McIndoe vaginoplasty and a stage of excision of the atretic cervical tissue and anastomosing the uterus to the neovagina. Follow-up was done by gynecological and ultrasound examination in a duration ranged from 12 to 36 months. Occurrence of regular menstrual flow and relief of the severe cyclic pain. All patients had relief of the severe cyclic pain. Four patients had regular menstrual flow. One patient developed occlusion of the track after 1 year and needed dilatation once. Three patients developed low vaginal stenosis without occlusion of the track. One patient had rectal injury repaired without causing postoperative morbidity. Uterovaginal anastomosis is a promising conservative management option for cervical atresia with vaginal aplasia, which has benefits but is not free of risks. Long-term follow-up is still needed to judge its feasibility. We recommend performing McIndoe vaginoplasty as a starting stage before the anastomosis preferably in a separate setting. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Reduced growth due to belowground sink limitation is not fully explained by reduced photosynthesis.

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Campany, Courtney E; Medlyn, Belinda E; Duursma, Remko A

2017-08-01

Sink limitation is known to reduce plant growth, but it is not known how plant carbon (C) balance is affected, limiting our ability to predict growth under sink-limited conditions. We manipulated soil volume to impose sink limitation of growth in Eucalyptus tereticornis Sm. seedlings. Seedlings were grown in the field in containers of different sizes and planted flush to the soil alongside freely rooted (Free) seedlings. Container volume negatively affected aboveground growth throughout the experiment, and light saturated rates of leaf photosynthesis were consistently lower in seedlings in containers (-26%) compared with Free seedlings. Significant reductions in photosynthetic capacity in containerized seedlings were related to both reduced leaf nitrogen content and starch accumulation, indicating direct effects of sink limitation on photosynthetic downregulation. After 120 days, harvested biomass of Free seedlings was on average 84% higher than seedlings in containers, but biomass distribution in leaves, stems and roots was not different. However, the reduction in net leaf photosynthesis over the growth period was insufficient to explain the reduction in growth, so that we also observed an apparent reduction in whole-plant C-use efficiency (CUE) between Free seedlings and seedlings in containers. Our results show that sink limitation affects plant growth through feedbacks to both photosynthesis and CUE. Mass balance approaches to predicting plant growth under sink-limited conditions need to incorporate both of these feedbacks. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Evidence Report: Risk of Performance Errors Due to Training Deficiencies

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Barshi, Immanuel; Dempsey, Donna L.

2016-01-01

Substantial evidence supports the claim that inadequate training leads to performance errors. Barshi and Loukopoulos (2012) demonstrate that even a task as carefully developed and refined over many years as operating an aircraft can be significantly improved by a systematic analysis, followed by improved procedures and improved training (see also Loukopoulos, Dismukes, & Barshi, 2009a). Unfortunately, such a systematic analysis of training needs rarely occurs during the preliminary design phase, when modifications are most feasible. Training is often seen as a way to compensate for deficiencies in task and system design, which in turn increases the training load. As a result, task performance often suffers, and with it, the operators suffer and so does the mission. On the other hand, effective training can indeed compensate for such design deficiencies, and can even go beyond to compensate for failures of our imagination to anticipate all that might be needed when we send our crew members to go where no one else has gone before. Much of the research literature on training is motivated by current training practices aimed at current training needs. Although there is some experience with operations in extreme environments on Earth, there is no experience with long-duration space missions where crews must practice semi-autonomous operations, where ground support must accommodate significant communication delays, and where so little is known about the environment. Thus, we must develop robust methodologies and tools to prepare our crews for the unknown. The research necessary to support such an endeavor does not currently exist, but existing research does reveal general challenges that are relevant to long-duration, high-autonomy missions. The evidence presented here describes issues related to the risk of performance errors due to training deficiencies. Contributing factors regarding training deficiencies may pertain to organizational process and training programs for

Cyber Risk Assessment of Transmission Lines in Smart Grids

Directory of Open Access Journals (Sweden)

Xuan Liu

2015-12-01

Full Text Available The increasing use of information technologies in power systems has increased the risk of power systems to cyber-attacks. In this paper, we assess the risk of transmission lines being overloaded due to cyber-based false data injection attacks. The cyber risk assessment is formulated as bilevel optimization problems that determine the maximum line flows under false data injection attacks. We propose efficient techniques to reduce the computation complexity of solving the bilevel problems. Specifically, primary and secondary filtering techniques are employed to identify the lines whose flows will never exceed their limits, which can significantly reduce computation burden. A special feasibility cut-based acceleration technique is introduced to further reduce the computation burden. The simulation results on the IEEE 30-bus, IEEE 118-bus, IEEE 300-bus and IEEE 2383-bus systems verify the proposed risk assessment model and the effectiveness of the proposed filtering and acceleration techniques.

Assessment of health risk due to PM 10 using fuzzy linear membership kriging with particle swarm optimization

International Nuclear Information System (INIS)

Singh, Jeetendra B.; Reddy, Vijay S.; Jana, Soumya; De, Swades

2013-01-01

Air quality is an important determinant of individual as well as broader well-being. Major pollutants include gasses as well as assorted suspended particulate matter (PM). In this paper, we focus on PM10, which are a collection of particles with median aerodynamic diameter less than 10 μm that remains suspended in the air for long periods. PM10, usually consist of smoke, dirt and dust particles, as well as spores and pollen, could easily be inhaled deep into lung. As a result, high outdoor PM10 concentration poses significant health hazard, and accurate modeling and prediction of health risk due to PM10 assume importance in pollution and public health management. In this backdrop, we propose an improved health risk assessment technique, and demonstrate its efficacy using widely used California PM10 database. At the heart of the proposed method lies indicator kriging, a well-known risk estimation technique. However, improved assessment of subjective health risk is achieved by posing the problem in a fuzzy setting, and optimizing the associated membership functions. In particular, we employ particle swarm optimization (PSO) algorithm, which has been motivated by natural behavior of organisms such as fish-schooling and bird flocking, and proven effective in various optimization contexts. We apply the fuzzy PSO membership grade kriging technique to predict the PM10 spatial distribution over the entire California state. (orig.)

Assessment of health risk due to PM 10 using fuzzy linear membership kriging with particle swarm optimization

Energy Technology Data Exchange (ETDEWEB)

Singh, Jeetendra B.; Reddy, Vijay S.; Jana, Soumya [Indian Institute of Technology, Hyderabad (India). Dept. of Electrical Engineering; De, Swades [Indian Institute of Technology, Delhi (India). Dept. of Electrical Engineering

2013-07-01

Air quality is an important determinant of individual as well as broader well-being. Major pollutants include gasses as well as assorted suspended particulate matter (PM). In this paper, we focus on PM10, which are a collection of particles with median aerodynamic diameter less than 10 {mu}m that remains suspended in the air for long periods. PM10, usually consist of smoke, dirt and dust particles, as well as spores and pollen, could easily be inhaled deep into lung. As a result, high outdoor PM10 concentration poses significant health hazard, and accurate modeling and prediction of health risk due to PM10 assume importance in pollution and public health management. In this backdrop, we propose an improved health risk assessment technique, and demonstrate its efficacy using widely used California PM10 database. At the heart of the proposed method lies indicator kriging, a well-known risk estimation technique. However, improved assessment of subjective health risk is achieved by posing the problem in a fuzzy setting, and optimizing the associated membership functions. In particular, we employ particle swarm optimization (PSO) algorithm, which has been motivated by natural behavior of organisms such as fish-schooling and bird flocking, and proven effective in various optimization contexts. We apply the fuzzy PSO membership grade kriging technique to predict the PM10 spatial distribution over the entire California state. (orig.)

Perception of health risks among adolescents due to consumption of cigarettes, alcohol and psychoactive substances in the Federation of Bosnia and Herzegovina.

Science.gov (United States)

Pilav, A; Rudić, A; Branković, S; Djido, V

2015-07-01

This article describes the perception of health risks in adolescents due to the consumption of cigarettes, alcohol and psychoactive substances in the Federation of Bosnia and Herzegovina (FBIH), as well as their observation of the behavior of their peers related to addictive behaviors. For the analysis was used a database from the European School Survey Project on Alcohol and Other Drugs (ESPAD) survey which was conducted in FBIH in 2011. The target population were students in the second grade of secondary schools in FBIH born in 1995 according to the ESPAD protocol. The total number of respondents from the cohort born in 1995 was 3813 students. The research results showed that the prevalence of risk perception due to the consumption of cigarettes, alcohol and psychoactive substances among adolescents in the FBIH is lower than the mean prevalence in countries which have implemented the ESPAD survey of 2011. PPreventive activities should be aimed at adolescent risk behaviours and empower them to make the right decisions that can have far reaching significance. Attention has to be paid to selective prevention that is directed towards individuals or subgroup of population where the risk of developing disorder is much higher than average. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Assessing Progress in Reducing the At-Risk Population after 13 Years of the Global Programme to Eliminate Lymphatic Filariasis

Science.gov (United States)

Hooper, Pamela J.; Chu, Brian K.; Mikhailov, Alexei; Ottesen, Eric A.; Bradley, Mark

2014-01-01

Background In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000—during which over 4.4 billion treatments have been distributed in 56 endemic countries—it is most appropriate to estimate the impact that the MDA has had on reducing the population at risk of LF. Methodology/Principal Findings To assess GPELF progress in reducing the population at-risk for LF, we developed a model based on defining reductions in risk of infection among cohorts of treated populations following each round of MDA. The model estimates that the number of people currently at risk of infection decreased by 46% to 789 million through 2012. Conclusions/Significance Important progress has been made in the global efforts to eliminate LF, but significant scale-up is required over the next 8 years to reach the 2020 elimination goal. PMID:25411843

Quantifying the dose-response of walking in reducing coronary heart disease risk: meta-analysis.

Science.gov (United States)

Zheng, Henry; Orsini, Nicola; Amin, Janaki; Wolk, Alicja; Nguyen, Van Thi Thuy; Ehrlich, Fred

2009-01-01

The evidence for the efficacy of walking in reducing the risk of and preventing coronary heart disease (CHD) is not completely understood. This meta-analysis aimed to quantify the dose-response relationship between walking and CHD risk reduction for both men and women in the general population. Studies on walking and CHD primary prevention between 1954 and 2007 were identified through Medline, SportDiscus and the Cochrane Database of Systematic Reviews. Random-effect meta-regression models were used to pool the relative risks from individual studies. A total of 11 prospective cohort studies and one randomized control trial study met the inclusion criteria, with 295,177 participants free of CHD at baseline and 7,094 cases at follow-up. The meta-analysis indicated that an increment of approximately 30 min of normal walking a day for 5 days a week was associated with 19% CHD risk reduction (95% CI = 14-23%; P-heterogeneity = 0.56; I (2) = 0%). We found no evidence of heterogeneity between subgroups of studies defined by gender (P = 0.67); age of the study population (P = 0.52); or follow-up duration (P = 0.77). The meta-analysis showed that the risk for developing CHD decreases as walking dose increases. Walking should be prescribed as an evidence-based effective exercise modality for CHD prevention in the general population.

Method for evaluation of risk due to seismic related design and construction errors based on past reactor experience

International Nuclear Information System (INIS)

Gonzalez Cuesta, M.; Okrent, D.

1985-01-01

This paper proposes a methodology for quantification of risk due to seismic related design and construction errors in nuclear power plants, based on information available on errors discovered in the past. For the purposes of this paper, an error is defined as any event that causes the seismic safety margins of a nuclear power plant to be smaller than implied by current regulatory requirements and industry common practice. Also, the actual reduction in the safety margins caused by the error will be called a deficiency. The method is based on a theoretical model of errors, called a deficiency logic diagram. First, an ultimate cause is present. This ultimate cause is consumated as a specific instance, called originating error. As originating errors may occur in actions to be applied a number of times, a deficiency generation system may be involved. Quality assurance activities will hopefully identify most of these deficiencies, requesting their disposition. However, the quality assurance program is not perfect and some operating plant deficiencies may persist, causing different levels of impact to the plant logic. The paper provides a way of extrapolating information about errors discovered in plants under construction in order to assess the risk due to errors that have not been discovered