WorldWideScience

Sample records for reported high risk

  1. Identifying Children at High Risk for a Child Maltreatment Report

    Science.gov (United States)

    Dubowitz, Howard; Kim, Jeongeun; Black, Maureen M.; Weisbart, Cindy; Semiatin, Joshua; Magder, Laurence S.

    2011-01-01

    Objective: To help professionals identify factors that place families at risk for future child maltreatment, to facilitate necessary services and to potentially help prevent abuse and neglect. Method: The data are from a prospective, longitudinal study of 332 low-income families recruited from urban pediatric primary care clinics, followed for…

  2. Surveillane of Middle and High School Mental Health Risk by Student Self-Report Screener

    Directory of Open Access Journals (Sweden)

    Bridget V Dever

    2013-08-01

    Full Text Available Introduction: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER for surveying community risk among 7 schools. Methods: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student. The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status.Results: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14% than boys (12%; middle school students reported fewer difficulties than high school students.Conclusion: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening viastudent self-report is potentially useful for identifying aggregated community

  3. High tech or high risk? An analysis of media reports about robotic surgery.

    Science.gov (United States)

    Ficko, Zita; Koo, Kevin; Hyams, Elias S

    2016-10-24

    Robotic surgery continues to increase in popularity and prevalence. The adoption of robotic technology has generated controversy and frequent media coverage. We evaluate recent reports of surgical robotics in the lay press to characterize its objectivity. LexisNexis and Factiva consumer news databases were queried for articles pertaining to robotic surgery published during 2010-2015 in the three highest circulation national (US) newspapers as well as New England regional newspapers. Two independent reviewers performed content analysis and assessed headline bias with strong reliability (mean κ = 0.96). 82 articles met inclusion criteria. Urological and gynecologic procedures were the most cited (54 and 57%, respectively). Commonly discussed aspects of robotic surgery included increased cost (45 articles, 55%), increased complications (38 articles, 43%), and easier recovery (32 articles, 39%). A minority of headlines (45%) had a neutral or unbiased tone. National newspapers were significantly more likely to report robotic surgery unfavorably by discussing disadvantages of the technology, only quoting surgeons with negative opinions, or citing scientific studies discrediting the robot (all p robotic surgery, while only 7 (26%) cited findings favoring robotic approaches. News reports about robotic surgery in the popular press contain a high proportion of negative bias. Non-neutral headlines and emphasis on research unfavorable to robotics were common. Clinicians should be aware of these reporting biases, which may affect patients' perceptions of robotic surgery.

  4. Montana Youth Risk Behavior Survey Report, 2005 for Montana High Schools: Statewide Analysis of Selected Behavior Risk Factors

    Science.gov (United States)

    Montana Office of Public Instruction, 2005

    2005-01-01

    The 2005 Youth Risk Behavior Survey (YRBS) report is a continuation of the surveillance and reporting system for adolescent risk behaviors developed by the Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention (CDC). The purpose of the Youth…

  5. Increased health risk in subjects with high self-reported seasonality.

    Directory of Open Access Journals (Sweden)

    Nicolas M Øyane

    Full Text Available BACKGROUND: Seasonal variations in mood and behaviour, termed seasonality, are commonly reported in the general population. As a part of a large cross-sectional health survey in Hordaland, Norway, we investigated the relationship between seasonality, objective health measurements and health behaviours. METHODOLOGY/PRINCIPAL FINDINGS: A total of 11,545 subjects between 40-44 years old participated, completing the Global Seasonality Score, measuring seasonality. Waist/hip circumference, BMI and blood pressure were measured, and blood samples were analyzed for total cholesterol, HDL cholesterol, triglycerides and glucose. Subjects also completed a questionnaire on miscellaneous health behaviours (exercise, smoking, alcohol consumption. Hierarchical linear regression analyses were used to investigate associations between seasonality and objective health measurements, while binary logistic regression was used for analysing associations between seasonality and health behaviours. Analyses were adjusted for sociodemographic factors, month of questionnaire completion and sleep duration. Seasonality was positively associated with high waist-hip-ratio, BMI, triglyceride levels, and in men high total cholesterol. Seasonality was negatively associated with HDL cholesterol. In women seasonality was negatively associated with prevalence of exercise and positively associated with daily cigarette smoking. CONCLUSIONS/SIGNIFICANCE: High seasonality was associated with objective health risk factors and in women also with health behaviours associated with an increased risk for cardiovascular disease.

  6. Auxiliary partial liver transplantation for acute liver failure using "high risk" grafts: Case report.

    Science.gov (United States)

    Duan, Wei-Dong; Wang, Xi-Tao; Wang, Hong-Guang; Ji, Wen-Bin; Li, Hao; Dong, Jia-Hong

    2016-02-07

    Acute liver failure (ALF) is a reversible disorder that is associated with an abrupt loss of hepatic mass, rapidly progressive encephalopathy and devastating complications. Despite its high mortality, an emergency liver transplantation nowadays forms an integral part in ALF management and has substantially improved the outcomes of ALF. Here, we report the case of a 32-year-old female patient who was admitted with grade IV hepatic encephalopathy (coma) following drug-induced ALF. We performed an emergency auxiliary partial orthotopic liver transplantation with a "high risk" graft (liver macrovesicular steatosis approximately 40%) from a living donor. The patient was discharged on postoperative day 57 with normal liver function. Weaning from immunosuppression was achieved 9 mo after transplantation. A follow-up using CT scan showed a remarkable increase in native liver volume and gradual loss of the graft. More than 6 years after the transplantation, the female now has a 4-year-old child and has returned to work full-time without any neurological sequelae.

  7. Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.

    Science.gov (United States)

    King, Rachel; Barker, Joseph; Nakayiwa, Sylvia; Katuntu, David; Lubwama, George; Bagenda, Danstan; Lane, Tim; Opio, Alex; Hladik, Wolfgang

    2013-01-01

    In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors.

  8. Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Rachel King

    Full Text Available In Uganda, men who have sex with men (MSM are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors.

  9. Screening for Autism Spectrum Disorders in 12-Month-Old High-Risk Siblings by Parental Report

    Science.gov (United States)

    Rowberry, Justin; Macari, Suzanne; Chen, Grace; Campbell, Daniel; Leventhal, John M.; Weitzman, Carol; Chawarska, Katarzyna

    2015-01-01

    This study examines whether parental report of social-communicative and repetitive behaviors at 12 months can be helpful in identifying autism spectrum disorder (ASD) in younger siblings of children with ASD [high-risk (HR)-siblings]. Parents of HR-siblings and infants without a family history of ASD completed the First Year Inventory at…

  10. Risk in financial reporting

    OpenAIRE

    Tsatsaronis, Kostas; Claudio E. V. Borio

    2015-01-01

    Advances in risk measurement technology have reshaped financial markets and the functioning of the financial system. More recently, they have been reshaping the prudential framework. Looking forward, they have the potential to reshape financial reporting too. Recent initiatives to improve financial reporting standards have brought to the fore significant differences in perspective between accounting standard setters and prudential authorities. Building on previous work, we argue that risk mea...

  11. Implications of Public Reporting of Risk-Adjusted Mortality Following Percutaneous Coronary Intervention: Misperceptions and Potential Consequences for High-Risk Patients Including Nonsurgical Patients.

    Science.gov (United States)

    Gupta, Anuj; Yeh, Robert W; Tamis-Holland, Jacqueline E; Patel, Shalin H; Guyton, Robert A; Klein, Lloyd W; Rab, Tanveer; Kirtane, Ajay J

    2016-10-24

    Assessment of clinical outcomes such as 30-day mortality following coronary revascularization procedures has historically been used to spur quality improvement programs. Public reporting of risk-adjusted outcomes is already mandated in several states, and proposals to further expand public reporting have been put forward as a means of increasing transparency and potentially incentivizing high quality care. However, for public reporting of outcomes to be considered a useful surrogate of procedural quality of care, several prerequisites must be met. First, the reporting measure must be truly representative of the quality of the procedure itself, rather than be dominated by other underlying factors, such as the overall level of illness of a patient. Second, to foster comparisons among physicians and institutions, the metric requires accurate ascertainment of and adjustment for differences in patient risk profiles. This is particularly relevant for high-risk clinical patient scenarios. Finally, the potential deleterious consequences of public reporting of a quality metric should be considered prior to expanding the use of public reporting more broadly. In this viewpoint, the authors review in particular the characterization of high-risk patients currently treated by percutaneous coronary interventional procedures, assessing the adequacy of clinical risk models used in this population. They then expand upon the limitations of 30-day mortality as a quality metric for percutaneous coronary intervention, addressing the strengths and limitations of this metric, as well as offering suggestions to enhance its future use in public reporting. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Auxiliary partial liver transplantation for acute liver failure using "high risk" grafts: Case report

    OpenAIRE

    Duan, Wei-Dong; Wang, Xi-Tao; Wang, Hong-Guang; Ji, Wen-Bin; Li, Hao; Jia-hong DONG

    2016-01-01

    Acute liver failure (ALF) is a reversible disorder that is associated with an abrupt loss of hepatic mass, rapidly progressive encephalopathy and devastating complications. Despite its high mortality, an emergency liver transplantation nowadays forms an integral part in ALF management and has substantially improved the outcomes of ALF. Here, we report the case of a 32-year-old female patient who was admitted with grade IV hepatic encephalopathy (coma) following drug-induced ALF. We performed ...

  13. High-Risk Pregnancy

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications High-Risk Pregnancy: Condition Information Skip sharing on social media links Share this: Page Content A high-risk pregnancy refers to anything that puts the ...

  14. Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR) of psychosis?: a case report

    OpenAIRE

    2012-01-01

    OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P) to treat individuals at ultra-high risk (UHR) of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS), the Scale of Prodromal Symptoms (SOPS), and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end...

  15. Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ji Hyeon; Kim, Yeon Joo; Kim, Young Seok [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2013-12-15

    To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer. Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions. The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity. WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.

  16. Framing recommendations to promote prevention behaviors among people at high risk: A simulation study of responses to melanoma genetic test reporting.

    Science.gov (United States)

    Taber, Jennifer M; Aspinwall, Lisa G

    2015-10-01

    A CDKN2A/p16 mutation confers 76 % lifetime risk of developing melanoma to US residents, and high-risk individuals are counseled to use sunscreen. Generally, for patients at population risk, gain framing more effectively promotes prevention behaviors; however, it is unknown whether loss frames might more effectively promote behavioral intentions and perceived control over disease risk among high-risk patients. Undergraduates (N = 146) underwent a simulated genetic counseling and test reporting session for hereditary melanoma. Participants watched a video of a genetic counselor providing information in which genetic risk of melanoma (Low: 15 %; High: 76 %) and framed recommendations to use sunscreen (Loss: Risk may increase by 15 % if don't use sunscreen; Gain: Risk may decrease by 15 % if use sunscreen) were manipulated. Controlling for baseline sunscreen use, high-risk participants given loss frames reported greater beliefs that sunscreen would reduce risk than high-risk participants given gain frames. Further, high-risk participants with fair skin tended to report greater intentions to use sunscreen when given loss frames versus gain frames. Perceived control over risk mediated the effect of message frame and disease risk on intentions to use sunscreen. When counseling patients with elevated cancer risk, genetic counselors may consider framing prevention behavioral recommendations in terms of potential losses.

  17. An Overview. High Risk Series.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  18. Do parents know best? Parent-reported vs. child-reported depression symptoms as predictors of future child mood disorder in a high-risk sample.

    Science.gov (United States)

    Lewis, Katie J S; Mars, Becky; Lewis, Gemma; Rice, Frances; Sellers, Ruth; Thapar, Ajay K; Craddock, Nicholas; Collishaw, Stephan; Thapar, Anita

    2012-12-10

    Parents with depression are thought to be unreliable reporters of children's depression symptoms, but findings are contradictory and primarily focus on discrepancies between parent and child reports rather than on the predictive validity of informants. Using a sample of parents with recurrent depression, our analyses utilised data from a prospective high-risk longitudinal study (the Early Prediction of Adolescent Depression study) to investigate whether baseline parental reports of child depression symptoms predicted new onset mood disorder (NOMD) in children. The sample included 287 parents with a history of recurrent depression and their adolescent offspring (aged 9-17 at baseline). Families were assessed at three time points. The Child and Adolescent Psychiatric assessment (parent and child versions) was used to assess the number of child depression symptoms (computed separately by informant at baseline) and NOMD at follow-up. All DSM-IV diagnoses were confirmed by two child psychiatrists. Parent reports of child depression symptoms at baseline significantly predicted NOMD in children. Secondary analyses stratifying the sample according to child age showed that, for younger children, parent reports were significantly better at predicting NOMD compared to child reports. For children aged 12 or older, there were no significant differences between parent and child reports in predicting NOMD. The pattern of association remained the same once we controlled for baseline levels of parental depression. Not all parents were currently experiencing an episode of depression at the baseline assessments; the sample consisted predominantly of mothers, thus findings may not be applicable to fathers or families without a history of parental depression. In this high risk sample, child and parent ratings of depression predict new onset child mood disorder to a similar degree. Clinicians and researchers should give due consideration to parent ratings of their children's depression

  19. High risk pregnancy

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-06-01

    Full Text Available It is estimated that roughly 20% of pregnancies fall into the high risk category, which in turn are responsible for over 80% of perinatal adverse outcome. Modern obstetrics has been very successful in reducing maternal morbidity and mortality. It has focused mainly on fetal and neonatal aspects, and on identifying the subgroup of pregnant women that need greater surveillance and care because of clearly identifiable risk factors. The article describes the preconceptional advice, its components and recommendations for its implementation, as well as its role in maternal and perinatal risk assessment. These interventions attempt to reduce the rates of maternal and perinatal mortality.

  20. Using parent and youth reports from the Behavior Assessment System for Children, Second Edition to identify individuals at clinical high-risk for psychosis.

    Science.gov (United States)

    Thompson, Elizabeth; Kline, Emily; Reeves, Gloria; Pitts, Steven C; Bussell, Kristin; Schiffman, Jason

    2014-04-01

    Brief self-report screening can help facilitate early identification of individuals at risk for or in early stages of psychosis. Existing screening tools focus on self-reported attenuated positive symptoms to detect potential risk; however, parent reports may also be helpful for assessing symptoms, especially in younger patients. Recent evidence has shown that the "atypicality" scale within the self-report form of the Behavior Assessment System for Children, Second Edition (BASC-2) may be useful for identifying high-risk youth within a more clinically comprehensive and potentially minimally stigmatizing format. The BASC-2 parent report form also includes the atypicality scale, but no research has investigated the relation of this scale to psychosis risk. The aim of the current study is to evaluate the association of parent along with youth reports of BASC-2 atypicality with attenuated positive symptoms as assessed by the Structured Interview for Psychosis-Risk Syndromes (SIPS), in a sample of help-seeking adolescents (n=63). Results indicate that both parent and youth reports of atypicality predict clinician-rated symptoms. Moreover, the combination of parent and youth report significantly improved prediction of SIPS scores over either single-informant scale. These findings suggest that parent report scales, as ascertained through part of a larger, commonly used measure, may help identify youth at risk for psychosis, particularly if used in conjunction with youth self-report. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR of psychosis?: a case report

    Directory of Open Access Journals (Sweden)

    Paula A. Martins

    2012-01-01

    Full Text Available OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P to treat individuals at ultra-high risk (UHR of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS, the Scale of Prodromal Symptoms (SOPS, and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end of PD-P. The evaluations were at baseline, after 6-, 12-, and 24-month follow-up. No medication was prescribed during the 24-month follow-up. RESULTS: The prodromal symptoms remitted. The initial total score on the SIPS/SOPS was 37 points. After the first 12 months of PD-P, there was a reduction to 12 points on the SIPS/SOPS score, which stabilized in the 24-month follow-up. There was also a slight improvement in his performance on the neuropsychological evaluations. CONCLUSION: This case report suggests that PD-P can reduce prodromal symptoms; nevertheless, a better understanding of the specificity and efficacy of PD-P as an option of treatment for UHR individuals is needed.

  2. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  3. Assessment as Intervention: Discerning the Needs of High-Risk Infants and Their Families. Final Report, 1986-1989.

    Science.gov (United States)

    Freund, Maxine B.

    The report documents activities of the 3-year (1986-1989) Assessment as Intervention Project at George Washington University (District of Columbia). Major activities of the project included: data collection with 25 families of newborn at-risk premature infants, including assessment-intervention sessions at 3, 6, 9, and 12 months of age; data…

  4. Pharmacology Risk Report

    Science.gov (United States)

    2010-01-01

    . Secondly, the integrity of stored pharmaceuticals must be established to ensure that adequate amounts of active compounds are available in each dose and that degradation to toxic compounds is minimized. This risk is also dependent on mission duration, since longer missions will require that drugs be stored much longer than their usual terrestrial shelf-lives.

  5. Brief report do university students have high cardiovascular risk? A pilot study from universiti malaysia sarawak (unimas).

    Science.gov (United States)

    Lee, Py; Ong, Ta; Muna, S; Syed Alwi, Sar; Kamarudin, K

    2010-01-01

    A health screening was done in UNIMAS in August 2008 for 237 undergraduate students. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured for all subjects. Total cholesterol and glucose levels were checked for those who fulfilled the screening criteria. The proportion of participants with cardiovascular (CVD) risk factors was high. The strategies for health promotion should not only be targeted to the older community but also to the younger community.

  6. Brief Report Do University Students Have High Cardiovascular Risk? A Pilot Study from Universiti Malaysia Sarawak (Unimas)

    OpenAIRE

    Lee, PY; Ong, TA; Muna, S; Syed Alwi, SAR; Kamarudin, K

    2010-01-01

    A health screening was done in UNIMAS in August 2008 for 237 undergraduate students. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured for all subjects. Total cholesterol and glucose levels were checked for those who fulfilled the screening criteria. The proportion of participants with cardiovascular (CVD) risk factors was high. The strategies for health promotion should not only be targeted to the older community but also to the younger community.

  7. Risk-based systems analysis of emerging high-level waste tank remediation technologies. Volume 2: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Peters, B.B.; Cameron, R.J.; McCormack, W.D. [Enserch Environmental Corp., Richland, WA (United States)

    1994-08-01

    The objective of DOE`s Radioactive Waste Tank Remediation Technology Focus Area is to identify and develop new technologies that will reduce the risk and/or cost of remediating DOE underground waste storage tanks and tank contents. There are, however, many more technology investment opportunities than the current budget can support. Current technology development selection methods evaluate new technologies in isolation from other components of an overall tank waste remediation system. This report describes a System Analysis Model developed under the US Department of Energy (DOE) Office of Technology Development (OTD) Underground Storage Tank-Integrated Demonstration (UST-ID) program. The report identifies the project objectives and provides a description of the model. Development of the first ``demonstration`` version of this model and a trial application have been completed and the results are presented. This model will continue to evolve as it undergoes additional user review and testing.

  8. Increased prevalence of self-reported psychotic illness predicted by crystal methamphetamine use: Evidence from a high-risk population.

    Science.gov (United States)

    Lappin, Julia M; Roxburgh, Amanda; Kaye, Sharlene; Chalmers, Jenny; Sara, Grant; Dobbins, Timothy; Burns, Lucinda; Farrell, Michael

    2016-12-01

    The potential of methamphetamine, and high-potency crystal methamphetamine in particular, to precipitate psychotic symptoms and psychotic illness is the subject of much speculation internationally. Established psychotic illness is disabling for individuals and costly to society. The aim of this study was to investigate whether use of crystal methamphetamine was associated with greater prevalence of self-reported psychotic illness, compared to use of other forms of methamphetamine. The sample comprised participants interviewed as part of an annual cross-sectional survey of Australian people who inject drugs. Comparisons were made between groups according to the nature of their methamphetamine use: crystal methamphetamine or other forms of methamphetamine. Self-reported diagnoses of psychotic illness and other mental health problems were compared between groups. Predictors of self-reported psychotic illness were examined using multivariable logistic regression analyses. Self-reported psychotic illness was highly prevalent among users of crystal methamphetamine (12.0%), and significantly more so than among users of other forms of methamphetamine (3.9%) (OR=3.36; CI: 1.03-10.97). Significant predictors of self-reported psychosis in the cohort were: use of crystal methamphetamine; dependent use; lack of education beyond high school; and younger age. Highly increased prevalence of self-reported psychotic illness is associated with use of high-potency crystal methamphetamine in people who inject drugs, particularly where there is dependent use. There is an urgent need to develop effective interventions for dependent crystal methamphetamine use; and a need to monitor for symptoms of psychotic illness in drug-using populations. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Aortic Valvuloplasty as Bridging for TAVI in High-Risk Patients with Heyde’s Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Cosmo Godino

    2012-01-01

    Full Text Available There is a frequent association between aortic valve stenosis and gastrointestinal bleeding, also known as Heyde’s syndrome. In these patients, the aortic valve replacement should be recommended as “gold standard.” In high-surgical-risk patients, the Transcatheter Aortic Valve Implantation (TAVI is an alternative option. However, the risk of bleeding recurrence, related to double antiplatelet therapy started after TAVI, cannot be excluded especially in the first months. We present a case of a patient with a severe aortic valve stenosis and a history of previously documented angiodysplasia and recurrence of gastrointestinal bleeding initially treated only with balloon aortic valvuloplasty that excluded recurrence of bleeding during the subsequent six months of followup. Therefore, a definite transfemoral Edwards XT valve implantation was planned to be performed in case of recurrence of aortic stenosis.

  10. Suicide Report: A Health Risk Behavior Comparison of Montana High School Students Based on Attempted Suicide. 2011 Montana Youth Risk Behavior Survey

    Science.gov (United States)

    Montana Office of Public Instruction, 2013

    2013-01-01

    The Montana Youth Risk Behavior Survey (YRBS) is administered by the Montana Office of Public Instruction every two years to students in grades 7 through 12. The purpose of the survey is to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems…

  11. Smokers Report: A Health Risk Behavior Comparison of Montana High School Students Based on Current Smoking. 2011 Montana Youth Risk Behavior Survey

    Science.gov (United States)

    Montana Office of Public Instruction, 2013

    2013-01-01

    The Montana Youth Risk Behavior Survey (YRBS) is administered by the Montana Office of Public Instruction every two years to students in grades 7 through 12. The purpose of the survey is to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems…

  12. The effect of integrated reporting on integrated thinking between risk ...

    African Journals Online (AJOL)

    The effect of integrated reporting on integrated thinking between risk, opportunity and strategy and the disclosure of risks and ... Southern African Business Review ... For this purpose, a web-based research questionnaire was sent to high-level ...

  13. Prediction of transition to psychosis in patients with a clinical high risk for psychosis: a systematic review of methodology and reporting.

    Science.gov (United States)

    Studerus, E; Ramyead, A; Riecher-Rössler, A

    2017-05-01

    To enhance indicated prevention in patients with a clinical high risk (CHR) for psychosis, recent research efforts have been increasingly directed towards estimating the risk of developing psychosis on an individual level using multivariable clinical prediction models. The aim of this study was to systematically review the methodological quality and reporting of studies developing or validating such models. A systematic literature search was carried out (up to 14 March 2016) to find all studies that developed or validated a clinical prediction model predicting the transition to psychosis in CHR patients. Data were extracted using a comprehensive item list which was based on current methodological recommendations. A total of 91 studies met the inclusion criteria. None of the retrieved studies performed a true external validation of an existing model. Only three studies (3.5%) had an event per variable ratio of at least 10, which is the recommended minimum to avoid overfitting. Internal validation was performed in only 14 studies (15%) and seven of these used biased internal validation strategies. Other frequently observed modeling approaches not recommended by methodologists included univariable screening of candidate predictors, stepwise variable selection, categorization of continuous variables, and poor handling and reporting of missing data. Our systematic review revealed that poor methods and reporting are widespread in prediction of psychosis research. Since most studies relied on small sample sizes, did not perform internal or external cross-validation, and used poor model development strategies, most published models are probably overfitted and their reported predictive accuracy is likely to be overoptimistic.

  14. New Onset of Chronic Diseases and Changes in Lifestyle Risk Factors Among Gulf War Veterans: A Longitudinal Comparison of High and Low Symptom Reporters.

    Science.gov (United States)

    Gwini, Stella M; Kelsall, Helen L; Ikin, Jil F; Sim, Malcolm R; McFarlane, Alexander C; Forbes, Andrew B

    2016-08-01

    The aim of this study was to compare new chronic diseases onset and longitudinal changes in lifestyle risk factors between Gulf War veterans with different symptom reporting. Data were collected from Gulf War veterans over two periods, and participants were grouped according to baseline symptom reporting. Logistic, nominal, and ordinal regressions were used for between-group comparisons. The veterans comprised low, moderate, and high symptom reporters. New onset of sleep apnea [odds ratio (OR) = 9.49; 95% confidence interval (CI) = 3.48 to 25.86], musculoskeletal (OR = 8.70; 95% CI = 4.17 to 18.17), psychological (OR = 5.36; 95% CI = 2.46 to 11.70), and cardiovascular (OR = 3.86; 95% CI = 1.33 to 11.23) conditions was elevated in high versus low symptom reporters. Although odds of obesity and alcohol use increased over time and smoking halved, the changes were similar across groups. These findings show increasing obesity and alcohol use, and indicate that high symptomatology among veterans may predict future disease onset.

  15. The Evolving Forms of Risk Reporting Practices

    DEFF Research Database (Denmark)

    Christiansen, Ulrik; Thrane, Sof; Andersen, Torben Juul

    reporting system. The risk management frameworks generally assume that information is communicated in exact codified form, but little research has analyzed the construction of risk when the reporting trespasses organizational levels. The managers in the middle however are often depicted as mediators between...... shaped by systematic variation in reporting practices at different hierarchical levels. Here the tactical middle layer adheres to temporalizing form of risk reporting practices in attempts to create flexibility within a rigid management reporting system....

  16. Performance and comparison of self-reported STI symptoms among high-risk populations - MSM, sex workers, persons living with HIV/AIDS - in El Salvador.

    Science.gov (United States)

    Shah, Neha S; Kim, Evelyn; de Maria Hernández Ayala, Flor; Guardado Escobar, Maria Elena; Nieto, Ana Isabel; Kim, Andrea A; Paz-Bailey, Gabriela

    2014-12-01

    Resource-limited countries have limited laboratory capability and rely on syndromic management to diagnose sexually transmitted infections (STIs). We aimed to estimate the sensitivity, specificity and positive predictive value (PPV) of STI syndromic management when used as a screening method within a study setting. Men who have sex with men (MSM), female sex workers (FSWs) and people living with HIV/AIDS (PLWHA) participated in a behavioural surveillance study. Data were obtained on demographics, sexual behaviours, STI history and service utilisation. Biological specimens were tested for genital inflammatory infections (Neisseria gonorrhoeae [GC], Chlamydia trachomatis [CT], Mycoplasma genitalium [MG], Trichomonas vaginalis [TV]) and genital ulcerative infection (syphilis and Herpes simplex virus-2). There was a high prevalence of Herpes simplex virus-2 (MSM 48.1%, FSW 82.0% and PLWHA 84.4%). Most participants reported no ulcerative symptoms and the majority of men reported no inflammatory symptoms. Sensitivity and PPV were poor for inflammatory infections among PLWHA and MSM. Sensitivity in FSWs for inflammatory infections was 75%. For ulcerative infections, sensitivity was poor, but specificity and PPV were high. Reliance on self-reported symptoms may not be an effective screening strategy for these populations. STI prevention studies should focus on symptom recognition and consider routine screening and referral for high-risk populations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Pathways and barriers to genetic testing and screening: Molecular genetics meets the high-risk family. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Duster, T.

    1998-11-01

    The proliferation of genetic screening and testing is requiring increasing numbers of Americans to integrate genetic knowledge and interventions into their family life and personal experience. This study examines the social processes that occur as families at risk for two of the most common autosomal recessive diseases, sickle cell disease (SC) and cystic fibrosis (CF), encounter genetic testing. Each of these diseases is found primarily in a different ethnic/racial group (CF in Americans of North European descent and SC in Americans of West African descent). This has permitted them to have a certain additional lens on the role of culture in integrating genetic testing into family life and reproductive planning. A third type of genetic disorder, the thalassemias was added to the sample in order to extent the comparative frame and to include other ethnic and racial groups.

  18. Intensity-modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high-risk prostate cancer: a preliminary report of disease control.

    Science.gov (United States)

    Saracino, Biancamaria; Petrongari, Maria Grazia; Marzi, Simona; Bruzzaniti, Vicente; Sara, Gomellini; Arcangeli, Stefano; Arcangeli, Giorgio; Pinnarò, Paola; Giordano, Carolina; Ferraro, Anna Maria; Strigari, Lidia

    2014-10-01

    The aim of the study was to report the clinical results in patients with high-risk prostate cancer treated with pelvic intensity-modulated radiation therapy (IMRT) and simultaneous integrated boost (SIB) to the prostate area. A total of 110 patients entered our study, 37 patients presented with localized prostate cancer and radiological evidence of node metastases or ≥15% estimated risk of lymph node (LN) involvement, while 73 patients underwent postoperative adjuvant or salvage irradiation for biochemical or residual/recurrent disease, LN metastases, or high risk of harboring nodal metastases. All patients received androgen deprivation therapy (ADT) for 2 years. The median follow-up was 56.5 months. For the whole patient group, the 3- and 5-year freedom from biochemical failure were 82.6% and 74.6%, respectively, with a better outcome in patients treated with radical approach. The 3- and 5-year freedom from local failure were 94.4% and 90.2%, respectively, while the 3- and 5-year distant metastasis-free survival were 87.8% and 81.7%, respectively. For all study patients, the rate of freedom from G2 acute rectal, intestinal, and urinary toxicities was 60%, 77%, and 61%, respectively. There was no G3 acute toxicity, ≥G2 late intestinal toxicity, or G3 late urinary or rectal toxicity. The 3- and 5-year ≥G2 freedom from late rectal toxicity rate were 98% and 95%, respectively, while the 3- and 5-year ≥G2 freedom from late urinary toxicity rate were 95% and 88%, respectively. The study concludes that pelvic IMRT and SIB to the prostatic area in association with 2-year ADT was a well-tolerated technique, providing high disease control in patients with prostate cancer requiring LN treatment.

  19. Not all risks are equal: the risk taking inventory for high-risk sports.

    Science.gov (United States)

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  20. The Evolving Forms of Risk Reporting Practices

    DEFF Research Database (Denmark)

    Christiansen, Ulrik; Thrane, Sof; Andersen, Torben Juul

    reporting system. The risk management frameworks generally assume that information is communicated in exact codified form, but little research has analyzed the construction of risk when the reporting trespasses organizational levels. The managers in the middle however are often depicted as mediators between......This study investigates the risk reporting between central administration and different operating units performed on major project investments supervised by the Danish Ministry of Defense. The study analyses how risk information is communicated across hierarchical levels based on a formalized risk...... intent communicated from top management and updated insights from the operating core. In order to analyze this intermediation and how reported risk develops across hierarchical levels, we conduct a temporal content analysis of 32 risk management reports exchanged between the central administration...

  1. Direct Adherence Measurement Using an Ingestible Sensor Compared With Self-Reporting in High-Risk Cardiovascular Disease Patients Who Knew They Were Being Measured: A Prospective Intervention

    Science.gov (United States)

    Thompson, David; Mackay, Teresa; Matthews, Maria; Edwards, Judith; Connolly, Susan B

    2017-01-01

    Background Use of appropriate cardioprotective medication is a cornerstone of cardiovascular disease prevention, but less-than-optimal patient adherence is common. Thus, strategies for improving adherence are recommended to adopt a multifaceted approach. Objective The objective of our study was to test a system comprising a biodegradable, ingestible sensor for direct measurement of medication ingestion in a group of patients at elevated cardiovascular risk attending a cardiac prevention and rehabilitation program. Methods In this prospective intervention trial in a single group of 21 patients running from April 2014 to June 2015, we measured adherence by self-report and adherence determined objectively by the system. The sensor emits a signal when it encounters the acidic environment of the stomach, detectable by an externally worn patch and linked software app. Longitudinal adherence data in the form of daily progress charts for sensed dosing events as compared with scheduled dosing are visible to patients on their tablet computer’s medication dosing app, thus providing patients with continuous medication adherence feedback. We sought feedback on patient acceptability by questionnaire assessment. Participants used the system for the 12-week period of their cardiac prevention and rehabilitation program. Results Only 1 patient at initial assessment and 1 patient at end-of-program assessment reported often missing medication. The remaining patients reported never missing medication or had missing data. Only 12 (57%) of patients overall achieved system-determined adherence of 80% or more, and 3 patients had scores below 40%. Participants reported high levels of acceptability. Conclusions This integrated system was well tolerated in a group of 21 patients over an appreciable time frame. Its ability to measure adherence reveals the sizeable disconnect between patient self-reported adherence and actual medication taking and has promising potential for clinical use as a

  2. Clinical high risk for psychosis

    DEFF Research Database (Denmark)

    van der Steen, Y; Gimpel-Drees, J; Lataster, T

    2017-01-01

    OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress sensitiza...

  3. At-Risk Students Report

    Science.gov (United States)

    Montana Office of Public Instruction, 2010

    2010-01-01

    Montana's definition of a basic system of quality public elementary and secondary schools includes educational programs for at-risk students (20-9-309, MCA). State statute defines an at-risk student as a "student who is affected by environmental conditions that negatively impact the student's educational performance or threaten a student's…

  4. Bimonthly half-dose ranibizumab in large pigment epithelial detachment and retinal angiomatous proliferation with high risk of retinal pigment epithelium tear: a case report

    Directory of Open Access Journals (Sweden)

    Monés J

    2013-06-01

    Full Text Available Jordi Monés,1,2 Marc Biarnés,1 Josep Badal11Institut de la Màcula i de la Retina, Barcelona, Spain; 2Barcelona Macula Foundation, Barcelona, SpainIntroduction: The management of large pigment epithelial detachments (PEDs associated with retinal angiomatous proliferation (RAP remains a challenge due to the high risk of retinal pigment epithelial (RPE tear. We describe the successful progressive anatomical result and the maintenance of visual acuity to bimonthly, half-dose ranibizumab in a patient with this condition.Purpose: To describe the management of a large PED secondary to RAP with bimonthly, half-dose ranibizumab.Method: Case report.Patient: A 71-year-old woman presented with visual symptoms due to an enlarged PED, compared with previous visits, secondary to a RAP lesion, with a visual acuity of 20/32. To reduce the risk of an RPE tear and a significant decrease in vision, we discussed with the patient the possibility of treating the lesion in a progressive manner, with more frequent but smaller doses of ranibizumab. The patient was treated biweekly with 0.25 mg of ranibizumab until flattening of the PED.Results: The large PED flattened progressively, and visual acuity was preserved with no adverse events.Discussion: The use of half-dose antiangiogenic therapy may be useful in managing large vascularized PED associated with RAP, in an attempt to reduce the risk of RPE tear.Keywords: age-related macular degeneration, pigment epithelial detachment, ranibizumab, retinal angiomatous proliferation, RPE tear

  5. Evidence Report: Risk of Renal Stone Formation

    Science.gov (United States)

    Sibonga, Jean D.; Pietrzyk, Robert

    2017-01-01

    The formation of renal stones poses an in-flight health risk of high severity, not only because of the impact of renal colic on human performance but also because of complications that could potentially lead to crew evacuation, such as hematuria, infection, hydronephrosis, and sepsis. Evidence for risk factors comes from urine analyses of crewmembers, documenting changes to the urinary environment that are conducive to increased saturation of stone-forming salts, which are the driving force for nucleation and growth of a stone nidus. Further, renal stones have been documented in astronauts after return to Earth and in one cosmonaut during flight. Biochemical analysis of urine specimens has provided indication of hypercalciuria and hyperuricemia, reduced urine volumes, and increased urine saturation of calcium oxalate and calcium phosphate. A major contributor to the risk for renal stone formation is bone atrophy with increased turnover of the bone minerals. Dietary and fluid intakes also play major roles in the risk because of the influence on urine pH (more acidic) and on volume (decreased). Historically, specific assessments on urine samples from some Skylab crewmembers indicated that calcium excretion increased early in flight, notable by day 10 of flight, and almost exceeded the upper threshold for normal excretion (300mg/day in males). Other crewmember data documented reduced intake of fluid and reduced intake of potassium, phosphorus, magnesium, and citrate (an inhibitor of calcium stone formation) in the diet. Hence, data from both short-duration and long-duration missions indicate that space travel induces risk factors for renal stone formation that continue to persist after flight; this risk has been documented by reported kidney stones in crewmembers.

  6. A Real World Report on Intravenous High-Dose and Non-High-Dose Proton-Pump Inhibitors Therapy in Patients with Endoscopically Treated High-Risk Peptic Ulcer Bleeding

    Directory of Open Access Journals (Sweden)

    Lung-Sheng Lu

    2012-01-01

    Full Text Available Background and Study Aims. The optimal dose of intravenous proton-pump inhibitor (PPI therapy for the prevention of peptic ulcer (PU rebleeding remains controversial. This study aimed to understand the real world experiences in prescribing high-dose PPI and non-high-dose PPI for preventing rebleeding after endoscopic treatment of high-risk PU. Patients and Methods. A total of 220 subjects who received high-dose and non-high-dose pantoprazole for confirmed acute PU bleeding that were successfully treated endoscopically were enrolled. They were divided into rebleeding (n=177 and non-rebleeding groups (n=43. Randomized matching of the treatment-control group was performed. Patients were randomly selected for non-high-dose and high-dose PPI groups (n=44 in each group. Results. Univariate analysis showed, significant variables related to rebleeding were female, higher creatinine levels, and higher Rockall scores (≧6. Before case-control matching, the high-dose PPI group had higher creatinine level, higher percentage of shock at presentation, and higher Rockall scores. After randomized treatment-control matching, no statistical differences were observed for rebleeding rates between the high-dose and non-high-dose groups after case-control matching. Conclusion. This study suggests that intravenous high-dose pantoprazole may not be superior to non-high-dose regimen in reducing rebleeding in high-risk peptic ulcer bleeding after successful endoscopic therapy.

  7. CORPORATE RISK REPORTING IN BOSNIA AND HERZEGOVINA

    OpenAIRE

    2015-01-01

    Corporate reporting in Bosnia and Herzegovina is traditionally focused on meeting the legislation frame for the financial reporting. Changes in business environment influence on business perspective of doing business but also on decision making process for wide range of corporate stakeholders. All the matters aforesaid contribute to the necessary changes in traditional financial reporting. Risk reporting is only a first step of corporate reporting process improvement. The institutional frames...

  8. Prevalence, Incidence, and Clearance of Anogenital Warts in Kenyan Men Reporting High-Risk Sexual Behavior, Including Men Who Have Sex With Men

    Science.gov (United States)

    Neme, Santiago; Wahome, Elizabeth; Mwashigadi, Grace; Thiong'o, Alexander N.; Stekler, Joanne D.; Wald, Anna; Sanders, Eduard J.; Graham, Susan M.

    2015-01-01

    Background. Human papillomavirus (HPV) causes a spectrum of disease, ranging from warts to cancer. Prevalence, incidence, and factors associated with anogenital warts in East African men are unknown. Methods. Kenyan men reporting high-risk sexual behavior were inspected for anogenital warts at enrollment and follow-up visits. Logistic regression was performed to identify associations with anogenital warts at baseline. Cox regression was performed to analyze predictors of incident anogenital warts, and Kaplan–Meier curves were used to estimate clearance. Results. Baseline anogenital wart prevalence in 1137 men was 2.9% (95% confidence interval [CI], 2.0%–4.0%) overall, 2.0% in human immunodeficiency virus (HIV)-uninfected men, and 9.4% in HIV-1-infected men (adjusted odds ratio, 5.43; 95% CI, 2.03–11.29). Over a median of 1.4 years, anogenital wart incidence among 1104 men was 5.3 (95% CI, 4.3–6.5) per 100 person-years. Having HIV-1 infection at baseline (adjusted hazard ratio [aHR], 1.66; 95% CI, 1.01–2.72) or a genital syndrome during follow-up (aHR, 4.78; 95% CI, 3.03–7.56) was associated with increased wart incidence. Wart clearance was lower in HIV-1-infected men (log-rank Pwart prevalence and incidence were increased in HIV-1-infected men, and anogenital warts co-occurred with other genital syndromes. Quadrivalent HPV vaccination should be recommended for young men in settings with high HIV-1 prevalence. PMID:26110169

  9. Managing Climate Risk. Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Obersteiner, M.; Mechler, R.; Nilsson, S. [International Institute for Applied Systems Analysis IIASA, Laxenburg (Austria); Azar, C. [Department of Physical Resource Theory, Chalmers University of Technology, Goeteborg University, Goeteborg (Sweden); Kossmeier, S. [Department of Economics and Finance, Institute for Advanced Studies, Vienna (Austria); Moellersten, K.; Yan, J. [Department of Chemical Engineering and Technology, Royal Institute of Technology KTH, Stockholm (Sweden); Read, P. [Economics Department, Massey University, Palmerston North (New Zealand); Yamagata, Y. [Climate Change Research Project, National Institute for Environmental Studies NIES, Ibaraki (Japan)

    2001-12-01

    At the heart of the traditional approach to strategy in the climate change dilemma lies the assumption that the global community, by applying a set of powerful analytical tools, can predict the future of climate change accurately enough to choose a clear strategic direction for it. We claim that this approach might involve underestimating uncertainty in order to lay out a vision of future events sufficiently precise to be captured in a discounted cost flow analysis in integrated assessment models. However, since the future of climate change is truly uncertain, this approach might at best be marginally helpful and at worst downright dangerous: underestimating uncertainty can lead to strategies that do not defend the world against unexpected and sometimes even catastrophic threats. Another danger lies on the other extreme: if the global community can not find a strategy that works under traditional analysis or if uncertainties are too large that clear messages are absent, they may abandon the analytical rigor of their planning process altogether and base their decisions on good instinct and consensus of some future process that is easy to agree upon. In this paper, we try to outline a system to derive strategic decisions under uncertainty for the climate change dilemma. What follows is a framework for determining the level of uncertainty surrounding strategic decisions and for tailoring strategy to that uncertainty. Our core argument is that a robust strategy towards climate change involves the building of a technological portfolio of mitigation and adaptation measures that includes sufficient opposite technological positions to the underlying baseline emission scenarios given the uncertainties of the entire physical and socioeconomic system in place. In the case of mitigation, opposite technological positions with the highest leverage are particular types of sinks. A robust climate risk management portfolio can only work when the opposite technological positions are

  10. Risk and causality in newspaper reporting.

    Science.gov (United States)

    Boholm, Max

    2009-11-01

    The study addresses the textual representation of risk and causality in news media reporting. The analytical framework combines two theoretical perspectives: media frame analysis and the philosophy of causality. Empirical data derive from selected newspaper articles on risks in the Göta älv river valley in southwest Sweden from 1994 to 2007. News media content was coded and analyzed with respect to causal explanations of risk issues. At the level of individual articles, this study finds that the media provide simple causal explanations of risks such as water pollution, landslides, and flooding. Furthermore, these explanations are constructed, or framed, in various ways, the same risk being attributed to different causes in different articles. However, the study demonstrates that a fairly complex picture of risks in the media emerges when extensive material is analyzed systematically.

  11. Validation of family cancer history data in high-risk families: the influence of cancer site, ethnicity, kinship degree, and multiple family reporters.

    Science.gov (United States)

    Tehranifar, Parisa; Wu, Hui-Chen; Shriver, Tom; Cloud, Ann J; Terry, Mary Beth

    2015-02-01

    Information on family cancer history (FCH) is often collected for first-degree relatives, but more extensive FCH information is critical for greater accuracy in risk assessment. Using self-reported diagnosis of cancer as the gold standard, we examined differences in the sensitivity and specificity of relative-reported FCH by cancer site, race/ethnicity, language preference, and kinship degree (1,524 individuals from 557 families; average number of relatives per family = 2.7). We evaluated the impact of FCH data collected in 2007-2013 from multiple relatives by comparing mean values and proportions for the number of relatives with any cancer, breast cancer, or ovarian cancer as reported by a single relative and by multiple relatives in the same family. The sensitivity of FCH was lower in Hispanics, Spanish-speaking persons, and third-degree relatives (e.g., for all cancers, sensitivities were 80.7%, 87.4%, and 91.0% for third-, second-, and first-degree relatives, respectively). FCH reported by multiple relatives included a higher number of relatives with cancer than the number reported by a single relative (e.g., mean increase of 1.2 relatives with any cancer), with more relatives diagnosed with any cancer, breast cancer, and ovarian cancer in 52%, 36% and 12% of families, respectively. Collection of FCH data from multiple relatives may provide a more comprehensive picture of FCH and may potentially improve risk assessment and preventive care. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Bridge to the Future. Addressing The Needs of Students At Risk during the High School Years. Technical Team Report. Submitted to the Commission for Students At Risk of School Failure.

    Science.gov (United States)

    Maryland State Dept. of Education, Baltimore.

    This report analyzes practices and conditions that seek to prevent at-risk behaviors among adolescents. Discussion begins with a description of the developmental tasks that adolescents need to complete before they can assume productive adult roles in society. While two conflicting views of adolescence are noted, the capacity of young people to…

  13. Intensive sequential chemotherapy (ISC 95) with growth factors and blood stem cell support in high-intermediate and high-risk (IPI 2 and IPI 3) aggressive non-Hodgkin's lymphoma: an oligocentric report on 42 patients.

    Science.gov (United States)

    Bouabdallah, R; Stoppa, A M; Rossi, J F; Lepeu, G; Coso, D; Xerri, L; Ladaique, P; Chabannon, C; Blaise, D; Bardou, V J; Alzieu, C; Gastaut, J A; Maraninchi, D

    1999-06-01

    We previously reported feasibility and efficacy of a monocentric pilot study of intensive sequential chemotherapy (ISC) in poor-risk aggressive non-Hodgkin's lymphoma (NHL) in patients or = 5 cm at diagnosis. Forty-two patients were enrolled in this study; 36 completed the treatment and received 75% or more of the planned DI for both Cy and Doxo. Median duration of grade 4 neutropenia was 14 days (range, 2 to 28) for the regimen as a whole, and median duration of rehospitalization for febrile neutropenia was 18 days (range, 4 to 41). Overall response rate was 83%, with 29 patients (69%) in complete response (CR). Six patients failed to respond and one died of toxicity. With a median follow-up of 22.5 months (range, 10 to 42), the 3-year event-free survival (EFS) is 55% (95% CI, 39-71), while disease-free survival (DFS) is 79% (95% CI, 63-95). Ambulatory ISC is accessible and feasible in an oligocentric study. PBSC allow repeated delivery of high-dose chemotherapy cycles, and result in encouraging CR, EFS, and DFS rates for poor-risk aggressive NHL's patients.

  14. Hematopoietic stem cell transplantation for children with high-risk acute lymphoblastic leukemia in first complete remission: a report from the AIEOP registry.

    Science.gov (United States)

    Fagioli, Franca; Quarello, Paola; Zecca, Marco; Lanino, Edoardo; Rognoni, Carla; Balduzzi, Adriana; Messina, Chiara; Favre, Claudio; Foà, Roberto; Ripaldi, Mimmo; Rutella, Sergio; Basso, Giuseppe; Prete, Arcangelo; Locatelli, Franco

    2013-08-01

    Children with high-risk acute lymphoblastic leukemia in first complete remission can benefit from allogeneic hematopoietic stem cell transplantation. We analyzed the outcome of 211 children with high-risk acute lymphoblastic leukemia in first complete remission who were given an allogeneic transplant between 1990 and 2008; the outcome of patients who, despite having an indication for transplantation and a suitable donor, did not receive the allograft for different reasons in the same time period was not analyzed. Sixty-nine patients (33%) were transplanted between 1990 and 1999, 58 (27%) between 2000 and 2005, and 84 (40%) between 2005 and 2008. A matched family donor was employed in 138 patients (65%) and an unrelated donor in 73 (35%). The 10-year probabilities of overall and disease-free survival were 63.4% and 61%, respectively. The 10-year cumulative incidences of transplantation-related mortality and relapse were 15% and 24%, respectively. After 1999, no differences in either disease-free survival or transplant-related mortality were observed in patients transplanted from unrelated or matched family donors. In multivariate analysis, grade IV acute graft-versus-host disease was an independent factor associated with worse disease-free survival. By contrast, grade I acute graft-versus-host disease and age at diagnosis between 1 and 9 years were favorable prognostic variables. Our study, not intended to evaluate whether transplantation is superior to chemotherapy for children with acute lymphoblastic leukemia in first complete remission and high-risk features, shows that the allograft cured more than 60% of these patients; in the most recent period, the outcome of recipients of grafts from matched family and unrelated donors was comparable.

  15. Adding dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block for amputation of lower limb in high-risk patient-a case report.

    Science.gov (United States)

    Wang, Chun-Guang; Ding, Yan-Ling; Han, Ai-Ping; Hu, Chang-Qing; Hao, Shi; Zhang, Fang-Fang; Li, Yong-Wang; Liu, Hu; Han, Zhe; Guo, De-Li; Zhang, Zhi-Qiang

    2015-01-01

    The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb. Dexmedetomidine 1 μg/kg was added to 0.33% ropivacaine for lumbar plexus and sciatic nerve block in this case for intra-operative anesthesia and post-operative analgesia. The sensory function was blocked fully for surgery and the duration of analgesia maintained 26 hours with haemodynamic stability and moderate sedation. The patient did not complain pain and require any supplementary analgesics after surgery. This case showed that adding 1 μg/kg dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block may be a feasible and safe technique for high-risk patients for lower limb surgery of amputation.

  16. Risk Factors for High Blood Pressure

    Science.gov (United States)

    ... Share this page from the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... Lifestyle Habits Unhealthy lifestyle habits can raise your risk for high blood pressure, and they include: Eating too much sodium or ...

  17. Evidence Report: Risk of Radiation Carcinogenesis

    Science.gov (United States)

    Huff, Janice; Carnell, Lisa; Blattnig, Steve; Chappell, Lori; Kerry, George; Lumpkins, Sarah; Simonsen, Lisa; Slaba, Tony; Werneth, Charles

    2016-01-01

    As noted by Durante and Cucinotta (2008), cancer risk caused by exposure to space radiation is now generally considered a main hindrance to interplanetary travel for the following reasons: large uncertainties are associated with the projected cancer risk estimates; no simple and effective countermeasures are available, and significant uncertainties prevent scientists from determining the effectiveness of countermeasures. Optimizing operational parameters such as the length of space missions, crew selection for age and sex, or applying mitigation measures such as radiation shielding or use of biological countermeasures can be used to reduce risk, but these procedures have inherent limitations and are clouded by uncertainties. Space radiation is comprised of high energy protons, neutrons and high charge (Z) and energy (E) nuclei (HZE). The ionization patterns and resulting biological insults of these particles in molecules, cells, and tissues are distinct from typical terrestrial radiation, which is largely X-rays and gamma-rays, and generally characterized as low linear energy transfer (LET) radiation. Galactic cosmic rays (GCR) are comprised mostly of highly energetic protons with a small component of high charge and energy (HZE) nuclei. Prominent HZE nuclei include He, C, O, Ne, Mg, Si, and Fe. GCR ions have median energies near 1 GeV/n, and energies as high as 10 GeV/n make important contributions to the total exposure. Ionizing radiation is a well known carcinogen on Earth (BEIR 2006). The risks of cancer from X-rays and gamma-rays have been established at doses above 50 mSv (5 rem), although there are important uncertainties and on-going scientific debate about cancer risk at lower doses and at low dose rates (leads to significant uncertainties in projecting cancer risks during space exploration (Cucinotta and Durante 2006; Durante and Cucinotta 2008).

  18. Isolated low high density lipoprotein-cholesterol (HDL-C: implications of global risk reduction. Case report and systematic scientific review

    Directory of Open Access Journals (Sweden)

    Tyagi Suresh C

    2005-01-01

    Full Text Available Abstract Background The importance of low high-density lipoprotein cholesterol (HDL-C, elevated non HDL-C (as part of the metabolic syndrome, prediabetes, and type 2 diabetes mellitus, and an isolated low HDL-C is rapidly emerging. The antiatherosclerotic roles of reverse cholesterol transport and the pleiotropic antioxidant – anti-inflammatory mechanistic effects of HDL-C are undergoing rapid exponential growth. Case presentation In 1997 a 53-year-old Caucasian male presented with a lipoprotein profile of many years duration with an isolated low HDL-C and uric acid levels in the upper quintile of normal. He developed an acute myocardial infarction involving the right coronary artery and had percutaneous transluminal coronary angioplasty with stenting of this lesion. He also demonstrated a non-critical non-flow limiting lesion of the proximal left anterior descending coronary artery at the time of this evaluation. Following a program of global risk reduction this patient has done well over the past 7 years and remains free of any clinical signs and symptoms of atherosclerosis. His HDL-C and uric acid levels are currently in the normal physiological range. Conclusion Low HDL-C and isolated low HDL-C constitute an important risk factor for atherosclerosis. Therapies that lead to a return to normal physiologic range of HDL-C may result in the delay of atherosclerotic progression.

  19. Risk assessment meta tool LDRD final report.

    Energy Technology Data Exchange (ETDEWEB)

    Bouchard, Ann Marie; Osbourn, Gordon Cecil

    2006-12-01

    The goal of this project was to develop a risk analysis meta tool--a tool that enables security analysts both to combine and analyze data from multiple other risk assessment tools on demand. Our approach was based on the innovative self-assembling software technology under development by the project team. This technology provides a mechanism for the user to specify his intentions at a very high level (e.g., equations or English-like text), and then the code self-assembles itself, taking care of the implementation details. The first version of the meta tool focused specifically in importing and analyzing data from Joint Conflict and Tactical Simulation (JCATS) force-on-force simulation. We discuss the problem, our approach, technical risk, and accomplishments on this project, and outline next steps to be addressed with follow-on funding.

  20. Performance of Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) in discriminating indeterminate lesions at low and high risk of malignancy. A systematic review and meta-analysis.

    Science.gov (United States)

    Trimboli, Pierpaolo; Crescenzi, Anna; Giovanella, Luca

    2017-08-07

    Italian consensus for the classification and reporting of thyroid cytology was published in 2014 and it has been used in almost all Italian institutions. To date, there are not solid data on the reliability of Italian consensus for the classification and reporting of thyroid cytology in classifying low and high risk indeterminate nodules (Tir 3A and Tir 3B, respectively). Here, we reviewed and meta-analyzed the results of published articles to obtain evidence-based information on this topic. A comprehensive literature exploration of online databases was conducted by searching all published papers citing Italian consensus for the classification and reporting of thyroid cytology. The search was updated until June 2017, and references of the retrieved articles were also screened. Only original articles reporting histologic follow-up of nodules cytologically classified as Tir 3A and Tir 3B were eligible for inclusion. The literature search revealed 62 articles and six of these were eligible for the study. All papers were retrospective and published very recently. Overall, 423 indeterminate lesions, of which 180 Tir 3A and 243 Tir 3B, were found. Of these, 29 cancers were recorded in Tir 3A and 127 in Tir 3B. The pooled rate of malignancy was 17% (95% CI = 12 to 22%) in Tir 3A and 52% (95% CI = 46 to 58%) in Tir 3B. No significant publication bias was evident. Italian consensus for the classification and reporting of thyroid cytology 2014 shows high reliability in discriminating indeterminate lesions at low risk of malignancy from those at high risk.

  1. North Carolina Youth Risk Behavior Survey: 2013 WCPSS High School Results. Data Trends. D&A Report No. 14.06

    Science.gov (United States)

    Townsend, Megan

    2014-01-01

    The 2013 North Carolina Youth Risk Behavior Survey (NCYRBS) was developed by the Centers for Disease Control and Prevention (CDC) and adapted by the North Carolina Department of Public Instruction (NCDPI) to monitor the health-risk behaviors and to measure progress toward achieving Healthy North Carolina 2020 objectives. The survey, administered…

  2. Characteristics Predicting Tuberculosis Risk under Tumor Necrosis Factor-α Inhibitors: Report from a Large Multicenter Cohort with High Background Prevalence.

    Science.gov (United States)

    Kisacik, Bunyamin; Pamuk, Omer Nuri; Onat, Ahmet Mesut; Erer, Sait Burak; Hatemi, Gulen; Ozguler, Yesim; Pehlivan, Yavuz; Kilic, Levent; Ertenli, Ihsan; Can, Meryem; Direskeneli, Haner; Keser, Gökhan; Oksel, Fahrettin; Dalkilic, Ediz; Yilmaz, Sedat; Pay, Salih; Balkarli, Ayse; Cobankara, Veli; Cetin, Gözde Yildirim; Sayarlioglu, Mehmet; Cefle, Ayse; Yazici, Ayten; Avci, Ali Berkant; Terzioglu, Ender; Ozbek, Suleyman; Akar, Servet; Gul, Ahmet

    2016-03-01

    Screening strategies for latent tuberculosis (TB) before starting tumor necrosis factor (TNF)-α inhibitors have decreased the prevalence of TB among patients who are treated with these agents. However, despite vigilant screening, TB continues to be an important problem, especially in parts of the world with a high background TB prevalence. The aim of this study was to determine the factors related to TB among a large multicenter cohort of patients who were treated with anti-TNF. Fifteen rheumatology centers participated in this study. Among the 10,434 patients who were treated with anti-TNF between September 2002 and September 2012, 73 (0.69%) had developed TB. We described the demographic features and disease characteristics of these 73 patients and compared them to 7695 patients who were treated with anti-TNF, did not develop TB, and had complete data available. Among the 73 patients diagnosed with TB (39 men, 34 women, mean age 43.6 ± 13 yrs), the most frequent diagnoses were ankylosing spondylitis (n = 38) and rheumatoid arthritis (n = 25). More than half of the patients had extrapulmonary TB (39/73, 53%). Six patients died (8.2%). In the logistic regression model, types of anti-TNF drugs [infliximab (IFX), OR 3.4, 95% CI 1.88-6.10, p = 0.001] and insufficient and irregular isoniazid use (< 9 mos; OR 3.15, 95% CI 1.43-6.9, p = 0.004) were independent predictors of TB development. Our results suggest that TB is an important complication of anti-TNF therapies in Turkey. TB chemoprophylaxis less than 9 months and the use of IFX therapy were independent risk factors for TB development.

  3. Preliminary report on hepatic and cardiovascular risk assessment of ...

    African Journals Online (AJOL)

    Preliminary report on hepatic and cardiovascular risk assessment of ... The triglyceride level, artherogenic and coronary risk index of the mechanics was higher ... risk, mechanics, lipid profile, cardiovascular disease, liver dysfunction, benzene.

  4. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  5. Understand Your Risk for High Cholesterol

    Science.gov (United States)

    ... Aortic Aneurysm More Understand Your Risk for High Cholesterol Updated:Apr 1,2016 LDL (bad) cholesterol is ... content was last reviewed on 04/21/2014. Cholesterol Guidelines: Putting the pieces together Myth vs. Truth – ...

  6. High Blood Pressure May Hike Dementia Risk

    Science.gov (United States)

    ... fullstory_161398.html High Blood Pressure May Hike Dementia Risk New statement from American Heart Association warns ... in middle age, might open the door to dementia, the American Heart Association warns in a new ...

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

    Science.gov (United States)

    2010-07-01

    the combat readiness of Soldiers by ensuring a drug free environment.69 ASAP provides commanders with a mechanism for testing and treating those who...describes the processes in place to detect potentially high risk behavior. It is the duty of every leader to understand the mechanisms in place that are...amphetamines such as ecstasy . ARMY HP/RR/SP REPORT 2010 54 The Department of Defense requires a minimum of 20% of all samples be tested against the

  8. Planning High-Risk High-Reward Activities.

    NARCIS (Netherlands)

    Casault, Sébastien

    2014-01-01

    This body of work addresses a gap in financial and economic theories related to assets that are typically associated with high uncertainty. Specifically, this thesis provides some foundational work towards a new way to quantify and explain how high-risk high-reward activities, such as exploration,

  9. Assessment of knowledge, awareness, and self-reported risk factors for type II diabetes among adolescents.

    Science.gov (United States)

    Mahajerin, Arash; Fras, Andrew; Vanhecke, Thomas E; Ledesma, Jeremiah

    2008-08-01

    This study assessed adolescents' level of knowledge of and self-reported risk factors for type II diabetes mellitus (T2DM). We found adolescents had a relatively high level of knowledge and perception of health consequences from T2DM, but also had a high rate of self-reported risk factors.

  10. Psychological implications of high-risk pregnancy.

    Science.gov (United States)

    Cumberbatch, Carla-Joy; Birndorf, Catherine; Dresner, Nehama

    2005-01-01

    The psychological adjustments of "normal" pregnancy are complex, and those of high-risk pregnancy are even more pronounced and severe. A pregnancy may be determined to be at high risk because of obstetric factors in previous pregnancies or the present one; more general medical factors, such as preexisting or emergent disease (often, diabetes); and conditions that are, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which are a background for a disturbed pregnancy and might complicate a pregnancy denominated high risk for some other reason. This paper discusses these concepts and, in addition, includes sections on pregnancy in adolescence, in the developmentally disabled, and in the situation of chemical dependence (substance abuse).

  11. High risk process control system assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

    2009-07-01

    The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

  12. Psychological profile of high risk sports athlets

    Directory of Open Access Journals (Sweden)

    Tanja Kajtna

    2004-05-01

    Full Text Available The research attempted to compose a psycjhological profile of high risk sports athletes, based on personality, values and sensation seeking. 38 high risk sports athletes participated in the research (alpinists, sky divers, parachute gliders, white water kayakers, downhill mountain bikers, motocross riders, downhill skiers and Nordic jumpers, the non risk sports athletes consisted of 38 swimmers, track athletes, sailers, still water kayakers, rowers, Nordic skiers, sports climbers and karate players, whereas non athletes were equalled with both groups in age and education and included 76 non athletes. We used the self descriptive scale Big five observer, Musek's Value scale and Zuckerman' Sensation seeking scale IV. The dimensions, obtained from the discrimination analysis, were named personality maturity and sensation seeking in a social environment. Our results show that high risk sports athletes are more mature personalities than non risk sports athletes and non athletes and that they do not attempt to find stimulation in social environments. We also suggest some possibilities for further research.

  13. Risk Factors for Self-Reported Colon Polyps

    Science.gov (United States)

    Kahn, Henry S; Tatham, Lilith M; Thun, Michael J; Heath, Clark W

    1998-01-01

    OBJECTIVE Investigate risk factors for colon polyp using multivariate analyses. DESIGN In a group responding to a 1992 mail survey, we assessed the association between physician-diagnosed colon polyp and possible risk factors reported primarily 10 years earlier. SETTING Survey respondents within the Cancer Prevention Study II. PARTICIPANTS Respondents, 72,868 men and 81,356 women, who reported no polyp diagnosis when questioned in 1982 at ages 40 to 64 years. MEASUREMENTS AND MAIN RESULTS The characteristics of 7,504 men (10.3%) and 5,111 women (6.3%) reporting a first colon polyp were compared with those of participants who did not report a polyp. After adjustments for age, family history of colorectal cancer, and other potential risk factors, polyp occurrence was associated with 1982 histories of smoking, former smoking, alcohol use of at least two drinks per day (odds ratios [ORs] from 1.5 to 1.1; all p < .005), and a body mass index ≥ 28 kg/m 2(men's OR 1.06; 95% confidence interval [CI] 1.00, 1.13; women's OR 1.08; 95% CI 0.99, 1.17). Polyps were also associated with a diagnosis of gallbladder disease or gallstone at any time and with gallbladder surgery up to 1982 (OR from 2.7 to 1.3; all p < .001). Polyp occurrence was inversely associated with 1982 histories of high exercise level (men's OR 0.83; 95% CI 0.76, 0.91; women's OR 0.90; 95% CI 0.78, 1.03), frequent aspirin use in women (OR 0.85; 95% CI 0.77, 0.95), and high parity in women (OR 0.84; 95% CI 0.75, 0.94). Among participants lacking a clinically normal gallbladder, the polyp risks associated with smoking and high body mass index were reduced (p < .04 for interactions). CONCLUSIONS Despite the limitations and potential biases in these self-reported data, the risk factors described here may be useful for identifying persons at modestly increased risk of having a colon polyp. The effect-modifying role of gallbladder status deserves further investigation. PMID:9613885

  14. Identification of Patients at High Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Igor V. Sergienko, PhD, ScD

    2012-06-01

    Full Text Available Objective: To identify individuals at high cardiovascular risk (CVR to check for an additional estimate of CVR with the use of the ESH/ESC Guidelines (2003, 2007 in patients earlier classified as being at low and moderate risk on «SCORE». Material and methods: The study included 600 people (155 men and 445 women with low and moderate cardiovascular risk on the SCORE scale. All patients were examined with duplex scanning of the carotid arteries (DSCA to the determined of the thickness of the intima – media (IMT, the presence of atherosclerotic plaques (ASP; it has also been performed sphygmographic computer (SC with automatic estimation of brachial-ankle pulse wave velocity (baPWV, biochemical analysis of blood lipid spectrum. Results: The frequency of ASP was 59.5% (357 out of 600, and a thickening of thecomplex "intima-media" (IMT> 0.9 mm was detected in only 5% of the cases (28 persons out of 600, that indicated a slight contribution to the magnitude of the risk of such parameters as the IMT. The total number of patients with signs of preclinicallesions of the arterial wall (the presence of ASP and/or increased baPWV was 337 (56% of 600. Our results showed that the presence of subclinical atherosclerosis is in itself a risk factor. Conclusion: The usage of instrumental methods of research (DSCA, SC allowed to detect 32% of individuals with high CVR from 600 previously classified as low and moderate risk on SCORE scale. In our opinion, the proposed algorithm is convenient and easy to use for transfer of the patients into high-risk group.

  15. 75 FR 58468 - Terrorism Risk Insurance Program; Program Loss Reporting

    Science.gov (United States)

    2010-09-24

    ... Terrorism Risk Insurance Program; Program Loss Reporting AGENCY: Departmental Offices, Terrorism Risk...(c)(2)(A)). Currently, the Terrorism Risk Insurance Program Office is seeking comments regarding... or by mail (if hard copy, preferably an original and two copies) to: Terrorism Risk Insurance Program...

  16. Early Identification of Educationally High Potential and High Risk Children.

    Science.gov (United States)

    Keogh, Barbara K.; Smith, Carol E.

    Early identification of educationally high potential and high risk children was investigated by following the same 49 children from kindergarten entrance through grade five of a regular school program. Kindergarten predictive measures were the Bender Gestalt Test and teachers' evaluations; follow-up measures were yearly standard achievement test…

  17. Breast MRI in high risk patients

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie)

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital

  18. Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Gyanendra Kumar Acharya

    2015-01-01

    Full Text Available Thrombus-in-transit is not uncommon in pulmonary embolism but Right Heart Transvalvular Embolus (RHTVE complicating this is rare. A 54-year-old obese male with recent hospitalization presented with severe dyspnea and collapse. Initial investigations revealed elevated d-dimer and troponin. CTA showed saddle pulmonary embolus and bedside echocardiogram revealed right ventricular (RV pressure overload and dilatation (RV > 41 mm, McConnell’s sign, and mobile echodensity attached to tricuspid valve. Patient was immediately resuscitated and promptly transferred for surgical embolectomy under cardiopulmonary bypass. A long segment of embolus traversing through the tricuspid valve and extensive bilateral pulmonary artery embolus were removed. IVC filter was placed for a persistent right lower extremity DVT. Hypercoagulable work-up was negative. Patient continued to do well after discharge on Coumadin. Open embolectomy offers great promises where there is no consensus in optimal management approach in such patients. Bedside echocardiogram is vital in risk stratification and deciding choice of advanced PE treatment.

  19. 基于ASP.NET的护理高危不良事件报告系统研发与应用%Study and Application of Nursing High-risk Adverse Events Report System on ASP.NET

    Institute of Scientific and Technical Information of China (English)

    李泰环; 陆霞

    2011-01-01

    Objective: Implementation the nursing high risk adverse events reporting system, strengthen the nursing safety management. Methods: Extract data of the system needs in hospital information system (HIS), while adding part of the data tables in HIS , adopting of B/S architecture, in Visual Studio2008 development platform, using ASP. NET platform architecture and C# development language, system was developed. Result: All functions of the nursing risk adverse event reporting system was implemented, at present, the system is running stably. Conclusion: Using the system, supervision of the nursing high risk adverse events was realized, the safety management of high-risk patients was ensured, the work efficiency and management quality was improved, a strong information security was provided for the nursing department leadership decision-making, at the same time, it make information management and decision-making capacity of the nursing administrators was improved, the standardization and informatization of care management was achieved.%目的:实现护理高危不良事件报告系统,强化护理安全管理.方法:从医院信息系统(HIS)中提取该系统需要的数据,同时在HIS系统中新增部分数据表,采用B/S架构,在Visual Studio2008开发平台下,使用ASP.NET平台架构和C#开发语言进行系统的研发.结果:实现了护理高危不良事件报告系统的各项功能,目前系统在全院的各科室运行稳定.结论:利用该系统,能够实现护理高危不良事件的监管,保证了对高危病人的安全管理,提高了护理工作效率和管理质量;为护理部领导决策提供了有力的信息保障,提高了护理管理者的信息管理和决策能力,实现了护理管理的规范化和信息化.

  20. Cardiovascular risk factors in high-need psoriasis patients and its implications for biological therapies.

    NARCIS (Netherlands)

    Driessen, R.J.B.; Boezeman, J.B.M.; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de

    2009-01-01

    BACKGROUND: The associations between psoriasis and cardiovascular risk factors are reported to be stronger as psoriasis severity increases. This makes studying cardiovascular risk factors in high-need psoriasis patients, eligible for biological therapy, interesting. OBJECTIVE: To survey the prevalen

  1. High-Level Waste Melter Study Report

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Joseph M.; Bickford, Dennis F.; Day, Delbert E.; Kim, Dong-Sang; Lambert, Steven L.; Marra, Sharon L.; Peeler, David K.; Strachan, Denis M.; Triplett, Mark B.; Vienna, John D.; Wittman, Richard S.

    2001-07-13

    At the Hanford Site in Richland, Washington, the path to site cleanup involves vitrification of the majority of the wastes that currently reside in large underground tanks. A Joule-heated glass melter is the equipment of choice for vitrifying the high-level fraction of these wastes. Even though this technology has general national and international acceptance, opportunities may exist to improve or change the technology to reduce the enormous cost of accomplishing the mission of site cleanup. Consequently, the U.S. Department of Energy requested the staff of the Tanks Focus Area to review immobilization technologies, waste forms, and modifications to requirements for solidification of the high-level waste fraction at Hanford to determine what aspects could affect cost reductions with reasonable long-term risk. The results of this study are summarized in this report.

  2. High-Level Waste Melter Study Report

    Energy Technology Data Exchange (ETDEWEB)

    Perez Jr, Joseph M; Bickford, Dennis F; Day, Delbert E; Kim, Dong-Sang; Lambert, Steven L; Marra, Sharon L; Peeler, David K; Strachan, Denis M; Triplett, Mark B; Vienna, John D; Wittman, Richard S

    2001-07-13

    At the Hanford Site in Richland, Washington, the path to site cleanup involves vitrification of the majority of the wastes that currently reside in large underground tanks. A Joule-heated glass melter is the equipment of choice for vitrifying the high-level fraction of these wastes. Even though this technology has general national and international acceptance, opportunities may exist to improve or change the technology to reduce the enormous cost of accomplishing the mission of site cleanup. Consequently, the U.S. Department of Energy requested the staff of the Tanks Focus Area to review immobilization technologies, waste forms, and modifications to requirements for solidification of the high-level waste fraction at Hanford to determine what aspects could affect cost reductions with reasonable long-term risk. The results of this study are summarized in this report.

  3. Breast MRI in high risk patients

    OpenAIRE

    Obdeijn, Inge-Marie

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital mammography the screening efficacy is improved. However, the additional value of mammography over MRI is little while at the same time BRCA carriers are more sensitive the risks of low dose radiation ...

  4. Cavity degradation risk insurance assessment. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hampson, C.; Neill, P.; de Bivort, L.

    1980-01-01

    This study examined the risks and risk management issues involved with the implementation by electric power utilities of compressed air energy storage and underground pumped hydro storage systems. The results are listed in terms of relative risks for the construction and operation of these systems in different geologic deposits, with varying amounts of pressurization, with natural or man-made disasters in the vicinity of the storage equipment, and with different modes of operating the facilities. (LCL)

  5. Cardiovascular risk in Gullah African Americans with high familial risk of type 2 diabetes mellitus: project SuGAR.

    Science.gov (United States)

    Hunt, Kelly J; Kistner-Griffin, Emily; Spruill, Ida; Teklehaimanot, Abeba A; Garvey, W Timothy; Sale, Michèle; Fernandes, Jyotika

    2014-10-01

    To determine the prevalence of cardiovascular disease, levels of cardiovascular risk factors, and extent of preventive care in Gullah African Americans with a high familial risk of type 2 diabetes mellitus. Between 1995 and 2003, 1321 Gullah African Americans with a high prevalence of diabetes mellitus from the South Carolina Sea Islands consented to and enrolled in the Sea Islands Genetic African American Registry (Project SuGAR). A cross-sectional analysis of cardiometabolic risk, preventive care, and self-reported cardiovascular disease was conducted. Cardiometabolic risk factor levels were high and vascular disease was prevalent. Among the subjects with diabetes mellitus, the mean disease duration was 10.5 years; approximately one-third reported reduced vision or blindness; and >80% reported numbness, pain, or burning in their feet. Preventive diabetes care was limited, with level of cardiovascular risk in this population but also the pathophysiological mechanisms central to ancestral differences in cardiometabolic risk in the broader African American population.

  6. Leisure-Time Exercise Could Lower Your Risk of High Blood Pressure

    Science.gov (United States)

    ... Leisure-time exercise could lower your risk of high blood pressure American Heart Association Rapid Access Journal Report September ... copyright American Heart Association Download (1.4 MB) High Blood Pressure A high blood pressure reading. copyright American Heart ...

  7. APRI - Accident Phenomena of Risk Importance. Final Report; APRI - Accident Phenomena of Risk Importance. Slutrapport

    Energy Technology Data Exchange (ETDEWEB)

    Frid, W. [Swedish Nuclear Power Inspectorate, Stockholm (Sweden); Hammar, L.; Soederman, E. [ES-konsult, Stockholm (Sweden)

    1996-12-01

    The APRI-project started in 1992 with participation of the Swedish Nuclear Power Inspectorate (SKI) and the Swedish utilities. The Finnish utility TVO joined the project in 1993. The aim of the project has been to work with phenomenological questions in severe accidents, concentrating on the risk-dominating issues. The work is reported in separate sub-project reports, the present is the final report of the methodological studies as well as a final report for the total project. The research has led to clarifications of the risk complex, and ameliorated the basis for advanced probabilistic safety analyses, specially for the emission risks (PSA level 2) which are being studied at the Swedish plants. A new method has been tried for analysis of complicated accident courses, giving a possibility for systematic evaluation of the impact of different important phenomena (e.g. melt-through, high pressure melt-through with direct heating of the containment atmosphere, steam explosions). In this method, the phenomena are looked upon as top events of a `phenomena-tree`, illustrating how various conditions must be met before the top-event can happen. This method has been useful, in particular for applying `expert estimates`. 47 refs.

  8. Reproductive health education and sexual risk among high-risk female adolescents and young adults.

    Science.gov (United States)

    Ancheta, Rosedelia; Hynes, Colin; Shrier, Lydia A

    2005-04-01

    The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.

  9. Report data identify risk areas for improper payments.

    Science.gov (United States)

    Corrato, Robert R

    2011-10-01

    Hospitals should take several steps in using data from the Program for Evaluating Payment Patterns Report (PEPPER) to enhance compliance efforts and identify risk areas for improper payments: Designate one person to monitor PEPPER releases and download the quarterly report. Review the reports and list all areas where the hospital is most at risk for improper payments. Prioritize at-risk areas with the national comparison, followed by jurisdictional and state comparison. Conduct small-sample case reviews in at-risk areas and determine next steps, such as process improvement or rebilling. Include hospital finance, compliance, legal, case management, and coding experts as part of discussion.

  10. Toxicity risk of non-target organs at risk receiving low-dose radiation: case report

    Directory of Open Access Journals (Sweden)

    Chen Yu-Jen

    2009-12-01

    Full Text Available Abstract The spine is the most common site for bone metastases. Radiation therapy is a common treatment for palliation of pain and for prevention or treatment of spinal cord compression. Helical tomotherapy (HT, a new image-guided intensity modulated radiotherapy (IMRT, delivers highly conformal dose distributions and provides an impressive ability to spare adjacent organs at risk, thus increasing the local control of spinal column metastases and decreasing the potential risk of critical organs under treatment. However, there are a lot of non-target organs at risk (OARs occupied by low dose with underestimate in this modern rotational IMRT treatment. Herein, we report a case of a pathologic compression fracture of the T9 vertebra in a 55-year-old patient with cholangiocarcinoma. The patient underwent HT at a dose of 30 Gy/10 fractions delivered to T8-T10 for symptom relief. Two weeks after the radiotherapy had been completed, the first course of chemotherapy comprising gemcitabine, fluorouracil, and leucovorin was administered. After two weeks of chemotherapy, however, the patient developed progressive dyspnea. A computed tomography scan of the chest revealed an interstitial pattern with traction bronchiectasis, diffuse ground-glass opacities, and cystic change with fibrosis. Acute radiation pneumonitis was diagnosed. Oncologists should be alert to the potential risk of radiation toxicities caused by low dose off-targets and abscopal effects even with highly conformal radiotherapy.

  11. Sustainability and Risk Disclosure: An Exploratory Study on Sustainability Reports

    Directory of Open Access Journals (Sweden)

    Elisa Truant

    2017-04-01

    Full Text Available Recent policy changes in sustainability reporting, such as the ones related to the new European Directive on non-financial disclosure (2014/95/EU, the standards issued by the American Sustainability Accounting Standard Board (SASB, the G4 guidelines issued by the Global Sustainability Standard Board (GSSB, and the framework of the International Integrated Reporting Council (IIRC stress the importance of extending the disclosure of ethical, social, and environmental risks within financial and social-environmental reporting. Institutional pressure has notably increased among organizations, in setting up risk management tools to understand sustainability risks within managerial and reporting practices. Given such institutional pressure, the corporate reaction in providing additional sustainability risk disclosure calls for attention and scrutiny. Therefore, this study aims at addressing such issues from an exploratory perspective. We based our analysis on a sample of large Italian organizations that issued sustainability disclosure in accordance with the Global Reporting Initiative (GRI, G4 guidelines, and we tested the relationship between their level of risk disclosure and other relevant variables. Consistently with the literature, we found that “experienced” sustainable reporters provide a significant volume of disclosure, and that disclosure quality on risk is positively influenced by their international presence and reporting experience. However, when accounting for specific risk-related areas of disclosure, only a few of them seem to adopt a managerial perspective linking strategy, risk metrics, and disclosure.

  12. Reportable Creation: value, performance and risk measurement in financial reporting

    NARCIS (Netherlands)

    N.G. de Jager

    2006-01-01

    textabstractReporting on value or reporting value-relevant information unavoidably implies that estimates of future cash flows should be made. Consequently, uncertainty becomes an important factor in (external) financial reporting. For a long time, uncertainty was dealt with by substituting relevant

  13. Reportable Creation: value, performance and risk measurement in financial reporting

    NARCIS (Netherlands)

    N.G. de Jager

    2006-01-01

    textabstractReporting on value or reporting value-relevant information unavoidably implies that estimates of future cash flows should be made. Consequently, uncertainty becomes an important factor in (external) financial reporting. For a long time, uncertainty was dealt with by substituting relevant

  14. Selection in reported epidemiological risks: an empirical assessment.

    Directory of Open Access Journals (Sweden)

    Fotini K Kavvoura

    2007-03-01

    Full Text Available Epidemiological studies may be subject to selective reporting, but empirical evidence thereof is limited. We empirically evaluated the extent of selection of significant results and large effect sizes in a large sample of recent articles.We evaluated 389 articles of epidemiological studies that reported, in their respective abstracts, at least one relative risk for a continuous risk factor in contrasts based on median, tertile, quartile, or quintile categorizations. We examined the proportion and correlates of reporting statistically significant and nonsignificant results in the abstract and whether the magnitude of the relative risks presented (coined to be consistently > or =1.00 differs depending on the type of contrast used for the risk factor. In 342 articles (87.9%, > or =1 statistically significant relative risk was reported in the abstract, while only 169 articles (43.4% reported > or =1 statistically nonsignificant relative risk in the abstract. Reporting of statistically significant results was more common with structured abstracts, and was less common in US-based studies and in cancer outcomes. Among 50 randomly selected articles in which the full text was examined, a median of nine (interquartile range 5-16 statistically significant and six (interquartile range 3-16 statistically nonsignificant relative risks were presented (p = 0.25. Paradoxically, the smallest presented relative risks were based on the contrasts of extreme quintiles; on average, the relative risk magnitude was 1.41-, 1.42-, and 1.36-fold larger in contrasts of extreme quartiles, extreme tertiles, and above-versus-below median values, respectively (p < 0.001.Published epidemiological investigations almost universally highlight significant associations between risk factors and outcomes. For continuous risk factors, investigators selectively present contrasts between more extreme groups, when relative risks are inherently lower.

  15. Distribution of influenza vaccine to high-risk groups.

    Science.gov (United States)

    Ompad, Danielle C; Galea, Sandro; Vlahov, David

    2006-01-01

    Vaccine distribution programs have historically targeted individuals at high risk of complications due to influenza. Despite recommendations from the Advisory Committee on Immunization Practices, vaccination coverage among high-risk populations has been generally low. This review systematically summarizes the recent literature evaluating programs in different settings, from within medical settings to venue-based and community-based approaches, in an effort to identify successful program components. The published literature was identified by using the MEDLINE database from 1990 to 2006 covering studies that reported on interventions or programs aimed at vaccinating high-risk populations. The authors reviewed 56 studies. In the United States, the Healthy People 2010 goals included 90% vaccination coverage for adults aged > or = 65 years and 60% for high-risk adults aged 18-64 years. Only a handful of the studies reviewed managed to meet those goals. Interventions that increased vaccination coverage to Healthy People 2010 goals included advertising, provider and patient mailings, registry-based telephone calls, patient and staff education, standing orders coupled with standardized forms, targeting of syringe exchange customers, and visiting nurses. Few studies evaluated the impact of vaccination programs by race/ethnicity and socioeconomic status. Few studies targeted individuals outside of the health-care and social services sectors. Given the growing disparities in health and health-care access, understanding the way in which interventions can remedy disparities is crucial.

  16. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... atrial fibrillation has more than five times the risk of stroke.” “Because high blood pressure is so frequent, affecting tens of millions of ... is a more potent risk factor.” The two risk factors are also related to each other: High blood pressure is a risk factor for atrial fibrillation. Middle- ...

  17. High-Risk Childhood Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Bhojwani, Deepa; Howard, Scott C.; Pui, Ching-Hon

    2009-01-01

    Although most children with acute lymphoblastic leukemia (ALL) are cured, certain subsets have a high risk of relapse. Relapse risk can be predicted by early response to therapy, clinical and pharmacogenetic features of the host, and genetic characteristics of leukemic cells. Though early treatment response can be assessed by the peripheral blast cell count after 1 week of single-agent glucocorticoid treatment or percent of bone marrow blasts by morphology after 1 or 2 weeks of multiagent induction treatment, determination of minimal residual disease by polymerase chain reaction (PCR) or flow cytometry after 2 to 6 weeks of induction is the most precise and useful measure. Augmented therapy has improved outcome for the poor responders to initial treatment. Infants with mixed-lineage leukemia (MLL)–rearranged ALL comprise a very poor-risk group wherein further intensification of chemotherapy causes significant toxicity. Hybrid protocols incorporating drugs effective for acute myeloid leukemia could improve survival, a strategy being tested in international trials. Studies on the biology of MLL-induced leukemogenesis have prompted the development of novel targeted agents, currently under evaluation in clinical trials. Short-term outcomes of patients with Philadelphia chromosome (Ph)–positive ALL have improved significantly by adding tyrosine kinase inhibitors to standard chemotherapy regimens. New agents and methods to overcome resistance are under investigation, and allogeneic stem cell transplantation is recommended for certain subsets of patients, for example those with Ph+ and T-cell ALL with poor early response. Genome-wide interrogation of leukemic cell genetic abnormalities and germline genetic variations promise to identify new molecular targets for therapy. PMID:19778845

  18. High resolution fire risk mapping in Italy

    Science.gov (United States)

    Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

    2014-05-01

    The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

  19. Performance of sentinel lymph node biopsy in high-risk endometrial cancer

    Directory of Open Access Journals (Sweden)

    Jessie Ehrisman

    2016-08-01

    Conclusion: SLN mapping rates for high-risk cancers are slightly lower than in prior reports of lower risk cancers. The NPV of the SLN mapping alone is 92% and rises to 100% when the SLN algorithm is applied. Such results are acceptable and consistent with larger subsets of lower risk endometrial cancers.

  20. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  1. Wandering spleen: 'presentation in adolescent with high thrombotic risk'.

    Science.gov (United States)

    Tchidjou, Hyppolite K; Castelluzzo, Maria A; Messia, Virginia; Luciani, Matteo; Monti, Lidia; Grimaldi, Chiara; Bernardi, Stefania; D'Argenio, Patrizia

    2014-07-01

    The term 'wandering spleen' refers to an abnormal hypermobility of the spleen, which may be congenital or acquired. The absence or abnormal laxity of splenic ligaments combined with an abnormally long and mobile vascular pedicle predispose to complications such as torsion of the splenic pedicle, infarction and splenic vein thrombosis. The clinical presentation of such disease is highly variable. In this case, we describe an asymptomatic case of wandering spleen in high thrombotic risk patients with cavernoma of splenic vein and infarction of the spleen. Physical examination was normal except the enlarged and no tender consistency spleen palpable at left iliac fossa. Ultrasonography revealed enlarged spleniform mass below its normal position suggesting vascular impairment and subsequently has been confirmed by colour Doppler ultrasound and computed tomography. The family history was positive for ischemic thrombotic vascular diseases and the screening for thrombotic risk has revealed hyperhomocysteinemia, thrombophilic homozygous gene mutations for factor V (H1299R) and MTHFR (C677T). For high thrombotic risk, prophylaxis postsplenectomy was suggested according to the international recommendations with subcutaneous low molecular weight heparin, associated with a preventive treatment with acetyl salicylic acid and folic acid along with B-vitamin. This case report may be helpful for clinicians involved in the care of splenectomized patients, because it has shown the importance of an appropriate pre and postoperative antithrombotic management to reduce as soon as possible the risk of thrombotic events in such patients after splenectomy.

  2. [POL-TAVI First--Polish report on transcatheter aortic valve implantation (TAVI) of Edwards-Sapien prosthesis in the first 19 high risk patients with severe aortic stenosis and comorbidities].

    Science.gov (United States)

    Zembala, Marian; Wilczek, Krzysztof; Przybylski, Roman; Chodór, Piotr; Nadziakiewicz, Paweł; Krasoń, Marcin; Sadowski, Jerzy; Dudek, Dariusz; Kapelak, Bogusław; Forysz, Danuta; Witkowski, Adam; Demkow, Marcin; Chmielak, Zbigniew; Kuśmierski, Krzysztof; Juraszyński, Zbigniew; Bochenek, Andrzej; Cisowski, Marek; Trusz-Gluza, Maria; Buszman, Paweł; Woś, Stanisław; Kalarus, Zbigniew; Poloński, Lech; Gasior, Mariusz; Opolski, Grzegorz; Ruzyłło, Witold

    2009-08-01

    Patients with severe symptomatic aortic stenosis, who from November 2008 to March 2009 were treated with Edwards-Sapien transcatheter aortic valve implantation (TAVI) within the POL-TAVI First Polish Registry, were included in the analysis. Nineteen patients aged 78+/-4.8 years with high operation risk and Logistic EuroSCORE 25+/-7.6% were reported (74% were females). In 15 (79%) patients the valve was implanted transapically (TA), in the other four (21%)--via the femoral arterial access (TF). The valve was successfully implanted in 16 (84%) patients, in one patient aortic valvuloplasty alone was performed. During in-hospital period two patients died (one during periprocedural period and another one--two months after the implantation). During the mean follow-up of 5+/-1.5 months (except for one patient who is still in hospital) all patients are in NYHA class I or II. Results of the initial series of 19 TAVI patients in Poland are satisfactory, and the trial will be continued with careful medical and economical analysis.

  3. Risk factors for high-risk human papillomavirus infection and cofactors for high-grade cervical disease in Peru.

    Science.gov (United States)

    Almonte, Maribel; Ferreccio, Catterina; Gonzales, Miguel; Delgado, Jose Manuel; Buckley, C Hilary; Luciani, Silvana; Robles, Sylvia C; Winkler, Jennifer L; Tsu, Vivien D; Jeronimo, Jose; Cuzick, Jack; Sasieni, Peter

    2011-12-01

    To evaluate the association between potential risk factors for high-risk human papillomavirus (HR-HPV) infection and cofactors for cervical intraepithelial lesions grade 2 or worse (CIN2+) in women attending cervical screening in Amazonian Peru. Participants completed a risk factor questionnaire before screening. High-risk human papillomavirus infection was determined by Hybrid Capture II. Logistic regression was used to evaluate associations between potential risk factors for HR-HPV infection and between cofactors and risk of CIN2+ among women with HR-HPV infection. Screening and questionnaires were completed by 5435 women aged 25 to 49 years. The prevalence of HR-HPV was 12.6% (95% confidence interval [CI], 11.8%-13.6%) and decreased by age. Early age at first sexual intercourse and several lifetime sexual partners increased the risk of having HR-HPV (age-adjusted odds ratio [AOR] of age at first sexual intercourse <18 vs ≥20, 1.5; 95% CI, 1.2-2.0; AOR of ≥5 lifetime sexual partners vs 1, 2.1; 95% CI, 1.4-3.2). Among women with HR-HPV infection, those with no schooling (AOR relative to 1-5 years of schooling, 3.2; 95% CI, 1.3-8.3) and those with parity ≥3 (AOR relative to parity <3, 2.6; 95% CI, 1.4-4.9) were at increased risk of CIN2+. The effect of parity was stronger for cancer (AOR of parity ≥3 vs <3, 8.3; 95% CI, 1.0-65.6). Further analysis showed that the association between parity and CIN2+ was restricted to women younger than 40. Most women (83%) had previously been screened. Sixty-four percent of CIN2+ cases detected in this study occurred in women who reported having had a Papanicolaou test in the previous 3 years. Only 4 of 20 cancers were detected in women never screened before. Having had a previous abnormal Papanicolaou test increased the risk of CIN2+ (OR, 16.1; 95% CI, 6.2-41.9). Among women with HR-HPV, high parity (in young women), no schooling, lack of good-quality screening and of adequate follow-up care are the main risk factors for

  4. Approach Regarding a Framework for Risk Reporting in Order to Enhance the Related Good Practices

    Directory of Open Access Journals (Sweden)

    Mirela Nichita

    2015-08-01

    Full Text Available The nowadays accounting information user profile became more sophisticated and the financial reports face new challenges in accomplishing process to meet users’ needs. The purpose of financial reports is to provide useful information to users. According to International Accounting Standards Board, the utility of information is defined through the qualitative characteristics (fundamental and enhancing. The financial crisis emphasized the limits of financial reporting who has been unable to prevent investors about the risks they were facing. Some managers expressed reservations about the quality and relevance of corporate reporting, stating that the annual report is no longer a useful tool. Due to the current changes in business environment, managers have been highly motivated to rethink and improve the risk governance philosophy, processes and methodologies. The lack of quality, timely data and adequate systems to capture, report and measure the right information across the organization is a fundamental challenge to implementing and sustaining all aspects of effective risk management. Starting from 80s, the investors became more interested in narratives (Notes to financial statements, than in primary reports (financial position and performance. Our research suggests a framework for risk reporting with the main goal of improving the good practice in risk management field. Also, we will debate the relation between the qualitative characteristics of accounting information, transparency and risk, and explore the possibility of developing some good practices in risk reporting.

  5. LHC Report: reaching high intensity

    CERN Multimedia

    Jan Uythoven

    2015-01-01

    After both beams having been ramped to their full energy of 6.5 TeV, the last two weeks saw the beam commissioning process advancing on many fronts. An important milestone was achieved when operators succeeded in circulating a nominal-intensity bunch. During the operation, some sudden beam losses resulted in beam dumps at top energy, a problem that needed to be understood and resolved.   In 2015 the LHC will be circulating around 2800 bunches in each beam and each bunch will contain just over 1 x 1011 protons. Until a few days ago commissioning was taking place with single bunches of 5 x 109 protons. The first nominal bunch with an intensity of 1 x 1011 protons was injected on Tuesday, 21 April. In order to circulate such a high-intensity bunch safely, the whole protection system must be working correctly: collimators, which protect the aperture, are set at preliminary values known as coarse settings; all kicker magnets for injecting and extracting the beams are commissioned with beam an...

  6. Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

    Directory of Open Access Journals (Sweden)

    Nicoleta-Elena Buzatu

    2012-05-01

    Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

  7. [Are near-death experiences following attempted suicide important for suicide risk assessment? A case report].

    Science.gov (United States)

    Kralovec, Karl; Plöderl, Martin; Aistleiner, Ursula; Fartacek, Clemens; Fartacek, Reinhold

    2009-01-01

    We describe a 59-year old patient who reported a near-death experience following attempted suicide. The near-death experience induced reduction of suicidality. Previous studies suggested a high prevalence of near-death experiences following attempted suicide and that near-death experiences may decrease rather than increase subsequent suicide risk. Implications for suicide risk assessment are discussed.

  8. High performance MEAs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-15

    The aim of the present project is through modeling, material and process development to obtain significantly better MEA performance and to attain the technology necessary to fabricate stable catalyst materials thereby providing a viable alternative to current industry standard. This project primarily focused on the development and characterization of novel catalyst materials for the use in high temperature (HT) and low temperature (LT) proton-exchange membrane fuel cells (PEMFC). New catalysts are needed in order to improve fuel cell performance and reduce the cost of fuel cell systems. Additional tasks were the development of new, durable sealing materials to be used in PEMFC as well as the computational modeling of heat and mass transfer processes, predominantly in LT PEMFC, in order to improve fundamental understanding of the multi-phase flow issues and liquid water management in fuel cells. An improved fundamental understanding of these processes will lead to improved fuel cell performance and hence will also result in a reduced catalyst loading to achieve the same performance. The consortium have obtained significant research results and progress for new catalyst materials and substrates with promising enhanced performance and fabrication of the materials using novel methods. However, the new materials and synthesis methods explored are still in the early research and development phase. The project has contributed to improved MEA performance using less precious metal and has been demonstrated for both LT-PEM, DMFC and HT-PEM applications. New novel approach and progress of the modelling activities has been extremely satisfactory with numerous conference and journal publications along with two potential inventions concerning the catalyst layer. (LN)

  9. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-01-01

    Background: Sexual behavior is a complex activity affecting all aspects of human’s life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. Methods: we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of “risky sexual behavior assessment”, “sexual risk assessment”, “high risk sexual behavior”, “sexual risk taking”. By reviewing references of the articles, some complementary studies were added. Results: Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Conclusion: Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended. PMID:27047267

  10. Challenging Propofol Sedation in Gastrointestinal Endoscopy: High Risk Patients and High Risk Procedures

    Directory of Open Access Journals (Sweden)

    Eduardo Redondo-Cerezo

    2012-12-01

    Full Text Available Sedation is increasingly becoming a must for most endoscopic procedures. Non-anesthesiologist administration of propofol is the standard of practice in many European countries. Nevertheless, despite anesthesiology societies concerns about sedation guided by endoscopist, practitioners find some limits to propofol administration, related to high risk patients or high risk and complex procedures, which can be long lasting and technically challenging. The main patient related risk factors for sedation are elderly patients, obesity, ASA≥3 patients, individuals with craniofacial abnormalities or with pharyngolaringeal tumors, patients with an acute gastrointestinal bleeding, under pain medications, sedatives, antidepressants, or who consume significant amounts of alcohol or drugs. Procedure related risk factors have more to do with the duration and complexity of the procedure than with other factors, in which considering a general anesthesia allows the endoscopist to concentrate on a difficult task. Published papers addressing the most challenging sedation groups in endoscopy are exploring and even trespassing previously assumed frontiers, and new scenarios are opening to the endoscopist, increasing his/her autonomy, reducing costs and giving patients levels of comfort previously unknown. In this review we analyse each risk group determining the ones in which a sedation protocol could be widely applied, and other in which the published evidence does not guarantee a safe endoscopist guided propofol sedation.

  11. Improved outcomes with European Society of Cardiology guideline-adherent antithrombotic treatment in high-risk patients with atrial fibrillation: a report from the EORP-AF General Pilot Registry.

    Science.gov (United States)

    Lip, Gregory Y H; Laroche, Cécile; Popescu, Mircea Iaochim; Rasmussen, Lars Hvilsted; Vitali-Serdoz, Laura; Dan, Gheorghe-Andrei; Kalarus, Zbigniew; Crijns, Harry J G M; Oliveira, Mario Martins; Tavazzi, Luigi; Maggioni, Aldo P; Boriani, Giuseppe

    2015-12-01

    Guideline-adherent therapy for stroke prevention in atrial fibrillation has been associated with better outcomes, in terms of thromboembolism (TE) and bleeding. In this report from the EuroObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot General Registry, we describe the associated baseline features of 'high risk' AF patients in relation to guideline-adherent antithrombotic treatment, i.e. whether they were adherent, over-treated, or under-treated based on the 2012 European Society of Cardiology (ESC) guidelines. Secondly, we assessed the predictors of guideline-adherent antithrombotic treatment. Thirdly, we evaluated outcomes for all-cause mortality, TE, bleeding, and the composite endpoint of 'any TE, cardiovascular death or bleeding' in relation to whether they were ESC guideline-adherent treatment. From the EORP-AF cohort, the follow-up dataset of 2634 subjects was used to assess the impact of guideline adherence or non-adherence. Of these, 1602 (60.6%) were guideline adherent, whilst 458 (17.3%) were under-treated, and 574 (21.7%) were over-treated. Non-guideline-adherent treatment can be related to region of Europe as well as associated clinical features, but not age, AF type, symptoms, or echocardiography indices. Over-treatment per se was associated with symptoms, using the EHRA score, as well as other comorbidities. Guideline-adherent antithrombotic management based on the ESC guidelines is associated with significantly better outcomes. Specifically, the endpoint of 'all cause death and any TE' is increased by >60% by undertreatment [hazard ratio (HR) 1.679 (95% confidence interval (CI) 1.202-2.347)] or over-treatment [HR 1.622 (95% CI 1.173-2.23)]. For the composite endpoint of 'cardiovascular death, any TE or bleeding', over-treatment increased risk by >70% [HR 1.722 (95% CI 1.200-2.470)]. Even in this cohort with high overall rates of oral anticoagulation use, ESC guideline-adherent antithrombotic management is associated with

  12. The Manager's Role in Financial Reporting: A Risk Consultant's Perspective

    Science.gov (United States)

    Bell, Reginald L.

    2007-01-01

    This article presents an interview with Ray Gonzalez, a risk consultant at Deloitte & Touche LLP, in Houston, Texas, about the financial reporting responsibilities of top, middle, and frontline managers in large and medium-size firms. This interview spotlights the necessity for timely and accurate reporting of financial information relating to…

  13. Job Strain and the Risk of Depression: Is Reporting Biased?

    DEFF Research Database (Denmark)

    Kolstad, Henrik; Hansen, Åse Marie; Kærgaard, Anette

    2011-01-01

    It is unknown whether the relation between job strain and depression reflects causal characteristics of the working environment or reporting bias. The authors investigated reporting bias by analyzing individual versus work-unit measures of job strain and the risk of depressive symptoms (n = 287) ...

  14. Cyberbullying in those at clinical high risk for psychosis.

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2013-11-01

    Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called 'cyberbullying'. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. It is possible that cyberbullying may be a problem for those at CHR of psychosis, and due to the vulnerable nature of these young people may have longitudinal implications. © 2013 Wiley Publishing Asia Pty Ltd.

  15. Cyberbullying in those at Clinical High Risk for psychosis

    Science.gov (United States)

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2012-01-01

    Aim Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called ‘cyberbullying’. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Methods Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Results Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. Conclusion It is possible that cyberbullying may be a problem for those at CHR of psychosis and due to the vulnerable nature of these young people, may have longitudinal implications. PMID:23343259

  16. Lung cancer screening: identifying the high risk cohort

    OpenAIRE

    Marcus, Michael W.; Raji, Olaide Y; John K. Field

    2015-01-01

    Low dose computed tomography (LDCT) is a viable screening tool for early lung cancer detection and mortality reduction. In practice, the success of any lung cancer screening programme will depend on successful identification of individuals at high risk in order to maximise the benefit-harm ratio. Risk prediction models incorporating multiple risk factors have been recognised as a method of identifying individuals at high risk of developing lung cancer. Identification of individuals at high ri...

  17. Risky Business: The Science and Art of Radiation Risk Communication in the High Risk Context of Space Travel

    Science.gov (United States)

    Elgart, Shona Robin; Shavers, Mark; Huff, Janice; Patel, Zarana; Semones, Edward

    2016-01-01

    Successfully communicating the complex risks associated with radiation exposure is a difficult undertaking; communicating those risks within the high-risk context of space travel is uniquely challenging. Since the potential risks of space radiation exposure are not expected to be realized until much later in life, it is hard to draw comparisons between other spaceflight risks such as hypoxia and microgravity-induced bone loss. Additionally, unlike other spaceflight risks, there is currently no established mechanism to mitigate the risks of incurred radiation exposure such as carcinogenesis. Despite these challenges, it is the duty of the Space Radiation Analysis Group (SRAG) at NASA's Johnson Space Center to provide astronauts with the appropriate information to effectively convey the risks associated with exposure to the space radiation environment. To this end, astronauts and their flight surgeons are provided with an annual radiation risk report documenting the astronaut's individual radiation exposures from space travel, medical, and internal radiological procedures throughout the astronaut's career. In an effort to improve this communication and education tool, this paper critically reviews the current report style and explores alternative report styles to define best methods to appropriately communicate risk to astronauts, flight surgeons, and management.

  18. REGRESSION MODEL FOR RISK REPORTING IN FINANCIAL STATEMENTS OF ACCOUNTING SERVICES ENTITIES

    Directory of Open Access Journals (Sweden)

    Mirela NICHITA

    2015-06-01

    Full Text Available The purpose of financial reports is to provide useful information to users; the utility of information is defined through the qualitative characteristics (fundamental and enhancing. The financial crisis emphasized the limits of financial reporting which has been unable to prevent investors about the risks they were facing. Due to the current changes in business environment, managers have been highly motivated to rethink and improve the risk governance philosophy, processes and methodologies. The lack of quality, timely data and adequate systems to capture, report and measure the right information across the organization is a fundamental challenge for implementing and sustaining all aspects of effective risk management. Starting with the 80s, the investors are more interested in narratives (Notes to financial statements, than in primary reports (financial position and performance. The research will apply a regression model for assessment of risk reporting by the professional (accounting and taxation services for major companies from Romania during the period 2009 – 2013.

  19. REGRESSION MODEL FOR RISK REPORTING IN FINANCIAL STATEMENTS OF ACCOUNTING SERVICES ENTITIES

    Directory of Open Access Journals (Sweden)

    Mirela NICHITA

    2015-06-01

    Full Text Available The purpose of financial reports is to provide useful information to users; the utility of information is defined through the qualitative characteristics (fundamental and enhancing. The financial crisis emphasized the limits of financial reporting which has been unable to prevent investors about the risks they were facing. Due to the current changes in business environment, managers have been highly motivated to rethink and improve the risk governance philosophy, processes and methodologies. The lack of quality, timely data and adequate systems to capture, report and measure the right information across the organization is a fundamental challenge for implementing and sustaining all aspects of effective risk management. Starting with the 80s, the investors are more interested in narratives (Notes to financial statements, than in primary reports (financial position and performance. The research will apply a regression model for assessment of risk reporting by the professional (accounting and taxation services for major companies from Romania during the period 2009 – 2013.

  20. Trainees operating on high-risk patients without cardiopulmonary bypass: a high-risk strategy?

    Science.gov (United States)

    Ascione, Raimondo; Reeves, Barnaby C; Pano, Marco; Angelini, Gianni D

    2004-07-01

    The safety of teaching off-pump coronary artery bypass grafting to trainees is best tested in high-risk patients, who are more likely to experience significant morbidity after surgery. This study compared outcomes of off-pump coronary artery bypass grafting operations performed by consultants and trainees in high-risk patients. Data for consecutive patients undergoing off-pump coronary artery bypass grafting were collected prospectively. Patients satisfying at least one of the following criteria were classified as high-risk: age older than 75 years, ejection fraction less than 0.30, myocardial infarction in the previous month, current congestive heart failure, previous cerebrovascular accident, creatinine greater than 150 micromol/L, respiratory impairment, peripheral vascular disease, previous cardiac surgery, and left main stem stenosis greater than 50%. Early morbidity, 30-day mortality, and late survival were compared. From April 1996 to December 2002, 686 high-risk patients underwent off-pump coronary artery bypass grafting revascularization. Operations by five consultants (416; 61%) and four trainees (239; 35%) were the focus of subsequent analyses. Nine visiting or research fellows performed the other 31 operations. Prognostic factors were more favorable in trainee-led operations. On average, consultants and trainees grafted the same number of vessels. There were 18 (4.3%) and 5 (1.9%) deaths within 30 days, and 14 (3.4%) and 5 (1.9%) myocardial infarctions in consultant and trainee groups, respectively. After adjusting for imbalances in prognostic factors, odd ratios for almost all adverse outcomes implied no increased risk with trainee operators, although patients operated on by trainees had longer postoperative stays and were more likely to have a red blood cell transfusion. Kaplan-Meier cumulative mortality estimates at 24-month follow-up were 10.5% (95% confidence interval, 7.7% to 14.2%) and 6.4% (95% confidence interval, 3.8% to 10.9%) in consultant

  1. Final report of the phase I/II clinical trial of the E75 (nelipepimut-S) vaccine with booster inoculations to prevent disease recurrence in high-risk breast cancer patients

    Science.gov (United States)

    Mittendorf, E. A.; Clifton, G. T.; Holmes, J. P.; Schneble, E.; van Echo, D.; Ponniah, S.; Peoples, G. E.

    2014-01-01

    Background E75 (nelipepimut-S) is a human leukocyte antigen (HLA)-A2/A3-restricted immunogenic peptide derived from the HER2 protein. We have conducted phase I/II clinical trials vaccinating breast cancer patients with nelipepimut-S and granulocyte–macrophage colony-stimulating factor (GM-CSF) in the adjuvant setting to prevent disease recurrence. All patients have completed 60 months follow-up, and here, we report the final analyses. Patients and methods The studies were conducted as dose escalation/schedule optimization trials enrolling node-positive and high-risk node-negative patients with tumors expressing any degree of HER2 (immunohistochemistry 1–3+). HLA-A2/3+ patients were vaccinated; others were followed prospectively as controls. Local and systemic toxicity was monitored. Clinical recurrences were documented, and disease-free survival (DFS) was analyzed by Kaplan–Meier curves; groups were compared using log-rank tests. Results Of 195 enrolled patients, 187 were assessable: 108 (57.8%) in the vaccinated group (VG) and 79 (42.2%) in the control group (CG). The groups were well matched for clinicopathologic characteristics. Toxicities were minimal. Five-year DFS was 89.7% in the VG versus 80.2% in the CG (P = 0.08). Due to trial design, 65% of patients received less than the optimal vaccine dose. Five-year DFS was 94.6% in optimally dosed patients (P = 0.05 versus the CG) and 87.1% in suboptimally dosed patients. A voluntary booster program was initiated, and among the 21 patients that were optimally boosted, there was only one recurrence (DFS = 95.2%). Conclusion The E75 vaccine is safe and appears to have clinical efficacy. A phase III trial evaluating the optimal dose and including booster inoculations has been initiated. Clinical Trials NCT00841399, NCT00584789. PMID:24907636

  2. Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

    Science.gov (United States)

    Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

    2014-01-01

    Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

  3. [Anesthesiological management of the high-risk surgical patient].

    Science.gov (United States)

    Bertoldi, G; Avalle, M

    1980-03-01

    Evaluation of the anaesthesiological risk in surgical patients is described and an account is given of results obtained with an association of ketamin and NLA II in 57 high-risk patients subjected to general surgical management.

  4. Failure to acknowledge high suicide risk among veterinarians.

    Science.gov (United States)

    Skipper, Gregory E; Williams, Jerome B

    2012-01-01

    A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (pveterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (pveterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.

  5. Corporate reporting on risks: Evidence from Spanish companies

    Directory of Open Access Journals (Sweden)

    Luis Rodríguez Domínguez

    2014-07-01

    Likewise, the results obtained emphasize the complexity of the voluntary revelation of risks. While an extended management board might improve the provision of more detailed information about the risks required by the current regulation, it tends to adopt a conservative policy of reporting concerning the voluntary disclosure. Moreover, we show the relevance of transparency as a deterrent for providing voluntary information by larger companies, due to the concerns about negative strategic repercussions.

  6. Practical Techniques to Minimize the Risk of CIN in the High-risk Patient

    Directory of Open Access Journals (Sweden)

    Mark Downes

    2008-01-01

    Full Text Available The use of iodinated contrast media (CM is integral to the practice of interventional radiology, facilitating visualization of anatomic structures during MDCT guided diagnostic and therapeutic procedures and leading to advances in patient care.The benefits of contrast-enhanced MDCT imaging,"nhowever, must be viewed in the context of the potential risks of CM use, of which contrast-induced nephropathy (CIN may be the most serious. CIN is the third commonest cause of hospital-acquired renal insufficiency, with approximately 33% of these cases attributed to CM use in CT procedures in patients who are at risk of CIN due to the presence of established risk factors. Reported patient risk factors for CIN include age, congestive heart failure, and dehydration but pre-existing renal impairment, particularly in association with diabetes, is generally recognized as the most important variable. Based on this, it is recommended that patients who are to undergo intravenous administration of an iodinated contrast agent be questioned about potential renal dysfunction at the time of referral and those who answer positively to at least 1 question should be screened for elevated serum Cr. When a high-risk patient is identified, several strategies can be implemented to minimize the occurrence of CIN. Cessation of all nephrotoxic medications should be implemented if possible ≥24 hours before the contrast-enhanced CT procedure. Adequate pre-and post-procedural hydration is considered one of the most effective CIN prevention measures. Studies of pharmacological prophylaxis are less encouraging and the role of N-acetylcysteine for CIN prevention, for example, remains unclear to date. Finally, volume and type of CM used during the CT procedure may influence the development of CIN. Findings from randomized controlled trials that have considered the role of CM osmolality on nephrotoxicity in at-risk populations suggest that the iso-osmolar CM iodixanol is reno

  7. Research in High Energy Physics. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Conway, John S.

    2013-08-09

    This final report details the work done from January 2010 until April 2013 in the area of experimental and theoretical high energy particle physics and cosmology at the University of California, Davis.

  8. Panel report on high temperature ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Nolet, T C [ed.

    1979-01-01

    Fundamental research is reported concerning high temperature ceramics for application in turbines, engines, batteries, gasifiers, MHD, fuel cells, heat exchangers, and hot wall combustors. Ceramics microstructure and behavior are included. (FS)

  9. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach

    National Research Council Canada - National Science Library

    Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan

    2016-01-01

    .... Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation.

  10. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    Directory of Open Access Journals (Sweden)

    Lauren E. Joly

    2016-01-01

    Full Text Available Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45 of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61 of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability.

  11. Reducing sexual risk behavior among high-risk couples in Northern India.

    Science.gov (United States)

    Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

    2013-09-01

    With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

  12. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    Science.gov (United States)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  13. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation

    Science.gov (United States)

    Abud, Tulio B.; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  14. Risk factors and characteristics of youth living with, or at high risk for, HIV

    NARCIS (Netherlands)

    Huba, GJ; Melchior, LA; Panter, AT; Trevithick, L; Woods, ER; Wright, E; Feudo, R; Tierney, S; Schneir, A; Tenner, A; Remafedi, G; Greenberg, B; Sturdevant, M; Goodman, E; Hodgins, A; Wallace, M; Brady, RE; Singer, B

    2000-01-01

    Over 8,000 adolescents and young adults (4,111 males; 4,085 females) reported on several HIV-related risk behaviors during enrollment into 10 service demonstration projects targeted to youth living with, or at risk for, HIV. Distinct risk patterns emerged by gender when predicting HIV serostatus (ve

  15. Extreme risk taker who wants to continue taking part in high risk sports after serious injury.

    Science.gov (United States)

    Pain, M; Kerr, J H

    2004-06-01

    The case is reported of a 40 year old male high risk sport athlete who had seriously injured himself several times and as a result was partially physically disabled and had trouble with mental tasks requiring concentration such as spelling, reading numbers, and writing. The athlete was referred to a sports psychologist. In consultations, it became clear that he was having difficulty reconciling the difference between his life as it used to be and as it would be in the future. Part of his difficulty was dealing with the frustration and anger "outbursts" which resulted from not being able to perform straightforward everyday motor skills. In spite of his injuries and disability, the patient badly wanted to continue participating in extreme sports. Reversal theory is used in the discussion to provide theoretical explanations of the motivation for his extreme risk taking behaviour.

  16. Sex differences in self-reported risk-taking propensity on the Evaluation of Risks scale.

    Science.gov (United States)

    Killgore, William D S; Grugle, Nancy L; Killgore, Desiree B; Balkin, Thomas J

    2010-06-01

    The Evaluation of Risks scale was recently developed as a self-report inventory for assessing risk-taking propensity, but further validation is necessary because most studies have predominantly included male subjects. Because males commonly exhibit greater risk-taking propensity than females, evidence of such a sex difference on the scale would further support its construct validity. 29 men and 25 women equated for age (range: 18 to 36 years) completed the scale. Internal consistency of the scale was generally modest, particularly among women. Men scored significantly higher than women on four of nine indices of risk-taking propensity, including Danger Seeking, Energy, Invincibility, and Total Risk-Propensity. Factors measuring thrill seeking and danger seeking correlated positively with a concurrent measure of sensation seeking. Although the higher scores exhibited by men are consistent with prior research on other measures of risk-taking, further research on this scale with samples including women is warranted.

  17. Recommendations of activity restriction in high-risk pregnancy scenarios

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas;

    2015-01-01

    obstetricians and midwives prescribe activity restriction in most high-risk pregnancies. The degree of activity restriction and the presumed effect vary between clinicians. This may reflect different attitudes and lack of guidelines based on clinical studies of a possible benefit of activity restriction....... to the obstetricians, the midwives also reported that they expected the recommendation to be more effective. Most midwives and obstetricians reported that they thought strict activity restriction was associated with severe or moderate adverse effect, and recommended antithrombotic prophylaxis. Conclusions: Danish......Abstract Aims: To describe specific recommendations of activity restriction, place of care, expected beneficial and adverse effects, and recommended antithrombotic prophylaxis in nine clinical scenarios. Methods: A national survey. All members of the Danish Society of Obstetrics and Gynaecology...

  18. FINANCIAL RISK ASSESSMENT OF AN AGRICULTURAL COMPANY ACCORDING TO REPORTING

    Directory of Open Access Journals (Sweden)

    Kraskova A. A.

    2015-11-01

    Full Text Available The instruments of increasing competitive stability and decreasing financial risk of the company in the conditions of an economic crisis are considered in this article. The process of production in agriculture is closely related to the natural biological processes. Animals and plants function as means of production, and they are living organisms, developing on the biological laws that determine the dependence of the production process in the agricultural sector on natural factors. Besides, various soil climatic conditions have impact on results of economic activity of agricultural producers. Therefore, companies that work in rather worse natural zones are less competitive. The price factor doesn't provide financial well-being and doesn't reduce risk of bankrupt to such organizations. The economic situation in the country, emergence of new financial instruments and some other factors has essential impact on results of economic activity of an agrarian enterprise. Thus, the activity of the company in all its forms is connected with numerous risks, thus, financial risks play an essential role, generally, "a portfolio of risks". In this regard, an actual task in practice of an agrarian enterprise is the assessment of level of financial risk on the basis of accounting reports: the balance sheet records the financial situations of the organization at reporting date, and the report profits and losses results of financial activity. The system of internal control in various directions is necessary for risk management: acquisition of raw materials and materials, product sales, logistics, personals, finance and capital investments. A possibility of an agrarian company to estimate, to control and to operate its own risks is important competitive advantage, allowing to create financial and steady structure of the organization

  19. Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

    Science.gov (United States)

    Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

  20. Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol

    OpenAIRE

    Kirkegaard, Pia; Edwards, Adrian; Risør, Mette Bech; Thomsen, Janus Laust

    2013-01-01

    Background Previous studies have shown the importance of paying attention to lay peoples’ interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic patients with high cholesterol interpret risk of cardiovascular disease. Methods Fourteen patients with high cholesterol and risk of cardiovascular disease were interviewed, and patterns across patient a...

  1. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter;

    2011-01-01

    were assessed for both risk factors and subclinical atherosclerosis (n = 6104). The latter two groups underwent baseline examination in a dedicated mobile facility equipped with advanced imaging tools suitable for noninvasive screening for subclinical atherosclerosis (coronary artery calcium...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...... by computed tomography [CT], carotid and aortic disease by ultrasound, and ankle-brachial index). Selected participants were offered advanced imaging (contrast-enhanced CT, magnetic resonance imaging, and positron emission tomography/CT). Plasma, PAXgene RNA, and DNA samples were obtained for biomarker...

  2. High social class and suicide in persons at risk for schizophrenia.

    Science.gov (United States)

    Silverton, L; Mednick, S A; Holst, C; John, R

    2008-03-01

    The relationship between suicide and social class has been equivocal. While some authors have reported that higher social class is related to higher rates of suicide, most other studies report that lower social class is associated with higher rates of suicide. Our study attempted to resolve these inconsistencies by using a High Risk for schizophrenia method. Children of women with severe schizophrenia were assessed in 1962. In 2005, when subjects were a mean age of 58 years, we identified those who had committed suicide. A higher rate of suicide was associated with risk for schizophrenia in the High-Risk sample. Higher social class origin was associated with suicide in persons at risk for mental illness. Higher social class origin was associated with suicide in subjects at genetic risk for schizophrenia (but not those without risk).

  3. High risk pesticides in sugar beet protection

    Directory of Open Access Journals (Sweden)

    Šovljanski Radmila A.

    2006-01-01

    Full Text Available According to traits of pesticides permitted to use in sugar beet (oral percutaneus and inhalation toxicity, toxicity to wildlife, bees and aquatic organisms, re-entry interval, maximum number of treatments, effects on reproduction do not present health risk in sugar production/technology. However, the danger exists for workers by chronic exposure during the application, especially from pesticide being potential endocrine disruptors (EDS (fentin acetate, benomyl, endosulfan, methomyl, methidathion. EDS can cause sterility or decreased fertility, impaired development, birth defects of the reproductive tract and metabolic disorders. Authors recommend limited application of EDS pesticides (to limit the number of treatments to only one during the vegetation, replacement with pesticides with low risk to humans game and fishes, as well as mandatory submission of re-entry data for registration.

  4. High-risk pregnancy and the rheumatologist.

    Science.gov (United States)

    Soh, May Ching; Nelson-Piercy, Catherine

    2015-04-01

    Rheumatologists are increasingly involved in the care of young women who, in the age of biologic therapy, are now gaining control of their rheumatic diseases and attempting pregnancy. With careful planning, most women with rheumatic diseases have successful pregnancies. This article focuses specifically on the highest-risk pregnancies and controversial areas. We discuss the women at risk of complications, the types of maternal and fetal complications, the treatments that can be used in pregnancy (and breastfeeding) and longer-term outcomes that could affect the mother. SLE, RA, ANCA-associated vasculitides, large vessel vasculitis (e.g. Takayasu's) and other CTDs (e.g. scleroderma) are among the conditions covered. The evidence and controversies regarding the recommendations for the use of biologics in pregnancy are discussed. The role of the rheumatologist in pregnancy planning and caring for the pregnant and post-partum woman as part of the multidisciplinary team is discussed.

  5. (Brown) adipose tissue associated metabolic dysfunction and risk of cardiovascular disease in high risk patients

    NARCIS (Netherlands)

    Franssens, BT

    2016-01-01

    In this thesis it was shown that (brown) adipose tissue associated metabolic dysfunction increases the risk on development of cardiovascular disease in high risk patients. Quantity of adipose tissue is an important risk factor for adipose tissue dysfunction but functionality of adipose tissue not so

  6. How can we identify the high-risk patient?

    Science.gov (United States)

    Sankar, Ashwin; Beattie, W Scott; Wijeysundera, Duminda N

    2015-08-01

    Accurate and early identification of high-risk surgical patients allows for targeted use of perioperative monitoring and interventions that may improve their outcomes. This review summarizes current evidence on how information from the preoperative, operative, and immediate postoperative periods can help identify such individuals. Simple risk indices, such as the Revised Cardiac Risk Index or American Society of Anesthesiologists Physical Status scale, and online calculators allow risk to be estimated with moderate accuracy using readily available preoperative clinical information. Both specific specialized tests (i.e., cardiopulmonary exercise testing and cardiac stress testing) and promising novel biomarkers (i.e., troponins and natriuretic peptides) can help refine these risk estimates before surgery. Estimates of perioperative risk can be further informed by information acquired during the operative and immediate postoperative periods, such as risk indices (i.e., surgical Apgar score), individual risk factors (i.e., intraoperative hypotension), or postoperative biomarkers (i.e., troponins and natriuretic peptides). Preoperative clinical risk indices and risk calculators estimate surgical risk with moderate accuracy. Although novel biomarkers, specialized preoperative testing, and immediate postoperative risk indices show promise as methods to refine these risk estimates, more research is needed on how best to integrate risk information from these different sources.

  7. Reporting risk, producing prejudice: how news reporting on obesity shapes attitudes about health risk, policy, and prejudice.

    Science.gov (United States)

    Saguy, Abigail C; Frederick, David; Gruys, Kjerstin

    2014-06-01

    News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public health crisis article did not increase perception of obesity-related health risks but did significantly increase the expression of antifat prejudice in four out of seven comparisons. Across studies, compared to controls, participants who read an article about weight-based discrimination were less likely to agree that overweight constitutes a public health crisis or to support various obesity policies. Effects of exposure to an article questioning the health risks associated with overweight and obesity were mixed. These findings suggest that news reports on the "obesity epidemic" - and, by extension, on public health crises commonly blamed on personal behavior - may unintentionally activate prejudice.

  8. Retrospective reports of developmental stressors, syndemics, and their association with sexual risk outcomes among gay men.

    Science.gov (United States)

    Tulloch, Tyler G; Rotondi, Nooshin K; Ing, Stanley; Myers, Ted; Calzavara, Liviana M; Loutfy, Mona R; Hart, Trevor A

    2015-10-01

    Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questionnaires at baseline and 6-month follow-up. Syndemic variables included depression, polysubstance use, and intimate partner violence. Early life adversity variables measured retrospectively included physical and verbal bullying by peers and physical and sexual abuse by adults. A Cochran-Armitage trend test revealed a proportionate increase between number of syndemic problems and engagement in high-risk sex (p indirect effects of two types of early life adversity on high-risk sex via syndemic severity: verbal bullying by peers and physical abuse by adults. There was also an overall effect of physical bullying by peers on high-risk sexual behavior, but no specific direct or indirect effects were observed. Consistent with syndemic theory, results provide evidence that certain types of early life adversity impact high-risk sex later in life via syndemic problems. Behavioral interventions to reduce sexual risk among GBM should address anti-gay discrimination experienced before adulthood as well as adult psychological problems.

  9. Development of a risk-analysis model. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1979-10-01

    This report consists of a main body, which provides a presentation of risk analysis and its general and specific application to the needs of the Office of Buildings and Community Systems of the Department of Energy; and several case studies employing the risk-analysis model developed. The highlights include a discussion of how risk analysis is currently used in the private, regulated, and public sectors and how this methodology can be employed to meet the policy-analysis needs of the Office of Buildings and Community Systems of the Department of Energy (BCS/DOE). After a review of the primary methodologies available for risk analysis, it was determined that Monte Carlo simulation techniques provide the greatest degree of visibility into uncertainty in the decision-making process. Although the data-collection requirements can be demanding, the benefits, when compared to other methods, are substantial. The data-collection problem can be significantly reduced, without sacrificing proprietary-information rights, if prior arrangements are made with RD and D contractors to provide responses to reasonable requests for base-case data. A total of three case studies were performed on BCS technologies: a gas-fired heat pump; a 1000 ton/day anaerobic digestion plant; and a district heating and cooling system. The three case studies plus the risk-analysis methodology were issued as separate reports. It is concluded that, based on the overall research of risk analysis and the case-study experience, that the risk-analysis methodology has significant potential as a policy-evaluation tool within BCS.

  10. Elite High Schools Breed Higher Risk of Addiction

    Science.gov (United States)

    ... html Elite High Schools Breed Higher Risk of Addiction: Study Rates are two to three times higher ... Privilege doesn't necessarily offer protection from drug addiction, new research suggests. Teens at elite U.S. high ...

  11. Toddlers at High Risk of Chemical Eye Burns

    Science.gov (United States)

    ... fullstory_160258.html Toddlers at High Risk of Chemical Eye Burns: Study Access to household cleaning products to blame, ... and 2 years have relatively high rates of chemical eye burns, with everyday cleaners a common cause, researchers say. ...

  12. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, Afib and Your Risk of Stroke Updated:Sep ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  13. Evaluating Ecological Risk to Invertebrate Receptors from PAHs in Sediments at Hazardous Waste Sites (Final Report)

    Science.gov (United States)

    EPA's Ecological Risk Assessment Support Center (ERASC) announced the release of the final report, Evaluating Ecological Risk to Invertebrate Receptors from PAHs in Sediments at Hazardous Waste Sites. The report provides an overview of an approach for assessing risk to ...

  14. Evaluating Ecological Risk to Invertebrate Receptors from PAHs in Sediments at Hazardous Waste Sites (Final Report)

    Science.gov (United States)

    EPA's Ecological Risk Assessment Support Center (ERASC) announced the release of the final report, Evaluating Ecological Risk to Invertebrate Receptors from PAHs in Sediments at Hazardous Waste Sites. The report provides an overview of an approach for assessing risk to ...

  15. Clinical options for women at high risk for breast cancer.

    Science.gov (United States)

    Hartmann, L C; Sellers, T A; Schaid, D J; Nayfield, S; Grant, C S; Bjoraker, J A; Woods, J; Couch, F

    1999-10-01

    Women at hereditary risk of breast cancer face a difficult clinical decision. Each of the options available to them has unique advantages and disadvantages that are summarized in Table 9. Many components enter a high-risk woman's decision: her objective risk of breast cancer; clinical features, such as the consistency of breast tissue and resultant ease of examination; breast density on mammography; personal characteristics, including her experience with cancer within her family; her role and [table: see text] responsibilities within her own nuclear family; her values and goals; her experiences with the medical system; and her subjective assessment of risk. It is generally believed that women significantly overestimate their risk of breast cancer. Thus, it is vital that a woman at risk have access to a genetic counselor who can provide accurate assessment of her risk. Women should be encouraged to take time to understand their risk level and the advantages and disadvantages of the options before them.

  16. High risk populations and HIV-1 infection in China

    Institute of Scientific and Technical Information of China (English)

    Tuo Fu ZHU; Chun Hui WANG; Peng LIN; Na HE

    2005-01-01

    China is currently experiencing one of the most rapidly expanding HIV epidemics in the world. Although the overall prevalence rate is still low, with a population of 1.3 billion, high-risk factors which have contributed to the HIV/AIDS epidemics worldwide continue to prevail in China, including a high rate of injecting drug use and needle sharing,commercial sex with low rates of condom use, and concurrent sex with both commercial sex workers and noncommercial casual or steady sex partners. In addition, there are increasing "double risk" populations overlapping drug users and sex workers, as well as increasing rates of STDs and HIV among high-risk populations. Sexual transmission,therefore, may serve as a bridge connecting high-risk populations with general populations. There is an urgent need to prevent the spread of HIV from these high-risk populations into the general population of China.

  17. State Department Report: Wilde Lake High School.

    Science.gov (United States)

    Wilde Lake High School, Columbia, MD.

    The report describes general education courses offered at Wilde Lake High School--a school that maintains a flexible environment conducive to learning and hopefully fosters individual development and growth. The aim of the school is to create an environment that helps students: adjust and cope with their environment outside the school; develop…

  18. Patients at High-Risk for Surgical Site Infection.

    Science.gov (United States)

    Mueck, Krislynn M; Kao, Lillian S

    Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

  19. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders

    Science.gov (United States)

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-01-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were…

  20. Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa; Amuleru-Marshall, Omowale; Mufune, Pempelani; Zeid, Alaa Abou

    2016-12-01

    The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

  1. Student Financial Aid. High Risk Series.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report discusses the continuing concerns of the U.S. General Accounting Office (GAO) in regard to the Department of Education's management and oversight of postsecondary student financial aid programs, especially the Federal Family Education Loan, the Ford Direct Loan, and the Federal Pell Grant Programs. GAO commends the department for its…

  2. A comparison of genetic variants between proficient low- and high-risk sport participants.

    Science.gov (United States)

    Thomson, Cynthia J; Power, Rebecca J; Carlson, Scott R; Rupert, Jim L; Michel, Grégory

    2015-01-01

    Athletes participating in high-risk sports consistently report higher scores on sensation-seeking measures than do low-risk athletes or non-athletic controls. To determine whether genetic variants commonly associated with sensation seeking were over-represented in such athletes, proficient practitioners of high-risk (n = 141) and low-risk sports (n = 132) were compared for scores on sensation seeking and then genotyped at 33 polymorphic loci in 14 candidate genes. As expected, athletes participating in high-risk sports score higher on sensation seeking than did low-risk sport athletes (P sport participation for two genes (stathmin, (P = .004) and brain-derived neurotrophic factor (P = .03)) as well as when demographically matched subsets of the sport cohorts were compared (P < .05); however, in all cases, associations did not survive correction for multiple testing.

  3. Media literacy as a prevention intervention for college women at low- or high-risk for eating disorders.

    Science.gov (United States)

    Coughlin, Janelle W; Kalodner, Cynthia

    2006-03-01

    This study examined whether the media literacy program, ARMED, is an effective prevention intervention for college women at low- or high-risk for an eating disorder. Changes in eating disorder risk factors were assessed in low- (n=26) and high-risk (n=19) women participating in a two-session media literacy intervention as compared to low- (n=31) and high-risk (n=16) controls. Women at high-risk for an eating disorder reported significant decreases in body dissatisfaction, drive for thinness, feelings of ineffectiveness, and internalization of societal standards of beauty after participating in ARMED, whereas control participants did not. No significant decreases in perfectionism, physical appearance comparisons, or awareness of societal standards of beauty were reported among high-risk participants. Changes in eating disorder risk factors were not found among low-risk participants, regardless of treatment condition. Findings suggest that media literacy may be an effective secondary prevention intervention for eating disorders.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  5. High Framingham risk score decreases quality of life in adults

    Directory of Open Access Journals (Sweden)

    Christian Yosaputra

    2010-04-01

    Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

  6. Risk Management Techniques and Practice Workshop Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, T; Zosel, M

    2008-12-02

    At the request of the Department of Energy (DOE) Office of Science (SC), Lawrence Livermore National Laboratory (LLNL) hosted a two-day Risk Management Techniques and Practice (RMTAP) workshop held September 18-19 at the Hotel Nikko in San Francisco. The purpose of the workshop, which was sponsored by the SC/Advanced Scientific Computing Research (ASCR) program and the National Nuclear Security Administration (NNSA)/Advanced Simulation and Computing (ASC) program, was to assess current and emerging techniques, practices, and lessons learned for effectively identifying, understanding, managing, and mitigating the risks associated with acquiring leading-edge computing systems at high-performance computing centers (HPCCs). Representatives from fifteen high-performance computing (HPC) organizations, four HPC vendor partners, and three government agencies attended the workshop. The overall workshop findings were: (1) Standard risk management techniques and tools are in the aggregate applicable to projects at HPCCs and are commonly employed by the HPC community; (2) HPC projects have characteristics that necessitate a tailoring of the standard risk management practices; (3) All HPCC acquisition projects can benefit by employing risk management, but the specific choice of risk management processes and tools is less important to the success of the project; (4) The special relationship between the HPCCs and HPC vendors must be reflected in the risk management strategy; (5) Best practices findings include developing a prioritized risk register with special attention to the top risks, establishing a practice of regular meetings and status updates with the platform partner, supporting regular and open reviews that engage the interests and expertise of a wide range of staff and stakeholders, and documenting and sharing the acquisition/build/deployment experience; and (6) Top risk categories include system scaling issues, request for proposal/contract and acceptance testing, and

  7. 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.

  8. 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

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

    Science.gov (United States)

    Lanou, Amy Joy; Svenson, Barbara

    2011-01-01

    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. PMID:21407994

  10. Safety Assessment for Explosive Risk (SAFER) peer review report.

    Energy Technology Data Exchange (ETDEWEB)

    Heimdahl, Olaf E. R. (Naval Air Warfare Center, China Lake, CA); LaHoud, Paul (Athens, AL); Chapman, Leon Darrel

    2004-08-01

    At the direction of the Department of Defense Explosives Safety Board (DDESB), a Peer Review Team was established to review the status of development of the risk-based explosives safety siting process and criteria as currently implemented in the software 'Safety Assessment for Explosive Risk (SAFER)' Version 2.1. The objective of the Peer Review Team was to provide an independent evaluation of the components of the SAFER model, the ongoing development of the model and the risk assessment process and criteria. This peer review report addressed procedures; protocols; physical and statistical science algorithms; related documents; and software quality assurance, validation and verification. Overall, the risk-based method in SAFER represents a major improvement in the Department of Defense (DoD) approach to explosives safety management. The DDESB and Risk Based Explosives Safety Criteria Team (RBESCT) have made major strides in developing a methodology, which over time may become a worldwide model. The current status of all key areas of the SAFER code has been logically developed and is defensible. Continued improvement and refinement can be expected as implementation proceeds. A consistent approach to addressing and refining uncertainty in each of the primary areas (probability of event, consequences of event and exposure) will be a very beneficial future activity.

  11. Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

    Science.gov (United States)

    Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

    2010-01-01

    Background Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically-defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment; where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions and research efforts. Methods We describe the results of a segmentation analysis of those individuals who self-report consuming five or more drinks per drinking episode at least twice in the last 30-days. The study used the proprietary PRIZM™ audience segmentation database merged with Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top ten of the 66 PRIZM™ audience segments for this risky drinking pattern are described. For five of these segments we provide additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers reside. Results The top ten audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge drinking behavior is referred to as the “Cyber Millenials.” This cluster is characterized as “the nation's tech-savvy singles

  12. Characterizing and reaching high-risk drinkers using audience segmentation.

    Science.gov (United States)

    Moss, Howard B; Kirby, Susan D; Donodeo, Fred

    2009-08-01

    Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment, including where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions, and research efforts. We described the results of a segmentation analysis of those individuals who self-reported to consume 5 or more drinks per drinking episode at least twice in the last 30 days. The study used the proprietary PRIZM (Claritas, Inc., San Diego, CA) audience segmentation database merged with the Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top 10 of the 66 PRIZM audience segments for this risky drinking pattern are described. For five of these segments we provided additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers resided. The top 10 audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge-drinking behavior is referred to as the "Cyber Millenials." This cluster is characterized as "the nation's tech

  13. Special features of high-risk pregnancies as factors in development of mental distress: a review

    Directory of Open Access Journals (Sweden)

    Paula Borba Rodrigues

    Full Text Available Abstract Introduction: Approximately 22% of all pregnant women are classified as having high-risk pregnancies, which may involve feelings of vulnerability because of having a high-risk pregnancy, resulting in greater exposure to stressful feelings. Objective: To review aspects of high-risk pregnancy that can have a negative impact on the these women's mental health status. Method: Original articles were identified by conducting searches of the PubMed/MEDLINE, LILACS and SciELO databases, followed by a manual search of references to select articles and additional bibliographic material. Articles from the last 22 years were included in the review (1992-2014. Results: Fifteen articles were found that specifically studied high-risk pregnancies and mental health outcomes. Women with high-risk pregnancies exhibited a significantly higher level of stress and reported negative emotions as they dealt with stress and had worse emotional status than women with normal pregnancies. Researchers found that hospitalized pregnant women had higher levels of anxiety than non-hospitalized women. Studies of women going through normal and high-risk pregnancies show that women with normal pregnancies had good self-perceived quality of life. Conclusion: Special features of high-risk pregnancies could be factors in development of mental distress, in addition to psychological and social factors. Therefore, only a biopsychosocial research study would be able to identify the factors that can affect the quality of mental health during high-risk pregnancy.

  14. Hybrid palliation of interrupted aortic arch in a high-risk neonate

    Directory of Open Access Journals (Sweden)

    Karimi Mohsen

    2010-01-01

    Full Text Available We report a case of a high-risk neonate with interrupted aortic arch (IAA and ventricular septal defect who underwent a successful hybrid palliative procedure using a ductal stent and bilateral branch pulmonary artery banding. This case represents not only a successful use of hybrid approach in high-risk neonates with IAA, but also introduces an alternative and safe access for ductal stent insertion through the right ventricular infundibulum.

  15. HIV and sexual risk behaviors among recognized high-risk groups in Bangladesh: need for a comprehensive prevention program.

    Science.gov (United States)

    Islam, Md Mofizul; Conigrave, Katherine M

    2008-07-01

    To examine trends in HIV and related risk behaviors among recognized high-risk groups in Bangladesh, the types and extent of prevention initiatives that have been undertaken, and highlight the immediate needs. Journal publications and conference abstracts and proceedings were reviewed. Experts involved in the development and evaluation of current programs or policy were contacted for official reports and policy documents. The trends in sexual risk behaviors over five rounds of national surveillance were tabulated. Gaps in the ongoing prevention interventions have been assessed in the light of the Anderson-May equation. Periodic surveillance on recognized high-risk groups shows that HIV prevalence has been increasing steadily. In the capital city, HIV prevalence in one subset of a high-risk group is close to the level of a concentrated epidemic (4.9%). The high prevalence of sexual risk behaviors among drug users and sex workers and their clients is alarming. Although a small increase in condom use and a reduction of syphilis have been noted among subsets of high-risk groups in recent years, this is clearly not enough to curb the threat of a possible HIV epidemic. There is an urgent need for a comprehensive prevention program that should include more efforts on education and condom promotion, effective management of all sexually transmitted infections, a screening program for migrant workers, the continuation of both behavioral and serological components of HIV surveillance, and the expansion of surveillance to cover the remaining high-risk groups, with due consideration to the consistency of surveillance indicators.

  16. Cibola High Levee Pond annual report 2004

    Science.gov (United States)

    Mueller, Gordon A.; Carpenter, Jeanette; Marsh, Paul C.

    2005-01-01

    This represents the fourth and last annual report of a five year study investigating the early life ecology of the bonytail and razorback sucker at Cibola High Levee Pond. The work in 2004 included: telemetry studies, collection of physical water quality measurements, zooplankton samples, netting fish, the collection of scale samples for aging, predator/prey tank tests and a preliminary analysis of the data base.

  17. How do high-risk youth use the Internet? Characteristics and implications for prevention.

    Science.gov (United States)

    Wells, Melissa; Mitchell, Kimberly J

    2008-08-01

    Using data from the Second Youth Internet Safety Survey, a nationally representative telephone survey of 1,500 youth Internet users (ages 10 to 17), this study explores differences in Internet use characteristics between high risk youth and other Internet users. Those youth who engaged in aggressive behavior online and those who used the Internet on a cell phone were about twice as likely to be classified as high risk (having experienced high parent conflict or child maltreatment) as compared to other Internet users. Those youth who talked with known friends online were significantly less likely to be included in the high risk group. Controlling for demographic and Internet use characteristics, youth who received an aggressive sexual solicitation were almost 2.5 times as likely to report experiencing physical abuse, sexual abuse or high parent conflict. Implications for prevention are discussed, including avenues for reaching high risk populations of youth.

  18. A social work study high-risk behavior among teenagers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

  19. INFLUENCE OF RISKS ON INDICATORS OF ACCOUNTING FINANCIAL REPORTING

    Directory of Open Access Journals (Sweden)

    Sigidov Y. I.

    2016-05-01

    Full Text Available In terms of financial instability, contributing to increase in risks associated with conducting a business activity on the territory of the Russian Federation, there comes the need for the settlement of the procedure for reflection of information about the risks of the economic activity in financial statements. This article discusses the concepts of risks, their impact on the performance of financial accounting. There is a classification of risks: legal, country, financial and regional, their special features. To reduce the decline of the economic performance of the organization a variety of activities was offered. One way to solve this problem is the creation of reserves. For this purpose, various options for the establishment of reserves to reduce the impact of risks of the organization are considered in the article. The first option is the creation of reserves at the expense of the cost of production where the reserves are formed on the credit of account 96 "Reserves of forthcoming expenses". The second option is the reservation of funds as a reserve capital: reserves are formed on the credit of account 82 "Reserve capital". The third option is the creation of reserves due to other expenses; such reserves are used to adjust the value of assets. The article provides the calculation of the valuation of receivables. Based on data of accounting balance and the report on financial results of the buyer-debtor the calculation was carried out for the assessment of the credit risk for the organization, which the debtor must repay the debt to. Calculations are based on the methodology of the scientists of the Department of theory of accounting of Kuban State Agrarian University

  20. Tolerance for cougars diminished by high perception of risk

    Directory of Open Access Journals (Sweden)

    Aliah Adams Knopff

    2016-12-01

    Full Text Available In North America, both human and cougar populations are expanding and increasingly sharing the same space, including modified landscapes viewed by people as their "backyard." Low tolerance for cougars in modified landscapes has been identified as a key factor that could restrict continued cougar range expansion in North America, or even reverse some of the gains made by cougar populations in recent decades. To better understand factors influencing tolerance and identify opportunities to improve conservation prospects for cougars, we implemented a questionnaire in west-central Alberta, where both human and cougar populations have increased over the past 20 years and where we had developed a resource selection function for cougars from telemetry data. Respondents overestimated risk from cougars, and more than half believed cougars posed the same or greater risk as driving a car, even though only one Albertan has been killed by a cougar in the last century and hundreds die in car accidents each year. Although respondents valued cougars highly, they indicated that cougars belonged in the wilderness and not near their homes. We predicted that tolerance for cougars would be negatively correlated with increased probability of cougar selection near the respondent's home, but our prediction was not supported. Although such correlations have been reported at broader spatial scales, we suggest they may break down at finer scales. Other factors, such as education, were important drivers of tolerance for cougars in Alberta. Our results suggest that education undertaken to improve large carnivore conservation should focus on accurately defining the risks and ecological benefits resulting from maintaining cougars on the landscape. Education may also need to focus on the importance of nonwilderness habitats (i.e., the rapidly expanding backyard as an important part of long-term conservation and continued range expansion and repatriation of adaptable large

  1. Engineered nanoconstructs for the multiplexed and sensitive detection of high-risk pathogens

    Science.gov (United States)

    Seo, Youngmin; Kim, Ji-Eun; Jeong, Yoon; Lee, Kwan Hong; Hwang, Jangsun; Hong, Jongwook; Park, Hansoo; Choi, Jonghoon

    2016-01-01

    Many countries categorize the causative agents of severe infectious diseases as high-risk pathogens. Given their extreme infectivity and potential to be used as biological weapons, a rapid and sensitive method for detection of high-risk pathogens (e.g., Bacillus anthracis, Francisella tularensis, Yersinia pestis, and Vaccinia virus) is highly desirable. Here, we report the construction of a novel detection platform comprising two units: (1) magnetic beads separately conjugated with multiple capturing antibodies against four different high-risk pathogens for simple and rapid isolation, and (2) genetically engineered apoferritin nanoparticles conjugated with multiple quantum dots and detection antibodies against four different high-risk pathogens for signal amplification. For each high-risk pathogen, we demonstrated at least 10-fold increase in sensitivity compared to traditional lateral flow devices that utilize enzyme-based detection methods. Multiplexed detection of high-risk pathogens in a sample was also successful by using the nanoconstructs harboring the dye molecules with fluorescence at different wavelengths. We ultimately envision the use of this novel nanoprobe detection platform in future applications that require highly sensitive on-site detection of high-risk pathogens.

  2. Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

    National Research Council Canada - National Science Library

    Jeanne Teixeira Bessa Fuly; Nayara Paula Bermudes Giovaninni; Daniele Gasparini Marcato; Eduardo Roberty Badiani Alves; Jessica Dutra Sampaio; Leonardo Iezzi de Moraes; Thais Coutinho Nicola; Julyanna Silva Araujo de Jesus; Everlayny Fiorot Costalonga

    2014-01-01

    OBJECTIVE: To estimate the prevalence of high blood pressure (BP) in school children, as well as the reported frequency of previous measurements of BP in these children, and to identify high BP risk markers in the sample. METHODS...

  3. POPULATION CHARACTERS IN HIGH RISK PEDIGREES OF NASOPHARYNGEAL CARCINOMA (NPC)

    Institute of Scientific and Technical Information of China (English)

    HUANG Teng-bo; ZHANG Jin-ming; HUANG Hui-ming; LI Jing-lian; HUANG Guo-dong

    1999-01-01

    Objective: To investigate population characters in high risk pedigrees of NPC in Guangdong area and to explore the effect each other between tumor genetic susceptibility and infection of EB virus on pathogenic mechanism. Methods: Pedigree investigation, examination of DNA fingerprint, multi-antibodies of EB virus and nasopharyngeal cavity were done for all of the members in each high risk pedigree. Results: High positive rate of EBV VCA/IgA (23.22%), high percentage of high risk population of NPC (6.53-10.40%),high detected rate of malignant tumor (9552.59/105), and high detected rate of NPC (8464.32/105) were discovered and NPC was most common in first degree relative of a pedigree. Conclusion: Tumor genetic susceptibility,infection of EB virus might play a role in coordination of reinforced effect on occurrence of NPC.

  4. Polo pony injuries: player-owner reported risk, perception, mitigation and risk factors.

    Science.gov (United States)

    Inness, C M; Morgan, K L

    2015-07-01

    Polo, one of the world's oldest sports, is unique in merging human skill and balance with animal agility and performance in a contact sport. These modern-day 'centaurs' offer medical, dental and veterinary scientists an unrivalled, if quirky, opportunity to collaborate. Collection of epidemiological data on injuries to UK polo riders and ponies is the first step. To measure the reported risk and risk factors for injuries to UK polo ponies, their perception and mitigation by player-owners. A retrospective cohort design and telephone interviews were used. Data on equine injuries, preseason training and risk perception were collected from a random sample of player-owners using a structured questionnaire. Injuries were defined as requiring veterinary treatment. Frequencies were represented as percentages and 95% confidence intervals (CIs). Risk factors for injuries were identified by univariable and multivariable analyses. The cumulative incidence of player-owner-reported injury was 10.6% (95% CI 8.4-12.7). Tendon injuries were most common (4.3%; 95% CI 2.9-5.7), followed by wounds and splints. The only risk factor was stabling all season (odds ratio 4.79; 95% CI 1.46-15.73). Tendon injuries were perceived as the major risk and hard ground the most important risk factor. Risk mitigation practices were bandaging before exercise (45.7%; 95% CI 34.8-56.5), checking tendons (84.0%; 95% CI 76.0-91.9), cold hosing (40.7%; 95% CI 30.0-51.4), bandaging (38.3%; 95% CI 27.7-48.9) and using clays and coolants after exercise (24.7%; 15.3-34.1). Cuts and wounds were considered most frequent by only 2.5% (95% CI 0.0-3.6) of players but were the second most common injury, accounting for 21.6% of veterinary treatments. Splints accounted for 12.5% of injuries. The risk of injury to polo ponies is similar to that in the general horse population; musculoskeletal injuries, particularly tendon injuries, are most common, followed by wounds and splints. The association between stabling and

  5. More than Poverty—Teen Pregnancy Risk and Reports of Child Abuse Reports and Neglect

    Science.gov (United States)

    Lara, Gerassi; Melissa, Jonson-Reid; Katie, Plax; Brett, Drake

    2015-01-01

    Purpose To compare risk for teen pregnancies between children living in poverty with no Child Protection Services (CPS) report history, and those in poverty with a history of CPS report. Methods Children selected from families in poverty, both with and without CPS report histories were prospectively followed from 1993–2009 using electronic administrative records from agencies including child protective services, emergency departments, Medicaid services and juvenile courts. A total of 3281 adolescent females were followed until age 18. Results For teens with history of poverty only, 16.8% had been pregnant at least once by age 17. In teens with history of both poverty and report of child abuse or neglect, 28.9% had been pregnant at least once by age 17. While multivariate survival analyses revealed several other significant factors at the family and youth services levels, a report of maltreatment remained significant (about a 66% higher risk). Conclusions Maltreatment is a significant risk factor for teen pregnancy among low income youth even after controlling for neighborhood disadvantage, other caregiver risks and indicators of individual emotional and behavioral problems. PMID:26206437

  6. Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk.

    Science.gov (United States)

    Morman, Nichole A; Byrne, Lindsey; Collins, Christy; Reynolds, Kelly; Bell, Jeffrey G

    2017-08-01

    The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman's perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women's perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort's compliance with recommendations was suboptimal, physicians' interactions with their patients may have a positive influence on their compliance.

  7. Communicating about risk: strategies for situations where public concern is high but the risk is low

    Directory of Open Access Journals (Sweden)

    Claire Hooker

    2017-02-01

    Full Text Available In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

  8. Treating Patients with High-Risk Smoldering Myeloma

    Science.gov (United States)

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  9. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  10. Risk-taking behaviour of Cape Peninsula high school students ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN ... South African Medical Journal ... 7 340 students from 16 schools in the three major ed ucation departments.

  11. High Pain Tolerance Tied to 'Silent' Heart Attack Risk

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_162666.html High Pain Tolerance Tied to 'Silent' Heart Attack Risk Unusual symptoms ... is. But the new findings suggest that pain tolerance might be a factor. Using a standard test ...

  12. Suicide Risk Especially High for U.S. Farmers

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166800.html Suicide Risk Especially High for U.S. Farmers Other occupations ... Two decades after the U.S. farm crisis, the suicide rate among American farmers remains much higher than ...

  13. review article risk factors, threats and prevention of highly ...

    African Journals Online (AJOL)

    Dr Oboro VO

    2006-02-09

    Feb 9, 2006 ... mixing vehicle for re-assortment of the virus. The domestic ducks get ... importation of poultry and poultry products from high risk countries, effective disease surveillance ..... therefore an extremely important safety measure to ...

  14. Young moped riders : reducing high risks and high insurance premiums.

    NARCIS (Netherlands)

    Wegman, F.C.M.

    1992-01-01

    The paper examines the reported fall in fatal accidents for moped riders in The Netherlands, and also describes developments with respect to the ownership and use of mopeds. An analysis considers the safety problems of moped riders and suggests how insurance companies might help overcome the safety

  15. Predicting High Risk Adolescents' Substance Use over Time: The Role of Parental Monitoring

    Science.gov (United States)

    Clark, Heddy Kovach; Shamblen, Stephen R.; Ringwalt, Chris L.; Hanley, Sean

    2012-01-01

    We examined whether parental monitoring at baseline predicted subsequent substance use in a high-risk youth population. Students in 14 alternative high schools in Washington State completed self-report surveys at three time points over the course of 2 years. Primary analyses included 1,423 students aged 14-20 who lived with at least one parent or…

  16. Predicting High Risk Adolescents' Substance Use over Time: The Role of Parental Monitoring

    Science.gov (United States)

    Clark, Heddy Kovach; Shamblen, Stephen R.; Ringwalt, Chris L.; Hanley, Sean

    2012-01-01

    We examined whether parental monitoring at baseline predicted subsequent substance use in a high-risk youth population. Students in 14 alternative high schools in Washington State completed self-report surveys at three time points over the course of 2 years. Primary analyses included 1,423 students aged 14-20 who lived with at least one parent or…

  17. Beijing Encourages High-Risk Groups to Undertake AIDS Test

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    High-risk groups in Beijing, China's capital city, such as sex workers, drug-takers who share needles and gay communities are being encouraged to take voluntary counseling and tests (VCT) as part of an effort to stem the spread of AIDS. Tens of thousands of flyers have been distributed to disease control centers at district levels, and they will be handed to high-risk individuals by AIDS workers and volunteers over the next few weeks.

  18. Individuals at high risk for suicide are categorically distinct from those at low risk.

    Science.gov (United States)

    Witte, Tracy K; Holm-Denoma, Jill M; Zuromski, Kelly L; Gauthier, Jami M; Ruscio, John

    2017-04-01

    Although suicide risk is often thought of as existing on a graded continuum, its latent structure (i.e., whether it is categorical or dimensional) has not been empirically determined. Knowledge about the latent structure of suicide risk holds implications for suicide risk assessments, targeted suicide interventions, and suicide research. Our objectives were to determine whether suicide risk can best be understood as a categorical (i.e., taxonic) or dimensional entity, and to validate the nature of any obtained taxon. We conducted taxometric analyses of cross-sectional, baseline data from 16 independent studies funded by the Military Suicide Research Consortium. Participants (N = 1,773) primarily consisted of military personnel, and most had a history of suicidal behavior. The Comparison Curve Fit Index values for MAMBAC (.85), MAXEIG (.77), and L-Mode (.62) all strongly supported categorical (i.e., taxonic) structure for suicide risk. Follow-up analyses comparing the taxon and complement groups revealed substantially larger effect sizes for the variables most conceptually similar to suicide risk compared with variables indicating general distress. Pending replication and establishment of the predictive validity of the taxon, our results suggest the need for a fundamental shift in suicide risk assessment, treatment, and research. Specifically, suicide risk assessments could be shortened without sacrificing validity, the most potent suicide interventions could be allocated to individuals in the high-risk group, and research should generally be conducted on individuals in the high-risk group. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. 多重高危因素患者肾移植一例并文献复习%Renal Transplantation for One Patient with Multiple High Risk Factors:a Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    聂峰; 孙煦勇; 秦科; 董建辉; 杨建均; 李美思; 李壮江

    2015-01-01

    Objective To investigate the characteristics of one patient with multiple high risk factors taking renal transplantation in order to improve the levels of diagnosis and treatment in clinic. Methods Clinical data of the patient with multiple high risk factors taking renal transplantation was retrospectively analyzed. The 45-year-old female received the first renal transplantation because of paralysis and atrophy of both the lower limbs induced by poliomyelitis and a chro-nic renal failure (CRF), and secondary renal transplantation was performed because of pregnancy. The positive panel re-action antibody was detected before the operation. The organ was donated by a 5-year-old child after cardiac death. The mismatched human leucocyte antigens were 3 pieces, and the complement-dependent cytotoxicity test was negative. After the operation, Basiliximab was dosed as immunosuppression induction, and steroid impact was used, and then and Ta-crolimus + Mycophenolate Mofetil + Prednisone was used as immunosuppressant. Results The patient was discharged after the successful recovery of renal function, but complications such as incomplete intestinal obstruction, urinary fistula, acute rejection and pulmonary infection were successively found after the patient was discharged, and in the end the pa-tient died of circulatory and respiratory failure. Conclusion Renal transplantation for patients with multiple high risk factors should be given thorough preoperative assessment and donors selection. A complete and thorough plan of treatment and nursing during peroperative period and post-discharge, and a close follow-up and timely adjustment should be made.%目的:探讨1例具多重高危因素肾移植的疾病特点,提高对高危肾移植患者的临床处置水平。方法回顾性分析1例多重高危因素肾移植患者临床资料。女性45岁,因脊髓灰质炎双下肢瘫痪并萎缩,患慢性肾衰竭行首次肾移植并妊娠后,移植肾衰竭行再次肾

  20. Review of screening for pancreatic cancer in high risk individuals

    Institute of Scientific and Technical Information of China (English)

    Alina Stoita; Ian D Penman; David B Williams

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  1. Review of screening for pancreatic cancer in high risk individuals.

    Science.gov (United States)

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-05-21

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  2. High Risk for Thoracotomy but not Thoracoscopic Lobectomy.

    Science.gov (United States)

    Donahoe, Laura L; de Valence, Moira; Atenafu, Eshetu G; Hanna, Waël C; Waddell, Thomas K; Pierre, Andrew F; Yasufuku, Kazuhiro; de Perrot, Marc; Cypel, Marcelo; Keshavjee, Shaf; Darling, Gail E

    2017-06-01

    Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk. A retrospective review of an institutional database was performed for all patients undergoing lobectomy from 2002 to 2010. Patients were grouped into high-risk (HR) and standard-risk (SR) cohorts according to the American College of Surgeons Oncology Group Z4099/Radiation Therapy Oncology Group 1021 criteria. From 2002 to 2010, 72 HR and 536 SR patients underwent lobectomy. Mean age was 73 years for HR and 66 years for SR (p risk for open lobectomy a feasible procedure, with no difference in overall survival compared with SR patients, and decreased morbidity compared with open lobectomy. VATS lobectomy should be considered for patients who historically may not have been considered for surgical resection. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. High performance computing and communications panel report

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-01

    In FY92, a presidential initiative entitled High Performance Computing and Communications (HPCC) was launched, aimed at securing U.S. preeminence in high performance computing and related communication technologies. The stated goal of the initiative is threefold: extend U.S. technological leadership in high performance computing and computer communications; provide wide dissemination and application of the technologies; and spur gains in U.S. productivity and industrial competitiveness, all within the context of the mission needs of federal agencies. Because of the importance of the HPCC program to the national well-being, especially its potential implication for industrial competitiveness, the Assistant to the President for Science and Technology has asked that the President's Council of Advisors in Science and Technology (PCAST) establish a panel to advise PCAST on the strengths and weaknesses of the HPCC program. The report presents a program analysis based on strategy, balance, management, and vision. Both constructive recommendations for program improvement and positive reinforcement of successful program elements are contained within the report.

  4. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A

  5. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A p

  6. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    Science.gov (United States)

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  7. On risk, leverage and banks: do highly leveraged banks take on excessive risk?

    NARCIS (Netherlands)

    Koudstaal, M.; van Wijnbergen, S.

    2012-01-01

    This paper deals with the relation between excessive risk taking and capital structure in banks. Examining a quarterly dataset of U.S. banks between 1993 and 2010, we find that equity is valued higher when more risky portfolios are chosen when leverage is high, and that more risk taking has a negati

  8. Predicting reattendance at a high-risk breast cancer clinic.

    Science.gov (United States)

    Ormseth, Sarah R; Wellisch, David K; Aréchiga, Adam E; Draper, Taylor L

    2015-10-01

    The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

  9. Legionnaires’ disease and occupational risk: a case report

    Directory of Open Access Journals (Sweden)

    Antonella Mansi

    2004-12-01

    Full Text Available

    We report results of environmental microbiological sampling in an office building whose occupants referred different symptoms ascribable to the air conditioning system.

    Legionella pneumophila serogroup 1 was detected in water samples drawn from the cooling tower with counts that ranged from 1.4 x105 to 1.5x107 CFU/L.

     This biological agent is classified in the second risk group according to Italian law (D.Lgs. 626/94, consequently proper control measures in order to re-establish acceptable hygienic environment conditions and to assure healthy workplace are needed.

  10. High Temperature Materials Laboratory third annual report

    Energy Technology Data Exchange (ETDEWEB)

    Tennery, V.J.; Foust, F.M.

    1990-12-01

    The High Temperature Materials Laboratory has completed its third year of operation as a designated DOE User Facility at the Oak Ridge National Laboratory. Growth of the user program is evidenced by the number of outside institutions who have executed user agreements since the facility began operation in 1987. A total of 88 nonproprietary agreements (40 university and 48 industry) and 20 proprietary agreements (1 university, 19 industry) are now in effect. Sixty-eight nonproprietary research proposals (39 from university, 28 from industry, and 1 other government facility) and 8 proprietary proposals were considered during this reporting period. Research projects active in FY 1990 are summarized.

  11. Risk factors for high-risk and multi-type Human Papillomavirus infections among women in Ho Chi Minh City, Vietnam: a cross-sectional study.

    Science.gov (United States)

    Tran, Ly Thi-Hai; Tran, Loi Thi; Bui, Thanh Cong; Le, Dung Thi-Kieu; Nyitray, Alan G; Markham, Christine M; Swartz, Michael D; Vu-Tran, Chau Bao; Hwang, Lu-Yu

    2015-01-01

    Concurrent infection with multiple types of Human Papillomavirus (HPV) is associated with an increased risk of cervical cancer; yet, little is known about risk factors for concurrent HPV infection in Vietnam. This study investigated the prevalence of and risk factors for high-risk-type HPV and multi-type HPV infections among women in Ho Chi Minh City, Vietnam. Data were collected from a population-based survey of 1,550 women (mean age = 42.4; SD = 9.5), using a multi-stage sampling process. Socio-demographic and behavioral variables were obtained by self-report. HPV genotypes in cervical specimens were identified using PCR protocols. The prevalence of any high-risk HPV infection was 9.0%, and of multi-type HPV infection was 1.9%. In the HPV+ subsample, the percentage of high-risk HPV was 84% and of multi-type HPV was 20%. All multi-type HPV infections were high-risk-type. Lifetime smoking and older age of first sex were significantly associated with any high-risk and multi-type HPV infections. Regular condom use was inversely associated with high-risk and multi-type HPV infection. Risk factors for high-risk and multi-type HPV infections were similar. Further research and intervention are needed to reduce HPV infections in order to prevent HPV-related cancers.

  12. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tilburt Jon C

    2011-05-01

    Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

  13. 2011 Montana Youth Risk Behavior Survey High School Results and 2011 Comparative Report for: Grades 7-8; American Indian Students on or near a Reservation; American Indian Students in Urban Schools; Nonpublic Accredited Schools; Alternative Schools; Students with Disabilities

    Science.gov (United States)

    Montana Office of Public Instruction, 2011

    2011-01-01

    The Youth Risk Behavior Survey (YRBS) is an epidemiologic surveillance system that was established by the U.S. Centers for Disease Control and Prevention (CDC) to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems that can occur during…

  14. Cellular immune profiling after sequential clofarabine and lenalidomide for high risk myelodysplastic syndromes and acute myeloid leukemia.

    Science.gov (United States)

    Jain, Prachi; Klotz, Jeffrey; Dunavin, Neil; Lu, Kit; Koklanaris, Eleftheria; Draper, Debbie; Superata, Jeanine; Chinian, Fariba; Yu, Quan; Keyvanfar, Keyvan; Wong, Susan; Muranski, Pawel; Barrett, A John; Ito, Sawa; Battiwalla, Minoo

    2017-01-01

    Patients with high risk myelodysplastic syndromes (MDS) and acute myelogenous leukemia (AML) are commonly older with multiple co-morbidities, rendering them unsuitable for intensive induction chemotherapy or transplantation. We report preliminary cellular immune profiling of four cases receiving sequential clofarabine and lenalidomide for high risk MDS and AML in a phase I study. Our results highlight the potential of immune profiling for monitoring immune-modifying agents in high risk MDS and AML.

  15. Cellular immune profiling after sequential clofarabine and lenalidomide for high risk myelodysplastic syndromes and acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Prachi Jain

    2017-01-01

    Full Text Available Patients with high risk myelodysplastic syndromes (MDS and acute myelogenous leukemia (AML are commonly older with multiple co-morbidities, rendering them unsuitable for intensive induction chemotherapy or transplantation. We report preliminary cellular immune profiling of four cases receiving sequential clofarabine and lenalidomide for high risk MDS and AML in a phase I study. Our results highlight the potential of immune profiling for monitoring immune-modifying agents in high risk MDS and AML.

  16. Vaccination rates among the general adult population and high-risk groups in the United States.

    Directory of Open Access Journals (Sweden)

    Kathy Annunziata

    Full Text Available BACKGROUND: In order to adequately assess the effectiveness of vaccination in helping to control vaccine-preventable infectious disease, it is important to identify the adherence and uptake of risk-based recommendations. METHODS: The current project includes data from five consecutive datasets of the National Health and Wellness Survey (NHWS: 2007 through 2011. The NHWS is an annual, Internet-based health questionnaire, administered to a nationwide sample of adults (aged 18 or older which included items on vaccination history as well as high-risk group status. Vaccination rates and characteristics of vaccinees were reported descriptively. Logistic regressions were conducted to predict vaccination behavior from sociodemographics and risk-related variables. RESULTS: The influenza vaccination rate for all adults 18 years and older has increased significantly from 28.0% to 36.2% from 2007 to 2011 (ps<.05. Compared with those not at high risk (25.1%, all high-risk groups were vaccinated at a higher rate, from 36.8% (pregnant women to 69.7% (those with renal/kidney disease; however, considerable variability among high-risk groups was observed. Vaccination rates among high-risk groups for other vaccines varied considerably though all were below 50%, with the exception of immunocompromised respondents (57.5% for the hepatitis B vaccine and 52.5% for the pneumococcal vaccine and the elderly (50.4% for the pneumococcal. Multiple risk factors were associated with increased rate of vaccination for most vaccines. Significant racial/ethnic differences with influenza, hepatitis, and herpes zoster vaccination rates were also observed (ps<.05. CONCLUSIONS: Rates of influenza vaccination have increased over time. Rates varied by high-risk status, demographics, and vaccine. There was a pattern of modest vaccination rate increases for individuals with multiple risk factors. However, there were relatively low rates of vaccination for most risk-based recommendations

  17. High cardiovascular risk in severely obese young children and adolescents

    NARCIS (Netherlands)

    Emmerik, N.M.A. van; Renders, C.M.; Veer, M. van de; Buuren, S. van; Baan-Slootweg, O.H. van der; Kist-van Holthe, J.E.; HiraSing, R.A.

    2012-01-01

    Objective: To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents. Methods: A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2-18-year-old

  18. High cardiovascular risk in severely obese young children and adolescents

    NARCIS (Netherlands)

    Emmerik, N.M.A. van; Renders, C.M.; Veer, M. van de; Buuren, S. van; Baan-Slootweg, O.H. van der; Kist-van Holthe, J.E.; HiraSing, R.A.

    2012-01-01

    Objective: To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents. Methods: A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2-18-year-old c

  19. Telomerase activation by genomic rearrangements in high-risk neuroblastoma.

    Science.gov (United States)

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L; Sand, Frederik; Heuckmann, Johannes M; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Gloeckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R; Savelyeva, Larissa; Watkins, Simon C; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H; Herrmann, Carl; O'Sullivan, Roderick J; Westermann, Frank; Thomas, Roman K; Fischer, Matthias

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours.

  20. Psychological characteristics in high-risk MSM in China

    Directory of Open Access Journals (Sweden)

    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  1. Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

    Science.gov (United States)

    Mosack, Katie E.; Randolph, Mary E.; Dickson-Gomez, Julia; Abbott, Maryann; Smith, Ellen; Weeks, Margaret R.

    2010-01-01

    This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by…

  2. Integrated transcriptome and methylome analysis in youth at high risk for bipolar disorder: a preliminary analysis.

    Science.gov (United States)

    Fries, G R; Quevedo, J; Zeni, C P; Kazimi, I F; Zunta-Soares, G; Spiker, D E; Bowden, C L; Walss-Bass, C; Soares, J C

    2017-03-14

    First-degree relatives of patients with bipolar disorder (BD), particularly their offspring, have a higher risk of developing BD and other mental illnesses than the general population. However, the biological mechanisms underlying this increased risk are still unknown, particularly because most of the studies so far have been conducted in chronically ill adults and not in unaffected youth at high risk. In this preliminary study we analyzed genome-wide expression and methylation levels in peripheral blood mononuclear cells from children and adolescents from three matched groups: BD patients, unaffected offspring of bipolar parents (high risk) and controls (low risk). By integrating gene expression and DNA methylation and comparing the lists of differentially expressed genes and differentially methylated probes between groups, we were able to identify 43 risk genes that discriminate patients and high-risk youth from controls. Pathway analysis showed an enrichment of the glucocorticoid receptor (GR) pathway with the genes MED1, HSPA1L, GTF2A1 and TAF15, which might underlie the previously reported role of stress response in the risk for BD in vulnerable populations. Cell-based assays indicate a GR hyporesponsiveness in cells from adult BD patients compared to controls and suggest that these GR-related genes can be modulated by DNA methylation, which poses the theoretical possibility of manipulating their expression as a means to counteract the familial risk presented by those subjects. Although preliminary, our results suggest the utility of peripheral measures in the identification of biomarkers of risk in high-risk populations and further emphasize the potential role of stress and DNA methylation in the risk for BD in youth.

  3. Detection of high risk campylobacteriosis clusters at three geographic levels

    Directory of Open Access Journals (Sweden)

    Jennifer Weisent

    2011-11-01

    Full Text Available Campylobacteriosis is a leading cause of bacterial gastroenteritis in the United States and many other developed countries. Understanding the spatial distribution of this disease and identifying high-risk areas is vital to focus resources for prevention and control measures. In addition, determining the appropriate scale for geographical analysis of surveillance data is an area of concern to epidemiologists and public health officials. The purpose of this study was to (i compare standardized risk estimates for campylobacteriosis in Tennessee over three distinct geographical scales (census tract, zip code and county subdivision, and (ii identify and investigate high-risk spatial clustering of campylobacteriosis at the three geographical scales to determine if clustering is scale dependent. Significant high risk clusters (P <0.05 were detected at all three spatial scales. There were overlaps in regions of high-risk and clusters at all three geographic levels. At the census tract level, spatial analysis identified smaller clusters of finer resolution and detected more clusters than the other two levels. However, data aggregation at zip code or county subdivision yielded similar findings. The importance of this line of research is to create a framework whereby economically efficient disease control strategies become more attainable through improved geographical precision and risk detection. Accurate identification of disease clusters for campylobacteriosis can enable public health personnel to focus scarce resources towards prevention and control programmes on the most at-risk populations. Consistent results at multiple spatial levels highlight the robustness of the geospatial techniques utilized in this study. Furthermore, analyses at the zip code and county subdivision levels can be useful when address level information (finer resolution data are not available. These procedures may also be used to help identify regionally specific risk factors for

  4. Reducing mortality for high risk surgical patients in the UK.

    Science.gov (United States)

    Rogers, B A; Carrothers, A D; Jones, Chris

    2012-06-01

    Over 40 million surgical procedures are performed per annum in the USA and Europe, including several million patients who are considered to be high risk (Bennett-Guerrero et al 2003). Overall, the risk of death or major complications after surgery in the general surgical patient population is low, with a post-operative mortality rate of less than1% during the same hospital admission (Niskanen et al 2001).

  5. Lay media reporting of rosiglitazone risk: extent, messaging and quality of reporting

    Directory of Open Access Journals (Sweden)

    Brown Garielle E

    2009-07-01

    Full Text Available Abstract Background A meta-analysis suggested the use of rosiglitazone was associated with an increased risk for cardiovascular (CV events. Rosiglitazone remained available for use as more definitive safety trials were ongoing. This issue was reported in the lay media. Objective To review lay media articles to determine the extent of media coverage, the nature of the messaging, and to assess the quality of reporting. Methods The Factiva media database was used to identify articles published between May 18 and August 31, 2007. Two reviewers (a lay person and a physician screened full text articles for eligibility, appraised the articles for their tone (worrisome, neutral, not worrisome, and for the quality of medical data reporting. Results The search identified 156 articles, 95 of which were eligible for our review. Agreement between the lay and medical reviewers in the appraisal of the article tone was 67.4%. Among those with agreement, the articles were often appraised as "worrisome" (75.3%. Among those with disagreement, the lay reviewer was significantly more likely to appraise articles as worrisome compared to the medical reviewer (77.4% vs. 3.2%, X2 = 9.11, P = 0.003. Cardiovascular risk was discussed in 91.6% of the articles, but risk was often reported in qualitative or relative terms. Conclusion There were many lay media articles addressing the safety of rosiglitazone, and the general messaging of these articles was considered "worrisome" by reviewers. Quality of risk reporting in the articles reviewed was poor. The impact of such media coverage on public anxiety and confidence in treatment should be explored.

  6. High-Assurance Software: LDRD Report.

    Energy Technology Data Exchange (ETDEWEB)

    Hulette, Geoffrey Compton

    2014-06-01

    This report summarizes our work on methods for developing high-assurance digital systems. We present an approach for understanding and evaluating trust issues in digital systems, and for us- ing computer-checked proofs as a means for realizing this approach. We describe the theoretical background for programming with proofs based on the Curry-Howard correspondence, connect- ing the field of logic and proof theory to programs. We then describe a series of case studies, intended to demonstrate how this approach might be adopted in practice. In particular, our stud- ies elucidate some of the challenges that arise with this style of certified programming, including induction principles, generic programming, termination requirements, and reasoning over infinite state spaces.

  7. Child abuse potential inventory and parenting behavior: relationships with high-risk correlates.

    Science.gov (United States)

    Haskett, M E; Scott, S S; Fann, K D

    1995-12-01

    The primary purpose of this research was to examine the construct validity of the Child Abuse Potential Inventory by comparing maltreating and high-risk parents' CAP Inventory abuse scores to their behavior during interactions with their children. A second purpose was to determine the degree to which CAP Inventory scores and parenting behavior were related to several known correlates of abuse, as measured by parent and teacher reports. Participants (n = 41) included abusive and high-risk parents and their children referred to a treatment group. Correlational analyses revealed that CAP Inventory scores and observed parenting style yielded highly related findings, supporting construct validity of the CAP Inventory. However, the CAP Inventory and observed behavior index showed a different pattern of relationships to the risk correlates. Implications for assessment of risk status are discussed and recommendations are provided for continued research.

  8. RISK DISCLOSURE ANALYSIS IN THE CORPORATE GOVERNANCE ANNUAL REPORT USING FUZZY-SET QUALITATIVE COMPARATIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Pedro Carmona

    2016-05-01

    Full Text Available This paper explores the necessary and sufficient conditions of good Corporate Governance practices for high risk disclosure by firms in their Corporate Governance Annual Report. Additionally, we explore whether those recipes have changed during the financial crisis. With a sample of 271 Spanish listed companies, we applied fuzzy-set qualitative comparative analysis to a database of financial and non-financial data. We report that Board of Directors independence, size, level of activity and gender diversity, CEO duality, Audit Committee independence, being audited by the Big Four auditing firms and the presence of institutional investors are associated with high risk disclosure. The conditions included in almost every combination are the presence of institutional investors and being audited by the Big Four. We found similar combinations for 2006 and 2012, while the analysis for 2009 showed the lowest number of causal configurations.

  9. Caffeine and cognitive decline in elderly women at high vascular risk. : Caffeine and cognition in high-risk women

    OpenAIRE

    Vercambre, Marie-Noël; Berr, Claudine; Ritchie, Karen,; Kang, Jae,

    2013-01-01

    International audience; BACKGROUND: Persons with vascular disorders are at higher risk of cognitive decline. OBJECTIVE: To determine whether caffeine may be associated with cognitive decline reduction in elderly at high vascular risk. METHODS: We included 2,475 women aged 65+ years in the Women's Antioxidant Cardiovascular Study, a randomized trial of antioxidants and B vitamins for cardiovascular disease secondary prevention. We ascertained regular caffeine intake at baseline (1995-1996) usi...

  10. Interim Status Report for Risk Management for SFRs

    Energy Technology Data Exchange (ETDEWEB)

    Jankovsky, Zachary Kyle [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Groth, Katrina [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wheeler, Timothy A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-10-01

    Accident management is an important component to maintaining risk at acceptable levels for all complex systems, such as nuclear power plants. With the introduction of passive, or inherently safe, reactor designs the focus has shifted from management by operators to allowing the system's design to take advantage of natural phenomena to manage the accident. Inherently and passively safe designs are laudable, but nonetheless extreme boundary conditions can interfere with the design attributes which facilitate inherent safety, thus resulting in unanticipated and undesirable end states. This report examines an inherently safe and small sodium fast reactor experiencing a variety of beyond design basis events with the intent of exploring the utility of a Dynamic Bayesian Network to infer the state of the reactor to inform the operator's corrective actions. These inferences also serve to identify the instruments most critical to informing an operator's actions as candidates for hardening against radiation and other extreme environmental conditions that may exist in an accident. This reduction in uncertainty serves to inform ongoing discussions of how small sodium reactors would be licensed and may serve to reduce regulatory risk and cost for such reactors.

  11. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

    DEFF Research Database (Denmark)

    Woodward, E R; Sleightholme, H V; Considine, A M

    2007-01-01

    OBJECTIVE: To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. DESIGN: Retrospective audit. SETTING: NHS Trust. POPULATION: Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high-risk...... group (>10% lifetime risk of developing ovarian cancer), 77 in a moderate risk group (4-10% lifetime risk of developing ovarian cancer) and 71 in a near population risk group (risk). METHODS: Retrospective audit of case records, laboratory CA125 results, radiology reports, histology records...... endometrial cancer. Twenty-eight women (93.3%) had no malignancy. Sensitivity, specificity, PPV and NPV for TVU in the whole cohort were 33.3, 85.8, 0.6 and 99.8%, respectively. For high-risk individuals, the figures for TVU were 33.3, 84.5, 1.1 and 99.6, respectively. Combining both modalities for the whole...

  12. Hypertension Management in the High Cardiovascular Risk Population

    Directory of Open Access Journals (Sweden)

    Ilir Maraj

    2013-01-01

    Full Text Available The incidence of hypertension is increasing every year. Blood pressure (BP control is an important therapeutic goal for the slowing of progression as well as for the prevention of Cardiovascular disease. The management of hypertension in the high cardiovascular risk population remains a real challenge as the population continues to age, the incidence of diabetes increases, and more and more people survive acute myocardial infarction. We will review hypertension management in the high cardiovascular risk population: patients with coronary heart disease (CHD and heart failure (HF as well as in diabetic patients.

  13. Self-reported screen time and cardiometabolic risk in obese Dutch adolescents.

    Directory of Open Access Journals (Sweden)

    Teatske M Altenburg

    Full Text Available BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C, high-density (HDL-C and total cholesterol (TC, triglycerides, glucose and insulin were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000] and LDL-C (B = -0.002; CI = [-0.001;0.000]. CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities.

  14. Teenage cervical screening in a high risk American population

    Directory of Open Access Journals (Sweden)

    Songlin Zhang

    2011-01-01

    Full Text Available Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8% were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0, with 15.4% vs. 3.2% (P = 0 of low grade intraepithelial lesion (LSIL and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0. Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.

  15. Personality and sensation seeking in high-risk sports

    Directory of Open Access Journals (Sweden)

    Polona Klinar

    2017-03-01

    Full Text Available Background: Personality represents a relatively consistent and unique sum of psychological, cognitive and physical characteristics of an individual. Sensation seeking is defined as an action, characterized by the search for different, new, complex and intensive emotions and experiences and preparedness to take physical, social, legal and financial risks in order to achieve these experiences.Objective: We were looking for differences in personality and sensation seeking between high-risk sports athletes and recreational athletes and the correlation between one's purpose to participate in high-risk sports and actual participation.Method: The data was acquired using three different questionnaires: Sensation Seeking Scale (forms SSS - V and SSS - VI and the Big Five Questionnaire. The sample consisted of 76 high-risk sports athletes and 51 recreational athletes. Data was analyzed using the SPSS statistical program.Results: The results were unexpected because we noticed differences between the two groups in which recreational athletes received higher results, especially in openness. Mostly results from such research show the converse - athletes of high-risk sports are more open. We did not find any difference between the two groups in sensation seeking. We found some correlations between personality traits and factors of Sensation Seeking Scale (SSS - V and SSS - VI. Openness and the Thrill and adventure seeking factor correlated in both versions of SSS.Conclusions: We conclude that high-risk sports athletes differ from recreational athletes, especially in openness. Also, we can confirm that both used versions of SSS are equally effective for analyzing sensation seeking.

  16. Chernobyl Nuclear Catastrophe and the High Risk Potential for Mental Retardation.

    Science.gov (United States)

    Holowinsky, Ivan Z.

    1993-01-01

    This report considers potential effects of the 1986 nuclear explosion at the Chernobyl (Ukraine) nuclear reactor. Approximately 17 million people, of whom 2.5 million were below the age of 5, are thought to have suffered some radioactive contamination. Many of these children are at high risk for mental retardation and learning disorders.…

  17. EPA guidance on the early detection of clinical high risk states of psychoses

    DEFF Research Database (Denmark)

    Schultze-Lutter, F; Michel, C; Schmidt, S J

    2015-01-01

    The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rat...

  18. HIV Sentinel Surveillance Among High Risk Groups: Scenario In Gujarat

    Directory of Open Access Journals (Sweden)

    L B Chavan, Prakash Patel, Vaibhav Gharat

    2011-01-01

    Full Text Available Background: Surveillance is the ongoing systematic collection, collation, analysis and interpretation of data so that appropriate action can be taken within time. Aims and Objective: The present annual HIV sentinel surveillance (HSS was carried out for monitoring trends of HIV epidemic in high risk group populations in selected sites of Gujarat state.. Methodology: The HSS was carried out in representative populations from High Risk Group (HRG like Female Sex Workers (FSW, Man having Sex with Man (MSM and Single Male Migrant. Target sample size was 250 at each HRG site (Female Sex Worker, Male Sex Male & SMM. Consecutive sampling was done at designated sentinel site for selecting the survey participants. Results: Overall 3726 samples (1494 FSWs, 1732 MSMs & 500 SMM were tested in the High risk group of HSS 2008. The overall sero-positivity in samples from FSWs, MSMs sites was 4.5%. Sero-positivity was more or less high (? 5% among FSWs as well as MSMs irrespective of age, place of residence, literacy level, occupation; and migration status. Conclusion: The overall trend of sero-positivity in High risk groups shows decreasing trend of HIV in the state from 2004 to 2008.

  19. Risk factors for radiotherapy incidents and impact of an online electronic reporting system.

    Science.gov (United States)

    Chang, David W; Cheetham, Lynn; te Marvelde, Luc; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-08-01

    To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p5% deviation in dose (10.50 to 2.75%, p<0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Two-stage transjugular intrahepatic porta-systemic shunt for patients with cirrhosis and a high risk of portal-systemic encephalopathy patients as a bridge to orthotopic liver transplantation: A preliminary report

    NARCIS (Netherlands)

    T. Wroblewski; O. Rowinski; B. Ziarkiewicz-Wroblewska; B. Gornicka; J. Albrecht; E.A. Jones; M. Krawczyk

    2006-01-01

    Aim. Placement of a transjugular intrahepatic porta-systemic shunt (TIPS) is a therapeutic option for the management of bleeding esophageal varices. However, the procedure is associated with an increased risk of portal-systemic encephalopathy (PSE). In this study, a two-stage modification of the sta

  1. Circulating tumor cells in high-risk nonmetastatic colorectal cancer.

    Science.gov (United States)

    Gazzaniga, Paola; Gianni, Walter; Raimondi, Cristina; Gradilone, Angela; Lo Russo, Giuseppe; Longo, Flavia; Gandini, Orietta; Tomao, Silverio; Frati, Luigi

    2013-10-01

    The identification of patients at higher risk of recurrence after primary colorectal cancer resection is currently one of the challenges facing medical oncologists. Circulating tumor cell (CTC) may represent a surrogate marker of an early spread of disease in patients without overt metastases. Thirty-seven high-risk stages II-III colorectal cancer patients were evaluated for the presence of CTC. Enumeration of CTCs in 7.5 ml of blood was carried out with the FDA-cleared CellSearch system. CTC count was performed after primary tumor resection and before the start of adjuvant therapy. CTC was detected in 22 % of patients with a significant correlation with regional lymph nodes involvement and stage of disease. No significant correlation was found among the presence of CTC and other clinicopathological parameters. These data suggest that CTCs detection might help in the selection of high-risk stage II colorectal cancer patient candidates for adjuvant chemotherapy.

  2. Uncertainties in Cancer Risk Coefficients for Environmental Exposure to Radionuclides. An Uncertainty Analysis for Risk Coefficients Reported in Federal Guidance Report No. 13

    Energy Technology Data Exchange (ETDEWEB)

    Pawel, David [U.S. Environmental Protection Agency; Leggett, Richard Wayne [ORNL; Eckerman, Keith F [ORNL; Nelson, Christopher [U.S. Environmental Protection Agency

    2007-01-01

    Federal Guidance Report No. 13 (FGR 13) provides risk coefficients for estimation of the risk of cancer due to low-level exposure to each of more than 800 radionuclides. Uncertainties in risk coefficients were quantified in FGR 13 for 33 cases (exposure to each of 11 radionuclides by each of three exposure pathways) on the basis of sensitivity analyses in which various combinations of plausible biokinetic, dosimetric, and radiation risk models were used to generate alternative risk coefficients. The present report updates the uncertainty analysis in FGR 13 for the cases of inhalation and ingestion of radionuclides and expands the analysis to all radionuclides addressed in that report. The analysis indicates that most risk coefficients for inhalation or ingestion of radionuclides are determined within a factor of 5 or less by current information. That is, application of alternate plausible biokinetic and dosimetric models and radiation risk models (based on the linear, no-threshold hypothesis with an adjustment for the dose and dose rate effectiveness factor) is unlikely to change these coefficients by more than a factor of 5. In this analysis the assessed uncertainty in the radiation risk model was found to be the main determinant of the uncertainty category for most risk coefficients, but conclusions concerning the relative contributions of risk and dose models to the total uncertainty in a risk coefficient may depend strongly on the method of assessing uncertainties in the risk model.

  3. Complement C3 and High Risk of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Nørgaard, Ina; Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Complement activation may contribute to venous thromboembolism, including deep venous thrombosis and pulmonary embolism. We tested the hypothesis that high complement C3 concentrations are associated with high risk of venous thromboembolism in the general population. METHODS: We...... similar for deep venous thrombosis and pulmonary embolism separately. The multivariable-adjusted hazard ratio for venous thromboembolism for a 1-g/L increase in complement C3 was 2.43 (1.74-3.40). CONCLUSIONS: High concentrations of complement C3 were associated with high risk of venous thromboembolism...... included 80 517 individuals without venous thromboembolism from the Copenhagen General Population Study recruited in 2003-2012. Plasma complement C3 concentrations were measured at baseline, and venous thromboembolism (n = 1176) was ascertained through April 2013 in nationwide registries. No individuals...

  4. Hypertensive patients and diabetes : A high-risk population

    NARCIS (Netherlands)

    Bilo, HJG; Gans, ROB

    1998-01-01

    Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic patient

  5. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L;

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  6. Radical prostatectomy in clinically localized high-risk prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Berg, Kasper Drimer; Christensen, Ib Jarle;

    2013-01-01

    Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP) is regar......Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP......) is regarded as primary therapy by others. This study examined the outcome for high-risk localized PCa patients treated with RP. Material and methods. Of 1300 patients who underwent RP, 231 were identified as high-risk. Patients were followed for biochemical recurrence (BCR) (defined as prostate......-specific antigen ≥ 0.2 ng/ml), metastatic disease and survival. Excluding node-positive patients, none of the patients received adjuvant therapy before BCR was confirmed. Univariate and multivariate analysis was performed with Kaplan-Meier and Cox proportional hazard models. Results. Median follow-up was 4.4 years...

  7. Differentiated Instruction to Support High-Risk Preschool Learners

    Science.gov (United States)

    DeBaryshe, Barbara D.; Gorecki, Dana M.; Mishima-Young, Lori N.

    2009-01-01

    Differentiated instruction is a strategy for meeting the needs of diverse learners. In this article, we describe a differentiated instruction model and examine the effects on high-risk children. One hundred twenty-eight children and their teachers from 8 Head Start classrooms participated in the project. Teachers provided developmentally…

  8. Economic evaluation studies of obstetric interventions in high risk pregnancies

    NARCIS (Netherlands)

    Vijgen, S.M.C.

    2013-01-01

    In this thesis we performed comparative costs and cost-effectiveness analyses for several clinical dilemmas in high risk pregnancies or deliveries, and explored practical and methodological issues in such research and to discuss the context of evidence-based policy making in relation to complex dile

  9. Cyberbullying and Its Risk Factors among Chinese High School Students

    Science.gov (United States)

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  10. Detection of Patients at High Risk of Medication Errors

    DEFF Research Database (Denmark)

    Sædder, Eva Aggerholm; Lisby, Marianne; Nielsen, Lars Peter

    2016-01-01

    Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs...

  11. Prospective screening for deep vein thrombosis in high risk patients.

    Science.gov (United States)

    Barnes, R W

    1977-08-01

    In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.

  12. ORIGINAL ARTICLES Factors associated with female high-risk ...

    African Journals Online (AJOL)

    Africa in 2002,1 7% of disability-adjusted life-years (DALYS) and 7.1% of deaths ... high-risk drinking in women of reproductive age in a rural and an urban South .... hungry; employment status; highest level of education; and the presence of 8 ...

  13. Cyberbullying and Its Risk Factors among Chinese High School Students

    Science.gov (United States)

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  14. The High-mountain Cryosphere: Environmental Changes and Human Risks

    Directory of Open Access Journals (Sweden)

    Maria Shahgedanova

    2016-08-01

    Full Text Available Reviewed: The High-mountain Cryosphere: Environmental Changes and Human Risks Edited by Christian Huggel, Mark Carey, John J. Clague, and Andreas Kääb. Cambridge, UK: Cambridge University Press, 2015. xii + 363 pp. Hardcover: US$ 140.00, ISBN 978-1-107-06584-0. E-book: US$ 112.00, ISBN 978-1-316-35515-2.

  15. Big Books from Little Voices: Reaching High Risk Beginning Readers.

    Science.gov (United States)

    Trachtenburg, Phyllis; Ferruggia, Ann

    1989-01-01

    Discusses how interactive, whole class techniques (using a student-generated Big Book adaptation of "Corduroy") improved the reading skills of high risk first grade readers. Describes several activities, including sight word strategies, decoding techniques, and word processing, and suggests 27 Big Books for use with these activities. (MM)

  16. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Health risk behaviours of high school learners and their perceptions of preventive services offered by general ... Journal Home > Vol 51, No 3 (2009) > ... and the use of alcohol, tobacco and other drugs (ATOD use). ... Furthermore, the NAFCI initiative does not involve the general practitioner (GP) in the private sector.

  17. A pilot pharmacotherapy trial for depressed youths at high genetic risk for bipolarity.

    Science.gov (United States)

    Findling, Robert L; Lingler, Jacqui; Rowles, Brieana M; McNamara, Nora K; Calabrese, Joseph R

    2008-12-01

    Children and adolescents who are the offspring of a bipolar parent and who first present with major depressive disorder (MDD) are at high risk for eventually developing bipolar disorder. In this report, the authors describe a group of 9 such high-risk children and adolescents with MDD, aged 7-16 years, who were randomized to receive treatment with either paroxetine monotherapy or combination paroxetine-divalproex sodium therapy. In the long-term management of depressive symptomatology in these patients, neither treatment appeared to be particularly effective. As a result, future treatment studies in this population appear to be warranted, not only due to the putative impending risk of developing bipolar disorder, but also the manifest risk of current depressive episodes.

  18. Risk factors for FEV1 decline in mild COPD and high-risk populations

    Science.gov (United States)

    Chen, Shujing; Wang, Changhui; Li, Bing; Shi, Guochao; Li, Huiping; Zhang, Jing; Gu, Yutong; Zhou, Jian; Song, Yuanlin; Bai, Chunxue

    2017-01-01

    Background Early diagnosis of COPD is often not achieved due to limited recognition and limited access to the pulmonary function test. Our hypothesis was that lung function decline may be different between populations with mild COPD and those who are at high risk and do not receive treatment. Patients and methods Subjects with mild COPD and those from a high-risk COPD population were recruited from a community-based COPD epidemiological study after obtaining consent. Baseline clinical characteristics, symptom questionnaire, spirometry, low-dose computed tomography (LDCT) chest scan, and blood plasma biomarker data were collected initially and then 1 year later. Results A total of 617 participants were recruited, and 438 eventually completed the first-year follow-up visit; 72 participants (46 males) were in the mild COPD group, and 225 participants (165 males) were in the high-risk group. The mean forced expiratory volume in the first second of expiration (FEV1) decline in the mild COPD group was 129 mL, which was significantly higher than the 30 mL decline in the high-risk population group (P=0.005). Group category (odds ratio [OR] =0.230) and COPD Assessment Test (CAT) score (OR =9.912) were independent risk factors for an FEV1% predicted decline of >15% for all participants. In the mild COPD group, patients with a higher CAT (OR =5.310) and Emphysema Index (OR =5.681) were associated with a FEV1% predicted decline of >15% at the first-year follow-up. No factor showed a significantly predictive effect on FEV1 decline in the high-risk COPD group. Conclusion Group category was an independent influential factor associated with FEV1 decline. PMID:28184155

  19. Who takes risks in high-risk sport?: the role of alexithymia.

    Science.gov (United States)

    Barlow, Matthew; Woodman, Tim; Chapman, Caradog; Milton, Matthew; Stone, Daniel; Dodds, Tom; Allen, Ben

    2015-02-01

    People who have difficulty identifying and describing their emotions are more likely to seek out the experience of emotions in the high-risk domain. This is because the high-risk domain provides the experience of more easily identifiable emotions (e.g., fear). However, the continued search for intense emotion may lead such individuals to take further risks within this domain, which, in turn, would lead to a greater likelihood of experiencing accidents. Across three studies, we provide the first evidence in support of this view. In Study 1 (n = 762), alexithymia was associated with greater risk taking and a greater propensity to experience accidents and close calls. In Study 2 (n = 332) and Study 3 (n = 356), additional bootstrapped mediation models confirmed these relationships. The predictive role of alexithymia remained significant when controlling for sensation seeking (Study 1) and anhedonia (Study 2 and Study 3). We discuss the practical implications of the present model as they pertain to minimizing accidents and close calls in the high-risk domain.

  20. High wall shear stress and high-risk plaque: an emerging concept.

    Science.gov (United States)

    Eshtehardi, Parham; Brown, Adam J; Bhargava, Ankit; Costopoulos, Charis; Hung, Olivia Y; Corban, Michel T; Hosseini, Hossein; Gogas, Bill D; Giddens, Don P; Samady, Habib

    2017-01-10

    In recent years, there has been a significant effort to identify high-risk plaques in vivo prior to acute events. While number of imaging modalities have been developed to identify morphologic characteristics of high-risk plaques, prospective natural-history observational studies suggest that vulnerability is not solely dependent on plaque morphology and likely involves additional contributing mechanisms. High wall shear stress (WSS) has recently been proposed as one possible causative factor, promoting the development of high-risk plaques. High WSS has been shown to induce specific changes in endothelial cell behavior, exacerbating inflammation and stimulating progression of the atherosclerotic lipid core. In line with experimental and autopsy studies, several human studies have shown associations between high WSS and known morphological features of high-risk plaques. However, despite increasing evidence, there is still no longitudinal data linking high WSS to clinical events. As the interplay between atherosclerotic plaque, artery, and WSS is highly dynamic, large natural history studies of atherosclerosis that include WSS measurements are now warranted. This review will summarize the available clinical evidence on high WSS as a possible etiological mechanism underlying high-risk plaque development.

  1. Local poultry biosecurity risks to highly pathogenic avian influenza in Kaduna State, Nigeria.

    Science.gov (United States)

    Paul, Abdu A; Assam, Assam; Ndang, Tabe-Ntui L

    2013-01-01

    The study appraised local poultry biosecurity risks to highly pathogenic avian influenza by assessing farmers' knowledge, beliefs and poultry practices using a standard questionnaire. Farmers' knowledge on transmission and prevention was high but low on disease recognition. Radio was ineffective at informing Islamic educated farmers. Extensive knowledge on transmission and protection did not result in behavioural change as farmers engaged in risky practices of selling, eating or medicating infected poultry and not reporting poultry death. Islamic educated farmers do not believe highly pathogenic avian influenza is a serious and preventable disease. Women are more likely to self medicate when experiencing influenza-like illness. Audio-visual aids would improve avian influenza recognition while involvement of community leaders would enhance disease reporting. Outbreak of highly pathogenic avian influenza in local poultry in Nigeria would follow a similar pattern in Southeast Asia if the risk perception among farmers is not urgently articulated.

  2. 2013-2014 Behavioral Health Risk Assessment Data Report (BH-RADR)

    Science.gov (United States)

    2016-10-01

    Approved for public release, distribution unlimited General Medicine: 500A, Public Health Data 2013-2014 Behavioral Health Risk Assessment ...blank. 2011 Behavioral Health Risk Assessment Data Report No. S.0008056-14, October 2014 Epidemiology and Disease Surveillance Portfolio...Behavioral Health Risk Assessment Data Report (BH-RADR) Jerrica Nichols Eren Youmans Watkins Keri Kateley Kimberly Cevis Christine Lagana

  3. 75 FR 2723 - Fair Credit Reporting Risk-Based Pricing Regulations

    Science.gov (United States)

    2010-01-15

    ... System 12 CFR Part 222 Federal Trade Commission 16 CFR Parts 640 and 698 Fair Credit Reporting Risk-Based... Parts 640 and 698 RIN 3084-AA94 Fair Credit Reporting Risk-Based Pricing Regulations AGENCIES: Board of... credit offered or extended to a particular consumer to reflect the risk of nonpayment by that...

  4. 76 FR 41602 - Fair Credit Reporting Risk-Based Pricing Regulations

    Science.gov (United States)

    2011-07-15

    ... respective risk-based pricing rules to require disclosure of credit scores and information relating to credit scores in risk-based pricing notices if a credit score of the consumer is used in setting the material.... 1681m(h), to the Fair Credit Reporting Act (FCRA) to address risk-based pricing. Risk-based pricing...

  5. Assessment report on NRP sub-theme `Risk Analysis`

    Energy Technology Data Exchange (ETDEWEB)

    Biesiot, W.; Hendrickx, L. [eds.] [University of Groningen, Center for Energy and Environmental Studies, Groningen (Netherlands); Van Ham, J. [TNO Institute for Environmental Sciences, Delft (Netherlands); Olsthoorn, A.A. [VUA, Free University of Amsterdam, Amsterdam (Netherlands)

    1995-12-31

    An overview and assessment are presented of the three research projects carried out under NRP funding that concern risk-related topics: (1) The risks of nonlinear climate changes, (2) Socio-economic and policy aspects of changes in incidence and intensity of extreme (weather) events, and (3) Characterizing the risks: a comparative analysis of the risks of global warming and of relevant policy strategies. 1 tab., 6 refs.

  6. INFLUENCE OF RISKS ON INDICATORS OF ACCOUNTING FINANCIAL REPORTING

    OpenAIRE

    Sigidov Y. I.; Shetkina E. A.

    2016-01-01

    In terms of financial instability, contributing to increase in risks associated with conducting a business activity on the territory of the Russian Federation, there comes the need for the settlement of the procedure for reflection of information about the risks of the economic activity in financial statements. This article discusses the concepts of risks, their impact on the performance of financial accounting. There is a classification of risks: legal, country, financial and regional, their...

  7. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

    Directory of Open Access Journals (Sweden)

    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  8. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

    Science.gov (United States)

    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  9. Dating violence and associated health risks among high school students with disabilities.

    Science.gov (United States)

    Mitra, Monika; Mouradian, Vera E; McKenna, Maria

    2013-08-01

    Children with disabilities are at a higher risk for various forms of violence including sexual violence, bullying, and physical violence compared to those without disabilities. However there are no studies documenting the prevalence of dating violence amongst a population-based sample of adolescents with disabilities. The purpose of this study is to assess the prevalence of dating violence victimization against high schools students with and without disabilities and to examine associations of dating violence with health risks by disability status among high school girls. Data from the 2009 Massachusetts Youth Health Survey were analyzed in 2011 using bivariate and multivariate logistic regression. Among high school students who had ever been on a date, girls (25.9 %, 95 % CI 19.9-31.5) and boys (9.1 %, 95 % CI 5.8-12.4) with disabilities were more likely than girls (8.8 %, 95 % CI 6.8-10.8) and boys (4.5 %, 95 % CI 3.1-5.8) without disabilities to report dating violence. Multivariate analyses indicated that high school girls with disabilities who experienced dating violence were more likely to report feeling sad or hopeless for 2 weeks or more in the past year, suicide ideation in the past 12 months, and drug use in the past 30 days compared to those with disabilities who did not report dating violence and those without disabilities who reported and did not report dating violence. High school students with disabilities are at a greater risk for dating violence victimization compared to those without disabilities and high school girls with disabilities who experience dating violence are at increased risk for experiencing poor mental health outcomes and substance abuse.

  10. High-dimensional inference by unbiased risk estimation

    Science.gov (United States)

    Chetelat, Didier

    This thesis derives natural and efficient solutions of three high-dimensional statistical problems by exploiting unbiased risk estimation. They exemplify a general methodology that provides attractive estimators in situations where classical theory is unsuccessful, and that could be exploited in many other problems. First, we extend the classical James-Stein shrinkage estimator to the context where the number of covariates is larger than the sample size and the covariance matrix is unknown. The construction is obtained by manipulating an unbiased risk estimator and shown to dominate in invariant squared loss the maximum likelihood estimator. The estimator is interpreted as performing shrinkage only the random subspace spanned by the sample covariance matrix. Second, we investigate the estimation of a covariance and precision matrix, and discriminant coefficients, of linearly dependent data in a normal framework. By boundingthe difference in risk over classes of interest using unbiased risk estimation, we construct interesting estimators and show domination over naive solutions. Finally, we explore the problem of estimating the noise coefficient in the spiked covariance model. By decomposing an unbiased risk estimator and minimizing its dominant part using calculus of variations, we obtain an estimator in closed form that approximates the optimal solution. Several attractive properties are proven about the proposed construction. We conclude by showing that the associated spiked covariance estimators possess excellent behavior under the Frobenius loss.

  11. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    David E. Laaksonen

    2012-07-01

    Full Text Available Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar intake (sugar-sweetened beverages, sucrose and fructose on association with type 2 diabetes, cardiovascular disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood pressure, uric acid, inflammation markers, and on all-cause mortality, through a systematic review of prospective cohort studies and randomised controlled intervention studies published between January 2000 and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010. A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in April 2011 in SveMed+. An update was run in PubMed in January 2012. Two authors independently selected studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies, four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective cohort studies published in the years 2000–2011 suggest that sugar-sweetened beverages probably increase the risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and other types of sugars, too few studies

  12. Gang masculinity and high-risk sexual behaviours.

    Science.gov (United States)

    Dickson-Gomez, Julia; Quinn, Katherine; Broaddus, Michelle; Pacella, Maria

    2017-02-01

    High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang members from six different gangs to explore the role of powerful socialising peer groups that set gender, sexual and relationship roles and expectations for their male and female members. High-risk sexual behaviours among gang members included sex with multiple partners and group sex. Gang norms included the belief that male members were sexually insatiable with multiple sexual partners and that female gang members should be sexually available to male members. Alcohol and drugs were seen to have a large influence on sexual desire and the inability to use condoms. Much sexual behaviour with gangs, such as group sex, was viewed with ambivalence and seen as somewhat coercive. Finally, gendered sexual expectations (boys as sexually insatiable and girls as sexually available) made forming long-term romantic relationships problematic for gang members. The influence of gang norms such as these must be addressed in future programmes and interventions with gang members.

  13. High risk pregnancies and factors associated with neonatal death

    Directory of Open Access Journals (Sweden)

    Marcela de Oliveira Demitto

    Full Text Available Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality.

  14. Great expectations: different high-risk activities satisfy different motives.

    Science.gov (United States)

    Barlow, Matthew; Woodman, Tim; Hardy, Lew

    2013-09-01

    Research on people's motives for engaging in high-risk activities has typically been viewed through the single-focused lens of sensation seeking. We provide evidence that comprehensively challenges that view. First, we develop and confirm the structure of a 3-factor measure of motives: the Sensation Seeking, Emotion Regulation, and Agency Scale (SEAS; Study 1). We then use the SEAS to provide evidence of differential motives for 2 high-risk activities: skydiving and mountaineering. The motive for skydiving is strongly associated with sensation seeking; the motive for mountaineering is strongly associated with emotion regulation and agency but not with sensation seeking (Study 2). We also show that these conclusions cannot be drawn from existing measures of personality and sensation seeking (Study 3). Finally, individuals who are motivated by emotion regulation and agency needs also have greater expectations regarding their emotion regulation and agency. It is these greater expectations that most successfully discriminate mountaineers from skydivers and control participants (Study 4). It is concluded that researchers should no longer consider risk takers as a homogenous sensation-seeking group and that they should consider risk taking as a potential model of human endeavor. The SEAS can be used as a measure of motives for behavior whenever sensation seeking, agency, or emotion regulation is thought to be at the core of such motives, and the results are discussed in the context of encouraging personality researchers to consider the specific spontaneous behaviors that motivate different people.

  15. Return of individual genetic results in a high-risk sample: enthusiasm and positive behavioral change.

    Science.gov (United States)

    Hartz, Sarah M; Olfson, Emily; Culverhouse, Robert; Cavazos-Rehg, Patricia; Chen, Li-Shiun; DuBois, James; Fisher, Sherri; Kaphingst, Kimberly; Kaufman, David; Plunk, Andrew; Ramnarine, Shelina; Solomon, Stephanie; Saccone, Nancy L; Bierut, Laura J

    2015-05-01

    The goal of this study was to examine participant responses to disclosure of genetic results in a minority population at high risk for depression and anxiety. Eighty-two subjects in a genetic study of nicotine dependence were offered personalized genetic results. All were nicotine-dependent and 64% self-identified as African American. Pathway Genomics was used to evaluate genetic risks for five complex diseases. Participants returned 4-8 weeks after enrollment for in-person genetic counseling interviews and evaluation of baseline measures. A telephone follow-up was performed 4-8 weeks later to assess responses to results. Fifty of the 82 subjects (61%) were interested in receiving genetic results. These participants had multiple risk factors, including high baseline measures of depression (66%) and anxiety (32%), as well as low rates of employment (46%), adequate health literacy (46%), and health insurance (45%). Pathway Genomics reported "increased risk" for at least one disease in 77% of subjects. Ninety-five percent of participants reported that they appreciated the genetic results, and receiving these results was not associated with changes in symptoms of depression or anxiety. Furthermore, after return of genetic results, smoking cessation attempts increased (P = 0.003). Even in an underserved population at high risk for adverse psychological reactions, subjects responded positively to personalized genetic results.

  16. Identifying undetected cases of chronic kidney disease in Mexico. Targeting high-risk populations.

    Science.gov (United States)

    García-García, Guillermo; Gutiérrez-Padilla, Alfonso J; Chávez-Iñiguez, Jonathan; Pérez-Gómez, Héctor R; Mendoza-García, Martha; González-De la Peña, Ma Del Mar; Tonelli, Marcello

    2013-11-01

    Chronic kidney disease (CKD) is a major public health problem in Mexico. Current guidelines recommend routine CKD testing in patients at increased risk for CKD. We undertook this study to examine the diagnostic yield of targeted screening (case-finding) for CKD in high-risk populations in rural and urban communities in Jalisco, Mexico. In a cross-sectional study, we did laboratory tests searching for CKD and its risk factors and compared the characteristics of participants with those reported by the National Health and Nutrition Survey 2006 (NHNS). Individuals who were aware that they had CKD and those 126 mg/dl (56.1 vs. 14.4%, p = 0.0001) were more prevalent among the participants; self-reported hypertension (41.9 vs. 7.3%, p = 0.0001), systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg (52.5 vs. 43.2%, p = 0.0001), and obesity (42.8. vs. 29.3%, p = 0.0001) were also more frequent among participants. There were 19.7% with proteinuria; CKD was more prevalent among the high risk participants in our study (31.3 vs. 8.0%, p = 0.0001) than in the general population. CKD was detected frequently in high-risk Mexican populations. Trials of case-finding and intervention are feasible and warranted in Mexico. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

  17. An Epidemologic Study of High School Football Injuries in North Carolina--1968-1972. Final Report.

    Science.gov (United States)

    Blyth, Carl S.; Mueller, Frederick O.

    This report describes a study to demonstrate the effectiveness of applying epidemiologic methods in determining the extent of the problem of high school football injuries in North Carolina and to interrelate certain variables associated with the problem of risk in athletics. It provides a descriptive baseline of data on high school football…

  18. 13 CFR 120.1060 - Confidentiality of Reports, Risk Ratings and related Confidential Information.

    Science.gov (United States)

    2010-01-01

    ... order prior to disclosure. For purposes of this regulation, “Information Provider” means any contractor... abides by them. Any disclosure of the Report, Risk Rating, or Confidential Information other than as... Confidentiality of Reports, Risk Ratings and related Confidential Information. (a) In general. Reports and other...

  19. Evidence Report: Risk of Hypobaric Hypoxia from the Exploration Atmosphere

    Science.gov (United States)

    Norcross, Jason R.; Conkin, Johnny; Wessel, James H., III; Norsk, Peter; Law, Jennifer; Arias, Diana; Goodwin, Tom; Crucian, Brian; Whitmire, Alexandra; Bloomberg, Jacob; hide

    2015-01-01

    Extravehicular activity (EVA) is at the core of a manned space exploration program. Some elements of exploration may be safely and effectively performed by robots, but certain critical elements will require the trained, assertive, and reasoning mind of a human crewmember. To effectively use these skills, NASA needs a safe, effective, and efficient EVA component integrated into the human exploration program. The EVA preparation time should be minimized and the suit pressure should be low to accommodate EVA tasks without causing undue fatigue, physical discomfort, or suit-related trauma. Commissioned in 2005, the Exploration Atmospheres Working Group (EAWG) had the primary goal of recommending to NASA an internal environment that allowed efficient and repetitive EVAs for missions that were to be enabled by the former Constellation Program. At the conclusion of the EAWG meeting, the 8.0 psia and 32% oxygen (O2) environment were recommended for EVA-intensive phases of missions. After re-evaluation in 2012, the 8/32 environment was altered to 8.2 psia and 34% O2 to reduce the hypoxic stress to a crewmember. These two small changes increase alveolar O2 pressure by 11 mmHg, which is expected to significantly benefit crewmembers. The 8.2/34 environment (inspired O2 pressure = 128 mmHg) is also physiologically equivalent to the staged decompression atmosphere of 10.2 psia / 26.5% O2 (inspired O2 pressure = 127 mmHg) used on 34 different shuttle missions for approximately a week each flight. As a result of selecting this internal environment, NASA gains the capability for efficient EVA with low risk of decompression sickness (DCS), but not without incurring the additional negative stimulus of hypobaric hypoxia to the already physiologically challenging spaceflight environment. This report provides a review of the human health and performance risks associated with the use of the 8.2 psia / 34% O2 environment during spaceflight. Of most concern are the potential effects on the

  20. High-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil

    Directory of Open Access Journals (Sweden)

    Sandra L. Ulinski

    2016-01-01

    Full Text Available Objective: To explore high-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil. Method: Data from 398 drivers on sociodemographic parameters, high-risk behaviors, experiences with traffic law, and traffic law violations were collected through interviews conducted at sobriety checkpoints. Exploratory-descriptive and analytical statistics were used. Results: The mean age of the participants was 32.6±11.2 years (range, 18 to 75 years. Half of the drivers reported having driven after drinking in the last year, predominantly single men aged 18 to 29 years who drive cars and drink alcohol frequently. Only 55% of the drivers who had driven after drinking in the last year self-reported some concern about being detected in a police operation. Conclusions: A significant association was found between sociodemographic variables and behavior, which can help tailor public interventions to a specific group of drivers: young men who exhibit high-risk behaviors in traffic, such as driving after drinking alcohol, some of whom report heavy alcohol consumption. This group represents a challenge for educational and enforcement interventions, particularly because they admit to violating current laws and have a low perception of punishment due to the low risk of being detected by the police.

  1. Management of High-Risk Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Ariel E. Marciscano

    2012-01-01

    Full Text Available Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM. The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control.

  2. Dual mobility total hip replacement in a high risk population

    Science.gov (United States)

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  3. Dual mobility total hip replacement in a high risk population

    Directory of Open Access Journals (Sweden)

    Luthra Jatinder Singh

    2016-01-01

    Full Text Available Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

  4. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  5. Monitoring of newborns at high risk for brain injury

    OpenAIRE

    Pisani, Francesco; Spagnoli, Carlotta

    2016-01-01

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

  6. Rosuvastatin: Role in Cardiovascular High-risk Patient

    Directory of Open Access Journals (Sweden)

    John E Feliciano-Alfonso

    2013-01-01

    Full Text Available Statins are the lipid-lowering drug family of first choice in situations of hypercholesterolemia or mixed dyslipidemia with predominant increase in cholesterol. The evidence shows conclusively that each one of the commercially available statins have proven benefits on outcomes of cardiovascular morbidity and mortality. However, rosuvastatin has certain pharmacokinetic efficacy and cost-effectiveness characteristics that make it an attractive molecule to be the statin of choice in patients at high cardiovascular risk.

  7. TOB-G: Tobacco Cessation Guidelines for High risk Populations

    Directory of Open Access Journals (Sweden)

    Panagiotis Behrakis

    2016-03-01

    Full Text Available The TOB-G project is funded under the EU 3rd Health Programme which is the main instrument that the Commission uses to implement the EU Health Strategy. The project started in June 2014 and will be completed in September 2017. The project consortium consists of 5 partners from 4 European countries (Belgium, Greece, Ireland and Romania. The TOB-G project aims to develop and implement an innovative and cost effective approach to prevent chronic diseases related to tobacco dependence by focusing on creating specialized tobacco cessation guidelines for populations of high risk including adolescents, pregnant women, adults with COPD, Cardiovascular disease and diabetes. The specialized guidelines for high risks groups will be developed according to ENSP’s evidence based and good practices in tobacco cessation. The smoking cessation guidelines contain strategies and recommendations designed to assist clinicians/ doctors in delivering and supporting effective treatments for tobacco use and dependence and will also be available within the context of an e-learning platform for European clinicians. Overall, the TOB-G project will enhance the overall European capacity in the treatment of tobacco dependence, through offering smoking cessation tools, appropriately assessed and fitted to the specific needs of high risk groups.

  8. [HTLV-I infection in a high-risk group].

    Science.gov (United States)

    Pujol, E; Ollero, M; Gimeno, A; Colchero, J; Alcoucer, R; Márquez, P

    1990-07-01

    The aim of this study is to detect the presence of HTLV-1 in a high-risk population in west Andalusia. We studied 267 samples of serum from 255 patients: 179 of these patients being intravenous drug-users, 14 had ADVP sexual partners, 16 were inhalation drug-users, 4 were hemophiliacs, 9 had other high-risk habits and 25 hematological patients afflicted with leukemia or lymphoma. All of them were tested for antibodies against HTLV-1 by means of an in vitro qualitative ELISA technique (ELISA Du Pont HTLV-1). The positive results were confirmed by the Western blot technique. Additionally, the p24 antigen and the antibodies against VIH-1 and VIH-2 (ENV/CORE) were analysed, except in the 25 hematological patients. We found 20 serum samples positive to HTLV-1 by ELISA (7.4%), but only 1 (0.3%) was confirmed by the Western blot technique. The prevalence of VIH-1 was 46%; 9% had p24 VIH antigen and 26% had false positive ELISA to VIH-2. We found a statistically significant relationship (p = 0.0005) between positive ELISA to HTLV-1 and antibodies against VIH. We conclude that HTLV-1 has penetrated into the high-risk population of west Andalusia , although not yet to a great degree, and point out the need for seric epidemiological surveillance to prevent the spread of the retrovirus in these groups.

  9. Learning rate and temperament in a high predation risk environment

    Science.gov (United States)

    DePasquale, C.; Wagner, Tyler; Archard, G.A.; Ferguson, B.; Braithwaite, V.A.

    2014-01-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration—collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  10. Learning rate and temperament in a high predation risk environment.

    Science.gov (United States)

    DePasquale, C; Wagner, T; Archard, G A; Ferguson, B; Braithwaite, V A

    2014-11-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration-collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  11. Cardiovascular risk factor treatment targets and renal complications in high risk vascular patients: a cohort study

    Directory of Open Access Journals (Sweden)

    Visseren Frank LJ

    2011-07-01

    Full Text Available Abstract Background To determine if recommended treatment targets, as specified in clinical practice guidelines for the management of cardiovascular disease, reduces the risk of renal complications in high risk patient populations. Methods This was a cohort study. Participants in Utrecht, The Netherlands either at risk of, or had cardiovascular disease were recruited. Cardiovascular treatment targets were achievement of control in systolic and diastolic blood pressure, total and low-density cholesterol, and treatment of albuminuria. Outcome measures were time to development of end stage renal failure or symptomatic renal atherosclerotic disease requiring intervention. Results The cohort consisted of 7,208 participants; 1,759 diabetics and 4,859 with clinically manifest vascular disease. The median age was 57 years and 67% were male. Overall, 29% of the cohort achieved the treatment target for systolic blood pressure, 39% for diastolic blood pressure, 28% for total cholesterol, 31% for LDL cholesterol and 78% for albuminuria. The incidence rate for end stage renal failure and renal atherosclerotic disease reduced linearly with each additional treatment target achieved (p value less than 0.001. Achievement of any two treatment targets reduced the risk of renal complications, hazard ratio 0.46 (95% CI 0.26-0.82. For patients with clinically manifest vascular disease and diabetes, the hazard ratios were 0.56 (95% CI 0.28 - 1.12 and 0.28 (95%CI 0.10 - 0.79 respectively. Conclusion Clinical guidelines for cardiovascular disease management do reduce risk of renal complications in high risk patients. Benefits are seen with attainment of any two treatment targets.

  12. Rare neonatal diabetes insipidus and associated late risks: Case report

    Directory of Open Access Journals (Sweden)

    Rivas-Crespo Maximiliano

    2012-05-01

    Full Text Available Abstract Background Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other handicaps in the patient. The infant’s prognosis will be determined by his or her own early age and disability as well as by the physician’s skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with it. Case Presentation A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis, swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported. Conclusions The child’s overall development advanced rapidly when his nutrition was improved by gastrostomy: This was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to intranasal desmopressin treatment in young children.

  13. Phase 1 data summary report for the Clinch River Remedial Investigation: Health risk and ecological risk screening assessment

    Energy Technology Data Exchange (ETDEWEB)

    Cook, R.B.; Adams, S.M.; Beauchamp, J.J.; Bevelhimer, M.S.; Blaylock, B.G.; Brandt, C.C.; Ford, C.J.; Frank, M.L.; Gentry, M.J.; Holladay, S.K.; Hook, L.A.; Levine, D.A.; Longman, R.C.; McGinn, C.W.; Skiles, J.L.; Suter, G.W.; Williams, L.F.

    1992-12-01

    The Clinch River Remedial Investigation (CRRI) is designed to address the transport, fate, and distribution of waterborne contaminants released from the US Department of Energy's (DOE's) Oak Ridge Reservation (ORR) and to assess potential risks to human health and the environment associated with these contaminants. The contaminants released since the early 1940s include a variety of radionuclides, metals, and organic compounds. The purpose of this report is to summarize the results of Phase 1 of the CRRI. Phase 1 was designed to (1) obtain high-quality data to confirm existing historical data for contaminant levels in fish, sediment, and water from the CR/WBR; (2) determine the in the range of contaminant concentrations present river-reservoir system; (3) identify specific contaminants of concern; and (4) establish the reference (background) concentrations for those contaminants.

  14. Forecasting Value-at-Risk Using High-Frequency Information

    Directory of Open Access Journals (Sweden)

    Huiyu Huang

    2013-06-01

    Full Text Available in the prediction of quantiles of daily Standard&Poor’s 500 (S&P 500 returns we consider how to use high-frequency 5-minute data. We examine methods that incorporate the high frequency information either indirectly, through combining forecasts (using forecasts generated from returns sampled at different intraday interval, or directly, through combining high frequency information into one model. We consider subsample averaging, bootstrap averaging, forecast averaging methods for the indirect case, and factor models with principal component approach, for both direct and indirect cases. We show that in forecasting the daily S&P 500 index return quantile (Value-at-Risk or VaR is simply the negative of it, using high-frequency information is beneficial, often substantially and particularly so, in forecasting downside risk. Our empirical results show that the averaging methods (subsample averaging, bootstrap averaging, forecast averaging, which serve as different ways of forming the ensemble average from using high-frequency intraday information, provide an excellent forecasting performance compared to using just low-frequency daily information.

  15. Risk based culling for highly infectious diseases of livestock

    Directory of Open Access Journals (Sweden)

    te Beest Dennis E

    2011-06-01

    Full Text Available Abstract The control of highly infectious diseases of livestock such as classical swine fever, foot-and-mouth disease, and avian influenza is fraught with ethical, economic, and public health dilemmas. Attempts to control outbreaks of these pathogens rely on massive culling of infected farms, and farms deemed to be at risk of infection. Conventional approaches usually involve the preventive culling of all farms within a certain radius of an infected farm. Here we propose a novel culling strategy that is based on the idea that farms that have the highest expected number of secondary infections should be culled first. We show that, in comparison with conventional approaches (ring culling, our new method of risk based culling can reduce the total number of farms that need to be culled, the number of culled infected farms (and thus the expected number of human infections in case of a zoonosis, and the duration of the epidemic. Our novel risk based culling strategy requires three pieces of information, viz. the location of all farms in the area at risk, the moments when infected farms are detected, and an estimate of the distance-dependent probability of transmission.

  16. Risk Reporting: An Analysis of the German Banking Industry

    NARCIS (Netherlands)

    L. van Oorschot (Laura)

    2010-01-01

    textabstractExecutive summary The recent financial crisis resulted in an increased attention on the risks of banks and their financial instruments. This article discusses the outcomes of a study on the quantity and quality of market, credit, and liquidity risk disclosures and the relationship 1)

  17. Cibola High Levee Pond Annual Report 2003. Interim Report

    Science.gov (United States)

    Mueller, G.A.; Carpenter, J.; Marsh, P.C.; Minckley, C.O.

    2003-01-01

    Bonytail and razorback sucker have once again spawned and produced swim-up larvae in Cibola High Levee Pond (CHLP). CHLP continues to support annual recruitment of bonytail while recent razorback sucker recruitment remains elusive. Thus far, razorbacks have experienced intermittent years of spawning success. Both native species were observed spawning on, or near, the riprap on the river levee. Razorbacks spawned from late January until mid-March over gravel and large cobble along the levee toe (2-3 m depth) and bonytail spawned along the levee shoreline during mid-April. Razorback suckers rapidly fin during the reproductive act, which flushes fines from the substrate and leaves gravel relatively clean. Bonytail on the other hand, appear to spawn over or on substrate that has been disturbed by beaver activity. Substrate scour or disturbance appears to be an important factor in spawning site selectiona?|

  18. Increased Risk of Drug-Induced Hyponatremia during High Temperatures

    Directory of Open Access Journals (Sweden)

    Anna K Jönsson

    2017-07-01

    Full Text Available Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA. Methods: All individual adverse drug reactions (ADR reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hyponatremia and random controls were identified. Reports where the ADR had been assessed as having at least a possible relation to the suspected drug were included. Information on administered drugs, onset date, causality assessment, sodium levels, and the geographical origin of the reports was extracted. A case-crossover design was used to ascertain the association between heat exposure and drug-induced hyponatremia at the individual level, while linear regression was used to study its relationship to sodium concentration in blood. Temperature exposure data were obtained from the nearest observation station to the reported cases. Results: During the study period, 280 reports of hyponatremia were identified. More cases of drug-induced hyponatremia were reported in the warmer season, with a peak in June, while other ADRs showed an opposite annual pattern. The distributed lag non-linear model indicated an increasing odds ratio (OR with increasing temperature in the warm season with a highest odds ratio, with delays of 1–5 days after heat exposure. A cumulative OR for a lag time of 1 to 3 days was estimated at 2.21 at an average daily temperature of 20 °C. The change in sodium per 1 °C increase in temperature was estimated to be −0.37 mmol/L (95% CI: −0.02, −0.72. Conclusions: Warm weather appears to increase the risk of drug-induced hyponatremia

  19. Increased Risk of Drug-Induced Hyponatremia during High Temperatures

    Science.gov (United States)

    Jönsson, Anna K.; Lövborg, Henrik; Lohr, Wolfgang; Ekman, Bertil; Rocklöv, Joacim

    2017-01-01

    Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA). Methods: All individual adverse drug reactions (ADR) reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hyponatremia and random controls were identified. Reports where the ADR had been assessed as having at least a possible relation to the suspected drug were included. Information on administered drugs, onset date, causality assessment, sodium levels, and the geographical origin of the reports was extracted. A case-crossover design was used to ascertain the association between heat exposure and drug-induced hyponatremia at the individual level, while linear regression was used to study its relationship to sodium concentration in blood. Temperature exposure data were obtained from the nearest observation station to the reported cases. Results: During the study period, 280 reports of hyponatremia were identified. More cases of drug-induced hyponatremia were reported in the warmer season, with a peak in June, while other ADRs showed an opposite annual pattern. The distributed lag non-linear model indicated an increasing odds ratio (OR) with increasing temperature in the warm season with a highest odds ratio, with delays of 1–5 days after heat exposure. A cumulative OR for a lag time of 1 to 3 days was estimated at 2.21 at an average daily temperature of 20 °C. The change in sodium per 1 °C increase in temperature was estimated to be −0.37 mmol/L (95% CI: −0.02, −0.72). Conclusions: Warm weather appears to increase the risk of drug-induced hyponatremia. PMID:28737683

  20. Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2016-07-01

    Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group.

  1. HIV infection and high-risk behaviours in a Paraguayan military population.

    Science.gov (United States)

    Laguna-Torres, V Alberto; Aguayo, Nicolás; Aguilar, Gloria; Ampuero, Julia S; Galeano, Adolfo; Barboza, Alma; Villafane, Margarita; Jiménez, Liliana; Perez, Juan; Kochel, Tadeusz J; Halsey, Eric S

    2014-10-01

    Between July 2005 and January 2006 we evaluated 1248 Paraguayan active duty military volunteers. Participants provided a blood sample for HIV testing and answered an anonymous survey. HIV seroprevalence was 0.4% (5 of 1248) among participants. The median age at first sexual intercourse was 16 years. Only 14.8% of participants reported condom use with every sexual encounter. Military students used condoms the most. Participants older than 45 years, compared with younger participants, had a fourfold (adjusted odds ratio 4.3) increased risk of not using condoms. Men were less likely to use a condom, more likely to practice anal intercourse, and had more sexual partners than women. Officers and non-commissioned officers were identified to have a twofold (as measured by adjusted odds ratio = 2.00 and 2.22, respectively) increased risk of having more than two sexual partners in the last month compared with students. Both officers and non-commissioned officers were twice as likely as students to practice anal intercourse. Despite the high-risk behaviours reported by those surveyed, HIV seroprevalence in active duty personnel was low. Future efforts should emphasize on the correct condom use keeping focus on the high-risk behaviours of groups at risk, and on routinely testing the military personnel for HIV.

  2. A program for at-risk high school students informed by evolutionary science.

    Science.gov (United States)

    Wilson, David Sloan; Kauffman, Richard A; Purdy, Miriam S

    2011-01-01

    Improving the academic performance of at-risk high school students has proven difficult, often calling for an extended day, extended school year, and other expensive measures. Here we report the results of a program for at-risk 9th and 10th graders in Binghamton, New York, called the Regents Academy that takes place during the normal school day and year. The design of the program is informed by the evolutionary dynamics of cooperation and learning, in general and for our species as a unique product of biocultural evolution. Not only did the Regents Academy students outperform their comparison group in a randomized control design, but they performed on a par with the average high school student in Binghamton on state-mandated exams. All students can benefit from the social environment provided for at-risk students at the Regents Academy, which is within the reach of most public school districts.

  3. Clinical potentials of methylator phenotype in stage 4 high-risk neuroblastoma: an open challenge.

    Directory of Open Access Journals (Sweden)

    Barbara Banelli

    Full Text Available Approximately 20% of stage 4 high-risk neuroblastoma patients are alive and disease-free 5 years after disease onset while the remaining experience rapid and fatal progression. Numerous findings underline the prognostic role of methylation of defined target genes in neuroblastoma without taking into account the clinical and biological heterogeneity of this disease. In this report we have investigated the methylation of the PCDHB cluster, the most informative member of the "Methylator Phenotype" in neuroblastoma, hypothesizing that if this epigenetic mark can predict overall and progression free survival in high-risk stage 4 neuroblastoma, it could be utilized to improve the risk stratification of the patients, alone or in conjunction with the previously identified methylation of the SFN gene (14.3.3sigma that can accurately predict outcome in these patients. We have utilized univariate and multivariate models to compare the prognostic power of PCDHB methylation in terms of overall and progression free survival, quantitatively determined by pyrosequencing, with that of other markers utilized for the patients' stratification utilizing methylation thresholds calculated on neuroblastoma at stage 1-4 and only on stage 4, high-risk patients. Our results indicate that PCDHB accurately distinguishes between high- and intermediate/low risk stage 4 neuroblastoma in agreement with the established risk stratification criteria. However PCDHB cannot predict outcome in the subgroup of stage 4 patients at high-risk whereas methylation levels of SFN are suggestive of a "methylation gradient" associated with tumor aggressiveness as suggested by the finding of a higher threshold that defines a subset of patients with an extremely severe disease (OS <24 months. Because of the heterogeneity of neuroblastoma we believe that clinically relevant methylation markers should be selected and tested on homogeneous groups of patients rather than on patients at all stages.

  4. Psychopathy, Treatment Change, and Recidivism in High-Risk, High-Need Sexual Offenders

    Science.gov (United States)

    Looman, Jan; Abracen, Jeffrey; Serin, Ralph; Marquis, Peter

    2005-01-01

    The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy…

  5. The Importance of Taking Risks: A Report on the Conference

    Directory of Open Access Journals (Sweden)

    Kotliar I.A.,

    2016-04-01

    Full Text Available The paper gives an overview of the 14th interdisciplinary conference The Importance of Taking Risks held by the Welsh branch of the International Play Association. The meeting focused on various aspects of supporting children’s play and on the role of risk in child development. The conference had a clear multidis- ciplinary character and brought together specialists from a variety of fields: psychologists, teachers, social workers, experts in risk assessment, and health care professionals. The paper outlines how risk is understood in modern western theory and practice and distinguishes between risk and danger. A child must be taught to assess situations as safe or dangerous. However, modern developmental environment tends to reduce the possibility of risks for the child, which deprives him/her of the natural means of learning about the world and reduces creativity and independence and holds back the child’s self-regulation, prolonging compelled dependence and making children more infantile. The conference also involved discussions concerning tech- niques for risk assessment and a number of prevention programmes and practices. This work was supported by the Russian Foundation for Humanities (project No 15-06-10627 “Psychological and pedagogical analysis of children’s play environment of the modern city”.

  6. Evaluation of high-risk living kidney donors.

    Science.gov (United States)

    Tangdhanakanond, Kawin; Mandelbrot, Didier

    2015-01-01

    Careful evaluation of potential living kidney donors is crucial to assure the well being of the donors, especially because they do not gain any direct medical benefit from donation. This process also helps assess the quality and safety of the organs donated to the recipients. While all programs share these goals, donor selection criteria vary significantly among U.S. transplant centers. In part, this is due to the limited data that exists as to long-term outcomes among donors who are medically complex, or at higher risk for complications, such as those with hypertension, obesity, or lower kidney function. This article reviews available evidence regarding outcomes after living donation and current trends in U.S. practices, and seeks to provide practical guidance in evaluating high-risk potential living kidney donors.

  7. Risk Analysis and Decision Making FY 2013 Milestone Report

    Energy Technology Data Exchange (ETDEWEB)

    Engel, David W.; Dalton, Angela C.; Dale, Crystal; Jones, Edward; Thompson, J.

    2013-06-01

    Risk analysis and decision making is one of the critical objectives of CCSI, which seeks to use information from science-based models with quantified uncertainty to inform decision makers who are making large capital investments. The goal of this task is to develop tools and capabilities to facilitate the development of risk models tailored for carbon capture technologies, quantify the uncertainty of model predictions, and estimate the technical and financial risks associated with the system. This effort aims to reduce costs by identifying smarter demonstrations, which could accelerate development and deployment of the technology by several years.

  8. Next Generation Risk Assessment: Incorporation of Recent Advances in Molecular, Computational, and Systems Biology (Final Report)

    Science.gov (United States)

    EPA announced the release of the final report, Next Generation Risk Assessment: Incorporation of Recent Advances in Molecular, Computational, and Systems Biology. This report describes new approaches that are faster, less resource intensive, and more robust that can help ...

  9. Next Generation Risk Assessment: Incorporation of Recent Advances in Molecular, Computational, and Systems Biology (Final Report)

    Science.gov (United States)

    EPA announced the release of the final report, Next Generation Risk Assessment: Incorporation of Recent Advances in Molecular, Computational, and Systems Biology. This report describes new approaches that are faster, less resource intensive, and more robust that can help ...

  10. Future high energy colliders symposium. Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Parsa, Z. [Univ. of California, Santa Barbara, CA (United States). Institute for Theoretical Physics]|[Brookhaven National Lab., Upton, CA (United States)

    1996-12-31

    A `Future High Energy Colliders` Symposium was held October 21-25, 1996 at the Institute for Theoretical Physics (ITP) in Santa Barbara. This was one of the 3 symposia hosted by the ITP and supported by its sponsor, the National Science Foundation, as part of a 5 month program on `New Ideas for Particle Accelerators`. The long term program and symposia were organized and coordinated by Dr. Zohreh Parsa of Brookhaven National Laboratory/ITP. The purpose of the symposium was to discuss the future direction of high energy physics by bringing together leaders from the theoretical, experimental and accelerator physics communities. Their talks provided personal perspectives on the physics objectives and the technology demands of future high energy colliders. Collectively, they formed a vision for where the field should be heading and how it might best reach its objectives.

  11. Influenza vaccination in children at high risk of respiratory disease.

    Science.gov (United States)

    Patria, Maria Francesca; Tagliabue, Claudia; Longhi, Benedetta; Esposito, Susanna

    2013-05-01

    Chronic respiratory diseases (CRDs) are a heterogeneous group of diseases that can affect the pediatric population and health authorities throughout the world recommend influenza vaccination because of the significant risk of influenza-related complications. However, despite this recommendation, vaccine coverage is generally unsatisfactory. The aim of this review is to analyze the impact of influenza on children at high risk of respiratory disease, and the immunogenicity, safety and efficacy of influenza vaccination in such children. The results show that there is a significant risk of influenza-related complications in preterm neonates and infants, in whom influenza vaccines are immunogenic and safe (although their efficacy has not been specifically studied). There are conflicting data concerning the effect of influenza infection on asthma morbidity in children, and whether or not influenza vaccination helps to prevent asthma exacerbations. Recent data provide no evidence that influenza is more frequent in patients with cystic fibrosis than in healthy subjects, or that it is responsible for increased lower respiratory tract morbidity. The lack of any clear correlate of protection suggests that future studies should also consider the efficacy of the different influenza vaccines and not only evaluate them in terms of immunogenicity. Furthermore, there is a need for clinical studies to assess the effectiveness of the available vaccines in patients with other rare CRDs and other chronic underlying diseases with possibly severe respiratory involvement. It is also important to determine whether children with recurrent respiratory tract infections should be included in the list of those for whom influenza vaccination is recommended. In the meantime, given the increasing evidence of the burden of influenza on the population as a whole and the benefits associated with vaccination, annual influenza vaccinations should be recommended for all children at high risk of

  12. Reporting and evaluation criteria as means towards a transparent use of ecotoxicity data for environmental risk assessment of pharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Agerstrand, M., E-mail: maa2@kth.se [Royal Institute of Technology/Kungliga Tekniska Hoegskolan, Department of Philosophy and the History of Technology, Teknikringen 78B, SE-100 44 Stockholm (Sweden); Kuester, A.; Bachmann, J. [Federal Environment Agency (UBA), Pharmaceuticals, Washing and Cleaning Agents, Woerlitzer Platz 1, 06813 Dessau (Germany); Breitholtz, M. [Stockholm University, Department of Applied Environmental Science, Svante Arrhenius vaeg 8c, SE-106 91Stockholm (Sweden); Ebert, I.; Rechenberg, B. [Federal Environment Agency (UBA), Pharmaceuticals, Washing and Cleaning Agents, Woerlitzer Platz 1, 06813 Dessau (Germany); Ruden, C. [Royal Institute of Technology/Kungliga Tekniska Hoegskolan, Department of Philosophy and the History of Technology, Teknikringen 78B, SE-100 44 Stockholm (Sweden)

    2011-10-15

    Ecotoxicity data with high reliability and relevance are needed to guarantee the scientific quality of environmental risk assessments of pharmaceuticals. The main advantages of a more structured approach to data evaluation include increased transparency and predictability of the risk assessment process, and the possibility to use non-standard data. In this collaboration, between the research project MistraPharma and the German Federal Environment Agency, a new set of reporting and evaluation criteria is presented and discussed. The new criteria are based on the approaches in the literature and the OECD reporting requirements, and have been further developed to include both reliability and relevance of test data. Intended users are risk assessors and researchers performing ecotoxicological experiments, but the criteria can also be used for education purposes and in the peer-review process for scientific papers. This approach intends to bridge the gap between the regulator and the scientist's needs and way of work. - Highlights: > A structured approach to data evaluation increases the transparency and predictability of the risk assessment process. > A structured approach to data reporting opens up for use of data from the open scientific literature in risk assessments. > Both relevance and reliability aspects are included in the reporting and evaluation criteria. > The criteria can be used by risk assessors, by researchers, for education purposes and in the peer-review process. - The need for reporting and evaluation criteria towards a transparent and reliable use of ecotoxicity data.

  13. High risk behavior for HIV transmission among former injecting drug users:a survey from Indonesia

    Directory of Open Access Journals (Sweden)

    Iskandar Shelly

    2010-08-01

    Full Text Available Abstract Background Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use. Methods Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test. Results Ninety-two out of 210 participants (44% were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66% and current (60% IDUs. Conclusion Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.

  14. Evidence Report: Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure

    Science.gov (United States)

    Patel, Zarana; Huff, Janice; Saha, Janapriya; Wang, Minli; Blattnig, Steve; Wu, Honglu; Cucinotta, Francis

    2015-01-01

    (SI unit for ionizing radiation dosage, i.e. one joule of radiation energy per one kilogram of matter)) to facilitate risk prediction. This risk has considerable uncertainty associated with it, and no acceptable model for projecting degenerative tissue risk is currently available. In particular, risk factors such as obesity, alcohol, and tobacco use can act as confounding factors that contribute to the large uncertainties. The PELs could be violated under certain scenarios, including following a large SPE (solar proton event) or long-term GCR (galactic cosmic ray) exposure. Specifically, for a Mars mission, the accumulated dose is sufficiently high that epidemiology data and preliminary risk estimates suggest a significant risk for cardiovascular disease. Ongoing research in this area is intended to provide the evidence base for accurate risk quantification to determine criticality for extended duration missions. Data specific to the space radiation environment must be compiled to quantify the magnitude of this risk to decrease the uncertainty in current PELs and to determine if additional protection strategies are required. New research results could lead to estimates of cumulative radiation risk from CNS and degenerative tissue diseases that, when combined with the cancer risk, may have major negative impacts on mission design, costs, schedule, and crew selection. The current report amends an earlier report (Human Research Program Requirements Document, HRP-47052, Rev. C, dated Jan 2009) in order to provide an update of evidence since 2009.

  15. CT scan screening for lung cancer: risk factors for nodules and malignancy in a high-risk urban cohort.

    Directory of Open Access Journals (Sweden)

    Alissa K Greenberg

    Full Text Available BACKGROUND: Low-dose computed tomography (CT for lung cancer screening can reduce lung cancer mortality. The National Lung Screening Trial reported a 20% reduction in lung cancer mortality in high-risk smokers. However, CT scanning is extremely sensitive and detects non-calcified nodules (NCNs in 24-50% of subjects, suggesting an unacceptably high false-positive rate. We hypothesized that by reviewing demographic, clinical and nodule characteristics, we could identify risk factors associated with the presence of nodules on screening CT, and with the probability that a NCN was malignant. METHODS: We performed a longitudinal lung cancer biomarker discovery trial (NYU LCBC that included low-dose CT-screening of high-risk individuals over 50 years of age, with more than 20 pack-year smoking histories, living in an urban setting, and with a potential for asbestos exposure. We used case-control studies to identify risk factors associated with the presence of nodules (n=625 versus no nodules (n=557, and lung cancer patients (n=30 versus benign nodules (n=128. RESULTS: The NYU LCBC followed 1182 study subjects prospectively over a 10-year period. We found 52% to have NCNs >4 mm on their baseline screen. Most of the nodules were stable, and 9.7% of solid and 26.2% of sub-solid nodules resolved. We diagnosed 30 lung cancers, 26 stage I. Three patients had synchronous primary lung cancers or multifocal disease. Thus, there were 33 lung cancers: 10 incident, and 23 prevalent. A sub-group of the prevalent group were stable for a prolonged period prior to diagnosis. These were all stage I at diagnosis and 12/13 were adenocarcinomas. CONCLUSIONS: NCNs are common among CT-screened high-risk subjects and can often be managed conservatively. Risk factors for malignancy included increasing age, size and number of nodules, reduced FEV1 and FVC, and increased pack-years smoking. A sub-group of screen-detected cancers are slow-growing and may contribute to over

  16. Risk factor distribution for cardiovascular diseases among high school boys and girls of urban Dibrugarh, Assam

    Science.gov (United States)

    Ekta, Gupta; Tulika, Mahanta Goswami

    2016-01-01

    Introduction: Chronic noncommunicable diseases (NCDs) including cardiovascular diseases (CVDs) are the leading cause of death in the world, and their incidence is rising rapidly due to increasing rates of risk factors such as hypertension, dyslipidemia, diabetes, obesity, physical inactivity, and tobacco use. These risk factors track from childhood to adulthood, and their distribution varies among males and females; hence, there is a need to determine risk factor prevalence among adolescent age group so as to plan preventive strategies. Objective: To determine the distribution of risk factors of CVDs amongst high school boys and girls of urban Dibrugarh, Assam. Subjects and Methods: A cross-sectional study was conducted from October 2012 to June 2013 in the schools of urban Dibrugarh, Assam wherein data was collected from 1000 students of Class 8–10 using multistage random sampling and risk factors were assessed using WHO steps methodology. Statistical Analysis: Statistical analysis was done using SPSS 16 software and test of differences used were Chi-square test and t-test. Results: The prevalence of ever tobacco use was 32.3% among boys and 6.6% among girls (P < 0.001) while ever alcohol use was reported by 11.9% boys and 1% girls (P < 0.001). Prevalence of overweight and hypertension was found to be higher among girls (11.7% and 24.1%) as compared to boys (6.8% and 18.1%). Prevalence of hypercholesterolemia was higher among boys while high triglycerides levels were more prevalent among girls. Conclusion: The study revealed a high prevalence of various risk factors among boys and girls. There is a need to reduce the risk factor prevalence of CVD among this group of the population to address the future epidemic of NCD. Different health promotional activities need to be implemented to target boys and girls as the risk factor distribution among these groups is different. PMID:27453853

  17. Risk Estimation with Epidemiologic Data When Response Attenuates at High-Exposure Levels

    National Research Council Canada - National Science Library

    Kyle Steenland; Ryan Seals; Mitch Klein; Jennifer Jinot; Henry D. Kahn

    2011-01-01

    Background: In occupational studies, which are commonly used for risk assessment for environmental settings, estimated exposure-response relationships often attenuate at high exposures. Relative risk (RR...

  18. Seismic risk assessment of a BWR: status report

    Energy Technology Data Exchange (ETDEWEB)

    Chuang, T.Y.; Bernreuter, D.L.; Wells, J.E.; Johnson, J.J.

    1985-02-01

    The seismic risk methodology developed in the US NRC Seismic Safety Margins Research Program (SSMRP) was demonstrated by its application to the Zion nuclear power plant, a pressurized water reactor (PWR). A detailed model of Zion, including systems analysis models (initiating events, event trees, and fault trees), SSI and structure models, and piping models was developed and analyzed. The SSMRP methodology can equally be applied to a boiling water reactor (BWR). To demonstrate its applicability, to identify fundamental differences in seismic risk between a PWR and a BWR, and to provide a basis of comparison of seismic risk between a PWR and a BWR when analyzed with comparable methodology and assumptions, a seismic risk analysis is being performed on the LaSalle County Station nuclear power plant.

  19. The effect of integrated reporting on integrated thinking between risk ...

    African Journals Online (AJOL)

    iSouthern African Business Review Volume 20 2016. The effect of ... its business model and strategy to respond to its external environment and the risks and opportunities it ...... Harvard Business School Research Working. Paper, 11–100.

  20. Technology and Risk Sciences Program. FY99 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    Regens, James L.

    2000-01-01

    In making the transition from weapons production to environmental restoration, DOE has found that it needs to develop reliable means of defining and understanding health and environmental risks and of selecting cost-efficient environmental management technologies so that cleanup activities can be appropriately directed. Through the Technology and Risk Sciences Project, the Entergy Spatial Analysis Research Laboratory attempts to provide DOE with products that incorporate spatial analysis techniques in the risk assessment, communication, and management processes; design and evaluate methods for evaluating innovative environmental technologies; and collaborate and access technical information on risk assessment methodologies, including multimedia modeling and environmental technologies in Russia and the Ukraine, while in addition training and developing the skills of the next generation of scientists and environmental professionals.

  1. High-Resolution PET Detector. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Karp, Joel

    2014-03-26

    The objective of this project was to develop an understanding of the limits of performance for a high resolution PET detector using an approach based on continuous scintillation crystals rather than pixelated crystals. The overall goal was to design a high-resolution detector, which requires both high spatial resolution and high sensitivity for 511 keV gammas. Continuous scintillation detectors (Anger cameras) have been used extensively for both single-photon and PET scanners, however, these instruments were based on NaI(Tl) scintillators using relatively large, individual photo-multipliers. In this project we investigated the potential of this type of detector technology to achieve higher spatial resolution through the use of improved scintillator materials and photo-sensors, and modification of the detector surface to optimize the light response function.We achieved an average spatial resolution of 3-mm for a 25-mm thick, LYSO continuous detector using a maximum likelihood position algorithm and shallow slots cut into the entrance surface.

  2. Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding.

    Science.gov (United States)

    Duché, Mathieu; Ducot, Béatrice; Ackermann, Oanez; Guérin, Florent; Jacquemin, Emmanuel; Bernard, Olivier

    2017-02-01

    Primary prophylaxis of bleeding is debated for children with portal hypertension because of the limited number of studies on its safety and efficacy, the lack of a known endoscopic pattern carrying a high-risk of bleeding for all causes, and the assumption that the mortality of a first bleed is low. We report our experience with these issues. From 1989 to 2014, we managed 1300 children with portal hypertension. Endoscopic features were recorded; high-risk varices were defined as: grade 3 esophageal varices, grade 2 varices with red wale markings, or gastric varices. Two hundred forty-six children bled spontaneously and 182 underwent primary prophylaxis. The results of primary prophylaxis were reviewed as well as bleed-free survival, overall survival and life-threatening complications of bleeding. High-risk varices were found in 96% of children who bled spontaneously and in 11% of children who did not bleed without primary prophylaxis (phypertension. Life-threatening complications of bleeding were recorded in 19% of children with cirrhosis and high-risk varices who bled spontaneously. Ten-year probabilities of bleed-free survival after primary prophylaxis in children with high-risk varices were 96% and 72% for non-cirrhotic causes and cirrhosis respectively. Ten-year probabilities of overall survival after primary prophylaxis were 100% and 93% in children with non-cirrhotic causes and cirrhosis respectively. In children with portal hypertension, bleeding is linked to the high-risk endoscopic pattern reported here. Primary prophylaxis of bleeding based on this pattern is fairly effective and safe. In children with liver disease, the risk of bleeding from varices in the esophagus is linked to their large size, the presence of congestion on their surface and their expansion into the stomach but not to the child's age nor to the cause of portal hypertension. Prevention of the first bleed in children with high-risk varices can be achieved by surgery or endoscopic

  3. 2017 Taiwan lipid guidelines for high risk patients

    Directory of Open Access Journals (Sweden)

    Yi-Heng Li

    2017-04-01

    Full Text Available In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C and non-high density lipoprotein cholesterol (non-HDL-C are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD, including coronary artery disease (CAD, ischemic stroke and peripheral arterial disease (PAD. Because the risk of ASCVD is high in patients with diabetes mellitus (DM, chronic kidney disease (CKD and familial hypercholesterolemia (FH, lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins, cholesterol absorption inhibitors (ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors, nicotinic acids (niacin, fibric acids derivatives (fibrates, and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS and stable CAD, LDL-C 40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR < 60 mL/min/1.73m2 without chronic dialysis (CKD stage 3–5, statin therapy should be initiated if LDL-C ≥ 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid

  4. Using risk to target HPV vaccines in high-risk, low-resource organizations.

    Science.gov (United States)

    Small, Stephanie L; Sampselle, Carolyn M; Martyn, Kristy K; Dempsey, Amanda F

    2013-05-01

    Organizations in developed countries with limited financial resources may find it difficult to determine whether it is preferable to use these resources for HPV vaccination, management of HPV-related diseases, or a "hybrid" strategy, such as vaccinating only the highest risk individuals. We determined the organizational costs and clinical impacts of three different organizational approaches to female HPV vaccination in a low-resource setting, including vaccinating everyone, vaccinating no one, or vaccinating only those considered high-risk. To determine patients at highest risk, HPV risk factors were identified using information routinely gathered at the annual preventive maintenance visit. The three vaccination strategies were then compared using a decision tree analysis. The three strategies demonstrated very little difference in cost. However, the least expensive strategy was to vaccinate no one. In contrast, the strategy with the best clinical outcomes was for the organization to vaccinate everyone. Organizations with limited resources must decide how to best allocate these funds to provide the greatest clinical benefits. This study showed little difference in costs but improved clinical outcomes when using the universal HPV vaccination strategy. Thus, the improvement in clinical outcomes when vaccinating everyone may be worth the relatively small increase in cost of vaccinating everyone.

  5. Non-traditional risk factors for atherosclerosis in high risk children.

    Science.gov (United States)

    Blieden, L C; Kuberger, N; Goez, R; Abramov, N; Laron, Z; Weizman, A; Gil-Ad, I

    1996-12-01

    Non-traditional risk factors for atherosclerosis were examined in children whose fathers suffered from myocardial infarction up to age 48. Factors examined were hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five cases (9%) and hypoinsulinemia in two. Insulin output following glucose load was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low density lipoprotein in 6 cases. Increased fibrinogen and positive correlation with insulin abnormality was present in 29% (76% females) (P >0.02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holter monitoring pattern was sympathetic in 39% and parasympathetic in 47% of cases. Thus a number of non-traditional risk factors were found to be higher than normal in a relatively large number of children at high risk for atherosclerosis, with 25 children having more than three risk factors.

  6. 76 FR 13902 - Fair Credit Reporting Risk-Based Pricing Regulations

    Science.gov (United States)

    2011-03-15

    ... the Fair Credit Reporting Act (FCRA). The final rules generally require a creditor to provide a risk... Commission propose to amend their respective risk-based pricing rules to require disclosure of credit scores and information relating to credit scores in risk-based pricing notices if a credit score of the...

  7. Entropy measure of credit risk in highly correlated markets

    Science.gov (United States)

    Gottschalk, Sylvia

    2017-07-01

    We compare the single and multi-factor structural models of corporate default by calculating the Jeffreys-Kullback-Leibler divergence between their predicted default probabilities when asset correlations are either high or low. Single-factor structural models assume that the stochastic process driving the value of a firm is independent of that of other companies. A multi-factor structural model, on the contrary, is built on the assumption that a single firm's value follows a stochastic process correlated with that of other companies. Our main results show that the divergence between the two models increases in highly correlated, volatile, and large markets, but that it is closer to zero in small markets, when asset correlations are low and firms are highly leveraged. These findings suggest that during periods of financial instability, when asset volatility and correlations increase, one of the models misreports actual default risk.

  8. High school Bullying as a Risk for Later Depression and Suicidality

    OpenAIRE

    Klomek, Anat Brunstein; Kleinman, Marjorie; Altschuler, Elizabeth; Marrocco, Frank; Amakawa, Lia; Gould, Madelyn S.

    2011-01-01

    This is the first study to examine whether high-school students experiencing frequent bullying behaviors are at risk for later depression and suicidality. 236 students who reported frequent bullying behavior without depression or suicidality during a suicide screening were interviewed four years later to reassess depression, suicidal ideation, attempts, substance problems, and functional impairment and were compared to “at-risk” youth identified during the screen, including 96 youth who also ...

  9. Stathmin 1 is involved in the highly proliferative phenotype of high-risk myelodysplastic syndromes and acute leukemia cells.

    Science.gov (United States)

    Machado-Neto, João Agostinho; de Melo Campos, Paula; Favaro, Patricia; Lazarini, Mariana; Lorand-Metze, Irene; Costa, Fernando Ferreira; Olalla Saad, Sara Teresinha; Traina, Fabiola

    2014-02-01

    Stathmin 1 is an important cytoplasmic microtubule-destabilizing protein that plays critical roles in proliferation and accurate chromosome segregation through regulation of microtubule dynamics. High levels of Stathmin 1 expression have been reported in leukemia and solid tumors. However, Stathmin 1 has not been studied in myelodysplastic syndrome cells. We, herein, report that significantly higher Stathmin 1 levels were observed in proliferating hematopoietic cells, in high-risk MDS and acute leukemia cells. In addition, Stathmin 1 silencing in U937 and Namalwa leukemia cells reduced cell proliferation and clonogenicity. Our data suggest that Stathmin 1 expression may be related to the highly proliferative phenotype of hematopoietic cells and add new insights into the participation of Stathmin 1 in hematological malignancies.

  10. [Residual risk: The roles of triglycerides and high density lipoproteins].

    Science.gov (United States)

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target.

  11. Proteomic profiling of high risk medulloblastoma reveals functional biology.

    Science.gov (United States)

    Staal, Jerome A; Lau, Ling San; Zhang, Huizhen; Ingram, Wendy J; Hallahan, Andrew R; Northcott, Paul A; Pfister, Stefan M; Wechsler-Reya, Robert J; Rusert, Jessica M; Taylor, Michael D; Cho, Yoon-Jae; Packer, Roger J; Brown, Kristy J; Rood, Brian R

    2015-06-10

    Genomic characterization of medulloblastoma has improved molecular risk classification but struggles to define functional biological processes, particularly for the most aggressive subgroups. We present here a novel proteomic approach to this problem using a reference library of stable isotope labeled medulloblastoma-specific proteins as a spike-in standard for accurate quantification of the tumor proteome. Utilizing high-resolution mass spectrometry, we quantified the tumor proteome of group 3 medulloblastoma cells and demonstrate that high-risk MYC amplified tumors can be segregated based on protein expression patterns. We cross-validated the differentially expressed protein candidates using an independent transcriptomic data set and further confirmed them in a separate cohort of medulloblastoma tissue samples to identify the most robust proteogenomic differences. Interestingly, highly expressed proteins associated with MYC-amplified tumors were significantly related to glycolytic metabolic pathways via alternative splicing of pyruvate kinase (PKM) by heterogeneous ribonucleoproteins (HNRNPs). Furthermore, when maintained under hypoxic conditions, these MYC-amplified tumors demonstrated increased viability compared to non-amplified tumors within the same subgroup. Taken together, these findings highlight the power of proteomics as an integrative platform to help prioritize genetic and molecular drivers of cancer biology and behavior.

  12. Youth-caregiver Agreement on Clinical High-risk Symptoms of Psychosis

    Science.gov (United States)

    Golembo-Smith, Shana; Bachman, Peter; Senturk, Damla; Cannon, Tyrone D.; Bearden, Carrie E.

    2014-01-01

    Early identification of individuals who will go on to develop schizophrenia is a difficult endeavor. The variety of symptoms experienced by clinical high-risk youth make it difficult to identify who will eventually develop schizophrenia in the future. Efforts are being made, therefore, to more accurately identify at-risk individuals and factors that predict conversion to psychosis. As in most assessments of children and adolescents, however, both youth and parental report of symptomatology and resulting dysfunction are important to assess. The goals of the current study were to assess the extent of cross-informant agreement on the Structured Interview for Prodromal Symptoms (SIPS), a widely-used tool employed to determine clinical high-risk status. A total of 84 youth-caregiver pairs participated. Youth and caregiver raters displayed moderate overall agreement on SIPS-rated symptoms. Both youth and caregiver ratings of youth symptomatology contributed significantly to predicting conversion to psychosis. In addition, youth age and quality of youth-caregiver relationships appear to be related to cross-informant symptom ratings. Despite differences on individual SIPS domains, the majority of dyads agreed on youth clinical high-risk status. Results highlight the potential clinical utility of using caregiver informants to determine youth psychosis risk. PMID:24092494

  13. How well can adolescents really judge risk? Simple, self reported risk factors out-predict teens' self estimates of personal risk

    Directory of Open Access Journals (Sweden)

    Alexander Persoskie

    2013-01-01

    Full Text Available Recent investigations of adolescents' beliefs about risk have led to surprisingly optimistic conclusions: Teens' self estimates of their likelihood of experiencing various life events not only correlate sensibly with relevant risk factors (Fischhoff et al., 2000, but they also significantly predict later experiencing the events (Bruine de Bruin et al., 2007. Using the same dataset examined in previous investigations, the present study extended these analyses by comparing the predictive value of self estimates of risk to that of traditional risk factors for each outcome. The analyses focused on the prediction of pregnancy, criminal arrest, and school enrollment. Three findings emerged. First, traditional risk factor information tended to out-predict self assessments of risk, even when the risk factors included crude, potentially unreliable measures (e.g., a simple tally of self-reported criminal history and when the risk factors were aggregated in a nonoptimal way (i.e., unit weighting. Second, despite the previously reported correlations between self estimates and outcomes, perceived invulnerability was a problem among the youth: Over half of the teens who became pregnant, half of those who were not enrolled in school, and nearly a third of those who were arrested had, one year earlier, indicated a 0% chance of experiencing these outcomes. Finally, adding self estimates of risk to the other risk factor information produced only small gains in predictive accuracy. These analyses point to the need for greater education about the situations and behaviors that lead to negative outcomes.

  14. Teamwork in high-risk environments analogous to space

    Science.gov (United States)

    Kanki, Barbara G.

    1990-01-01

    Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

  15. Against the tide: climate change and high-risk cities

    Energy Technology Data Exchange (ETDEWEB)

    Dodman, David

    2008-11-15

    In the world's poorest and most vulnerable nations, most cities and towns face a distinct dual pressure: rapidly growing population and high vulnerability to the impacts of climate change. Drought, storms, flooding and sea level rise are likely to hit hardest here. These in turn put water supplies, infrastructure, health and livelihoods at risk in the very cities already struggling to provide or safeguard such key needs. An effective response demands capable local and national government and support from strong international networks in building capacity to cope. Most of the Least Developed Countries lack both.

  16. Measles Outbreak in High Risk Areas of Delhi: Epidemiological Investigation and Laboratory Confirmation.

    Science.gov (United States)

    Raoot, Amita; Dewan, Dharmendra Kumar; Dubey, A P; Batra, R K; Seth, Suresh

    2016-03-01

    To describe epidemiological and laboratory characteristics of the measles outbreaks recorded in the urban slums of Delhi (designated as high risk areas under the Polio program), from February through July 2014. As a part of surveillance and containment measures, an extensive field investigation for measles case search (WHO definition) through 'house to house survey' was conducted by district health teams and field volunteers of National Polio Surveillance Project (NPSP), WHO, Delhi from February through July, 2014. The data generated by the health teams was collected and analyzed. About 1.1 million households in the high risk areas of Delhi were surveyed for epidemiological investigations. A total of 1337 suspected measles cases were reported. The case fatality rate (CFR) was 1.2 %. Statistical analysis showed significant relation between age of the child (measles case) and immunization status. Higher numbers of reported cases were above 5 y and less than 9 mo of age. Measles IgM was detected in 132 cases and D8 strain was isolated on genotyping. The outbreak was predominantly localized to the high risk areas (urban slums) of the city. Low CFR was reported during the outbreaks. The outbreaks highlight the need to extend the reach of immunization services to urban slums and strengthen measles surveillance including laboratory based surveillance.

  17. Receipt of genetic counseling recommendations among black women at high risk for BRCA mutations.

    Science.gov (United States)

    Thompson, Hayley S; Sussner, Katarina; Schwartz, Marc D; Edwards, Tiffany; Forman, Andrea; Jandorf, Lina; Brown, Karen; Bovbjerg, Dana H; Valdimarsdottir, Heiddis B

    2012-11-01

    Low use of BRCA counseling and testing services among black women has been reported in several studies, even though such services may play an important role in reducing racial disparities in breast cancer. Surprisingly, little is known about the extent to which black women at high risk for BRCA mutations actually receive recommendations for BRCA counseling. Thus, a primary goal of the current study was to identify sociodemographic and clinical factors associated with the receipt of physician recommendation for genetic counseling based on the self-report of black women at high risk for BRCA mutations. In this cross-sectional study, participants were 125 black women with a family history suggestive of a hereditary breast and/or ovarian cancer syndrome. Participants were asked about their receipt of genetic counseling recommendation or referral. Physician recommendation was reported by over two-thirds of the sample. Multivariate analyses revealed that older age and study recruitment source, specifically community-based recruitment, were significantly and independently associated with lower likelihood of physician recommendation. Findings highlight the need for additional research to identify subgroups of high-risk black women among whom physician recommendation of genetic counseling is low but would benefit from such counseling.

  18. Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25-65 Years.

    Science.gov (United States)

    Winer, Rachel L; Hughes, James P; Feng, Qinghua; Stern, Joshua E; Xi, Long Fu; Koutsky, Laura A

    2016-09-01

    The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25-65 years). Triannually, 420 female online daters aged 25-65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan-Meier and Cox proportional hazards methods. The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%-30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38-5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners. Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  19. Assessment of Methods for Estimating Risk to Birds from Ingestion of Contaminated Grit Particles (Final Report)

    Science.gov (United States)

    The U.S. EPA Ecological Risk Assessment Support Center (ERASC) announced the release of the final report entitled, Assessment of Methods for Estimating Risk to Birds from Ingestion of Contaminated Grit Particles. This report evaluates approaches for estimating the probabi...

  20. Risk perception and risk attitudes in Tokyo: A report of the first administration of DOSPERT+M in Japan

    Directory of Open Access Journals (Sweden)

    Alan Schwartz

    2013-11-01

    Full Text Available Background: The Domain-Specific Risk Taking scale (DOSPERT has been used to measure risk perceptions and attitudes in several nations and cultures. Takahashi translated DOSPERT to Japanese but DOSPERT responses from Japan have never been reported. Butler et al. (2012 developed an additional medical risk domain subscale to be added to DOSPERT to form DOSPERT+M. Objective: To describe the translation of the medical risk domain subscale to Japanese and to characterize domain-specific risk attitudes in Tokyo. Methods: Members of a probability-weighted online panel representative of the Tokyo metro area were randomized to complete pairs of DOSPERT+M tasks (risk attitude, risk perception, benefit perception. We explored relationships among domains through correlational and factor analysis; we tested the hypothesis that the medical risk domain and DOSPERT's health/safety domains were uncorrelated. Participants: One hundred eighty panelists. Results: Six of the original DOSPERT items (two each in the ethics, health/safety, and financial domains are not useable in Japan according to the Japanese Marketing Research Association code because they ask about participation in illegal activities; we thus used abbreviated versions of those domains leaving out these items. The DOSPERT+M items generally did not cluster cleanly into the expected domains, although items within the same domain usually were intercorrelated. Participants demonstrated domain-specific conventional risk attitudes, although nearly half of those assessed were perceived-risk neutral in all domains. Unlike our recently reported findings in the U.S. population, DOSPERT+M medical domain scores were associated with health/safety domain scores, although they were often more strongly associated with scores in other domains, such as recreational activities. Conclusion: The DOSPERT (and DOSPERT+M instruments are problematic in Japan but Japanese citizens may also differ from those of other nations

  1. Modifiable health risks in Atlantic Canadian employees: a 5-year report.

    Science.gov (United States)

    Makrides, L; Sawatzky, C; Petrie, J; Veinot, P

    2010-12-01

    A number of modifiable health risks, such as smoking, inactivity and obesity have been linked to increased employer costs, including decreased productivity and increased absenteeism and health claims. The purpose of this paper is to report on the health profile and prevalence of modifiable health risks in an Atlantic Canadian Employee Database. Data were collected over a 5-year period (2001-2006) by the Atlantic Health and Wellness Institute, the research arm of Creative Wellness Solutions, in Halifax, Nova Scotia, Canada. Each employee of 51 workplaces (n = 6067; 2665 males, 3402 females; average age 41.3 years) completed a Health Risk Assessment questionnaire on smoking, nutrition and physical activity behaviours. Clinical data measurements were blood pressure, blood cholesterol, weight and height. Data were compared for private, public and health sectors. Sixteen percent had elevated blood pressure (≥ 140/90 mmHg), 20% smoked cigarettes, 70% were overweight [body mass index (BMI) ≥ 25 kg/m(2)], 31% were obese (BMI ≥ 30 kg/m(2)), 38% had elevated non-fasting cholesterol levels (≥ 5.20 mmol/l) and 49% were inactive (health risks (i.e. daily tobacco smoking, physical inactivity, overweight and high blood pressure). Health care sector employees were healthier overall, but there was substantial room for improvement. The present analysis identified an alarming prevalence of modifiable health risks in Atlantic Canadian employees. Workplaces need to invest in workplace wellness to reduce the risks and promote better health among employees, thus increasing productivity and decreasing the financial burden on employers.

  2. Understanding high magnitude flood risk: evidence from the past

    Science.gov (United States)

    MacDonald, N.

    2009-04-01

    The average length of gauged river flow records in the UK is ~25 years, which presents a problem in determining flood risk for high-magnitude flood events. Severe floods have been recorded in many UK catchments during the past 10 years, increasing the uncertainty in conventional flood risk estimates based on river flow records. Current uncertainty in flood risk has implications for society (insurance costs), individuals (personal vulnerability) and water resource managers (flood/drought risk). An alternative approach is required which can improve current understanding of the flood frequency/magnitude relationship. Historical documentary accounts are now recognised as a valuable resource when considering the flood frequency/magnitude relationship, but little consideration has been given to the temporal and spatial distribution of these records. Building on previous research based on British rivers (urban centre): Ouse (York), Trent (Nottingham), Tay (Perth), Severn (Shrewsbury), Dee (Chester), Great Ouse (Cambridge), Sussex Ouse (Lewes), Thames (Oxford), Tweed (Kelso) and Tyne (Hexham), this work considers the spatial and temporal distribution of historical flooding. The selected sites provide a network covering many of the largest river catchments in Britain, based on urban centres with long detailed documentary flood histories. The chronologies offer an opportunity to assess long-term patterns of flooding, indirectly determining periods of climatic variability and potentially increased geomorphic activity. This research represents the first coherent large scale analysis undertaken of historical multi-catchment flood chronologies, providing an unparalleled network of sites, permitting analysis of the spatial and temporal distribution of historical flood patterns on a national scale.

  3. Sustainable prevention of resource conflicts. Approaches to minimize risk (Report 4); Rohstoffkonflikte nachhaltig vermeiden. Ansaetze zur Risikominimierung (Teilbericht 4)

    Energy Technology Data Exchange (ETDEWEB)

    Taenzler, Dennis; Westerkamp, Meike [Adelphi Research, Berlin (Germany); Supersberger, Nikolaus; Ritthoff, Michael; Bleischwitz, Raimund [Wuppertal Institut (Germany)

    2011-04-15

    Conflicting constellations and the resulting risk of conflict over raw materials are highly complex. This report investigates approaches of various groups of actors and various fields of politics to minimize this risk, with the intention of identifying and analyzing relevant and innovative approaches and to outline their potential and shortcomings in solving risky constellations. The approaches presented here were selected for their relevance and actuality. This includes, on the one hand, approaches that investigate violent conflicts in the producer countries. On the other hand, approaches are considered that attempt to influence the risk of conflict by governmental or private environmental, climate and resources policies. (orig./RHM)

  4. High Penetration Photovoltaic Case Study Report

    Energy Technology Data Exchange (ETDEWEB)

    Bank, J.; Mather, B.; Keller, J.; Coddington, M.

    2013-01-01

    Technical concerns with integrating higher penetrations of photovoltaic (PV) systems include grid stability, voltage regulation, power quality (voltage rise, sags, flicker, and frequency fluctuations), and protection and coordination. The current utility grid was designed to accommodate power flows from the central generation source to the transmission system and eventually to the distribution feeders. At the distribution level, the system was designed to carry power from the substation toward the load. Renewable distributed generation, particularly solar PV, provides power at the distribution level challenging this classical paradigm. As these resources become more commonplace the nature of the distribution network and its operation is changing to handle power flow in both directions. This report is focused on large PV installations in which penetration is significantly greater than 15% of maximum daytime feeder load. These case studies are intended to demonstrate success stories with integration of large PV plants at the distribution level as well as some of the solutions used by the utility to ensure safe, reliable operation of both the PV system and the distribution network.

  5. Risk Assessment for Natural-Hazard Impact on Hazardous Chemical Installations: Workshop Outcome Report

    OpenAIRE

    2016-01-01

    The impact of natural hazards on hazardous installations can cause major chemical accidents. This so-called “Natech” risk is increasing due to industrialisation and climate change. Capacity building in EU Member States, Candidate Countries and EU Neighbourhood Countries on Natech risk required for Natech risk reduction. This report summarises the findings of a training workshop on risk assessment for natural-hazard impact on hazardous chemical installations which the JRC organised in the ...

  6. Prediction of depression in individuals at high familial risk of mood disorders using functional magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Heather C Whalley

    Full Text Available OBJECTIVE: Bipolar disorder is a highly heritable condition. First-degree relatives of affected individuals have a more than a ten-fold increased risk of developing bipolar disorder (BD, and a three-fold risk of developing major depressive disorder (MDD than the general population. It is unclear however whether differences in brain activation reported in BD and MDD are present before the onset of illness. METHODS: We studied 98 young unaffected individuals at high familial risk of BD and 58 healthy controls using functional Magnetic Resonance Imaging (fMRI scans and a task involving executive and language processing. Twenty of the high-risk subjects subsequently developed MDD after the baseline fMRI scan. RESULTS: At baseline the high-risk subjects who later developed MDD demonstrated relatively increased activation in the insula cortex, compared to controls and high risk subjects who remained well. In the healthy controls and high-risk group who remained well, this region demonstrated reduced engagement with increasing task difficulty. The high risk subjects who subsequently developed MDD did not demonstrate this normal disengagement. Activation in this region correlated positively with measures of cyclothymia and neuroticism at baseline, but not with measures of depression. CONCLUSIONS: These results suggest that increased activation of the insula can differentiate individuals at high-risk of bipolar disorder who later develop MDD from healthy controls and those at familial risk who remain well. These findings offer the potential of future risk stratification in individuals at risk of mood disorder for familial reasons.

  7. Waste area Grouping 2 Phase I task data report: Human health risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Purucker, S.T.; Douthat, D.M.

    1996-06-01

    This report is one of five reports issued in 1996 that provide follow- up information to the Phase 1 Remedial Investigation (RI) Report for Waste Area Grouping (WAG) 2 at Oak Ridge National Laboratory (ORNL). The five reports address areas of concern that could cause potential human health risk and ecological risk within WAG2 at ORNL. The purpose of this report is to present a summary of the human health risk assessment results based on the data collected for the WAG 2 Phase 1 RI. Estimates of risk are provided based on measured concentrations in the surface water, floodplain soil, and sediment of White Oak Creek, Melton Branch, and their tributaries. The human health risk assessment methodology used in this risk assessment is based on Risk Assessment Guidance for Superfund (RAGS). First, the data for the different media are elevated to determine usability for risk assessment. Second, through the process of selecting chemicals of potential concern (COPCs), contaminants to be considered in the risk assessment are identified for each assessment of exposure potential is performed, and exposure pathways are identified. Subsequently, exposure is estimated quantitatively, and the toxicity of each of the COPCs is determined. The results of these analyses are combined and summarized in a risk characterization.

  8. High pressure/high temperature thermogravimetric apparatus. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Calo, J.M.; Suuberg, E.M.

    1999-12-01

    The purpose of this instrumentation grant was to acquire a state-of-the-art, high pressure, high temperature thermogravimetric apparatus (HP/HT TGA) system for the study of the interactions between gases and carbonaceous solids for the purpose of solving problems related to coal utilization and applications of carbon materials. The instrument that we identified for this purpose was manufactured by DMT (Deutsche Montan Technologies)--Institute of Cokemaking and Coal Chemistry of Essen, Germany. Particular features of note include: Two reactors: a standard TGA reactor, capable of 1100 C at 100 bar; and a high temperature (HT) reactor, capable of operation at 1600 C and 100 bar; A steam generator capable of generating steam to 100 bar; Flow controllers and gas mixing system for up to three reaction gases, plus a separate circuit for steam, and another for purge gas; and An automated software system for data acquisition and control. The HP/TP DMT-TGA apparatus was purchased in 1996 and installed and commissioned during the summer of 1996. The apparatus was located in Room 128 of the Prince Engineering Building at Brown University. A hydrogen alarm and vent system were added for safety considerations. The system has been interfaced to an Ametek quadruple mass spectrometer (MA 100), pumped by a Varian V250 turbomolecular pump, as provided for in the original proposed. With this capability, a number of gas phase species of interest can be monitored in a near-simultaneous fashion. The MS can be used in a few different modes. During high pressure, steady-state gasification experiments, it is used to sample, measure, and monitor the reactant/product gases. It can also be used to monitor gas phase species during nonisothermal temperature programmed reaction (TPR) or temperature programmed desorption (TPD) experiments.

  9. Robotic Mars Sample Return: Risk Assessment and Analysis Report

    Science.gov (United States)

    Lalk, Thomas R.; Spence, Cliff A.

    2003-01-01

    A comparison of the risk associated with two alternative scenarios for a robotic Mars sample return mission was conducted. Two alternative mission scenarios were identified, the Jet Propulsion Lab (JPL) reference Mission and a mission proposed by Johnson Space Center (JSC). The JPL mission was characterized by two landers and an orbiter, and a Mars orbit rendezvous to retrieve the samples. The JSC mission (Direct/SEP) involves a solar electric propulsion (SEP) return to earth followed by a rendezvous with the space shuttle in earth orbit. A qualitative risk assessment to identify and characterize the risks, and a risk analysis to quantify the risks were conducted on these missions. Technical descriptions of the competing scenarios were developed in conjunction with NASA engineers and the sequence of events for each candidate mission was developed. Risk distributions associated with individual and combinations of events were consolidated using event tree analysis in conjunction with Monte Carlo techniques to develop probabilities of mission success for each of the various alternatives. The results were the probability of success of various end states for each candidate scenario. These end states ranged from complete success through various levels of partial success to complete failure. Overall probability of success for the Direct/SEP mission was determined to be 66% for the return of at least one sample and 58% for the JPL mission for the return of at least one sample cache. Values were also determined for intermediate events and end states as well as for the probability of violation of planetary protection. Overall mission planetary protection event probabilities of occurrence were determined to be 0.002% and 1.3% for the Direct/SEP and JPL Reference missions respectively.

  10. Rapid Risk Assessment: FY05 Annual Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, Gene; Millard, W. David; Gelston, Gariann M.; Pelton, Mitch A.; Yang, Zhaoqing; Strenge, Dennis L.; Lee, Cheegwan; Sivaraman, Chitra; Simpson, Mary J.; Young, Joan K.; Khangaonkar, Tarang P.; Downing, Timothy R.; Hoopes, Bonnie L.; Hachmeister, Lon E.

    2006-03-06

    The Pacific Northwest National Laboratory (PNNL) is developing decision support tools that will assist in the transition of incident information into Protective Action Recommendations (PARs) that are understandable and can be executed in a real-world, operational environment. During emergencies, responders must rapidly assess risks and decide on the best course of action—all within minutes to hours. PNNL is blending existing modeling and decision support technology to develop new methods for transitioning science-based threat assessment to PARs. The rapid risk assessment tool will be both understandable and applicable to the emergency management community and would be a valuable tool during any water security-related incident. In 2005, PNNL demonstrated the integration of the multi-thematic modeling with emergency management decision support tools to create a Rapid Risk Assessment (RRA) tool that will transition risk to PARs that assist in responding to or mitigating the direct and indirect impacts of the incident(s). The RRA tool does this by aligning multi-thematic modeling capabilities with real-world response zones established by emergency and site operations managers. The RRA tool uses the risk assessment tool to drive prognostic models that use the type of incident, time of impact, severity of impact, and duration of impact to select the most appropriate PAR. Because PARs (and the thresholds by which they are selected) are jointly established by the technologists and the emergency management and operations decision makers, the science-based risk assessment can transition into a recommendation that can be understood and executed by people in the field.

  11. Nuclear risk from atmospheric dispersion in Northern Europe - Summary Report

    DEFF Research Database (Denmark)

    Lauritzen, Bent

    The objective of the NordRisk II project has been to derive practical means for assessing the risks from long-range atmospheric dispersion of radioac-tive materials. An atlas over different atmospheric dispersion and deposi-tion scenarios has been developed using historical numerical weather pre......-diction (NWP) model data. The NWP model data covers three years span-ning the climate variability associated with the North Atlantic Oscillation, and the atlas considers radioactive releases from 16 release sites in and near the Nordic countries. A statistical analysis of the long-range disper...

  12. Pharmacological management of dyslipidemia in high and very high cardiovascular risk patients

    Directory of Open Access Journals (Sweden)

    V. Pascual Fuster

    Full Text Available Dyslipaemia is one of the main risk factors in the development of cardiovascular diseases. Currently, there are different alternatives available (amongst which statins occupy a pre-eminent place, to optimise the treatment of patients at high or very high cardiovascular risk. Despite this, the percentage of patients that achieve good lipid control is low. The causes of the mismatch with proposed objectives include lack of patient adherence and therapeutic inertia. This review uses available evidence and the latest clinical guides as a basis to assess the pharmacological treatment of dyslipaemia in patients with a background of arteriosclerotic vascular disease, diabetes, chronic kidney disease, cardiovascular risk at ≥5% calculated by SCORE and familial hypercholesterolaemia. The treatment of hypertriglyceridemia is also reviewed along with the special consideration that poly-pharmacy deserves in patients treated with statins, making mention of the treatment of dyslipaemia with HIV infection. The global assessment of cardiovascular risk is of high priority to adapt treatment to the specific objectives of the c-LDL for each risk category.

  13. Prevalence and Correlates of Leprosy in a High-Risk Community Setting in Sri Lanka.

    Science.gov (United States)

    Dabrera, Thushani Marie Elizabeth; Tillekeratne, L Gayani; Fernando, M S Nilanthi; Kasturiaratchi, S T Kaushlya; Østbye, Truls

    2016-10-01

    Leprosy is caused by the Mycobacterium leprae bacillus. Pockets of high endemicity remain in a number of countries including Sri Lanka, in spite of the fact that elimination has been achieved at the national level. In 2012, in a village in the Puttlam district, dermatologists reported an increase in individuals with leprosy. This village had been established in the 1990s for people displaced from Northern Sri Lanka during a civil war. A comprehensive household survey was conducted by district health officials from June to July 2012, and all household members present during the survey period were examined for leprosy lesions. Patients with suspected leprosy were referred to a dermatology clinic for clinical or pathological confirmation. The prevalence of leprosy was high (511 per 10 000 population). Household contact with another patient with leprosy increased the risk of leprosy (odds ratio = 6.69; P leprosy at bay in high-risk communities.

  14. Sexting behaviors among young Hispanic women: incidence and association with other high-risk sexual behaviors.

    Science.gov (United States)

    Ferguson, Christopher J

    2011-09-01

    Several legal cases in the United States in which adolescents were charged with child pornography distribution after sharing nude photographs of themselves with romantic partners or others have highlighted the issue of sexting behaviors among youth. Although policy makers, mental health workers, educators and parents have all expressed concern regarding the potential harm of sexting behaviors, little to no research has examined this phenomenon empirically. The current study presents some preliminary data on the incidence of sexting behavior and associated high risk sexual behaviors in a sample of 207 predominantly Hispanic young women age 16-25. Approximately 20% of young women reported engaging in sexting behavior. Sexting behaviors were not associated with most other high-risk sexual behaviors, but were slightly more common in women who found sex to be highly pleasurable or who displayed histrionic personality traits.

  15. Minimax risks for sparse regressions: Ultra-high-dimensional phenomenons

    CERN Document Server

    Verzelen, Nicolas

    2010-01-01

    Consider the standard linear regression model $Y=X\\theta+\\epsilon$, where $Y\\in R^n$ is a response vector, $X\\in R^{n\\times p}$ is a design matrix, $\\theta\\in R^p$ is the unknown regression vector, and $\\epsilon\\sim N(0_p,\\sigma^2I_p)$ is a Gaussian noise. Numerous work have been devoted to building efficient estimators of $\\theta$ when $p$ is much larger than $n$. In such a situation, a classical approach amounts to assume that $\\theta$ is approximately sparse. This paper studies the minimax risks of estimation and testing over $k$-sparse vectors $\\theta$. These bounds shed light on the limitations due to high-dimensionality. The results encompass the problem of prediction (estimation of $X\\theta$), the inverse problem (estimation of $\\theta$) and linear testing (test of a linear hypothesis on $\\theta$). Interestingly, an elbow effect occurs when the number of variables $p$ becomes larger than $k\\exp(n/k)$. Indeed, the minimax risks and hypothesis separation distances blow up in this ultra-high dimensional s...

  16. Personality differences in high risk sports amateurs and instructors.

    Science.gov (United States)

    Watson, Alison E; Pulford, Briony D

    2004-08-01

    This study investigated the personality differences of 21 amateurs and 20 instructors who participated in the high risk sports of skydiving, hang-gliding, paragliding, scuba diving, microlighting, and rock climbing, versus those who did not. 38 men and 28 women (M age=32.6 yr., SD= 10.0) were assessed using the Eysenck Personality Questionnaire-Revised, the General Health Questionnaire, the Generalised Self-efficacy Scale, and a Type A/B personality measure. Instructors and Amateurs scored significantly higher on Extroversion and lower on Neuroticism than Nonparticipants; however, they differed from each other on the General Health Questionnaire and Type A/B personality scores. Amateurs scored significantly higher on Psychoticism and Self-efficacy than Instructors and Nonparticipants. In conclusion, these test scores suggest that people who are attracted to high risk sports tend to be at the extroverted and emotionally stable end of the scale, with a tendency to exhibit Type A characteristics; however, Instructors' scores on Psychoticism and Self-efficacy are more akin to those of Nonparticipants.

  17. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    Science.gov (United States)

    Tummers, Bart; Van Der Burg, Sjoerd H.

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review. PMID:26008697

  18. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review.

    Science.gov (United States)

    Onate, James A; Everhart, Joshua S; Clifton, Daniel R; Best, Thomas M; Borchers, James R; Chaudhari, Ajit M W

    2016-11-01

    A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5-6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2-18.4; P < 0.05), hip external:internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = -0.339, P = 0.008). Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury.

  19. High Risk Infants Follow-Up: A Case Study in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Heidarzadeh

    2015-01-01

    Full Text Available Background. A follow-up program for high risk infants was initiated in Alzahra Maternity Hospital in Tabriz city, Iran, in 2013. The aim of this paper is to give a brief report of the program. Material and Methods. Two groups of high risk neonates were studied. The first group comprising 509 infants received services in Alzahra Maternity Hospital implemented by the follow-up program. This included a full package for family to look after high risk infant and periodic clinical evaluation at two and four weeks after birth and then two, three, four, five, and six months later again. The second group including 131 infants in Taleqani Maternity Hospital received routine services after birth with no specific follow-up care. Results. Some anthropometric indices showed a significant improvement in the intervention hospital compared to control group. These included the following: head circumference at first and second months; weight in the first, fourth, fifth, and sixth months; and height in sixth month only. Clinical evaluation of infants showed an improvement for some of the medical conditions. Conclusion. Follow-up care program for a minimum of six months after discharge from maternity hospitals may help to avoid adverse and life threatening consequences in high risk infants.

  20. Commercial vehicles and road safety in Pakistan: exploring high-risk attributes among drivers and vehicles.

    Science.gov (United States)

    Mir, Mohammed Umer; Razzak, Junaid Abdul; Ahmad, Khabir

    2013-01-01

    Road traffic injuries are on the rise in developing countries with a disproportionately high number of crashes involving commercial vehicles. Baseline information on risk factors is necessary to develop targeted prevention programmes. A survey of commercial drivers was conducted at the largest bus and truck station in Rawalpindi, Pakistan. Structured interviews elicited information from 857 drivers on their socio-demographics, high-risk driving behaviours, fatigue, use of drugs while driving, vehicle maintenance and health conditions, as well as crash involvement. A binary logistic regression analysis was used to investigate the factors associated with crash involvement in the last five years. Overall, 92 (11.2%) drivers reported having had a road crash in the last 5 years. Factors independently associated with the occurrence of crashes were alcohol use (OR 2.2, 95% CI 1.1-4.4), poor vehicle maintenance (OR 3.4, 95% CI 1.7-7.01) and lack of seat belt use (OR 2.7, 95% CI 1.3-5.6). The high prevalence of high-risk attributes in the study population indicates a great need for targeted risk prevention.

  1. Adolescents misperceive and are influenced by high-status peers' health risk, deviant, and adaptive behavior.

    Science.gov (United States)

    Helms, Sarah W; Choukas-Bradley, Sophia; Widman, Laura; Giletta, Matteo; Cohen, Geoffrey L; Prinstein, Mitchell J

    2014-12-01

    Most peer influence research examines socialization between adolescents and their best friends. Yet, adolescents also are influenced by popular peers, perhaps due to misperceptions of social norms. This research examined the extent to which out-group and in-group adolescents misperceive the frequencies of peers' deviant, health risk, and adaptive behaviors in different reputation-based peer crowds (Study 1) and the prospective associations between perceptions of high-status peers' and adolescents' own substance use over 2.5 years (Study 2). Study 1 examined 235 adolescents' reported deviant (vandalism, theft), health risk (substance use, sexual risk), and adaptive (exercise, studying) behavior, and their perceptions of jocks', populars', burnouts', and brains' engagement in the same behaviors. Peer nominations identified adolescents in each peer crowd. Jocks and populars were rated as higher status than brains and burnouts. Results indicated that peer crowd stereotypes are caricatures. Misperceptions of high-status crowds were dramatic, but for many behaviors, no differences between populars'/jocks' and others' actual reported behaviors were revealed. Study 2 assessed 166 adolescents' substance use and their perceptions of popular peers' (i.e., peers high in peer perceived popularity) substance use. Parallel process latent growth analyses revealed that higher perceptions of popular peers' substance use in Grade 9 (intercept) significantly predicted steeper increases in adolescents' own substance use from Grade 9 to 11 (slope). Results from both studies, utilizing different methods, offer evidence to suggest that adolescents misperceive high-status peers' risk behaviors, and these misperceptions may predict adolescents' own risk behavior engagement. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  2. LHC Report: highs and wet lows

    CERN Multimedia

    Enrico Bravin and Stefano Redaelli for the LHC team

    2016-01-01

    Summertime, and the livin’ is easy… not so for the LHC, which is just entering four weeks of full-on luminosity production.   In the two weeks that followed the first technical stop (7-9 June), the LHC has demonstrated once again an outstanding performance. Thanks to the excellent availability of all systems, peaking at 93% in week 24, it was possible to chain physics fill after physics fill, with 60% of the time spent in collisions. We have now surpassed the total integrated luminosity delivered in 2015 (4.2 fb-1). The integrated luminosity for 2016 now exceeds 6 fb-1 for each of the two high-luminosity experiments, ATLAS and CMS. Long fills, exceeding 20 hours, are now part of regular operation, with some producing more than 0.5 fb-1. With the summer conferences approaching, this certainly provides a good dataset for the LHC experiments to analyse and present. Several records were broken again, namely the highest instantaneous luminosity – over 9 x 1033 cm-2...

  3. Annual Report: National Risk Assessment Partnership (30 September 2012)

    Energy Technology Data Exchange (ETDEWEB)

    Bromhal, Grant; Guthrie, George

    2014-01-06

    The U.S. Department of Energy’s (DOE) National Energy Technology Laboratory (NETL) is conducting research to advance the science and engineering knowledge base for technologies that will accelerate the business case for CO{sub 2} capture and storage, including prediction and quantification of risks that may relate to potential liabilities. As part of this effort, NETL, through its Office of Research and Development (ORD), is leading a multi-laboratory effort that leverages broad technical capabilities across the DOE complex: the National Risk Assessment Partnership (NRAP). NRAP involves five DOE national laboratories: NETL, Lawrence Berkeley National Laboratory (LBNL), Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), and Pacific Northwest National Laboratory (PNNL). This team is working together to develop a science-based method for quantifying the likelihood of risks (and associated potential liabilities) for CO{sub 2} storage sites. NRAP is an effort that harnesses the breadth of capabilities across the DOE National Laboratory (NL) system into a mission-focused platform that will develop the integrated science base that can be applied to risk assessment for long-term storage of CO{sub 2}.

  4. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  5. High Blood Cholesterol in Adults. Report of the Expert Panel on Detection, Evaluation, and Treatment.

    Science.gov (United States)

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    This report offers a patient-based approach to lowering blood cholesterol levels which seeks to identify individuals at high risk who will benefit from intensive intervention efforts. The goal is to establish criteria that define the candidates for medical intervention and to provide guidelines on how to detect, set goals for, treat, and monitor…

  6. The carcinogenic risks of low-LET and high-LET ionizing radiations. Revision

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I. [Lawrence Berkeley Lab., CA (United States)]|[California Univ., San Francisco, CA (United States)

    1991-08-01

    This report presents a discussion on risk from ionizing radiations to human populations. Important new information on human beings has come mainly from further follow-up of existing epidemiological studies, notably the Japanese atomic bomb survivors and the ankylosing spondylitis patients; from new epidemiological surveys, such as the patients treated for cancer of the uterine cervix; and from combined surveys, including workers exposed in underground mines. Since the numerous and complex differences among the different study populations introduce factors that influence the risk estimates derived in ways that are not completely understood, it is not clear how to combine the different risk estimates obtained. These factors involve complex biological and physical variables distributed over time. Because such carcinogenic effects occur too infrequently to be demonstrated at low doses, the risks of low-dose radiation can be estimated only by interpolation from observations at high doses on the basis of theoretical concepts, mathematical models and available empirical evidence, primarily the epidemiological surveys of large populations exposed to ionizing radiation. In spite of a considerable amount of research, only recently has there has been efforts to apply the extensive laboratory data in animals to define the dose-incidence relationship in the low dose region. There simply are insufficient data in the epidemiological studies of large human populations to estimate risk coefficients directly from exposure to low doses. The risk estimates for the carcinogenic effects of radiation have been, in the past, somewhat low and reassessment of the numerical values is now necessary.

  7. The carcinogenic risks of low-LET and high-LET ionizing radiations

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I. (Lawrence Berkeley Lab., CA (United States) California Univ., San Francisco, CA (United States))

    1991-08-01

    This report presents a discussion on risk from ionizing radiations to human populations. Important new information on human beings has come mainly from further follow-up of existing epidemiological studies, notably the Japanese atomic bomb survivors and the ankylosing spondylitis patients; from new epidemiological surveys, such as the patients treated for cancer of the uterine cervix; and from combined surveys, including workers exposed in underground mines. Since the numerous and complex differences among the different study populations introduce factors that influence the risk estimates derived in ways that are not completely understood, it is not clear how to combine the different risk estimates obtained. These factors involve complex biological and physical variables distributed over time. Because such carcinogenic effects occur too infrequently to be demonstrated at low doses, the risks of low-dose radiation can be estimated only by interpolation from observations at high doses on the basis of theoretical concepts, mathematical models and available empirical evidence, primarily the epidemiological surveys of large populations exposed to ionizing radiation. In spite of a considerable amount of research, only recently has there has been efforts to apply the extensive laboratory data in animals to define the dose-incidence relationship in the low dose region. There simply are insufficient data in the epidemiological studies of large human populations to estimate risk coefficients directly from exposure to low doses. The risk estimates for the carcinogenic effects of radiation have been, in the past, somewhat low and reassessment of the numerical values is now necessary.

  8. EXPLAINING THE AUDIT RISK AND ITS COMPONENTS: A COMPARATIVE CASE-STUDY BASED ON AUDIT REPORTS

    Directory of Open Access Journals (Sweden)

    ALINA VOICULESCU

    2014-08-01

    Full Text Available The players activating in the post-recession business environment have to and begin to be more and more prudent and attentive to any sign of human errors, uncertainty, lack of objectivity, attempt of fraud which may occur when financial statements are prepared, in their own case or in the case of their trade clients/suppliers, debtors, business partners, in general. Auditors thus became the mediators between the producers and the users of accountant information, using their high theoretical training, authority, competence and independence as pledge for the fairness of the financial statements and for the compliance with the Law. But even their reports are subject to uncertainty, therefore the author considered useful to approach in the current paper the issue of risk in financial audit, by use of a study-case of several audit reports, in order to explain and exemplify it and to highlight the difference between its components’ evaluation.

  9. Agreement between Framingham Risk Score and United Kingdom Prospective Diabetes Study Risk Engine in Identifying High Coronary Heart Disease Risk in North Indian Population.

    Science.gov (United States)

    Bansal, Dipika; Nayakallu, Ramya S R; Gudala, Kapil; Vyamasuni, Rajavikram; Bhansali, Anil

    2015-08-01

    The aim of the study is to evaluate the concurrence between Framingham Risk score (FRS) and United Kingdom Prospective Diabetes Study (UKPDS) risk engine in identifying coronary heart disease (CHD) risk in newly detected diabetes mellitus patients and to explore the characteristics associated with the discrepancy between them. A cross-sectional study involving 489 subjects newly diagnosed with type 2 diabetes mellitus was conducted. Agreement between FRS and UKPDS in classifying patients as high risk was calculated using kappa statistic. Subjects with discrepant scores between two algorithms were identified and associated variables were determined. The FRS identified 20.9% subjects (range, 17.5 to 24.7) as high-risk while UKPDS identified 21.75% (range, 18.3 to 25.5) as high-risk. Discrepancy was observed in 17.9% (range, 14.7 to 21.7) subjects. About 9.4% had high risk by UKPDS but not FRS, and 8.6% had high risk by FRS but not UKPDS. The best agreement was observed at high-risk threshold of 20% for both (κ=0.463). Analysis showed that subjects having high risk on FRS but not UKPDS were elderly females having raised systolic and diastolic blood pressure. Patients with high risk on UKPDS but not FRS were males and have high glycosylated hemoglobin. The FRS and UKPDS (threshold 20%) identified different populations as being at high risk, though the agreement between them was fairly good. The concurrence of a number of factors (e.g., male sex, low high density lipoprotein cholesterol, and smoking) in both algorithms should be regarded as increasing the CHD risk. However, longitudinal follow-up is required to form firm conclusions.

  10. Teenage cervical screening in a high risk American population

    OpenAIRE

    Songlin Zhang; Jaiyeola Thomas; Joel Thibodeaux; Ami Bhalodia; Fleurette Abreo

    2011-01-01

    Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8%) were from teenagers. A total of 192 teenagers with high...

  11. High risk pregnancies and factors associated with neonatal death.

    Science.gov (United States)

    Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

    2017-04-03

    To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

  12. High-risk diagnosis, social stress, and parent-child relationships: A moderation model.

    Science.gov (United States)

    Bentley, Eryn; Millman, Zachary B; Thompson, Elizabeth; Demro, Caroline; Kline, Emily; Pitts, Steven C; DeVylder, Jordan E; Smith, Melissa Edmondson; Reeves, Gloria; Schiffman, Jason

    2016-07-01

    Stress is related to symptom severity among youth at clinical high-risk (CHR) for psychosis, although this relation may be influenced by protective factors. We explored whether the association of CHR diagnosis with social stress is moderated by the quality of parent-child relationships in a sample of 96 (36 CHR; 60 help-seeking controls) adolescents and young adults receiving mental health services. We examined self-reported social stress and parent-child relationships as measured by the Behavior Assessment System for Children, Second Edition (BASC-2), and determined CHR status from the clinician-administered Structured Interview for Psychosis-Risk Syndrome (SIPS). The social stress subscale, part of the clinical domain of the BASC-2, assesses feelings of stress and tension in personal relationships and the relations with parents subscale, part of the adaptive domain of the BASC-2, assesses perceptions of importance in family and quality of parent-child relationship. There was a modest direct relation between risk diagnosis and social stress. Among those at CHR, however, there was a significant relation between parent-child relationships and social stress (b=-0.73, t[92]=-3.77, psocial stress for those at risk for psychosis. Findings provide additional evidence to suggest that interventions that simultaneously target both social stress and parent-child relationships might be relevant for adolescents and young adults at clinical high-risk for psychosis.

  13. High heart rate: more than a risk factor. Lessons from a clinical practice survey.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Bertomeu, Vicente; Murga, Nekane; de Pablo, Carmen; Asín, Enrique

    2009-11-12

    Several epidemiological studies have reported that an elevated heart rate (HR) is associated with coronary atherosclerosis independently of other risk factors. Nevertheless, it is still unclear whether HR is itself the cause or there is merely an association between HR and mortality in this population. A total of 1686 patients with hypertension and chronic ischemic heart disease were included in this study. According to the resting HR, the patients were distributed in 3 groups (group 1: HR82 bpm). 580 patients (34.4%) belonged to group 1; 936 (55.5%) to group 2 and 170 (10.1%) to group 3. Patients with high HR exhibited a poorer prognosis not only due to a worse clinical profile (more concomitant cardiovascular risk factors and organ damage), but suggestively because despite the use of a similar number of drugs, patients with higher HR were associated with lesser risk control rates in daily clinical practice. Despite current guidelines that do not still recognize HR as a cardiovascular risk factor, it appears that physicians should pay more attention to it in clinical practice since high HR is warning about an increased risk.

  14. Prevalence of needlestick injuries and other high risk exposures among healthcare workers in Jamaica.

    Science.gov (United States)

    Foster, T M; Lee, M G; McGaw, C D; Frankson, M A

    2010-03-01

    To assess the prevalence of needlestick injuries (NSIs) and other high risk exposures among healthcare workers at two hospitals in Jamaica. Employing a cross-sectional study design, medical personnel (physicians, nurses) at two hospitals in Jamaica, were studied, utilizing a structured questionnaire consisting of 14 items to collect data on needle stick injuries and other injuries. There were 67 needlestick injuries in 47 persons. Of those sustaining an injury, 52% of physicians and 40% of nurses had NSIs. Re-capping needles accounted for 21% of injuries, various minor procedures, 21%, injury during surgery, 19.4% and taking blood, 12%. In those sustaining NSIs, 47% were reported and 26% of reported cases received counselling. Appropriate blood tests were performed on 34% and post-exposure prophylaxis (PEP) for HIV was administered to 30%. Hollow bore needles caused 47.8% of injuries, 25.4% occurred with suture needles and 19.4% with intravenous branulas. Other occupational exposure was reported by 31%, including blood on hands and other body parts 39%, blood to face and eyes, 18%, splashed with liquor, 18%, splashed with bloody fluid, 11% and contact with vomitus and urine in eye, 4%. Needlestick injuries and other high risk exposures were high; incident reporting and post exposure management were inadequate. A comprehensive programme to address factors that contribute to the occurrence of NSIs and other occupational exposures is urgently needed.

  15. Trajectories of maltreatment re-reports from ages 4 to 12:: evidence for persistent risk after early exposure.

    Science.gov (United States)

    Proctor, Laura J; Aarons, Gregory A; Dubowitz, Howard; English, Diana J; Lewis, Terri; Thompson, Richard; Hussey, Jon M; Litrownik, Alan J; Roesch, Scott C

    2012-08-01

    This study identified trajectories of maltreatment re-reports between ages 4 and 12 for children first referred to Child Protective Services (CPS) for maltreatment prior to age 4 and either removed from the home or assessed by a CPS intake worker as moderately or highly likely to be abused/neglected in the future, absent intervention. Participants (n = 501) were children from the Southwest and Northwest sites of the Consortium for Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). During the 8-year follow-up period, 67% of children were re-reported. Growth mixture modeling identified four trajectory classes: No re-report (33%), Continuous re-reports (10%), Intermittent re-reports (37%), and Early re-reports (20%). Membership in classes with relatively more re-reports was predicted by several factors assessed at age 4, including physical abuse; living with a biological/stepparent; caregiver alcohol abuse, depression, and lack of social support; receipt of Aid to Families with Dependent Children (AFDC); and number of children in the home. For a subpopulation of high-risk children first reported in early childhood, risk for maltreatment re-reporting may persist longer than previously documented, continuing 8 to 12 years after the first report.

  16. High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; ten Kate, Min Ki; Waanders, Femke; Veeger, Nic J. G. M.; Brouwer, Jan-Leendert P.; Vogt, Liffert; Navis, Gerjan; van der Meer, Jan

    2008-01-01

    Background-No data are available on the absolute risk of either venous thromboembolism (VTE) or arterial thromboembolism (ATE) in patients with nephrotic syndrome. Reported risks are based on multiple case reports and small studies with mostly short-term follow-up. We assessed the absolute risk of V

  17. The Allure of High-Risk Rewards in Huntington’s disease

    Science.gov (United States)

    van Wouwe, Nelleke C.; Kanoff, Kristen E.; Claassen, Daniel O.; Ridderinkhof, K. Richard; Hedera, Peter; Harrison, Madaline B.; Wylie, Scott A.

    2017-01-01

    Objectives Huntington’s disease (HD) is a neurodegenerative disorder that produces a bias toward risky, reward-driven decisions in situations where the outcomes of decisions are uncertain and must be discovered. However, it is unclear whether HD patients show similar biases in decision-making when learning demands are minimized and prospective risks and outcomes are known explicitly. We investigated how risk decision-making strategies and adjustments are altered in HD patients when reward contingencies are explicit. Methods HD (N = 18) and healthy control (HC; N = 17) participants completed a risk-taking task in which they made a series of independent choices between a low-risk/low reward and high-risk/high reward risk options. Results Computational modeling showed that compared to HC, who showed a clear preference for low-risk compared to high-risk decisions, the HD group valued high-risks more than low-risk decisions, especially when high-risks were rewarded. The strategy analysis indicated that when high-risk options were rewarded, HC adopted a conservative risk strategy on the next trial by preferring the low-risk option (i.e., they counted their blessings and then played the surer bet). In contrast, following a rewarded high-risk choice, HD patients showed a clear preference for repeating the high-risk choice. Conclusions These results indicate a pattern of high-risk/high-reward decision bias in HD that persists when outcomes and risks are certain. The allure of high-risk/high-reward decisions in situations of risk certainty and uncertainty expands our insight into the dynamic decision-making deficits that create considerable clinical burden in HD. PMID:26708084

  18. Unintended pregnancy and perinatal depression trajectories in low-income, high-risk Hispanic immigrants.

    Science.gov (United States)

    Christensen, Anna L; Stuart, Elizabeth A; Perry, Deborah F; Le, Huynh-Nhu

    2011-09-01

    Perinatal depression is a prevalent and detrimental condition. Determining modifiable factors associated with it would identify opportunities for prevention. This paper: 1) identifies depressive symptom trajectories and heterogeneity in those trajectories during pregnancy through the first-year postpartum, and 2) examines the association between unintended pregnancy and depressive symptoms. Depressive symptoms (BDI-II) were collected from low-income Hispanic immigrants (n=215) five times from early pregnancy to 12-months postpartum. The sample was at high-risk for perinatal depression and recruited from two prenatal care settings. Growth mixture modeling (GMM) was used to identify distinct trajectories of depressive symptoms over the perinatal period. Multinomial logistic regression was then conducted to examine the association between unintended pregnancy (reported at baseline) and the depression trajectory patterns. Three distinct trajectory patterns of depressive symptoms were identified: high during pregnancy, but low postpartum ("Pregnancy High": 9.8%); borderline during pregnancy, with a postpartum increase ("Postpartum High": 10.2%); and low throughout pregnancy and postpartum ("Perinatal Low": 80.0%). Unintended pregnancy was not associated with the "Pregnancy High" pattern, but was associated with a marginally significant nearly four fold increase in risk of the "Postpartum High" pattern in depressive symptoms (RRR=3.95, ppregnancies during prenatal care must be educated of their increased risk, even if they do not exhibit antenatal depressive symptoms. Routine depression screening should occur postpartum, and referral to culturally appropriate treatment should follow positive screening results.

  19. Patterns of nonmasslike enhancement at screening breast MR imaging of high-risk premenopausal women.

    Science.gov (United States)

    Giess, Catherine S; Raza, Sughra; Birdwell, Robyn L

    2013-01-01

    Current U.S. recommendations for breast cancer screening of women with at least a 20%-25% lifetime risk of developing breast cancer include contrast material-enhanced magnetic resonance (MR) imaging of the breasts. The cancer detection rate in high-risk women undergoing screening MR imaging is approximately 10 times higher than that in normal-risk women undergoing screening mammography. Many of these high-risk women commence MR imaging screening while they are premenopausal, when the breasts are most influenced by cyclical hormonal changes. Healthy premenopausal breast tissue enhances in a cyclical and variable manner. This enhancement is described as background enhancement. Typically, enhancement of normal breast tissue occurs in a symmetric and diffuse pattern, and there is little diagnostic difficulty in classifying it as normal background parenchymal enhancement. However, sometimes the pattern is more focal, asymmetric, or regional. It may then be described as nonmasslike enhancement, an observation associated with both benign and malignant breast pathologic conditions. A review of the morphologic features and internal enhancement patterns in normal but nondiffuse background enhancement and abnormal nonmasslike enhancement in high-risk premenopausal women can help improve interpretive specificity and decrease false-positive interpretations. MR imaging pitfalls and interpretation strategies for localized background enhancement and pathologic nonmasslike enhancement in this high-risk population are highlighted. In evaluating nonmasslike enhancement, the use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon to perform careful analysis of morphologic features, along with an understanding of the role and limitations of kinetic information, will help balance early breast cancer detection against false-positive interpretation.

  20. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh.

    Science.gov (United States)

    Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel

    2012-03-01

    Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

  1. Is the effect of alcohol on risk of stroke confined to highly stressed persons?

    DEFF Research Database (Denmark)

    Nielsen, N R; Truelsen, T; Barefoot, J C

    2005-01-01

    BACKGROUND: Psychological stress and alcohol are both suggested as risk factors for stroke. Further, there appears to be a close relation between stress and alcohol consumption. Several experimental studies have found alcohol consumption to reduce the immediate effects of stress in a laboratory...... about their self-reported level of stress and their weekly alcohol consumption. The participants were followed-up until 31st of December 1997 during which 880 first ever stroke events occurred. Data were analysed by means of Cox regression modelling. RESULTS: At a high stress level, weekly total...... intake and ischaemic stroke events. Regarding specific types of alcoholic beverages, self-reported stress only modified the associations for intake of beer and wine. CONCLUSIONS: This study indicates that the apparent lower risk of stroke associated with moderate alcohol consumption is confined...

  2. Lack of risk-awareness and reporting behavior towards HIV infection through needlestick injury among European medical students.

    Science.gov (United States)

    Salzer, Helmut J F; Hoenigl, Martin; Kessler, Harald H; Stigler, Florian L; Raggam, Reinhard B; Rippel, Karoline E; Langmann, Hubert; Sprenger, Martin; Krause, Robert

    2011-09-01

    Medical students are at risk for occupational needlestick injuries (NSIs) which can result in substantial health consequences and psychological stress. Therefore, an open online survey among final year medical students from Austria, Germany, and the United Kingdom (UK) was conducted. The aim of the study was to evaluate risk-awareness and reporting behavior regarding needlestick injury (NSI), post-exposure prophylaxis, and level of education regarding the transmission of HIV through NSIs. Of 674 medical students, 226 (34%) reported at least one NSI during medical school. Respondents from Austria and Germany experienced a significantly higher number of NSIs in comparison to respondents from the UK. Seventy-six respondents (34%) did not report their most recent injury to an employee health office. Almost one third were not familiar with reporting procedures in case of a NSI and 45% of the study population feared that reporting an injury might have an adverse effect on their study success. 176 respondents (78%) who had suffered a NSI were not aware of the patient's HIV status. Education regarding NSIs and HIV transmission reduced the actual risk of experiencing a NSI significantly. These data indicate that medical students are at high risk of suffering NSIs during medical school. The rate of nonreporting of such injuries to an employee health service is alarmingly high. Improved medical curricula including precise recommendations may contribute to a more efficient prevention of occupational HIV infection in medical students. Copyright © 2011 Elsevier GmbH. All rights reserved.

  3. Workshop Report on Space Weather Risks and Society

    Science.gov (United States)

    Langhoff, Stephanie R.; Straume, Tore

    2012-01-01

    As technological innovations produce new capabilities, complexities, and interdependencies, our susceptibility to the societal impacts of space weather increase. There is real concern in the scientific community that our infrastructure would be at significant risk if a major geomagnetic storm should occur. To discuss the societal impacts of space weather, we brought together an interdisciplinary group of subject matter experts and societal stakeholders to participate in a workshop entitled Space Weather Risks and Society. The workshop was held at Ames Research Center (ARC) on 15-16 October 2011. The workshop was co-sponsored by NASA Ames Research Center (ARC), the Lockheed Martin Advanced Technology Center (LMATC), the Space Weather Prediction Center (SWPC, part of the National Oceanic and Atmospheric Administration NOAA), and the Rutherford Appleton Laboratory (RAL, part of the UK Science and Technology Facilities Council STFC). The workshop is part of a series of informal weekend workshops hosted by Center Director Pete Worden.

  4. Speech therapy procedures in high-risk newborns

    Directory of Open Access Journals (Sweden)

    Hipólito Virgílio Magalhães Júnior

    2010-06-01

    Full Text Available Objective: To investigate the speech therapy procedures performed in a neonatal ICU. Methods: A documental research based on registration records, comprised by a total of 34 newborns that required early stimulation by the speech therapy service in a neonatal ICU of a hospital with tertiary level of care. The study was held in the period between August, 2005 and January, 2006. From the sample, 14 children were female (41.2% and 20 were male (58.8%. The age of the newborns ranged from 3 to 57 life days. The studied variables included: risk conditions of the newborn, clinical assessment procedures, the intervention performed and the results obtained regarding weight. Results: The risk condition of preterm newborn (PTNB associated with respiratory distress syndrome (RDS was present in 25 (73.5% children. The initial weight of 15 (44.11% children ranged from 1170 to 1742 grams. The most widely discussed speech therapy procedures were the assessment of oral functions with identification of changes in sucking and swallowing in 25 (73.5% newborns and intervention by means of non-nutritive sucking in 18 (53% children. At the end of speech therapy, 19 (55.9% children weighed between 1742 to 2314 grams. Conclusions:The benefits of speech therapy performance were related to the identification of high-risk children who required intervention in oral functions and organization of the baby for feeding. It is assumed that the introduction of oral administration as quickly and safely as possible favored the improvement of the nutritional status of children and their clinical evolution

  5. Report on cancer risks associated with the ingestion of asbestos

    Energy Technology Data Exchange (ETDEWEB)

    Lemen, R.; Meinhardt, T.; Becking, G.; Cantor, K.; Cherner, J.

    1986-01-01

    Cancer risks associated with ingestion of asbestos are discussed. Asbestos contamination of drinking water is considered. At least 66.5% of the United States water systems are capable of eroding asbestos cement pipes. The ability of water to leach asbestos from asbestos cement pipes can be modified by coatings applied to the inside pipe surface. Asbestos contamination in foods or pharmaceuticals is discussed. Asbestos fibers at concentrations of 1.1 to 172.7 million fibers per liter have been found in beverages. To date, studies supported by the Food and Drug Administration (FDA) have provided no evidence that ingesting asbestos results in an increased cancer risk. The FDA has determined that no prohibition on using asbestos filters in processing food, beverages, and non-parenteral drugs is needed. Toxicological studies on asbestos ingestion and carcinogenicity are reviewed. Epidemiological evaluations of the association between drinking-water supplies containing asbestos and cancer mortality are discussed. It is concluded that the available information is insufficient for assessing the risk of cancer associated with ingesting asbestos.

  6. The toxicity of radiotherapy following high-dose chemotherapy with peripheral blood serum cell support in high-risk breast cancer: a preliminary analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wall, E. van der; Schaake-Koning, C.C.E.; Zandwijk, N. van [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands)] [and others

    1996-08-01

    High-dose chemotherapy with autologous bone marrow and/or peripheral blood stem cell (PBSC) support is increasingly employed in the adjuvant treatment of high-risk breast cancer. Subsequent radiotherapy has been reported to be associated with morbidity and mortality resulting from pulmonary toxicity. In addition, the course of radiation therapy may be hampered by excess myelosuppression. The aim of this study was to investigate the contribution to radiation-induced toxicity of a high-dose chemotherapy regimen (CTC) that incorporates cyclophosphamide, thiotepa and carboplatin, in patients with high-risk breast cancer. (author).

  7. Sleep Duration and Injury-Related Risk Behaviors Among High School Students--United States, 2007-2013.

    Science.gov (United States)

    Wheaton, Anne G; Olsen, Emily O'Malley; Miller, Gabrielle F; Croft, Janet B

    2016-04-08

    Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.

  8. Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants

    DEFF Research Database (Denmark)

    Giwercman, Charlotte; Halkjaer, Liselotte B; Jensen, Signe Marie

    2010-01-01

    Breast-feeding is recommended for the prevention of eczema, asthma, and allergy, particularly in high-risk families, but recent studies have raised concern that this may not protect children and may even increase the risk. However, disease risk, disease manifestation, lifestyle, and the choice...

  9. Renal outcomes in hypertensive Black patients at high cardiovascular risk.

    Science.gov (United States)

    Weir, Matthew R; Bakris, George L; Weber, Michael A; Dahlof, Bjorn; Devereux, Richard B; Kjeldsen, Sverre E; Pitt, Bertram; Wright, Jackson T; Kelly, Roxzana Y; Hua, Tsushung A; Hester, R Allen; Velazquez, Eric; Jamerson, Kenneth A

    2012-03-01

    The ACCOMPLISH trial (Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension) was a 3-year multicenter, event-driven trial involving patients with high cardiovascular risk who were randomized in a double-blinded manner to benazepril plus either hydrochlorothiazide or amlodipine and titrated in parallel to reach recommended blood pressure goals. Of the 8125 participants in the United States, 1414 were of self-described Black ethnicity. The composite kidney disease end point, defined as a doubling in serum creatinine, end-stage renal disease, or death was not different between Black and non-Black patients, although the Blacks were significantly more likely to develop a greater than 50% increase in serum creatinine to a level above 2.6 mg/dl. We found important early differences in the estimated glomerular filtration rate (eGFR) due to acute hemodynamic effects, indicating that benazepril plus amlodipine was more effective in stabilizing eGFR compared to benazepril plus hydrochlorothiazide in non-Blacks. There was no difference in the mean eGFR loss in Blacks between therapies. Thus, benazepril coupled to amlodipine was a more effective antihypertensive treatment than when coupled to hydrochlorothiazide in non-Black patients to reduced kidney disease progression. Blacks have a modestly higher increased risk for more advanced increases in serum creatinine than non-Blacks.

  10. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  11. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  12. The influence of addiction risk on nursing students' expectations of patients' pain reports: a clinical vignette approach.

    Science.gov (United States)

    Miceli, Paula C; Katz, Joel

    2009-01-01

    To examine the influence of addiction risk (substance abuse history [SAH]) and pain relief (PR) on nursing and non-nursing students' perceptions of pain in a postoperative vignette patient. Using a 2 x 2 design, the independent variables SAH (present/+, absent/-) and PR (adequate, little) were varied systematically to produce four vignettes. Participants were randomly assigned to receive one of the four vignettes that described a 45-year-old man after a total hip replacement. Participants rated the vignette patient's experienced and reported pain intensity (PI) on a 0 mm to 100 mm visual analogue scale and addiction risk on a 0 mm to 100 mm visual analogue scale. A pain congruence (PC) score was calculated (PC = reported PI -- experienced PI), and was interpreted as congruent (+/-2 mm) or incongruent (+2 mm to +100 mm for expected pain over-reporting; -2 mm to -100 mm for expected pain under-reporting). Responses from undergraduate nursing (n=89) and non-nursing (n=88) students were analyzed. The estimated addiction risk was significantly lower in nursing (14% to 45%) versus non-nursing students (50%). Nursing students' mean PC scores were not significantly altered by SAH alone. Expectations of pain over-reporting were observed under conditions of SAH+/adequate PR, but not SAH+/little PR. In non-nursing students, SAH and PR were significant and independent factors influencing mean PC scores in the direction of pain over-reporting. Under most conditions, nursing students expected pain under-reporting by the postoperative vignette patient. However, nursing students did expect pain to be over-reported when addiction risk was high and PR was adequate. These data suggest that nursing students' expectations regarding pain over- and under-reporting were sensitive to perceptions of addiction risk, but involved additional factors (eg, level of PR).

  13. Suicide Risk Is High for Psychiatric Patients Long After Discharge from Care

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166107.html Suicide Risk Is High for Psychiatric Patients Long After ... that psychiatric patients are at high risk for suicide immediately after being discharged from a mental health ...

  14. Risk-taking behaviour of Cape Peninsula high-school students. Part ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high-school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... South African Medical Journal ... The prevalence of a wide range of risk-taking behaviour among high-school students in ...

  15. Risk-taking behaviour of Cape Peninsula high-school students. Part ...

    African Journals Online (AJOL)

    Risk-taking behaviour of Cape Peninsula high-school students. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... South African Medical Journal ... The prevalence of a wide range of risk-taking behaviour atnong high-school students in ...

  16. Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

    Science.gov (United States)

    Kiykac Altinbas, Sadiman; Bayoglu Tekin, Yesim; Dilbaz, Berna; Kilic, Selim; Khalil, Susan S; Kandemir, Omer

    2014-12-01

    To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies. Does a high-risk pregnancy condition affect future postpartum contraceptive method choice? Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period. A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (pcontraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge. A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods. Copyright © 2014 Australian College of Midwives. All rights reserved.

  17. Maintenance antimicrobials in high risk urologic pediatric patients.

    Science.gov (United States)

    McCann, T M; Churchill, B M; Hardy, B E; Arbus, G S

    1982-03-01

    As an alternative to the practice of obtaining repeated laboratory cultures for patients at high risk of renal impairment from recurrent UTI, a program of bone monitoring using a mail-in culture dipspoon was started. A study involving 454 children with neurogenic bladder or other urologic abnormalities showed (1) that the incidence of UTI infection in patients for whom long term antimicrobial therapy had been prescribed was not significantly lower than that in patients who were not on antimicrobials and (2) that at least 50% of dipspoons inoculated due to presentation of UTI symptoms showed no or insignificant growth. These findings suggest that need for further assessment of the efficacy of long term prophylactic antimicrobials in preventing recurrent UTI and the advisability of obtaining a urine culture result before initiating treatment when symptoms are not severe.

  18. Reentry Programming for High-Risk Offenders: Insights From Participants.

    Science.gov (United States)

    Bender, Kimberly A; Cobbina, Jennifer E; McGarrell, Edmund F

    2016-10-01

    The mass increase in imprisonment of the last two decades has led to an increasing number of adults released from prison. Scholarly accounts of prisoner reentry have demonstrated that incarcerated individuals face barriers on release from prison and that intervention programs are necessary to assist their transition to the community. Here, we build from the insights of previous research by examining how high-risk offenders perceive a reentry program. Using a qualitative approach, our findings suggest that procedural and substantive justice affect their satisfaction and involvement with the program. This study highlights the importance of providing employment opportunities, social support, and fair and respectful delivery of services to assist incarcerated individuals transitioning to the community.

  19. Smell identification in individuals at clinical high risk for schizophrenia.

    Science.gov (United States)

    Gill, Kelly Elizabeth; Evans, Elizabeth; Kayser, Jürgen; Ben-David, Shelly; Messinger, Julie; Bruder, Gerard; Malaspina, Dolores; Corcoran, Cheryl Mary

    2014-12-15

    Smell identification deficits exist in schizophrenia, and may be associated with its negative symptoms. Less is known about smell identification and its clinical correlates in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders. We examined smell identification, symptoms and IQ in 71 clinical high-risk (CHR) subjects and 36 healthy controls. Smell identification was assessed using both the 40-item University of Pennsylvania Smell Identification Test (UPSIT; Doty, R.L., Shaman, P., Kimmelman, C.P., Dann, M.S., 1984. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176-178) and its extracted 12-item Brief Smell Identification Test (Goudsmit, N., Coleman, E., Seckinger, R.A., Wolitzky, R., Stanford, A.D., Corcoran, C., Goetz, R.R., Malaspina, D., 2003. A brief smell identification test discriminates between deficit and non-deficit schizophrenia. Psychiatry Research 120, 155-164). Smell identification did not significantly differ between CHR subjects and controls. Among CHR subjects, smell identification did not predict schizophrenia (N=19; 27%) within 2 years, nor was it associated with negative or positive symptoms. This is the third prospective cohort study to examine smell identification in CHR subjects, and overall, findings are inconclusive, similar to what is found for other disorders in adolescents, such as autism spectrum, attention deficit and anxiety disorders. Smell identification deficit may not have clear utility as a marker of emergent schizophrenia and related psychotic disorders. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Chagas disease, a risk factor for high blood pressure.

    Science.gov (United States)

    Vicco, Miguel Hernán; Rodeles, Luz; Yódice, Agustina; Marcipar, Iván

    2014-12-01

    Chagas disease is a parasite infection caused by the protozoan Trypanosoma cruzi. Its most common complications is chronic Chagas heart disease but impairments of the systemic vasculature also has been observed. Although the different mechanisms that regulate blood pressure are disrupted, to our knowledge data on the association of hypertension and chronic Chagas disease are scarce. In this regard we evaluate whether Chagas disease constitutes a high blood pressure risk factor. We recruited 200 individuals, half of them with positive serology for T. cruzi. They were subjected to a complete clinical examination. The mean age of sampled individuals was 46.7 ± 12.3, and the mean of systolic and diastolic blood pressure were 124 ± 12 mmHg and 82 ± 10 mmHg, respectively. There were no between-group differences regarding age, sex distribution or body mass index. Chagas disease contributed significantly to high blood pressure (OR = 4, 95% CI 1.8323-7.0864, p = 0.0002). Our results reveal an important association between Chagas disease and high blood pressure, which should be contemplated by physicians in order to promote preventive cardiovascular actions in patients with Chagas disease.

  1. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review

    Science.gov (United States)

    Onate, James A.; Everhart, Joshua S.; Clifton, Daniel R.; Best, Thomas M.; Borchers, James R.; Chaudhari, Ajit M.W.

    2016-01-01

    Objective A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. Data Sources A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Main Results Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5–6.1; P anterior cruciate ligament injury (OR, 5.0; CI, 1.2–18.4; P < 0.05), hip external: internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = −0.339, P = 0.008). Conclusions Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury. PMID:26978166

  2. Sports injuries in high school athletes: a review of injury-risk and injury-prevention research.

    Science.gov (United States)

    McGuine, Tim

    2006-11-01

    The objective of this review is to identify the available research regarding the risk factors and prevention of injuries in high school athletes (ages 14 to 18 years). Relevant manuscripts were identified by searching six electronic databases with a combination of key words and medical subject headings (high school, adolescent, athletic injury, sports injury, risk factors, prevention, and prospective). Original research that reported prospective data on high school athletes (ages 14 to 18), reported injury and exposure data, and used data collected throughout the entire sport season or school year. Twenty-nine studies that identified injury risk factors or injury prevention strategies were reviewed and summarized. Data extracted from the studies included a) sport(s) or injuries studied, b) year of publication, c) lead author, d) description of the subjects, e) sample-size calculation, f) variables studied (baseline demographic or performance variables), g) whether multivariate analyses were used, h) data reported (injury rates, risk ratios, and 95% CI), and i) results. Studies that introduced an intervention were characterized by the same data as well as the type of intervention employed and randomization procedures used. The quality of each injury-risk and injury-prevention study was assessed, and the results were summarized. The risk factors for injury in several specific sports such as soccer, American football, and basketball have been documented. Other sports are less well represented in the current literature. The risk factors for injuries to the ankle, head, and knee have been identified, to a limited degree. Upper-extremity injury risk factors are less well known. There is a need for high-quality prospective studies to further identify injury risk factors and injury-prevention strategies for high school athletes.

  3. How much does HDL cholesterol add to risk estimation? A report from the SCORE Investigators.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2009-06-01

    Systematic COronary Risk Evaluation (SCORE), the risk estimation system recommended by the European guidelines on cardiovascular disease prevention, estimates 10-year risk of cardiovascular disease mortality based on age, sex, country of origin, systolic blood pressure, smoking status and either total cholesterol (TC) or TC\\/high-density lipoprotein cholesterol (HDL-C) ratio. As, counterintuitively, these two systems perform very similarly, we have investigated whether incorporating HDL-C and TC as separate variables improves risk estimation.

  4. A psychological profile of depressed and nondepressed women at high risk for breast cancer.

    Science.gov (United States)

    Wellisch, D K; Lindberg, N M

    2001-01-01

    This study examines the difference on several demographic and psychosocial variables between women at high risk for breast cancer above and below the cut-off point of a depression measure (Center for Epidemiological Study Depression Scale). Data are presented for 430 consecutive patients from the UCLA Revlon Breast Center High Risk Clinic. Women scoring above the depression cut-off point were younger, had more relatives with breast cancer, reported more symptoms of anxiety, and had more self-perceived vulnerability to breast cancer. In addition, women above the depression cut-off point were more likely to be single, childless, to have not viewed the results of the surgical treatment of their relative, and to feel more anxiety regarding screening practices (mammography, pap smears, and breast self-examinations).

  5. Risk of High Dietary Calcium for Arterial Calcification in Older Adults

    Directory of Open Access Journals (Sweden)

    Philip J. Klemmer

    2013-09-01

    Full Text Available Concern has recently arisen about the potential adverse effects of excessive calcium intakes, i.e., calcium loading from supplements, on arterial calcification and risks of cardiovascular diseases (CVD in older adults. Published reports that high calcium intakes in free-living adults have relatively little or no beneficial impact on bone mineral density (BMD and fracture rates suggest that current recommendations of calcium for adults may be set too high. Because even healthy kidneys have limited capability of eliminating excessive calcium in the diet, the likelihood of soft-tissue calcification may increase in older adults who take calcium supplements, particularly in those with age or disease-related reduction in renal function. The maintenance of BMD and bone health continues to be an important goal of adequate dietary calcium consumption, but eliminating potential risks of CVDs from excessive calcium intakes needs to be factored into policy recommendations for calcium by adults.

  6. [High prevalence of drug consumption and sexual risk behaviors in men who have sex with men].

    Science.gov (United States)

    Folch, Cinta; Fernández-Dávila, Percy; Ferrer, Laia; Soriano, Raúl; Díez, Mercedes; Casabona, Jordi

    2015-08-07

    To describe the pattern of drug use among men who have sex with men (MSM) living in Spain and its association with sexual risk practices. The European MSM Internet Survey was implemented in 2010 in 38 European countries on websites for MSM and collected data on sociodemographics, sexual behavior, and other sexual health variables. The association between unprotected anal intercourse (UAI) with casual partners and drug consumption was evaluated using multivariate logistic regression models. Among the 13,111 participants, most consumed drugs were cannabis (30.1%), popper (28.4%) and cocaine (18.7%). The risk of UAI with casual partners was 1.5 among those who had used drugs in relation to the other participants. The proportion of MSM who had injected drugs at least once in life was 2.5%, and 1.4% in the last 12 months. The prevalence of UAI with casual partners (53.4%), human immunodeficiency virus (HIV) (23%), hepatitis C (8.2%) and sexually transmitted infections (STI) (15.8%) was higher in MSM injectors related to those who had not used injected drugs (P<.05). The results of this study confirm a high prevalence of drug use in MSM and their relationship to sexual risk behavior. Although the use of injected drugs in MSM is a minority, this group reported a higher level of sexual risk behaviors, self-reported HIV, hepatitis C and other STI. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. Counseling women at high risk for breast cancer.

    Science.gov (United States)

    Stefanek, M E

    1990-01-01

    Cancer risk analysis is a relatively new clinical service that has developed as more precise information has become available regarding specific risk factors. Both epidemiological and genetic factors contribute substantially to the identification of women at higher risk for developing breast cancer. The definition of what constitutes risk, an understanding of which factors influence risk, and the ability to present risk information clearly are critical features. In addition to providing information about risk and assessing each woman's perception of risk, the emotional issues must be addressed. The focus of intervention should center upon the benefits of early detection, assessment of breast self-examination skills, individualized breast cancer screening recommendations, such as mammography and physical exams, and recommendations for life style changes for possible prevention.

  8. how can i recognise the high-risk cardiovascular patient?

    African Journals Online (AJOL)

    Enrique

    duced into clinical medicine by the Framingham Heart Study.2 The major risk fac- tors are shown ... Age, male gender/post-menopausal state, genetics (family history) ... GLOBAL RISK ASSESSMENT .... In the Physician's Health Study,14 per-.

  9. Health risk behaviours of high school learners and their perceptions ...

    African Journals Online (AJOL)

    Most adolescent mortality and morbidity, attributable to such health risk behaviours, .... relevant information and education, immunising at-risk individuals and providing ..... 14% of females felt that they had already been affected by pregnancy.

  10. Chemicals in Meat Cooked at High Temperatures and Cancer Risk

    Science.gov (United States)

    ... meats? What research is being conducted on the relationship between the consumption of HCAs and PAHs and cancer risk in ... 20 ). What research is being conducted on the relationship between the consumption of HCAs and PAHs and cancer risk in ...

  11. Bullying as a Risk for Poor Sleep Quality among High School Students in China

    Science.gov (United States)

    Lu, Ci-yong; Deng, Jian-xiong; Huang, Jing-hui; Huang, Guo-liang; Deng, Xue-qing; Gao, Xue

    2015-01-01

    Objective To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China. Methods A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality. Results Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality. Conclusions Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents. PMID:25811479

  12. Empowering High-Risk Clients to Attain a Better Quality of Life: A Career Resiliency Framework

    Science.gov (United States)

    Rickwood, Rory R.; Roberts, Jillian; Batten, Suzanne; Marshall, Anne; Massie, Kendra

    2004-01-01

    Career counselors frequently encounter clients who are at high risk for career and life development difficulties. Research suggests there is a connection between resiliency and successful career development in high-risk clients. Many high-risk individuals have poor decision-making skills and lack motivation to succeed in life and career…

  13. Community health workers, social support and cervical cancer screening among high-risk groups in rural Mexico.

    Science.gov (United States)

    Elliott, Patrick F; Belinson, Suzanne E; Ottolenghi, Emma; Smyth, Kathleen; Belinson, Jerome L

    2013-11-01

    Rural Mexico has a low screening prevalence and high burden of cervical cancer. One strategy to increase screening coverage utilizes community health workers (CHWs) to recruit high-risk women and address barriers. We conducted a systematic cross-sectional survey of 196 women residing in Chiapas, Mexico who were recruited by either CHWs or traditional means for screening. This analysis compares 110 rural women's risk factors, attitudes and knowledge of cervical cancer and socioeconomic factors stratified by type of recruitment. Women who were informed of screening by CHWs were more likely to be of high risk sub-groups and report higher scores of social support but were also more likely to endorse difficulty with access and fatalistic attitudes about cancer. Utilizing CWHs results in increased screening among high-risk women and increased social support for screening among rural women, addressing a significant barrier, but may have limited effects on other barriers.

  14. Bystander Sexual Violence Prevention Program: Outcomes for High- and Low-Risk University Men.

    Science.gov (United States)

    Elias-Lambert, Nada; Black, Beverly M

    2015-05-05

    This research reports the findings of an evaluation of a peer-facilitated, bystander sexual violence prevention program to determine its effectiveness at changing attitudes and behaviors related to sexual violence with university males who are at low- and high-risk of using sexually coercive behavior. Bystander interventions focus on men and women as bystanders to change social norms in a peer culture that supports abusive behaviors. Few studies have examined the effectiveness of these interventions with high-risk populations, which is the focus of this study. A bystander sexual violence prevention program was presented to 142 fraternity members. A quasi-experimental design utilizing pre-, post-, and follow-up surveys was used to compare the effectiveness of this prevention program with university males who are at low- and high-risk of using sexually coercive behavior in intervention and comparison groups. Participants' risk status was measured prior to the intervention using the Modified-Sexual Experiences Survey. The measures evaluated changes in attitudes (rape myth acceptance and bystander attitudes) and behaviors (sexually coercive behaviors, sexually coercive behavioral intentions, and bystander behaviors). Data analyses included Repeated-Measures Analysis of Covariances. The findings suggest that a bystander sexual violence prevention program has a positive impact on attitudes and behaviors related to sexual violence among fraternity members, however, the program had less impact on high-risk males. The results of this study will expand our ability to design programs that can have an impact on reducing sexual violence on campus by ensuring the programs are having the desired impact on the target audience. © The Author(s) 2015.

  15. High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies.

    Science.gov (United States)

    Hedström, A K; Mowry, E M; Gianfrancesco, M A; Shao, X; Schaefer, C A; Shen, L; Olsson, T; Barcellos, L F; Alfredsson, L

    2016-05-01

    Previous studies on consumption of caffeine and risk of multiple sclerosis (MS) have yielded inconclusive results. We aimed to investigate whether consumption of coffee is associated with risk of MS. Using two population-representative case-control studies (a Swedish study comprising 1620 cases and 2788 controls, and a US study comprising 1159 cases and 1172 controls), participants with different habits of coffee consumption based on retrospective data collection were compared regarding risk of MS, by calculating ORs with 95% CIs. Logistic regression models were adjusted for a broad range of potential confounding factors. Compared with those who reported no coffee consumption, the risk of MS was substantially reduced among those who reported a high consumption of coffee exceeding 900 mL daily (OR 0.70 (95% CI 0.49 to 0.99) in the Swedish study, and OR 0.69 (95% CI 0.50 to 0.96) in the US study). Lower odds of MS with increasing consumption of coffee were observed, regardless of whether coffee consumption at disease onset or 5 or 10 years prior to disease onset was considered. In accordance with studies in animal models of MS, high consumption of coffee may decrease the risk of developing MS. Caffeine, one component of coffee, has neuroprotective properties, and has been shown to suppress the production of proinflammatory cytokines, which may be mechanisms underlying the observed association. However, further investigations are needed to determine whether exposure to caffeine underlies the observed association and, if so, to evaluate its mechanisms of action. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Computing limits on medicine risks based on collections of individual case reports

    OpenAIRE

    Caster, Ola; Norén, G. Niklas; Edwards, I. Ralph

    2014-01-01

    Background Quantifying a medicine’s risks for adverse effects is crucial in assessing its value as a therapeutic agent. Rare adverse effects are often not detected until after the medicine is marketed and used in large and heterogeneous patient populations, and risk quantification is even more difficult. While individual case reports of suspected harm from medicines are instrumental in the detection of previously unknown adverse effects, they are currently not used for risk quantification. Th...

  17. Adjuvant vaginal cuff brachytherapy for high-risk, early stage endometrial cancer

    Science.gov (United States)

    Eastwick, Gary; Anne, Pramila Rani; Rosenblum, Norman G.; Schilder, Russell J.; Chalian, Raffi; Zibelli, Allison M.; Kim, Christine H.; Den, Robert

    2014-01-01

    Purpose To report outcomes following adjuvant high-dose-rate vaginal brachytherapy (VBT) with or without chemotherapy for high-intermediate risk (HIR) and high-risk, early stage endometrial cancer as defined in Gynecologic Oncology Group trial 0249. Material and methods From May 2000 to January 2014, 68 women with HIR and high-risk endometrial cancer underwent surgical staging followed by VBT. Median VBT dose was 21 Gy delivered in three fractions prescribed to 0.5 cm depth. Paclitaxel 175 mg/m2 and carboplatin area under the curve 6 was administered every 21 days in sequence with VBT. Actuarial survival estimates were calculated using the Kaplan-Meier method. Results Patient demographics included a median age of 66 years (range: 36-91) and stages IA (49%), IB (38%), and II (13%), respectively. Thirty-one (46%) patients had HIR disease with endometrioid histology, and 33 (48%) patients had serous or clear cell histology. Thirty-seven (54%) patients received a median 3 cycles (range: 3-6) of chemotherapy in addition to VBT, and 65 patients (96%) completed all prescribed therapy. During a median follow up of 33.1 months (range: 4.0-161.7), four patients have recurred, including one vaginal recurrence. The 3-year estimates of vaginal, pelvic, and distant recurrences were 1.9%, 2.4%, and 9.1%, respectively. The 3-year rates of disease-free and overall survival were 87.7% and 93.9%, respectively. Conclusions Early outcomes with adjuvant VBT with or without chemotherapy demonstrate high rates of vaginal and pelvic control for women with HIR disease. Early vaginal and pelvic relapses in high-risk patients suggest that pelvic external beam radiotherapy is warranted in this subgroup, but additional data from large phase III trials is warranted. PMID:25337127

  18. Predictors of maintained high-risk behaviors among impoverished women.

    Science.gov (United States)

    Nyamathi, A M; Bennett, C; Leake, B

    1995-01-01

    The researchers sought to explore and describe the demographic, cognitive, psychosocial, and behavioral factors associated with the continued risky behavior of a convenience sample of homeless and drug-addicted women two to four weeks after they had completed an AIDS education program. The sample included 942 crack users and 767 women who had multiple sex partners. Analyses revealed that impoverished women who maintained multiple sexual partners were less likely to be in drug recovery programs than in homeless shelters. They were more likely to share needles and be involved sexually with male injection drug users compared with impoverished women who did not maintain multiple sexual partners. Persistent crack users were older than those who reported cessation of crack use, were more often African American, and were more likely to have sex partners who were injecting drug users. Women who demonstrated less improvement in depression and distress scores, concerns, use of affective coping, appraisal of threat, and social support were more likely to maintain crack use and multiple partners. The study's implications for the design of intervention programs aimed at risk reduction based on ethnicity are discussed.

  19. Targeted screening for colorectal cancer in high-risk individuals.

    Science.gov (United States)

    Wong, Martin C S; Wong, Sunny H; Ng, Siew C; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2015-12-01

    The idea of targeted screening for colorectal cancer based on risk profiles originates from its benefits to improve detection yield and optimize screening efficiency. Clinically, it allows individuals to be more aware of their own risk and make informed decisions on screening choice. From a public health perspective, the implementation of risk stratification strategies may better justify utilization of colonoscopic resources, and facilitate resource-planning in the formulation of population-based screening programmes. There are several at-risk groups who should receive earlier screening, and colonoscopy is more preferred. This review summarizes the currently recommended CRC screening strategies among subjects with different risk factors, and introduces existing risk scoring systems. Additional genetic, epidemiological, and clinical parameters may be needed to enhance their performance to risk-stratify screening participants. Future research studies should refine these scoring systems, and explore the adaptability, feasibility, acceptability, and user-friendliness of their use in clinical practice among different population groups.

  20. Use of surveillance data for prevention of healthcare-associated infection: risk adjustment and reporting dilemmas.

    LENUS (Irish Health Repository)

    O'Neill, Eoghan

    2009-08-01

    Healthcare-associated or nosocomial infection (HCAI) is of increasing importance to healthcare providers and the public. Surveillance is crucial but must be adjusted for risk, especially when used for interhospital comparisons or for public reporting.

  1. Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig;

    2014-01-01

    PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all pat...

  2. Governance of innovation and appropriateness of hospitalization for high-risk pregnancy: the TOCOMAT system.

    Science.gov (United States)

    Tagliaferri, Salvatore; Ippolito, Adelaide; Cuccaro, Patrizia; Annunziata, Maria Laura; Campanile, Marta; Di Lieto, Andrea

    2013-07-01

    Over the last 30 years, a great increase in the application of technologies in public health, with an undisputed impact on both the effectiveness of performance and the investment and management costs, has occurred. This evidence has induced the development of assessment tools to clarify the relationships among resources, outputs, and outcomes of technological innovations. This analysis was developed in order to examine the use of a telematic system for reporting remotely transmitted cardiotocographic traces, specifically (1) its impact on the health organization and on the appropriateness of the care setting used and (2) the efficiency of its adoption in a regional network. We adopted a case-control study on patients' medical records during the first 4 months of 2009, 2010, and 2011 and a cost analysis of resources used for the creation of a computerized telecardiotocography network connecting eight peripheral areas to the operations center. The case-control study showed a reduction in the average hospital stay days for high-risk patients (1.32) and for low-risk patient (1.7) with a total of cost savings of €89,628 for high-risk patients and €170,170 for low-risk patients. The cost savings of the regional network was €20,769.04. The adoption of a remote transmission system of cardiotocography provided a managerial and economic advantage in the reduction of inappropriate admissions for prepartum symptoms and an improvement in the admission indicators (hospital stay days).

  3. Biomarkers of folate and vitamin B12 and breast cancer risk : Report from the EPIC cohort

    NARCIS (Netherlands)

    Matejcic, M.; de Batlle, J.; Ricci, C.; Biessy, C.; Perrier, F.; Huybrechts, I.; Weiderpass, E.; Boutron-Ruault, M. C.; Cadeau, C.; His, M.; Cox, D. G.; Boeing, H.; Fortner, R. T.; Kaaks, R.; Lagiou, P.; Trichopoulou, A.; Benetou, V.; Tumino, R.; Panico, S.; Sieri, S.; Palli, D.; Ricceri, F.; Bueno-de-Mesquita, H. Bas; Skeie, G.; Amiano, P.; Sánchez, M. J.; Chirlaque, M. D.; Barricarte, A.; Quirós, J. R.; Buckland, G.; van Gils, C. H.; Peeters, P. H.; Key, T. J.; Riboli, E.; Gylling, B.; Zeleniuch-Jacquotte, A.; Gunter, M. J.; Romieu, I.; Chajès, V.

    2017-01-01

    Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC)

  4. 12 CFR 652.85 - When to report the risk-based capital level.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false When to report the risk-based capital level. 652.85 Section 652.85 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FEDERAL AGRICULTURAL MORTGAGE CORPORATION FUNDING AND FISCAL AFFAIRS Risk-Based Capital Requirements § 652.85 When...

  5. Non-sedating antihistamine drugs and cardiac arrhythmias : biased risk estimates from spontaneous reporting systems?

    NARCIS (Netherlands)

    De Bruin, M L; van Puijenbroek, E P; Egberts, A C G; Hoes, A W; Leufkens, H G M

    2002-01-01

    AIMS: This study used spontaneous reports of adverse events to estimate the risk for developing cardiac arrhythmias due to the systemic use of non-sedating antihistamine drugs and compared the risk estimate before and after the regulatory action to recall the over-the-counter status of some of these

  6. The national corporate social responsibility report : managing risks, leveraging opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Greenall, D. [Conference Board of Canada, Ottawa, ON (Canada)

    2004-06-01

    This document emphasized the value of corporate social responsibility (CSR) in contributing to a corporation's long-term sustainability and business success. The challenge lies in finding a balance between corporate and community interests in a manner that meets the needs of owners, corporations and stakeholders. This document presents an analysis of the self-assessed CSR management practices of 53 large Canadian companies. Public reporting practices were also reviewed for the largest 300 corporations in Canada. The 5 categories of the Corporate Responsibility Assessment Tool are: governance and management practices, (2) human resources management, (3) community investment and involvement, (4) environment, health and safety, and, (5) human rights. It was concluded that CSR will continue to be a key business issue and that companies will not be able to operate without considering the impact of their operations on society. The companies surveyed for this report have responded to the new challenges of social responsibility and have taken steps to incorporate CSR management practices into all 5 dimensions of activity. Industries subject to political or regulated environments such as mining, energy, forestry and banking have responded most strongly to stakeholder demands for CSR practices. It was noted that there is room for improvement, particularly in human rights. It was also noted that the level of reporting by the Top 300 corporations is low. refs., tabs., figs.

  7. Climate change : we are at risk : interim report

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, D.; Wiebe, J.

    2003-06-01

    Between November 2002 and May 2003 the Standing Senate Committee on Agriculture and Forestry travelled across Canada to hear the views of farmer organizations, rural associations, ecotourism groups and environmental organizations regarding concerns about climate change and the impact it may have on the agriculture and forestry sectors and rural communities. The Committee also examined potential adaptation strategies focusing on primary production, practices, technologies, ecosystems and other related areas. Farmers and forest operators are already facing changes in market conditions, domestic regulations, trade policies and technology. This interim report expressed the concerns of farmers and forest operators. It includes a review of the Saguenay flood of 1996, the Red River flood of 1997, the ice storm of 1998, and droughts since 1999. It also includes a discussion on climate change and its biophysical and economic effects on agriculture, forestry, water resources, rural communities, and Aboriginal communities. This interim report also briefly outlines the Kyoto Protocol, the emissions trading system, and the decarbonization of global energy systems. It emphasized the need for integrated research and government policies and programs that encourage adaptation to climate change. The final report will be released in October 2003 and will provide specific recommendations to ensure that Canada responds to the concerns of farmers and forest operators and to ensure continued prosperity in these sectors. refs., figs.

  8. Evaluation of the Illinois High School to College Success Report: Technical Report

    Science.gov (United States)

    Klostermann, Brenda; Cameron, Sean; Hamel, Rachel; Newberry, Melissa

    2013-01-01

    This report provides findings from an evaluation of the newly designed Illinois High School to College Success Report (HS2CSR). The evaluation study examined the dissemination, usefulness, and impact on collaborative efforts of the new HS2CSR. Education stakeholders' suggestions for improving the report are also included. Recommendations to…

  9. Evaluation of severe accident risks, Peach Bottom, Unit 2: Main report

    Energy Technology Data Exchange (ETDEWEB)

    Payne, A.C.; Breeding, R.J.; Jow, H.N.; Shiver, A.W. (Sandia National Labs., Albuquerque, NM (USA)); Helton, J.C. (Arizona State Univ., Tempe, AZ (USA)); Smith, L.N. (Science Applications International Corp., Albuquerque, NM (USA))

    1990-12-01

    In support of the Nuclear Regulatory Commission's (NRC's) assessment of the risk from severe accidents at commercial nuclear power plants in the US reported NUREG-1150, the Severe Accident Risk Reduction Program (SARRP) has completed a revised calculation of the risk to the general public from severe accidents at the Peach Bottom Atomic Power Station, Unit 2. This power plant, located in southeastern Pennsylvania, is operated by the Philadelphia Electric Company. The emphasis in this risk analysis was not on determining a so-called'' point estimate of risk. Rather, it was to determine the distribution of risk, and to discover the uncertainties that account for the breadth of this distribution. Off-site risk initiated by events both internal and external to the power station were assessed. 39 refs., 174 figs., 133 tabs.

  10. How reinforcement sensitivity and perceived risk influence young drivers' reported engagement in risky driving behaviors.

    Science.gov (United States)

    Harbeck, Emma L; Glendon, A Ian

    2013-05-01

    Gray's reinforcement sensitivity theory (RST), implementing Carver and White's behavior inhibition system (BIS) and behavior approach system (BAS) scales, was used to predict reported engagement in 10 risky driving behaviors: speeding (2 levels), driving under the influence of alcohol, racing other vehicles, cell phone use (hand-held and hands free), tailgating, unsafe overtaking, driving while fatigued, and not wearing a seatbelt. Participants were 165 young male and female (n=101) drivers aged 17-25 years who held a valid Australian driver's license. Effects of the explanatory variables and specific risk perceptions upon engagement in the reported risky driving behaviors were examined using SEM analyses. Also of interest was whether perceived risk mediated the relationship between the personality variables and reported engagement in risky driving behaviors. RST variables, negative reactivity, reward responsiveness and fun seeking, accounted for unique variance in young drivers' perceived risk. Reward responsiveness and perceived risk accounted for unique variance in young drivers' reported engagement in risky driving behaviors. Negative reactivity was completely mediated by perceived risk in its negative relationship with reported engagement. To better understand driving related risk decision making, future research could usefully incorporate drivers' motivation systems. This has the potential to lead to more tailored approaches to identifying risk-prone drivers and provide information for the development and implementation of media campaigns and educational programs.

  11. Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Sabine, E-mail: muellers@neuropeds.ucsf.edu [Department of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco, San Francisco, California (United States); Fullerton, Heather J. [Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, California (United States); Stratton, Kayla; Leisenring, Wendy [Fred Hutchinson Cancer Research Center, Seattle, Washington (United States); Weathers, Rita E.; Stovall, Marilyn [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Armstrong, Gregory T. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Goldsby, Robert E. [Department of Pediatrics, University of California, San Francisco, San Francisco, California (United States); Packer, Roger J. [Children' s National Medical Center, Washington, District of Columbia (United States); Sklar, Charles A. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bowers, Daniel C. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Robison, Leslie L.; Krull, Kevin R. [St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2013-07-15

    Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively.

  12. High alcohol consumption causes high IgE levels but not high risk of allergic disease

    DEFF Research Database (Denmark)

    Lomholt, Frederikke K; Nielsen, Sune F; Nordestgaard, Børge G

    2016-01-01

    disease. Genetically, we explored potential causal relationships between alcohol consumption and IgE levels and allergic disease. RESULTS: The multivariable adjusted odds ratio for IgE levels greater than versus less than 150 kU/L and compared with subjects without allergic disease was 2.3 (95% CI, 2......BACKGROUND: High alcohol consumption is associated with high IgE levels in observational studies; however, whether high alcohol consumption leads to high IgE levels and allergic disease is unclear. OBJECTIVE: We tested the hypothesis that high alcohol consumption is associated with high IgE levels...... for the alcohol-metabolizing enzymes alcohol dehydrogenase 1B (ADH-1B; rs1229984) and alcohol dehydrogenase 1c (ADH-1C; rs698). Observationally, we investigated associations between IgE levels and allergic disease (allergic asthma, rhinitis, and eczema) and between alcohol consumption and IgE levels and allergic...

  13. Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-08-01

    OAK B188 Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report. The overall goal of this research project is to support innovation in new nuclear power plant designs. This project is examining the implications, for future reactors and future safety regulation, of utilizing a new risk-informed regulatory system as a replacement for the current system. This innovation will be made possible through development of a scientific, highly risk-formed approach for the design and regulation of nuclear power plants. This approach will include the development and/or confirmation of corresponding regulatory requirements and industry standards. The major impediment to long term competitiveness of new nuclear plants in the U.S. is the capital cost component--which may need to be reduced on the order of 35% to 40% for Advanced Light Water Reactors (ALWRS) such as System 80+ and Advanced Boiling Water Reactor (ABWR). The required cost reduction for an ALWR such as AP600 or AP1000 would be expected to be less. Such reductions in capital cost will require a fundamental reevaluation of the industry standards and regulatory bases under which nuclear plants are designed and licensed. Fortunately, there is now an increasing awareness that many of the existing regulatory requirements and industry standards are not significantly contributing to safety and reliability and, therefore, are unnecessarily adding to nuclear plant costs. Not only does this degrade the economic competitiveness of nuclear energy, it results in unnecessary costs to the American electricity consumer. While addressing these concerns, this research project will be coordinated with current efforts of industry and NRC to develop risk-informed, performance-based regulations that affect the operation of the existing nuclear plants; however, this project will go further by focusing on the design of new plants.

  14. Establishment of a Risk Assessment Framework for Analysis of the Spread of Highly Pathogenic Avian Influenza

    Institute of Scientific and Technical Information of China (English)

    LI Jing; WANG Jing-fei; WU Chun-yan; YANG Yan-tao; JI Zeng-tao; WANG Hong-bin

    2007-01-01

    To evaluate the risk of highly pathogenic avian influenza (HPAI) in mainland China, a risk assessment framework was built.Risk factors were determined by analyzing the epidemic data using the brainstorming method; the analytic hierarchy process was designed to weigh risk factors, and the integrated multicriteria analysis was used to evaluate the final result.The completed framework included the risk factor system, data standards for risk factors, weights of risk factors, and integrated assessment methods. This risk assessment framework can be used to quantitatively analyze the outbreak and spread of HPAI in mainland China.

  15. High attributable risk due to arsenic for lung cancer in Yunnan tin mine reported by WD Hazelton et al%对Hazelton等提出的云锡矿工肺癌主要危险来自砷的商榷

    Institute of Scientific and Technical Information of China (English)

    孙世荃

    2004-01-01

    Using two-stage clonal expansion model with data-base provided by Lubin, WD Hazehon et al indicated the high risk of arsenic, but not radon, in the etiology of Yunnan tin miner' s lung cancer. The author of this review iterated the problems in the data-base of Lubin,and considered that it may result in low estimate for the risk of radon in paper of Hazehon et al. Attributable risk was estimated by them with changing exposure patterns of each individual, but the efficacy of this two-stage model will be violated by the invariability of appointed radon/arsenic exposures. Risk comparison was used to distinguish the contribution from radon/arsenic, which was hampered by the high correlation between their joint exposures. As Lubin, Hazehon et al neglected the confounding from environmental arsenic pollution in early years. From all of above, their viewpoint is worth to be deliberated.

  16. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    Science.gov (United States)

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  17. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    Science.gov (United States)

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  18. Sex Differences in Children with Autism Spectrum Disorder Identified within a High-Risk Infant Cohort

    Science.gov (United States)

    Zwaigenbaum, Lonnie; Bryson, Susan E.; Szatmari, Peter; Brian, Jessica; Smith, Isabel M.; Roberts, Wendy; Vaillancourt, Tracy; Roncadin, Caroline

    2012-01-01

    Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4%) and 28 of 143 girls (19.6%), implying…

  19. Modifiable risk factors and colorectal adenomas among those at high risk of colorectal cancer

    NARCIS (Netherlands)

    Botma, A.

    2011-01-01

    Epidemiological studies have identified several modifiable risk factors for colorectal neoplasms in the general population. However, associations between modifiable risk factors, including body mass index (BMI), smoking, alcohol consumption and dietary patterns, and colorectal neoplasms in two

  20. Metabolic Acidosis Assessment in High-Risk Surgeries: Prognostic Importance.

    Science.gov (United States)

    Silva, João Manoel; Ribas Rosa de Oliveira, Amanda Maria; Mendes Nogueira, Fernando Augusto; Vianna, Pedro M M; Amendola, Cristina Prata; Carvalho Carmona, Maria José; Sá Malbouisson, Luiz M

    2016-11-01

    Metabolic acidosis frequently is present in surgical patients; however, different types of metabolic acidosis (hyperlactatemia, hyperchloremia, and others) may have different relationships to perioperative outcomes. We hypothesized that in postoperative surgical patients, distinctive types of metabolic acidosis would correlate differently with the outcomes of high-risk surgeries. A prospective, multicenter observational study was performed in 3 different tertiary care hospitals. Patients who required postoperative admission to the intensive care unit (ICU) were included in this study. Patients with a short life expectancy (those with untreated cancer and limited treatment), hepatic failure, renal failure, or a diagnosis of diabetes were excluded. Patients were classified at ICU admission according to the presence and type of metabolic acidosis into 4 groups: those without acidosis, those with a base excess 12 mmol/L, and those with a base excess 2 mmol/L. Furthermore, patients were reclassified 12 hours after admission to the ICU to verify the metabolic acidosis behavior and outcome differences among the groups. The study included 618 patients. The incidence of acidosis at ICU admission was 59.1%; 23.9% presented with hyperchloremia, 21.3% with hyperlactatemia, 13.9% with increased anion gap, and 40.9% of the patients presented without metabolic acidosis. Patients whose metabolic acidosis persisted for 12 hours had an incidence of ICU complications rates in hyperlactatemia group of 68.8%, increased anion gap of 68.6%, hyperchloremic of 65.8%, and those without acidosis over 12 hours of 59.3%. A Cox regression model for postoperative 30-day mortality showed: in hyperlactatemic acidosis, hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.02-2.96; increased anion gap acidosis, HR = 1.68, 95% CI = 0.85-3.81; hyperchloremic acidosis, HR = 1.47, 95% CI = 0.75-2.89, and 10.3% of 30-day mortality rate in patients without acidosis. An adjusted survival curve by Cox

  1. Characteristics of Adolescents Who Report Very High Life Satisfaction

    Science.gov (United States)

    Gilman, Rich; Huebner, E. Scott

    2006-01-01

    This study investigated the characteristics of adolescents who report high levels of life global satisfaction. A total of 485 adolescents completed the "Students' Life Satisfaction Scale" (SLSS) (Huebner, E. S. (1991). "Sch. Psychol. Int." 12: 231-240.) along with self-report measures of intrapersonal, interpersonal, and school-related…

  2. SY Tank Farm ventilation isolation option risk assessment report

    Energy Technology Data Exchange (ETDEWEB)

    Powers, T.B.; Morales, S.D.

    1994-03-01

    The safety of the 241-SY Tank Farm ventilation system has been under extensive scrutiny due to safety concerns associated with tank 101-SY. Hydrogen and other gases are generated and trapped in the waste below the liquid surface. Periodically, these gases are released into the dome space and vented through the exhaust system. This attention to the ventilation system has resulted in the development of several alternative ventilation system designs. The ventilation system provides the primary means of mitigation of accidents associated with flammable gases. This report provides an assessment of various alternatives ventilation system designs.

  3. High-tension Electrical Burns: Report of Two Cases

    OpenAIRE

    Abbas, A.D.; Dabkana, T.M.; Tahir, C.; Naaya, H.U.

    2009-01-01

    High-tension electrical burns are a rare but devastating form of injury. The objective of this case report is to bring to the fore the severity of this rare form of injury and highlight the benefits of active surgical management of such a condition. We report the cases of two patients who were managed for high-tension electrical burns and highlight the main features of their presentation and management. Both patients needed urgent resuscitation and subsequent multiple amputations and disartic...

  4. Prostate Cancer in Patients With High Prostate-Specific Antigen Levels but Otherwise Very-Low-Risk Disease Behaves Like Prostate Cancer in High-Risk Patients.

    Science.gov (United States)

    Gestaut, Matthew M; Pruszynski, Jessica E; Swanson, Gregory P

    2017-08-01

    Rarely, patients with prostate cancer present with prostate-specific antigen (PSA) scores > 20 ng/mL but with otherwise very-low-risk disease. Oncologists have debated whether the malignancies in these patients behave more comparably to low-risk or high-risk disease. Our objective was to elucidate the behavior of these malignancies. A retrospective review was conducted of prostate cancer patients treated with radiation from 2000 to 2013. The inclusion criteria for very-low-risk disease included stage T1a-T1c, Gleason score ≤ 6, ≤ 3 positive cores, ≤ 50% involvement of any core, and PSA level high-grade, low-volume group consisted of patients with stage T1c-T2a, PSA level low-risk, and high-grade groups, respectively. Biochemical progression-free survival at 5 years was 71.3% for the divergent group, 68.8% for the high-grade group, and 98.3% for the low-risk group. The biochemical failure rate for the divergent group differed significantly from the low-risk group (P = .021), and that for the low-risk group was significantly different from that of the high-grade group (P = .025). However, the divergent group did not appear different from the high-grade group (P = .53). The results of our study have shown that the disease prognosis for the divergent-risk group is worse than that for the very-low-risk disease group and does not appear to be different from that for the low-volume, high-grade disease group. Oncologists should be aware that the outcomes for divergent patients are similarly poor to their low-volume, classically high-risk counterparts. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Breastfeeding among high-risk inner-city African-American mothers: a risky choice?

    Science.gov (United States)

    Furman, Lydia M; Banks, Elizabeth C; North, Angela B

    2013-02-01

    This study identified barriers to breastfeeding among high-risk inner-city African-American mothers. We used audiotaped focus groups moderated by an experienced International Board Certified Lactation Consultant, with recruitment supported by the community partner MomsFirst™ (Cleveland Department of Public Health, Cleveland, OH). Institutional Review Board approval and written informed consent were obtained. Notes-based analysis was conducted with use of a prior analytic structure called Factors Influencing Beliefs (FIBs), redefined with inclusion/exclusion criteria to address breastfeeding issues. Three focus groups included 20 high-risk inner-city expectant and delivered mothers. Relevant FIBs domains were as follows: Risk Appraisal, Self Perception, Relationship Issues/Social Support, and Structural/Environmental Factors. Risk Appraisal themes included awareness of benefits, fear of pain, misconceptions, and lack of information. Self Perception themes included low self-efficacy with fear of social isolation and limited expression of positive self-esteem. Relationship Issues/Social Support themes included formula as a cultural norm, worries about breastfeeding in public, and challenging family relationships. Structural/Environmental Factors themes included negative postpartum hospital experiences and lack of support after going home. Several findings have been previously reported, such as fear of pain with breastfeeding, but we identified new themes, including self-esteem and self-efficacy, and new concerns, for example, that large breasts would suffocate a breastfeeding infant. The FIBs analytic framework, as modified for breastfeeding issues, creates a context for future analysis and comparison of related studies and may be a useful tool to improve understanding of barriers to breastfeeding among high-risk inner-city women.

  6. High-dose chemotherapy and autologous haematopoietic stem cell rescue for children with high-risk neuroblastoma.

    Science.gov (United States)

    Yalçin, Bilgehan; Kremer, Leontien C M; van Dalen, Elvira C

    2015-10-05

    Despite the development of new treatment options, the prognosis of high-risk neuroblastoma patients is still poor; more than half of patients experience disease recurrence. High-dose chemotherapy and haematopoietic stem cell rescue (i.e. myeloablative therapy) might improve survival. This review is the second update of a previously published Cochrane review. Primary objectiveTo compare the efficacy, that is event-free and overall survival, of high-dose chemotherapy and autologous bone marrow or stem cell rescue with conventional therapy in children with high-risk neuroblastoma. Secondary objectivesTo determine adverse effects (e.g. veno-occlusive disease of the liver) and late effects (e.g. endocrine disorders or secondary malignancies) related to the procedure and possible effects of these procedures on quality of life. We searched the electronic databases The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, issue 11), MEDLINE/PubMed (1966 to December 2014) and EMBASE/Ovid (1980 to December 2014). In addition, we searched reference lists of relevant articles and the conference proceedings of the International Society for Paediatric Oncology (SIOP) (from 2002 to 2014), American Society for Pediatric Hematology and Oncology (ASPHO) (from 2002 to 2014), Advances in Neuroblastoma Research (ANR) (from 2002 to 2014) and American Society for Clinical Oncology (ASCO) (from 2008 to 2014). We searched for ongoing trials by scanning the ISRCTN register (www.isrct.com) and the National Institute of Health Register (www.clinicaltrials.gov). Both registers were screened in April 2015. Randomised controlled trials (RCTs) comparing the efficacy of myeloablative therapy with conventional therapy in high-risk neuroblastoma patients. Two authors independently performed study selection, data extraction and risk of bias assessment. If appropriate, we pooled studies. The risk ratio (RR) and 95% confidence interval (CI) was calculated for dichotomous

  7. [IDENTIFICATION OF OCCUPATIONAL RISK FOR ARTERIAL HYPERTENSION. REPORT II: ELIMINATION OF THE MODIFYNG INFLUENCE OF FACTORS OF CARDIOVASCULAR RISK].

    Science.gov (United States)

    Maksimov, S A; Skripchenko, A E; Mikhailuts, A P; Artamonova, G V

    2016-01-01

    This study is a continuation of (Report I) identification of the occupational risk of arterial hypertension (AH) in 13 occupational groups (3842 workers, men). In previous work there was eliminated the influence of traditional factors of the cardiovascular risk, in this study there was implemented the identification of the components of a healthy worker effect (HWE) and the elimination of their influence on the occupational risks of hypertension. Identification and removal of components HWE--the effect of a healthy recruitment (EHR) and the effect of the healthy worker persisting to work (EHWPW--was carried out by the analytic rearranging of the standardized for age and obesity prevalence rate of arterial hypertension with the use of own methodological approaches. For the determination of the presence and severity of EHR there was performed an analysis of the initial prevalence rate of arterial hypertension in the youngest age groups (under 31 years). To overcome HER standardized for age and obesity indices of the arterial hypertension prevalence rate were adjusted by the ratio of the frequency of arterial hypertension in the most young occupational and reference comparable groups. Identification of HWPW was executed by comparing the frequency of AH among workers retiring within 3 years from the occupational groups when compared to the whole sample. Then on the additional risk value there was adjusted the overall prevalence rate of AH in the occupation profession to overcome EHWPW. As a result of the consistent correction and elimination of the influence of HWE components on the prevalence rate of AH, there were obtained risks values, primarily reflecting the impact of occupational factors which can be considered as true occupational risks. Factors of the cardiovascular risk and HWE significantly modified true occupational risks for AH in a number of occupational groups up to inversion. At the same time, the pronouncement of EHR has a paramount importance in the

  8. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland.

    Science.gov (United States)

    Marques-Vidal, Pedro; Paccaud, Fred

    2012-03-28

    In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland. Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

  9. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland

    Directory of Open Access Journals (Sweden)

    Marques-Vidal Pedro

    2012-03-01

    Full Text Available Abstract Background In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs. We thus aimed at assessing geographical levels of CVRFs in Switzerland. Methods Swiss Health Survey for 2007 (N = 17,879. Seven administrative regions were defined: West (Leman, West-Central (Mittelland, Zurich, South (Ticino, North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. Results After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman and Italian (Ticino speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]. Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. Conclusions In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

  10. Evolution of social learning when high expected payoffs are associated with high risk of failure

    Science.gov (United States)

    Arbilly, Michal; Motro, Uzi; Feldman, Marcus W.; Lotem, Arnon

    2011-01-01

    In an environment where the availability of resources sought by a forager varies greatly, individual foraging is likely to be associated with a high risk of failure. Foragers that learn where the best sources of food are located are likely to develop risk aversion, causing them to avoid the patches that are in fact the best; the result is sub-optimal behaviour. Yet, foragers living in a group may not only learn by themselves, but also by observing others. Using evolutionary agent-based computer simulations of a social foraging game, we show that in an environment where the most productive resources occur with the lowest probability, socially acquired information is strongly favoured over individual experience. While social learning is usually regarded as beneficial because it filters out maladaptive behaviours, the advantage of social learning in a risky environment stems from the fact that it allows risk aversion to be circumvented and the best food source to be revisited despite repeated failures. Our results demonstrate that the consequences of individual risk aversion may be better understood within a social context and suggest one possible explanation for the strong preference for social information over individual experience often observed in both humans and animals. PMID:21508013

  11. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  12. Mud Pit Risk-Based Closure Strategy Report, Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Brain Hoenes

    2004-08-01

    This report presents the findings of the human and ecological risk assessment for the NTS mud pits. The risk assessment utilizes data from 52 of the 270 NTS mud pits in conjunction with corroborative data from 87 other DOE mud pits associated with nuclear testing (at locations on the NTS, in the western United States, and Alaska) as well as relevant process knowledge. Based on the risk assessment findings, the report provides a strategy for further evaluation, characterization, and closure of all 270 NTS mud pit CASs using the Streamlined Approach for Environmental Restoration (SAFER).

  13. Influenza and pneumococcal pneumonia immunization. Protecting our high risk population.

    Science.gov (United States)

    Siegel, B R; Mahan, C S; Witte, J J; Janowski, H T

    1990-06-01

    Pneumonia and influenza (P & I) constitute Florida's sixth leading cause of death. The P & I death rate in 1987, 10.5 per 100,000, was the highest since 1978. Major target groups for one or both vaccines used in prevention, as recommended by the Immunization Practices Advisory Committee (ACIP), include persons with chronic diseases of the heart or lungs, residents of nursing homes and other chronic care facilities, and persons aged 65 and older. Despite well-defined recommendations, vaccine coverage rates in Florida are as low as 30% in persons greater than or equal to 65 years of age. Knowledge and attitude surveys demonstrate that low coverage among various population groups may be due largely to insufficient awareness and/or negative attitudes regarding pneumococcal and influenza vaccines. Conversely, recommendations by physicians and other health care providers are strongly associated with receiving either vaccine. If the incidence of P & I is to decrease substantively in Florida, much wider use of the vaccines must occur. Because so many high-risk patients depend on private physicians for health care, their role is critical to the success of Florida public health strategies to reverse P & I trends.

  14. Psychology of high risk driving (review of foreign studies

    Directory of Open Access Journals (Sweden)

    Bulygina V.G.

    2016-06-01

    Full Text Available The article presents a brief review of foreign theoretical concepts, empirical data and methodological approaches to the problem of high risk driving. There were defined and described the factors of dangerous driving: factors of external environment and internal factors, including age, fatigue, use of medications, alcohol and drugs, personal styles, impaired sensory analyzers, neurological and cognitive disorders, emotional states, styles of responding to stress. Emphasizes the role of reduction of cognitive functioning, acquired brain injury, persistent or progressive neurological diseases, and acquired somatic disorders. The outline of its main models of driving: motivational, models of information processing, hierarchical management model. A separate section of the article focuses on cognitive factors, describes a wide spectrum of disorders of cognitive functions that may potentially impair driving safety. The theoretical and methodological grounds and empirical studies of cognitive functioning are described. Discuss prospects and limitations in studies of cognitive functioning, the predictive value of some tests, including neuropsychological. The conclusion made about the need for standardization and validation the Protocol of assessment drivers and candidates for drivers, also the necessity of the introduction of a common approach for all medical workers and specialists of nonmedical profile, in order to overcome the existing differences in estimates in the implementation of medical examination, expert activity and enforcement.

  15. High blood pressure in school children: prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Rivers Patrick A

    2006-11-01

    Full Text Available Abstract Background The purpose of this study was to determine the prevalence of high blood pressure (HBP and associated risk factors in school children 8 to 13 years of age. Methods Elementary school children (n = 1,066 were examined. Associations between HBP, body mass index (BMI, gender, ethnicity, and acanthosis nigricans (AN were investigated using a school based cross-sectional study. Blood pressure was measured and the 95th percentile was used to determine HBP. Comparisons between children with and without HBP were utilized. The crude and multiple logistic regression adjusted odds ratios were used as measures of association. Results Females, Hispanics, overweight children, and children with AN had an increased likelihood of HBP. Overweight children (BMI ≥ 85th percentile and those with AN were at least twice as likely to present with HBP after controlling for confounding factors. Conclusion Twenty one percent of school children had HBP, especially the prevalence was higher among the overweight and Hispanic group. The association identified here can be used as independent markers for increased likelihood of HBP in children.

  16. Improved results in high risk cadaveric kidney transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Toledo-Pereyra, L.H.; Baskin, S.; McNichol, L.; Edford, G.; Whitten, J.; Allaben, R.

    1980-01-01

    In general, cadaver kidney transplantation survival remains at 40-50% for the first year after transplantation. To compare the beneficial effect of a new immunosuppressive protocol to standard therapy (azathioprine and prednisone), we have studied 30 high risk first cadaveric renal allograft recipients who were randomly selected before (Group A, n.15) and after (Group B, n.15) 10/79. At 12 mos, actuarial graft survival of Group B is 75% compared to 46% in Group A. Actuarial patient survival for Group B is 94% for one year compared to 60% in Group A. We feel that these improved results are related to basic changes in our immunosuppressive protocol. These changes consist of: 1. Low doses of azathioprine and prednisolone (less than 1 mg/kg) with rapid reduction to very low levels (less than 0.3 mg/kg); 2. ALG administration at 30 mg/kg/day for 14 times; 3. Rapid placement (one month) on alternate day steroid therapy; 4. Elimination of steroids for the treatment of rejection; 5. Use of ALG (20 mg/kg/day for 10 days) for the treatment of rejection; 6. Use of ALG combined with modified lymph node irradiation for third rejection episodes; and 7. Long-term intermittent ALG administration provided that kidney function continues to be normal. The best immunosuppressive protocol is clearly the one associated with less morbidity and improved quality of life after transplantation. Our current protocol (Group B) provides the best results.

  17. Dynamics of High-Risk Nonvaccine Human Papillomavirus Types after Actual Vaccination Scheme

    Directory of Open Access Journals (Sweden)

    Raúl Peralta

    2014-01-01

    Full Text Available Human papillomavirus (HPV has been identified as the main etiological factor in the developing of cervical cancer (CC. This finding has propitiated the development of vaccines that help to prevent the HPVs 16 and 18 infection. Both genotypes are associated with 70% of CC worldwide. In the present study, we aimed to determine the emergence of high-risk nonvaccine HPV after actual vaccination scheme to estimate the impact of the current HPV vaccines. A SIR-type model was used to study the HPV dynamics after vaccination. According to the results, our model indicates that the application of the vaccine reduces infection by target or vaccine genotypes as expected. However, numerical simulations of the model suggest the presence of the phenomenon called vaccine—induced pathogen strain replacement. Here, we report the following replacement mechanism: if the effectiveness of cross-protective immunity is not larger than the effectiveness of the vaccine, then the high-risk nonvaccine genotypes emerge. In this scenario, further studies of infection dispersion by HPV are necessary to ascertain the real impact of the current vaccines, primarily because of the different high-risk HPV types that are found in CC.

  18. Dynamics of High-Risk Nonvaccine Human Papillomavirus Types after Actual Vaccination Scheme

    Science.gov (United States)

    Peralta, Raúl; Vargas-De-León, Cruz; Cabrera, Augusto; Miramontes, Pedro

    2014-01-01

    Human papillomavirus (HPV) has been identified as the main etiological factor in the developing of cervical cancer (CC). This finding has propitiated the development of vaccines that help to prevent the HPVs 16 and 18 infection. Both genotypes are associated with 70% of CC worldwide. In the present study, we aimed to determine the emergence of high-risk nonvaccine HPV after actual vaccination scheme to estimate the impact of the current HPV vaccines. A SIR-type model was used to study the HPV dynamics after vaccination. According to the results, our model indicates that the application of the vaccine reduces infection by target or vaccine genotypes as expected. However, numerical simulations of the model suggest the presence of the phenomenon called vaccine—induced pathogen strain replacement. Here, we report the following replacement mechanism: if the effectiveness of cross-protective immunity is not larger than the effectiveness of the vaccine, then the high-risk nonvaccine genotypes emerge. In this scenario, further studies of infection dispersion by HPV are necessary to ascertain the real impact of the current vaccines, primarily because of the different high-risk HPV types that are found in CC. PMID:24803952

  19. Case report: obstructive sleep apnea--an air safety risk.

    Science.gov (United States)

    Panton, S; Norup, P W; Videbaek, R

    1997-12-01

    Aviation safety reports indicate that many incidents are related to fatigue. Obstructive sleep apnea (OSA) is characterized by irregular snoring with repeated apnea episodes during sleep and excessive daytime sleepiness. Deprived of sleep, patients suffer from daytime sleepiness and involuntary sleep attacks. The prevalence of OSA among adult men is more than one percent, 0.5% in women. Predisposed are men aged 40-65 yr. Many patients, including pilots, are unaware of their sleeping disturbance and the symptoms are not easily recognized. Therefore, this condition may not be discovered during a regular health examination. However, this condition can be effectively treated. In our opinion, pilots suffering from OSA do not necessarily have to lose their certificate. Diagnosis and treatment can be conducted, followed by regular check-ups. We suggest that questions about sleep be included in pilots' health examinations.

  20. Papillon–Lefevre syndrome: Reporting consanguinity as a risk factor

    Directory of Open Access Journals (Sweden)

    Aasim Farooq Shah

    2014-07-01

    Full Text Available Papillon–Lefevre syndrome (PLS is an autosomal recessive genetic disorder characterized by palmoplantar hyperkeratosis associated with severe early-onset periodontitis and premature loss of primary and permanent teeth. This report describes two cases of PLS in 28-year-old female and 16-year-old male siblings with consanguineously married parents. The patients presented to the Department of Public Health Dentistry of a dental education and research institute in India with thickening, flaking, and scaling of the skin on the palms and soles of the feet. On oral examination, the female patient presented completely resorbed maxillary and mandibular alveolar ridges with retention of only the third molars. The male patient retained only teeth 18, 13, 28, 38, and 45. Based on complete histories and clinical examination findings, a final diagnosis of PLS was made and treatment was initiated using an interdisciplinary dental approach in both cases.

  1. Papillon-Lefevre syndrome: Reporting consanguinity as a risk factor.

    Science.gov (United States)

    Shah, Aasim Farooq; Tangade, Pradeep; Agarwal, Swatantra

    2014-07-01

    Papillon-Lefevre syndrome (PLS) is an autosomal recessive genetic disorder characterized by palmoplantar hyperkeratosis associated with severe early-onset periodontitis and premature loss of primary and permanent teeth. This report describes two cases of PLS in 28-year-old female and 16-year-old male siblings with consanguineously married parents. The patients presented to the Department of Public Health Dentistry of a dental education and research institute in India with thickening, flaking, and scaling of the skin on the palms and soles of the feet. On oral examination, the female patient presented completely resorbed maxillary and mandibular alveolar ridges with retention of only the third molars. The male patient retained only teeth 18, 13, 28, 38, and 45. Based on complete histories and clinical examination findings, a final diagnosis of PLS was made and treatment was initiated using an interdisciplinary dental approach in both cases.

  2. Child and environmental risk factors predicting readiness for learning in children at high risk of dyslexia.

    Science.gov (United States)

    Dilnot, Julia; Hamilton, Lorna; Maughan, Barbara; Snowling, Margaret J

    2017-02-01

    We investigate the role of distal, proximal, and child risk factors as predictors of reading readiness and attention and behavior in children at risk of dyslexia. The parents of a longitudinal sample of 251 preschool children, including children at family risk of dyslexia and children with preschool language difficulties, provided measures of socioeconomic status, home literacy environment, family stresses, and child health via interviews and questionnaires. Assessments of children's reading-related skills, behavior, and attention were used to define their readiness for learning at school entry. Children at family risk of dyslexia and children with preschool language difficulties experienced more environmental adversities and health risks than controls. The risks associated with family risk of dyslexia and with language status were additive. Both home literacy environment and child health predicted reading readiness while home literacy environment and family stresses predicted attention and behavior. Family risk of dyslexia did not predict readiness to learn once other risks were controlled and so seems likely to be best conceptualized as representing gene-environment correlations. Pooling across risks defined a cumulative risk index, which was a significant predictor of reading readiness and, together with nonverbal ability, accounted for 31% of the variance between children.

  3. An evaluation of the treatment of risk and uncertainties in the IPCC reports on climate change.

    Science.gov (United States)

    Aven, Terje; Renn, Ortwin

    2015-04-01

    Few global threats rival global climate change in scale and potential consequence. The principal international authority assessing climate risk is the Intergovernmental Panel on Climate Change (IPCC). Through repeated assessments the IPCC has devoted considerable effort and interdisciplinary competence to articulating a common characterization of climate risk and uncertainties. We have reviewed the assessment and its foundation for the Fifth Assessment Reports published in 2013 and 2014, in particular the guidance note for lead authors of the fifth IPCC assessment report on consistent treatment of uncertainties. Our analysis shows that the work carried out by the ICPP is short of providing a theoretically and conceptually convincing foundation on the treatment of risk and uncertainties. The main reasons for our assessment are: (i) the concept of risk is given a too narrow definition (a function of consequences and probability/likelihood); and (ii) the reports lack precision in delineating their concepts and methods. The goal of this article is to contribute to improving the handling of uncertainty and risk in future IPCC studies, thereby obtaining a more theoretically substantiated characterization as well as enhanced scientific quality for risk analysis in this area. Several suggestions for how to improve the risk and uncertainty treatment are provided. © 2014 Society for Risk Analysis.

  4. Use of nitric oxide in thoracic surgery for a high risk cardiac patient

    Directory of Open Access Journals (Sweden)

    Vishal Garg

    2014-01-01

    Full Text Available Nitric oxide (NO is a selective pulmonary vasodilator especially in the presence of pulmonary artery hypertension. With right ventricle (RV dysfunction, inhaled NO may increase RV ejection fraction and cardiac output. The main advantage of NO over intravenous therapy is its inability to decrease systemic pressure thereby maintaining the coronary perfusion pressure and the myocardial perfusion. In this case report, we discuss the use of NO in a routine thoracic surgery patient suffering with severe left ventricular dysfunction and a potential candidate for a very high cardiac risk.

  5. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling

    DEFF Research Database (Denmark)

    M. W. Wille, Mathilde; Dirksen, Asger; Ashraf, Haseem;

    2016-01-01

    RATIONALE: As of April 2015, participants in the Danish Lung Cancer Screening Trial had been followed for at least 5 years since their last screening. OBJECTIVES: Mortality, causes of death, and lung cancer findings are reported to explore the effect of computed tomography (CT) screening. METHODS...... fewer deaths in the screening group. CONCLUSIONS: No statistically significant effects of CT screening on lung cancer mortality were found, but the results of post hoc high-risk subgroup analyses showed nonsignificant trends that seem to be in good agreement with the results of the National Lung...

  6. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

    Directory of Open Access Journals (Sweden)

    Susan C Irvin

    Full Text Available Epidemiological studies suggest that medroxyprogesterone acetate (MPA may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms.Human vaginal epithelial (VK2/E6E7, peripheral blood mononuclear (PBMC, and polarized endometrial (HEC-1-A cells were treated with a range of concentrations of MPA (0.015-150 μg/ml and the impact on gene expression, protein secretion, and HIV infection was evaluated.Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively.We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  7. Molecular mechanisms linking high dose medroxyprogesterone with HIV-1 risk.

    Science.gov (United States)

    Irvin, Susan C; Herold, Betsy C

    2015-01-01

    Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms. Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated. Treatment of VK2/E6E7 cells with high doses (>15 μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively. We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo.

  8. Practice-specific risk perceptions and self-reported food safety practices.

    Science.gov (United States)

    Levy, Alan S; Choinière, Conrad J; Fein, Sara B

    2008-06-01

    The relationship between risk perception and risk avoidance is typically analyzed using self-reported measures. However, in domains such as driving or food handling, the validity of responses about usual behavior is threatened because people think about the situations in which they are self-aware, such as when they encounter a hazard. Indeed, researchers have often noted a divergence between what people say about their behavior and how they actually behave. Thus, in order to draw conclusions about risk perceptions and risk avoidance from survey data, it is important to identify particular cognitive elements, such as those measured by questions about risk and safety knowledge, risk perceptions, or information search behavior, which may be effective antecedents of self-reported safety behavior. It is also important to identify and correct for potential sources of bias that may exist in the data. The authors analyze the Food and Drug Administration's 1998 Food Safety Survey to determine whether there are consistent cognitive antecedents for three types of safe food practices: preparation, eating, and cooling of foods. An assessment of measurement biases shows that endogeneity of food choices affects reports of food preparation. In addition, response bias affects reports of cooling practices as evidenced by its relation to knowledge and information search, a pattern of cognitive effects unique to cooling practices. After correcting for these biases, results show that practice-specific risk perceptions are the primary cognitive antecedents of safe food behavior, which has implications for the design of effective education messages about food safety.

  9. Managing Reputational Risk through Environmental Management and Reporting: An Options Theory Approach

    Directory of Open Access Journals (Sweden)

    Juan Pineiro-Chousa

    2017-03-01

    Full Text Available Reputation is a complex and multidimensional concept that may be organized in downside and upside reputational risk. In this article, we present a formal modelling for the management capabilities of environmental management and reporting over reputational risk, considering that reputational risk is becoming increasingly important for organizations and it directly depends on the information available about companies’ environmental performances. As long as the effectiveness of communication and disclosure plays a key role in the process, the usefulness of environmental management and reporting as a hedging instrument for reputational risk is addressed through different levels of information transparency. When considering a scenario of voluntary reporting, we show that environmentally concerned companies can reduce the cost of environmental management as a reputational risk strategy, as well as reducing the potential loss of reputational value from reputational threats and increasing the potential profit from reputational opportunities. In the context of mandatory reporting, we highlight the role of assurance companies as bearers of the risk of bad reputations for non-concerned companies. As a result, this novel approach applies theoretical oriented research from options theory to reputational risk management literature, so that it benefits from the option’s well known theory, robustness, and conclusions.

  10. Kidney transplantation in immunologically high-risk patients.

    Science.gov (United States)

    Keven, K; Sengul, S; Celebi, Z K; Tuzuner, A; Yalcin, F; Duman, T; Tutkak, H

    2013-04-01

    An increased number of sensitized patients await kidney transplantation (KTx). Sensitization has a major impact on patient mortality and morbidity due to prolonged waiting time and may preclude live donor transplantation. However, recent reports have shown that KTx can be performed successfully using novel immunosuppressive protocols. This study presents our experience with patients displaying donor-specific antibody (DSA) (+). We enrolled 5 lymphocyte cross-match (LCM) negative (complement-dependent cytotoxicity) and panel-reactive antibody (PRA) plus DSA-positive patients mean fluorescein intensity [MFI] > 1000) who underwent living kidney donor procedures. All subjects were females and their mean age was 36.7 years. In our protocol, we started mycophenolate mofetil (2 g/d), tacrolimus (0.01 mg/kg) and prednisolone (0.5 mg/kg) on day -6. We performed 2 sessions of total plasma exchange (TPE) with albumin replacement and administered 2 doses of IVIG (5 g/d). On day -1, we added rituximab (200 mg). On the operation day and on day +4, the patients received doses of basiliximab. Serum samples were taken on days -6, 0, and 30 as well as at 1 year after transplantation. All patients displayed immediate graft function. Mean basal DSA titer was 5624 MFI. After desensitization, the MFI titers decreased at the time of transplantation to 2753 MFI, and were 2564 MFI at the 1st month and 802 MFI at 1st year. Three patients experienced acute rejection episodes (60%). After treatment for rejection, the average follow-up was 17 months and last creatinine levels were 0.6-0.8 mg/dL (minimum-maximum). In conclusion, KTx can be succesfully performed in sensitized patients displaying DSA. However, there seems to be a greater acute rejection risk. There is no consensus regarding adequate doses of IVIG or plasmapheresis treatments; furthermore, more studies are needed to clarify the safe MFI titer of the DSA.

  11. [High Energy Physics: Research in high energy physics]. Annual report, FY 1982

    Energy Technology Data Exchange (ETDEWEB)

    Barish, B C

    1982-12-31

    This report discusses high energy physics research on: Quantum chromodynamics; neutrinos; multiparticle spectrometers; inclusive scattering; Mark III detector; and cascade decays of phi resonances. (LSP)

  12. Gender Differences in Empathy in Parents at High- and Low-Risk of Child Physical Abuse

    Science.gov (United States)

    Perez-Albeniz, A.; de Paul, Joaquin

    2004-01-01

    Objectives: The present research was designed to study empathy in high-risk parents for child physical abuse. The main objective was to study if high-risk mothers and fathers, compared to low-risk mothers and fathers, presented more Personal distress, less Perspective-taking, less Empathic concern and a deficit in dispositional empathy toward…

  13. Optimal Cutoff Points of Anthropometric Parameters to Identify High Coronary Heart Disease Risk in Korean Adults.

    Science.gov (United States)

    Kim, Sang Hyuck; Choi, Hyunrim; Won, Chang Won; Kim, Byung-Sung

    2016-01-01

    Several published studies have reported the need to change the cutoff points of anthropometric indices for obesity. We therefore conducted a cross-sectional study to estimate anthropometric cutoff points predicting high coronary heart disease (CHD) risk in Korean adults. We analyzed the Korean National Health and Nutrition Examination Survey data from 2007 to 2010. A total of 21,399 subjects aged 20 to 79 yr were included in this study (9,204 men and 12,195 women). We calculated the 10-yr Framingham coronary heart disease risk score for all individuals. We then estimated receiver-operating characteristic (ROC) curves for body mass index (BMI), waist circumference, and waist-to-height ratio to predict a 10-yr CHD risk of 20% or more. For sensitivity analysis, we conducted the same analysis for a 10-yr CHD risk of 10% or more. For a CHD risk of 20% or more, the area under the curve of waist-to-height ratio was the highest, followed by waist circumference and BMI. The optimal cutoff points in men and women were 22.7 kg/m(2) and 23.3 kg/m(2) for BMI, 83.2 cm and 79.7 cm for waist circumference, and 0.50 and 0.52 for waist-to-height ratio, respectively. In sensitivity analysis, the results were the same as those reported above except for BMI in women. Our results support the re-classification of anthropometric indices and suggest the clinical use of waist-to-height ratio as a marker for obesity in Korean adults.

  14. Primary Treatment Options for High-Risk/Medically Inoperable Early Stage NSCLC Patients.

    Science.gov (United States)

    Jones, Guy C; Kehrer, Jason D; Kahn, Jenna; Koneru, Bobby N; Narayan, Ram; Thomas, Tarita O; Camphausen, Kevin; Mehta, Minesh P; Kaushal, Aradhana

    2015-11-01

    Lung cancer is among the most common cancers worldwide and is the leading cause of cancer death in both men and women. For patients with early stage (American Joint Committee on Cancer T1-2, N0) non-small-cell lung cancer, the current standard of care is lobectomy with systematic lymph node evaluation. Unfortunately, patients with lung cancer often have medical comorbities, which may preclude the option of surgical resection. In such cases, a number of minimally invasive to noninvasive treatment options have gained popularity in the treatment of these high-risk patients. These modalities provide significant advantages, including patient convenience, treatment in an outpatient setting, and acceptable toxicities, including reduced impact on lung function and a modest risk of postprocedure chest wall pain. We provide a comprehensive review of the literature, including reported outcomes, complications, and limitations of sublobar resection with or without intraoperative brachytherapy, radiofrequency ablation, microwave ablation, percutaneous cryoablation, photodynamic therapy, and stereotactic body radiotherapy.

  15. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Burnice Nalina Kumari Chellathurai

    2016-01-01

    Full Text Available Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation.

  16. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach.

    Science.gov (United States)

    Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan

    2016-01-01

    Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation.

  17. Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a Systematic Review of Methodology and Reporting Quality.

    Science.gov (United States)

    Wen, Zhang; Guo, Ya; Xu, Banghao; Xiao, Kaiyin; Peng, Tao; Peng, Minhao

    2016-04-01

    Postoperative pancreatic fistula is still a major complication after pancreatic surgery, despite improvements of surgical technique and perioperative management. We sought to systematically review and critically access the conduct and reporting of methods used to develop risk prediction models for predicting postoperative pancreatic fistula. We conducted a systematic search of PubMed and EMBASE databases to identify articles published before January 1, 2015, which described the development of models to predict the risk of postoperative pancreatic fistula. We extracted information of developing a prediction model including study design, sample size and number of events, definition of postoperative pancreatic fistula, risk predictor selection, missing data, model-building strategies, and model performance. Seven studies of developing seven risk prediction models were included. In three studies (42 %), the number of events per variable was less than 10. The number of candidate risk predictors ranged from 9 to 32. Five studies (71 %) reported using univariate screening, which was not recommended in building a multivariate model, to reduce the number of risk predictors. Six risk prediction models (86 %) were developed by categorizing all continuous risk predictors. The treatment and handling of missing data were not mentioned in all studies. We found use of inappropriate methods that could endanger the development of model, including univariate pre-screening of variables, categorization of continuous risk predictors, and model validation. The use of inappropriate methods affects the reliability and the accuracy of the probability estimates of predicting postoperative pancreatic fistula.

  18. Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients

    National Research Council Canada - National Science Library

    John Billings; Jennifer Dixon; Tod Mijanovich; David Wennberg

    2006-01-01

    Objective To develop a method of identifying patients at high risk of readmission to hospital in the next 12 months for practical use by primary care trusts and general practices in the NHS in England...

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

    Science.gov (United States)

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

    2008-10-01

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

  20. High Risk of Depressive Disorders in Patients With Gout

    Science.gov (United States)

    Changchien, Te-Chang; Yen, Yung-Chieh; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-01-01

    Abstract Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders. In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval. Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients. Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk. PMID:26717394

  1. Assessing the risk of self-diagnosed malaria in urban informal settlements of Nairobi using self-reported morbidity survey

    Directory of Open Access Journals (Sweden)

    Mugisha Frederick

    2007-05-01

    Full Text Available Abstract Background Because of the belief that Nairobi is a low risk zone for malaria, little empirical data exists on malaria risk in the area. The aim of this study was to explore the risk of perceived malaria and some associated factors in Nairobi informal settlements using self-reported morbidity survey. Methods The survey was conducted from May to August 2004 on 7,288 individuals in two informal settlements of Nairobi. Participants were asked to report illnesses they experienced in the past 14 days. Logistic regression was used to estimate the odds of perceived-malaria. The model included variables such as site of residence, age, ethnicity and number of reported symptoms. Results Participants reported 165 illnesses among which malaria was the leading cause (28.1%. The risk of perceived-malaria was significantly higher in Viwandani compared to Korogocho (OR 1.61, 95%CI: 1.10–2.26. Participants in age group 25–39 years had significantly higher odds of perceived-malaria compared to those under-five years (OR 2.07, 95%CI: 1.43–2.98. The Kikuyu had reduced odds of perceived-malaria compared to other ethnic groups. Individuals with five and more symptoms had higher odds compared to those with no symptoms (OR 23.69, 95%CI: 12.98–43.23. Conclusion Malaria was the leading cause of illness as perceived by the residents in the two informal settlements. This was rational as the number of reported symptoms was highly associated with the risk of reporting the illness. These results highlight the need for a more comprehensive assessment of malaria epidemiology in Nairobi to be able to offer evidence-based guidance to policy on malaria in Kenya and particularly in Nairobi.

  2. [Accident risk perception in high-voltage electrical maintenance workers].

    Science.gov (United States)

    Micheli, M; Zanaletti, W; Giorgi, I; Argentero, P; Candura, S M

    2006-01-01

    Promoting safety at work represents a fundamental task for achieving improvement in the quality of working life and preventing accidental injuries at work. Nevertheless, over the last few decades injuries at work have continued to constitute a significant problem. The aim of this study was to examine accident risk perception in a sample of 45 subjects employed in the electricity sector and to relate their risk perception to personality characteristics, cognitive functioning, and personal and professional history. The instruments used were: "Cognitive Behavioral Assessment 2.0", the "Workplace safety questionnaire" (an Italian questionnaire on safety at work), and a battery of neuropsychological tests. Findings show that electricity (current variability) was perceived as the most serious risk factor, while the most frequent perceived risk factors for accidents were accidental falls, cuts and bruises. The subjects of our sample showed a good awareness of risk perception, and good mood response and augmented psychophysiological activation during accidental injuries.

  3. Expected Risk Assessment—Annual Report versus Social Responsibility

    Directory of Open Access Journals (Sweden)

    Elvira Böcskei

    2015-07-01

    Full Text Available Global economic, social and environmental changes are inspiring companies to behave responsibly towards the environment, not only in the interest of others, but also in that of the future of their companies. It is crucial that companies are able to recognize any lack in their ability to grow values in a timely manner, because issues at companies require immediate intervention. A key factor in maintaining operations is the time interval required for companies to adjust to challenges. Are Annual Reports capable of indicating problems or possibly to inform decision-makers that a company is entering a period of decline? Such information can be gathered from the notes to the financial statement. Are annually prepared statements capable of indicating problems? Definitely, yes. Do yearly once due statements provide enough information? The answer must be no, as we are not living in a static economic environment. The more dynamic our economic environment is, the greater the role played by the question of time. Thanks to improvements in accounting and technology, we are able to create up-to-date analyses, based on accounting statements. However, in order to be effective, teamwork inside the company is essential and controllers should play a key role.

  4. An Assessment of the Risk of Bias in Randomized Controlled Trial Reports Published in Prosthodontic and Implant Dentistry Journals.

    Science.gov (United States)

    Papageorgiou, Spyridon N; Kloukos, Dimitrios; Petridis, Haralampos; Pandis, Nikolaos

    2015-01-01

    The objective of this study was to assess the risk of bias of randomized controlled trials (RCTs) published in prosthodontic and implant dentistry journals. The last 30 issues of 9 journals in the field of prosthodontic and implant dentistry (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Implant Dentistry, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthetic Dentistry) were hand-searched for RCTs. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool and analyzed descriptively. From the 3,667 articles screened, a total of 147 RCTs were identified and included. The number of published RCTs increased with time. The overall distribution of a high risk of bias assessment varied across the domains of the Cochrane risk of bias tool: 8% for random sequence generation, 18% for allocation concealment, 41% for masking, 47% for blinding of outcome assessment, 7% for incomplete outcome data, 12% for selective reporting, and 41% for other biases. The distribution of high risk of bias for RCTs published in the selected prosthodontic and implant dentistry journals varied among journals and ranged from 8% to 47%, which can be considered as substantial.

  5. 17 CFR 1.15 - Risk assessment reporting requirements for futures commission merchants.

    Science.gov (United States)

    2010-04-01

    ... exposure reports filed by such Material Affiliated Person with a foreign futures authority or other foreign... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Risk assessment reporting requirements for futures commission merchants. 1.15 Section 1.15 Commodity and Securities Exchanges COMMODITY...

  6. Sexual Orientation and Risk of Pregnancy Among New York City High-School Students.

    Science.gov (United States)

    Lindley, Lisa L; Walsemann, Katrina M

    2015-07-01

    We examined associations between sexual orientation and pregnancy risk among sexually experienced New York City high-school students. We analyzed data from 2005, 2007, and 2009 New York City Youth Risk Behavior Surveys. We excluded students who had never engaged in sexual intercourse, only had same-gender sexual partners, or had missing data on variables of interest, resulting in a final sample of 4892 female and 4811 male students. We employed multivariable logistic regression to examine pregnancy risk by sexual orientation, measured as self-reported sexual identity and gender of sexual partners, with adjustment for demographics and sexual behaviors. We stratified analyses by gender. Overall, 14.3% of female and 10.8% of male students had experienced a pregnancy. Students who identified as gay, lesbian, or bisexual or reported both male and female sexual partners had higher odds of pregnancy than heterosexual students or students who only had opposite-gender sexual partners. Sexual behaviors accounted for higher odds of pregnancy among female, but only partially accounted for higher odds of pregnancy involvement among male, sexual-minority students. Sexual orientation should be considered in future adolescent pregnancy-prevention efforts, including the design of pregnancy-prevention interventions.

  7. 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.

  8. [The critical incident reporting system as an instrument of risk management for better patient safety].

    Science.gov (United States)

    Panzica, M; Krettek, C; Cartes, M

    2011-09-01

    The probability that an inpatient will be harmed by a medical procedure is at least 3% of all patients. As a consequence, hospital risk management has become a central management task in the health care sector. The critical incident reporting system (CIRS) as a voluntary instrument for reporting (near) incidents plays a key role in the implementation of a risk management system. The goal of the CIRS is to register system errors without assigning guilt or meting out punishment and at the same time increasing the number of voluntary reports.

  9. Renal dysfunction and coronary disease: a high-risk combination.

    Science.gov (United States)

    Schiele, Francois

    2009-01-01

    Chronic kidney dysfunction is recognized as a risk factor for atherosclerosis and complicates strategies and treatment. Therefore, it is important for cardiologists not only to detect and measure potential kidney dysfunction, but also to know the mechanisms by which the heart and kidney interact, and recognize that in cases of acute coronary syndrome, the presence of renal dysfunction increases the risk of death. The detection and classification of kidney dysfunction into 5 stages is based on the estimated glomerular filtration rate (GFR). The presence of hypertension, endothelial dysfunction, dyslipidemia, inflammation, activation of the renin-angiotensin system and specific calcifications are the main mechanisms by which renal dysfunction can induce or compound cardiovascular disease. The magnitude of renal dysfunction is related to the cardiovascular risk; a linear relation links the extent of GFR decrease and the risk of cardiovascular events. Renal dysfunction and acute coronary syndromes are a dangerous combination: more common comorbidities, more frequent contraindications for effective drugs and higher numbers of drug-related adverse events such as bleeding partially explain the higher mortality in patients with renal dysfunction. In addition, despite higher risk, patients with renal dysfunction often receive fewer guideline-recommended treatments even in the absence of contraindications. Renal dysfunction induces and promotes atherosclerosis by various pathophysiologic pathways and is associated with other cardiovascular risk factors and underuse of appropriate therapy. Therefore, the assessment of renal function is an important step in the risk evaluation of patients with coronary artery disease.

  10. Identification of at-risk students and strategies to improve academic success in first year health programs. A Practice Report

    Directory of Open Access Journals (Sweden)

    Andrew Gerard Pearson

    2013-04-01

    Full Text Available The transition to university is a difficult process for many students, having a negative impact on their academic performance, ultimately resulting in failure or withdrawal from one or more courses in their first semester. This practice report describes a profile analysis and readiness assessment designed to identify students at high academic risk. Students so identified were offered additional workshops to address assumed knowledge and academic skills. Attendance at the workshops correlated with improved academic outcomes.

  11. Do couples at high risk of relationship problems attend premarriage education?

    Science.gov (United States)

    Halford, W Kim; O'Donnell, Charlotte; Lizzio, Alf; Wilson, Keithia L

    2006-03-01

    The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education.

  12. Iatrogenic high-risk populations and foodborne disease.

    Science.gov (United States)

    Acheson, David

    2013-09-01

    Certain subsets of the population are at a greater risk of acquiring foodborne infections and have a greater propensity to develop serious complications. Susceptibility to foodborne infection is dependent on numerous factors that largely relate to the status of an individual's defense systems in regard to both preventing and mitigating foodborne illness. Key examples include the increased susceptibility of pregnant women to listeriosis and increased severity of enteric bacterial infections in patients with AIDS. Clinicians must communicate with higher-risk patients about the risks of foodborne illness, and provide patients with information regarding safe food-handling practices.

  13. Comparison of methods trial for high-risk HPV.

    Science.gov (United States)

    Kurtycz, Daniel F I; Smith, Michele; He, Rong; Miyazaki, Kayo; Shalkham, John

    2010-02-01

    In efforts to improve service, we compared the performance of four methods of HPV detection: Invader HPV (Hologic), Hybrid Capture 2 (Qiagen), Inform HPV detection (Ventana), and standard PCR.Using blinded/de-identified cervical samples in Preservcyt (Hologic), we compared Ventana's Inform HPV Test, against Hologic's HPV Invader and PCR. In a separate evaluation, we compared Inform versus Invader versus hc2. Ventana employs in situ hybridization; Hologic's technology uses three specifically designed oligonucleotides and a fluorescent signal for detection. Qiagen's hc2 method incorporates enzyme-linked antibody detection of RNA-DNA hybrids. PCR testing was provided by Access Genetics (Minneapolis, MN). The United States Food and Drug Administration recently approved the Third Wave/Hologic Invader HPV high-risk test (rebranded as Cervista HPV HR Test).In this small study, involving a few hundred tests, Third Wave, Qiagen, and PCR tests were comparable. Kappa statistics comparing Third Wave to PCR and Third Wave to Qiagen were 0.88 and 0.74, respectively. Ventana's method did not correlate well with any of the other methods with Kappa's ranging from a low of 0.25 versus Qiagen to 0.31 versus PCR. Kappa statistics measure correlation and not accuracy of measurement.Although we felt that the specificity of our original HPV method, Ventana Inform was satisfactory and lowered our subsequent colposcopy rate, worries about its lower sensitivity caused us to look at other techniques. Other methods, PCR, hc2, and Invader, appeared comparable with one another in our series. We chose to implement the Third Wave test in our laboratory.

  14. Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

    Science.gov (United States)

    Dlamini, Xolisile; Almonte, Maribel; Herrero, Rolando; Jolly, Pauline E.; Tsoka-Gwegweni, Joyce M.; Weiderpass, Elisabete; Broutet, Nathalie; Sartorius, Benn

    2017-01-01

    Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, ppolicy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV infected people. PMID:28114325

  15. Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland.

    Science.gov (United States)

    Ginindza, Themba G; Dlamini, Xolisile; Almonte, Maribel; Herrero, Rolando; Jolly, Pauline E; Tsoka-Gwegweni, Joyce M; Weiderpass, Elisabete; Broutet, Nathalie; Sartorius, Benn

    2017-01-01

    High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8-49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6-17.5) were HPV16-positive, 13.8% (95%CI:12.0-15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2-29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6-11.9) for HPV51/59 and 11.0%, (95%CI: 7.9-15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7-46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043-7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3-29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6-7.1, OR = 4.6, 95%CI: 2.8-7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3-13.4, p<0.021 respectively). The prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among

  16. Listeria monocytogenes endophthalmitis - case report and review of risk factors and treatment outcomes.

    Science.gov (United States)

    Bajor, Anna; Luhr, Anke; Brockmann, Dorothee; Suerbaum, Sebastian; Framme, Carsten; Sedlacek, Ludwig

    2016-07-16

    The majority of cases of endophthalmitis are caused by exogenous pathogens; only 5-10 % are of endogenous origin. One cause of these rare cases of endogenous endophthalmitis is Listeria monocytogenes. Twenty-six cases of endophthalmitis due to this pathogen have been published over the last twenty years. The aim of this review is to summarize the main risk factors and common clinical findings of endogenous endophthalmitis due to Listeria monocytogenes. We report on a 62-year-old female presenting with a sterile hypopyon iritis with secondary glaucoma and an underlying rheumatoid disease. In microbiological analysis we identified Listeria monocytogenes. Further we searched through all published cases for typical signs, risk factors, details of medical and surgical treatment and outcome of endogenous endophthalmitis due to this rare pathogen. Ocular symptoms in almost all of these published cases included pain, redness of the eye, and decreased vision. Main clinical features included elevated intraocular pressure and fibrinous anterior chamber reaction, as well as a dark hypopyon. While the infection is typically spread endogenously, neither an exogenous nor endogenous source of infection could be identified in most cases. Immunocompromised patients are at higher risk of being infected than immunocompetent patients. The clinical course of endophthalmitis caused by Listeria monocytogenes had different visual outcomes. In some cases, the infection led to enucleation, blindness, or strong visual loss, whereas most patients showed a tendency of visual improvement during therapy. Early diagnosis and treatment initiation are crucial factors in the outcome of endogenous endophthalmitis caused by Listeria monocytogenes. This possible differential diagnosis should be kept in mind while treating patients with presumable sterile hypopyon and anterior uveitis having a high intraocular pressure. A bacterial source should be considered with a prompt initiation of systemic

  17. Concussion Knowledge and Reporting Behavior Differences between High School Athletes at Urban and Suburban High Schools

    Science.gov (United States)

    Wallace, Jessica; Covassin, Tracey; Nogle, Sally; Gould, Daniel; Kovan, Jeffrey

    2017-01-01

    Background: We determined differences in knowledge of concussion and reporting behaviors of high school athletes attending urban and suburban high schools, and whether a relationship exists between underreporting and access to an athletic trainer in urban schools. Methods: High school athletes (N = 715) from 14 high schools completed a validated…

  18. High-risk driving attitudes and everyday driving violations of car and racing enthusiasts in Ontario, Canada.

    Science.gov (United States)

    Yildirim-Yenier, Zümrüt; Vingilis, Evelyn; Wiesenthal, David L; Mann, Robert E; Seeley, Jane

    2015-01-01

    Attitudes and individual difference variables of car and racing enthusiasts regarding high-risk behaviors of street racing and stunt driving have recently been investigated. Positive attitudes toward high-risk driving, personality variables such as driver thrill seeking, and other self-reported risky driving acts were associated with these behaviors. However, probable relationships among high-risk driving tendencies, everyday driving behaviors, and negative road safety outcomes have remained largely unexamined. This study aimed to investigate the associations among car and racing enthusiasts' high-risk driving attitudes, self-reported everyday driving violations (i.e., ordinary and aggressive violations), and self-reported negative outcomes (i.e., collisions and driving offense citations). A web-based survey was conducted with members and visitors of car club and racing websites in Ontario, Canada. Data were obtained from 366 participants. The questionnaire included 4 attitude measures-(1) attitudes toward new penalties for Ontario's Street Racers, Stunt and Aggressive Drivers Legislation; (2) attitudes toward new offenses of stunt driving under the same legislation; (3) general attitudes toward street racing and stunt driving; (4) comparison of street racing with other risky driving behaviors-self-reported driving violations (i.e., ordinary and aggressive violations); self-reported collisions and offense citations; and background and driving questions (e.g., age, driving frequency). Results revealed that attitudes toward stunt driving offenses negatively and general attitudes toward street racing and stunt driving positively predicted ordinary violations, which, in turn, predicted offense citations. Moreover, general attitudes toward street racing and stunt driving positively predicted aggressive violations, which, in turn, predicted offense citations. The findings indicate that positive high-risk driving attitudes may be transferring to driving violations in

  19. [Branch retinal vein occlusion: high time for cardiovascular risk management

    NARCIS (Netherlands)

    Bredie, S.J.H.

    2013-01-01

    Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Re

  20. High prevalence of cardiovascular risk factors in Durban South ...

    African Journals Online (AJOL)

    ... risk factors in Durban South African Indians: The Phoenix Lifestyle Project. ... with the emergence of premature coronary artery disease in young Indian subjects. ... factors associated with DM and, together with fasting glucose, also predicted ...