WorldWideScience

Sample records for risk assessment tools

  1. Dutch Risk Assessment tools

    NARCIS (Netherlands)

    Venema, A.

    2015-01-01

    The ‘Risico- Inventarisatie- en Evaluatie-instrumenten’ is the name for the Dutch risk assessment (RA) tools. A RA tool can be used to perform a risk assessment including an evaluation of the identified risks. These tools were among the first online risk assessment tools developed in Europe. The

  2. Tools for Microbiological risk assessment

    DEFF Research Database (Denmark)

    Bassett, john; Nauta, Maarten; Lindqvist, Roland

    can increase the understanding of microbiological risks in foods. It is timely to inform food safety professionals about the availability and utility of MRA tools. Therefore, the focus of this report is to aid the food safety manager by providing a concise summary of the tools available for the MRA......Microbiological Risk Assessment (MRA) has emerged as a comprehensive and systematic approach for addressing the risk of pathogens in specific foods and/or processes. At government level, MRA is increasingly recognised as a structured and objective approach to understand the level of risk in a given...... food/pathogen scenario. Tools developed so far support qualitative and quantitative assessments of the risk that a food pathogen poses to a particular population. Risk can be expressed as absolute numbers or as relative (ranked) risks. The food industry is beginning to appreciate that the tools for MRA...

  3. Metal Vapor Arcing Risk Assessment Tool

    Science.gov (United States)

    Hill, Monika C.; Leidecker, Henning W.

    2010-01-01

    The Tin Whisker Metal Vapor Arcing Risk Assessment Tool has been designed to evaluate the risk of metal vapor arcing and to help facilitate a decision toward a researched risk disposition. Users can evaluate a system without having to open up the hardware. This process allows for investigating components at risk rather than spending time and money analyzing every component. The tool points to a risk level and provides direction for appropriate action and documentation.

  4. Analysis of Alternatives for Risk Assessment Methodologies and Tools

    Energy Technology Data Exchange (ETDEWEB)

    Nachtigal, Noel M. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). System Analytics; Fruetel, Julia A. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Gleason, Nathaniel J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Helms, Jovana [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Imbro, Dennis Raymond [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Sumner, Matthew C. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis

    2013-10-01

    The purpose of this document is to provide a basic overview and understanding of risk assessment methodologies and tools from the literature and to assess the suitability of these methodologies and tools for cyber risk assessment. Sandia National Laboratories (SNL) performed this review in support of risk modeling activities performed for the Stakeholder Engagement and Cyber Infrastructure Resilience (SECIR) division of the Department of Homeland Security (DHS) Office of Cybersecurity and Communications (CS&C). The set of methodologies and tools covered in this document is not intended to be exhaustive; instead, it focuses on those that are commonly used in the risk assessment community. The classification of methodologies and tools was performed by a group of analysts with experience in risk analysis and cybersecurity, and the resulting analysis of alternatives has been tailored to address the needs of a cyber risk assessment.

  5. Application of Risk Assessment Tools in the Continuous Risk Management (CRM) Process

    Science.gov (United States)

    Ray, Paul S.

    2002-01-01

    Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) is currently implementing the Continuous Risk Management (CRM) Program developed by the Carnegie Mellon University and recommended by NASA as the Risk Management (RM) implementation approach. The four most frequently used risk assessment tools in the center are: (a) Failure Modes and Effects Analysis (FMEA), Hazard Analysis (HA), Fault Tree Analysis (FTA), and Probabilistic Risk Analysis (PRA). There are some guidelines for selecting the type of risk assessment tools during the project formulation phase of a project, but there is not enough guidance as to how to apply these tools in the Continuous Risk Management process (CRM). But the ways the safety and risk assessment tools are used make a significant difference in the effectiveness in the risk management function. Decisions regarding, what events are to be included in the analysis, to what level of details should the analysis be continued, make significant difference in the effectiveness of risk management program. Tools of risk analysis also depends on the phase of a project e.g. at the initial phase of a project, when not much data are available on hardware, standard FMEA cannot be applied; instead a functional FMEA may be appropriate. This study attempted to provide some directives to alleviate the difficulty in applying FTA, PRA, and FMEA in the CRM process. Hazard Analysis was not included in the scope of the study due to the short duration of the summer research project.

  6. Development of an Automated Security Risk Assessment Methodology Tool for Critical Infrastructures.

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, Calvin Dell; Roehrig, Nathaniel S.; Torres, Teresa M.

    2008-12-01

    This document presents the security automated Risk Assessment Methodology (RAM) prototype tool developed by Sandia National Laboratories (SNL). This work leverages SNL's capabilities and skills in security risk analysis and the development of vulnerability assessment/risk assessment methodologies to develop an automated prototype security RAM tool for critical infrastructures (RAM-CITM). The prototype automated RAM tool provides a user-friendly, systematic, and comprehensive risk-based tool to assist CI sector and security professionals in assessing and managing security risk from malevolent threats. The current tool is structured on the basic RAM framework developed by SNL. It is envisioned that this prototype tool will be adapted to meet the requirements of different CI sectors and thereby provide additional capabilities.

  7. An Integrative Review of Pediatric Fall Risk Assessment Tools.

    Science.gov (United States)

    DiGerolamo, Kimberly; Davis, Katherine Finn

    Patient fall prevention begins with accurate risk assessment. However, sustained improvements in prevention and quality of care include use of validated fall risk assessment tools (FRATs). The goal of FRATs is to identify patients at highest risk. Adult FRATs are often borrowed from to create tools for pediatric patients. Though factors associated with pediatric falls in the hospital setting are similar to those in adults, such as mobility, medication use, and cognitive impairment, adult FRATs and the factors associated with them do not adequately assess risk in children. Articles were limited to English language, ages 0-21years, and publish date 2006-2015. The search yielded 22 articles. Ten were excluded as the population was primarily adult or lacked discussion of a FRAT. Critical appraisal and findings were synthesized using the Johns Hopkins Nursing evidence appraisal system. Twelve articles relevant to fall prevention in the pediatric hospital setting that discussed fall risk assessment and use of a FRAT were reviewed. Comparison between and accuracy of FRATs is challenged when different classifications, definitions, risk stratification, and inclusion criteria are used. Though there are several pediatric FRATs published in the literature, none have been found to be reliable and valid across institutions and diverse populations. This integrative review highlights the importance of choosing a FRAT based on an institution's identified risk factors and validating the tool for one's own patient population as well as using the tool in conjunction with nursing clinical judgment to guide interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Qualitative risk assessment as a remediation management tool

    International Nuclear Information System (INIS)

    Knutson, D.E.

    1991-01-01

    The technique used to complete this thesis utilizes existing NRC and EPA guidance on health-based risk to qualitatively prioritize preliminary assessments and provide a tool for the direction and management of remediation activities. This method is intended as a decision making tool to aid in prioritizing the remediation effort and manage the remedial investigation and feasibility study (RI/FS) process. It is not a replacement for the RI/FS. The methodology for qualitative risk assessment utilizes data gathered in preliminary assessments and calculates the health-based hazards and consequences from contaminants found at each individual location. The health-based qualitative risk indicated that number-sign 6 fuel oil, carbon tetrachloride, depleted uranium, and enriched uranium were the contaminants of major concern, in that order. Plutonium ranked approximately sixth in the contaminant of concern priority. 38 refs., 1 fig., 9 tabs

  9. Risk monitor - a tool for operational safety assessment risk monitor - user's manual

    International Nuclear Information System (INIS)

    Hari Prasad, M.; Vinod, Gopika; Saraf, R.K.; Ghosh, A.K.

    2006-06-01

    Probabilistic Safety Assessment has become a key tool as on today to identify and understand Nuclear Power Plant vulnerabilities. As a result of the availability of these PSA studies, there is a desire to use them to enhance plant safety and to operate the nuclear stations in the most efficient manner. Risk Monitor is a PC based tool, which computes the real time safety level and assists plant personnel to manage day-to-day activities. Risk Monitor is a PC based user friendly software tool used for modification and re-analysis of a nuclear Power plant. Operation of Risk Monitor is based on PSA methods for assisting in day to day applications. Risk Monitoring programs can assess the risk profile and are used to optimize the operation of Nuclear Power Plants with respect to a minimum risk level over the operating time. This report presents the background activities of Risk Monitor, its application areas and the step by step procedure for the user.to interact with the software. This software can be used with the PSA model of any Nuclear Power Plant. (author)

  10. Development of risk assessment tool for foundry workers.

    Science.gov (United States)

    Mohan, G Madhan; Prasad, P S S; Mokkapati, Anil Kumar; Venkataraman, G

    2008-01-01

    Occupational ill-health and work-related disorders are predominant in manufacturing industries due to the inevitable presence of manual work even after several waves of industrial automation and technological advancements. Ergonomic risk factors and musculoskeletal disorders like low-back symptoms have been noted amongst foundry workers. The purpose of this study was to formulate and develop a Physical Effort Index to assess risk factor. The questionnaire tool applicable to foundry environment has been designed and validated. The data recorded through survey across the foundries has been subjected to regression analysis to correlate between proposed physical effort index and the standard Borg's Ratings of Perceived Exertion (RPE) scale. The physical efforts of sixty seven workers in various foundry shop floors were assessed subjectively. The 'Job factors' and 'Work environment' were the two major parameters considered in assessing the worker discomfort level at workplace. A relation between Borg's RPE scale and the above two parameters were arrived at, through regression analysis. The study demonstrates the prevalence of risk factors amongst foundry workers and the effectiveness of the proposed index in estimating the risk factor levels. RELEVANCE TO THE INDUSTRY: The proposed tool will assist foundry supervisors and managers to assess the risk factors and helps in better understanding of the workplace to avoid work-related disorders, ensuring better output.

  11. A risk assessment tool for contaminated sites in low-permeability fractured media

    DEFF Research Database (Denmark)

    Chambon, Julie Claire Claudia; Binning, Philip John; Jørgensen, Peter R.

    2011-01-01

    A risk assessment tool for contaminated sites in low-permeability fractured media is developed, based on simple transient and steady-state analytical solutions. The discrete fracture (DF) tool, which explicitly accounts for the transport along fractures, covers different source geometries...... and history (including secondary sources) and can be applied to a wide range of compounds. The tool successfully simulates published data from short duration column and field experiments. The use for risk assessment is illustrated by three typical risk assessment case studies, involving pesticides...

  12. Chemical Risk Assessment Screening Tool of a Global Chemical Company

    Directory of Open Access Journals (Sweden)

    Evelyn Tjoe-Nij

    2018-03-01

    Full Text Available Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES, developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL or occupational exposure band (OEB. The inhalation exposure is estimated for tasks by preassigned ART1.5 activity classes and modifying factors. Results: CTES requires few inputs. The toxicological data, including OELs, OEBs, and vapor pressure are read from a database. Once the substance is selected, the user specifies its concentration and then chooses the task description and its duration. CTES has three outputs that may trigger follow-up: (1 inhalation risk score; (2 identification of the skin hazard with the skin warnings for local and systemic adverse effects; and (3 status for carcinogenic, mutagenic, or reprotoxic effects. Conclusion: The tool provides an effective way to rapidly screen low-concern tasks, and quickly identifies certain tasks involving substances that will need further review with, nevertheless, the appropriate conservatism. This tool shows that the higher-tier ART1.5 inhalation exposure assessment model can be included effectively in a screening tool. After 2 years of worldwide extensive use within the company, CTES is well perceived by the users, including the shop floor management, and it fulfills its target of screening tool. Keywords: occupational exposure, risk assessment, risk management

  13. Assessment of Interpersonal Risk (AIR) in Adults with Learning Disabilities and Challenging Behaviour--Piloting a New Risk Assessment Tool

    Science.gov (United States)

    Campbell, Martin; McCue, Michael

    2013-01-01

    A new risk assessment tool, "Assessment of Interpersonal Risk" (AIR), was piloted and evaluated to measure risk factors and compatibility between individuals living in an assessment and treatment unit in one NHS area. The adults with learning disabilities in this unit had severe and enduring mental health problems and/or behaviour that is severely…

  14. The comparative risk assessment framework and tools (CRAFT)

    Science.gov (United States)

    Southern Research Station. USDA Forest Service

    2010-01-01

    To help address these challenges, the USDA Forest Service’s Eastern Forest Environmental Threat Assessment Center (EFETAC) and the University of North Carolina Asheville’s National Environmental Modeling and Analysis Center (NEMAC) designed a planning framework, called the Comparative Risk Assessment Framework and Tools (CRAFT). CRAFT is...

  15. Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

    Science.gov (United States)

    Kim, Taekyoung; Xiong, Shuping

    2017-03-01

    This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

  16. Software Tool Implementing the Fuzzy AHP Method in Ecological Risk Assessment

    Directory of Open Access Journals (Sweden)

    Radionovs Andrejs

    2017-12-01

    Full Text Available Due to the increased spread of invasive animals and plants in the territory of Latvia, the necessity of ecological risk assessment related to such kind of spread has grown lately. In cases with sufficient statistical data, the risk assessment may be successfully performed on the basis of statistical methods. The amount of statistical data in the context of spread of invasive animals and plants is pretty poor; therefore, the only method of ecological risk assessment remains subjective judgements of experts. The present paper proposes using a programming tool for ecological risk analysis elaborated by the authors. With the help of this programming tool the method of Fuzzy Analytical Hierarchical Process is implemented. The elements of the pairwise comparison matrix are allowed to be expressed by triangular and trapezoidal fuzzy sets. The presented tool makes it possible to design the fuzzy pair-wise comparison matrix and process the results in a user-friendly way.

  17. Strategic Risk Assessment: A Decision Tool for Complex Decisions

    Energy Technology Data Exchange (ETDEWEB)

    Pollard, Simon; Duarte-Davidson, Raquel; Yearsley, Roger [Environment Agency, London (United Kingdom). National Centre for Risk Analysis and Options Appraisal; Kemp, Ray; Crawford, Mark [Galson Sciences Limited, Oakham (United Kingdom)

    2001-07-01

    Reporting on the state of the environment often requires policy makers and regulators to prioritise a range of diverse environmental issues for the purpose of directing future action on environmental protection and improvement. Information on environmental issues to inform this type of analysis can be disparate, it may be too voluminous or even absent. Data on a range of issues are rarely presented in a common format that allows easy comparison. Nevertheless, strategic judgements are required on the significance of impacts from various environmental pressures and on the inherent uncertainties. Prioritising issues forces a discussion among stakeholders of the relative significance of 'environmental harm' from pressures acting on various receptors in the environment. Discussions of this sort rapidly evolve into a discourse on risks and values. In an attempt to help systematise these discussions and provide practical tools for the analysis of environmental risks at a strategic level, the Environment Agency of England and Wales has initiated developmental research on strategic risk assessment. The tools developed under this research use the concept of 'environmental harm' as a common currency, viewed from technical, social and economic perspectives, to analyse impacts from a range of environmental pressures. Critical to an informed debate is an understanding and analysis both of the various characteristics of harm (spatial and temporal extent, reversibility, latency, etc.) and of the social response to the actual or potential environmental harm. Recent developments in this approach allow a presentation of the analysis in a structured fashion so as to better inform risk management decisions. Here, we present recent developments in the strategic risk assessment research tool, as tested by case studies from state of the environment reporting and the analysis of a regional environmental plan. We discuss its relative advantages and limitations and its

  18. Strategic Risk Assessment: A Decision Tool for Complex Decisions

    International Nuclear Information System (INIS)

    Pollard, Simon; Duarte-Davidson, Raquel; Yearsley, Roger

    2001-01-01

    Reporting on the state of the environment often requires policy makers and regulators to prioritise a range of diverse environmental issues for the purpose of directing future action on environmental protection and improvement. Information on environmental issues to inform this type of analysis can be disparate, it may be too voluminous or even absent. Data on a range of issues are rarely presented in a common format that allows easy comparison. Nevertheless, strategic judgements are required on the significance of impacts from various environmental pressures and on the inherent uncertainties. Prioritising issues forces a discussion among stakeholders of the relative significance of 'environmental harm' from pressures acting on various receptors in the environment. Discussions of this sort rapidly evolve into a discourse on risks and values. In an attempt to help systematise these discussions and provide practical tools for the analysis of environmental risks at a strategic level, the Environment Agency of England and Wales has initiated developmental research on strategic risk assessment. The tools developed under this research use the concept of 'environmental harm' as a common currency, viewed from technical, social and economic perspectives, to analyse impacts from a range of environmental pressures. Critical to an informed debate is an understanding and analysis both of the various characteristics of harm (spatial and temporal extent, reversibility, latency, etc.) and of the social response to the actual or potential environmental harm. Recent developments in this approach allow a presentation of the analysis in a structured fashion so as to better inform risk management decisions. Here, we present recent developments in the strategic risk assessment research tool, as tested by case studies from state of the environment reporting and the analysis of a regional environmental plan. We discuss its relative advantages and limitations and its wider potential role

  19. A risk assessment tool applied to the study of shale gas resources

    Energy Technology Data Exchange (ETDEWEB)

    Veiguela, Miguel [Mining, Energy and Materials Engineering School, University of Oviedo (Spain); Hurtado, Antonio; Eguilior, Sonsoles; Recreo, Fernando [Environment Department, CIEMAT, Madrid (Spain); Roqueñi, Nieves [Mining, Energy and Materials Engineering School, University of Oviedo (Spain); Loredo, Jorge, E-mail: jloredo@uniovi.es [Mining, Energy and Materials Engineering School, University of Oviedo (Spain)

    2016-11-15

    The implementation of a risk assessment tool with the capacity to evaluate the risks for health, safety and the environment (HSE) from extraction of non-conventional fossil fuel resources by the hydraulic fracturing (fracking) technique can be a useful tool to boost development and progress of the technology and winning public trust and acceptance of this. At the early project stages, the lack of data related the selection of non-conventional gas deposits makes it difficult the use of existing approaches to risk assessment of fluids injected into geologic formations. The qualitative risk assessment tool developed in this work is based on the approach that shale gas exploitation risk is dependent on both the geologic site and the technological aspects. It follows from the Oldenburg's ‘Screening and Ranking Framework (SRF)’ developed to evaluate potential geologic carbon dioxide (CO{sub 2}) storage sites. These two global characteristics: (1) characteristics centered on the natural aspects of the site and (2) characteristics centered on the technological aspects of the Project, have been evaluated through user input of Property values, which define Attributes, which define the Characteristics. In order to carry out an individual evaluation of each of the characteristics and the elements of the model, the tool has been implemented in a spreadsheet. The proposed model has been applied to a site with potential for the exploitation of shale gas in Asturias (northwestern Spain) with tree different technological options to test the approach. - Highlights: • The proposed methodology is a risk assessment useful tool for shale gas projects. • The tool is addressed to the early stages of decision making processes. • The risk assessment of a site is made through a qualitative estimation. • Different weights are assigned to each specific natural and technological property. • The uncertainty associated to the current knowledge is considered.

  20. A risk assessment tool applied to the study of shale gas resources

    International Nuclear Information System (INIS)

    Veiguela, Miguel; Hurtado, Antonio; Eguilior, Sonsoles; Recreo, Fernando; Roqueñi, Nieves; Loredo, Jorge

    2016-01-01

    The implementation of a risk assessment tool with the capacity to evaluate the risks for health, safety and the environment (HSE) from extraction of non-conventional fossil fuel resources by the hydraulic fracturing (fracking) technique can be a useful tool to boost development and progress of the technology and winning public trust and acceptance of this. At the early project stages, the lack of data related the selection of non-conventional gas deposits makes it difficult the use of existing approaches to risk assessment of fluids injected into geologic formations. The qualitative risk assessment tool developed in this work is based on the approach that shale gas exploitation risk is dependent on both the geologic site and the technological aspects. It follows from the Oldenburg's ‘Screening and Ranking Framework (SRF)’ developed to evaluate potential geologic carbon dioxide (CO_2) storage sites. These two global characteristics: (1) characteristics centered on the natural aspects of the site and (2) characteristics centered on the technological aspects of the Project, have been evaluated through user input of Property values, which define Attributes, which define the Characteristics. In order to carry out an individual evaluation of each of the characteristics and the elements of the model, the tool has been implemented in a spreadsheet. The proposed model has been applied to a site with potential for the exploitation of shale gas in Asturias (northwestern Spain) with tree different technological options to test the approach. - Highlights: • The proposed methodology is a risk assessment useful tool for shale gas projects. • The tool is addressed to the early stages of decision making processes. • The risk assessment of a site is made through a qualitative estimation. • Different weights are assigned to each specific natural and technological property. • The uncertainty associated to the current knowledge is considered.

  1. Venous Thromboembolism – Risk Assessment Tool and Thromboprophylaxis Policy: A National Survey

    LENUS (Irish Health Repository)

    Khan, MI

    2017-01-01

    Venous Thromboembolic (VTE) events in hospitalised patients are associated with significant mortality and morbidity and a major economic burden on the health service. It is well established in the literature that active implementation of a mandatory risk assessment tool and thromboprophylaxis policy reduces the incidence of hospital associated thrombosis (HAT). This study examines the utilization of a VTE risk assessment tool and thromboprophylaxis (TP) policy in Irish hospitals that manage acute admissions. A national survey was distributed to forty acute hospitals throughout Ireland. The response rate was 78% (31\\/40). The results showed that only 26% (n=8\\/31) of acute hospitals in Ireland have a local implemented TP policy. Six (75%) of these eight had a risk assessment tool in conjunction with the TP policy. All respondents who did not report to have a TP policy and risk assessment tool agreed that they should implement VTE prevention policy at their hospital. Based on the data from this survey and evidence from the effectiveness of the VTE prevention programme introduced in the United Kingdom, there is a need for a national risk assessment and thromboprophylaxis policy in Ireland. This change in practice would have the potential to prevent or reduce the morbidity and mortality associated with hospital acquired thrombosis

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  3. Colorectal Cancer Risk Assessment Tool

    Science.gov (United States)

    ... 11/12/2014 Risk Calculator About the Tool Colorectal Cancer Risk Factors Download SAS and Gauss Code Page ... Rectal Cancer: Prevention, Genetics, Causes Tests to Detect Colorectal Cancer and Polyps Cancer Risk Prediction Resources Update November ...

  4. Falls risk assessment begins with hello: lessons learned from the use of one home health agency's fall risk tool.

    Science.gov (United States)

    Flemming, Patricia J; Ramsay, Katherine

    2012-10-01

    Identifying older adults at risk for falls is a challenge all home healthcare agencies (HHAs) face. The process of assessing for falls risk begins with the initial home visit. One HHA affiliated with an academic medical center describes its experience in development and use of a Falls Risk Assessment (FRA) tool over a 10-year period. The FRA tool has been modified since initial development to clarify elements of the tool based on research and to reflect changes in the Outcome and Assessment Information Set (OASIS) document. The primary purpose of this article is to share a validated falls risk assessment tool to facilitate identification of fall-related risk factors in the homebound population. A secondary purpose is to share lessons learned by the HHA during the 10 years using the FRA.

  5. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis.

    Science.gov (United States)

    Park, Seong-Hi

    2018-01-01

    The prevention of falls among the elderly is arguably one of the most important public health issues in today's aging society. The aim of this study was to assess which tools best predict the risk of falls in the elderly. Electronic searches were performed using Medline, EMBASE, the Cochrane Library, CINAHL, etc., using the following keywords: "fall risk assessment", "elderly fall screening", and "elderly mobility scale". The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Selected studies were meta-analyzed with MetaDisc 1.4. A total of 33 studies were eligible out of the 2,321 studies retrieved from selected databases. Twenty-six assessment tools for fall risk were used in the selected articles, and they tended to vary based on the setting. The fall risk assessment tools currently used for the elderly did not show sufficiently high predictive validity for differentiating high and low fall risks. The Berg Balance scale and Mobility Interaction Fall chart showed stable and high specificity, while the Downton Fall Risk Index, Hendrich II Fall Risk Model, St. Thomas's Risk Assessment Tool in Falling elderly inpatients, Timed Up and Go test, and Tinetti Balance scale showed the opposite results. We concluded that rather than a single measure, two assessment tools used together would better evaluate the characteristics of falls by the elderly that can occur due to a multitude of factors and maximize the advantages of each for predicting the occurrence of falls.

  6. Risk Informed Design Using Integrated Vehicle Rapid Assessment Tools

    Data.gov (United States)

    National Aeronautics and Space Administration — A successful proof of concept was performed in FY 2012 integrating the Envision tool for parametric estimates of vehicle mass and the Rapid Response Risk Assessment...

  7. Risk assessment tools to identify women with increased risk of osteoporotic fracture. Complexity or simplicity?

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Friis-Holmberg, Teresa; Hermann, Anne Pernille

    2013-01-01

    A huge number of risk assessment tools have been developed. Far from all have been validated in external studies, more of them have absence of methodological and transparent evidence and few are integrated in national guidelines. Therefore, we performed a systematic review to provide an overview...... of existing valid and reliable risk assessment tools for prediction of osteoporotic fractures. Additionally, we aimed to determine if the performance each tool was sufficient for practical use and lastly to examine whether the complexity of the tools influenced their discriminative power. We searched Pub......Med, Embase and Cochrane databases for papers and evaluated these with respect to methodological quality using the QUADAS checklist. A total of 48 tools were identified, 20 had been externally validated, however only 6 tools had been tested more than once in a population-based setting with acceptable...

  8. Diagnostic Accuracy of Fall Risk Assessment Tools in People With Diabetic Peripheral Neuropathy

    Science.gov (United States)

    Pohl, Patricia S.; Mahnken, Jonathan D.; Kluding, Patricia M.

    2012-01-01

    Background Diabetic peripheral neuropathy affects nearly half of individuals with diabetes and leads to increased fall risk. Evidence addressing fall risk assessment for these individuals is lacking. Objective The purpose of this study was to identify which of 4 functional mobility fall risk assessment tools best discriminates, in people with diabetic peripheral neuropathy, between recurrent “fallers” and those who are not recurrent fallers. Design A cross-sectional study was conducted. Setting The study was conducted in a medical research university setting. Participants The participants were a convenience sample of 36 individuals between 40 and 65 years of age with diabetic peripheral neuropathy. Measurements Fall history was assessed retrospectively and was the criterion standard. Fall risk was assessed using the Functional Reach Test, the Timed “Up & Go” Test, the Berg Balance Scale, and the Dynamic Gait Index. Sensitivity, specificity, positive and negative likelihood ratios, and overall diagnostic accuracy were calculated for each fall risk assessment tool. Receiver operating characteristic curves were used to estimate modified cutoff scores for each fall risk assessment tool; indexes then were recalculated. Results Ten of the 36 participants were classified as recurrent fallers. When traditional cutoff scores were used, the Dynamic Gait Index and Functional Reach Test demonstrated the highest sensitivity at only 30%; the Dynamic Gait Index also demonstrated the highest overall diagnostic accuracy. When modified cutoff scores were used, all tools demonstrated improved sensitivity (80% or 90%). Overall diagnostic accuracy improved for all tests except the Functional Reach Test; the Timed “Up & Go” Test demonstrated the highest diagnostic accuracy at 88.9%. Limitations The small sample size and retrospective fall history assessment were limitations of the study. Conclusions Modified cutoff scores improved diagnostic accuracy for 3 of 4 fall risk

  9. Multi-Hazard Advanced Seismic Probabilistic Risk Assessment Tools and Applications

    International Nuclear Information System (INIS)

    Coleman, Justin L.; Bolisetti, Chandu; Veeraraghavan, Swetha; Parisi, Carlo; Prescott, Steven R.; Gupta, Abhinav

    2016-01-01

    Design of nuclear power plant (NPP) facilities to resist natural hazards has been a part of the regulatory process from the beginning of the NPP industry in the United States (US), but has evolved substantially over time. The original set of approaches and methods was entirely deterministic in nature and focused on a traditional engineering margins-based approach. However, over time probabilistic and risk-informed approaches were also developed and implemented in US Nuclear Regulatory Commission (NRC) guidance and regulation. A defense-in-depth framework has also been incorporated into US regulatory guidance over time. As a result, today, the US regulatory framework incorporates deterministic and probabilistic approaches for a range of different applications and for a range of natural hazard considerations. This framework will continue to evolve as a result of improved knowledge and newly identified regulatory needs and objectives, most notably in response to the NRC activities developed in response to the 2011 Fukushima accident in Japan. Although the US regulatory framework has continued to evolve over time, the tools, methods and data available to the US nuclear industry to meet the changing requirements have not kept pace. Notably, there is significant room for improvement in the tools and methods available for external event probabilistic risk assessment (PRA), which is the principal assessment approach used in risk-informed regulations and risk-informed decision-making applied to natural hazard assessment and design. This is particularly true if PRA is applied to natural hazards other than seismic loading. Development of a new set of tools and methods that incorporate current knowledge, modern best practice, and state-of-the-art computational resources would lead to more reliable assessment of facility risk and risk insights (e.g., the SSCs and accident sequences that are most risk-significant), with less uncertainty and reduced conservatisms.

  10. Multi-Hazard Advanced Seismic Probabilistic Risk Assessment Tools and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, Justin L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bolisetti, Chandu [Idaho National Lab. (INL), Idaho Falls, ID (United States); Veeraraghavan, Swetha [Idaho National Lab. (INL), Idaho Falls, ID (United States); Parisi, Carlo [Idaho National Lab. (INL), Idaho Falls, ID (United States); Prescott, Steven R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gupta, Abhinav [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    Design of nuclear power plant (NPP) facilities to resist natural hazards has been a part of the regulatory process from the beginning of the NPP industry in the United States (US), but has evolved substantially over time. The original set of approaches and methods was entirely deterministic in nature and focused on a traditional engineering margins-based approach. However, over time probabilistic and risk-informed approaches were also developed and implemented in US Nuclear Regulatory Commission (NRC) guidance and regulation. A defense-in-depth framework has also been incorporated into US regulatory guidance over time. As a result, today, the US regulatory framework incorporates deterministic and probabilistic approaches for a range of different applications and for a range of natural hazard considerations. This framework will continue to evolve as a result of improved knowledge and newly identified regulatory needs and objectives, most notably in response to the NRC activities developed in response to the 2011 Fukushima accident in Japan. Although the US regulatory framework has continued to evolve over time, the tools, methods and data available to the US nuclear industry to meet the changing requirements have not kept pace. Notably, there is significant room for improvement in the tools and methods available for external event probabilistic risk assessment (PRA), which is the principal assessment approach used in risk-informed regulations and risk-informed decision-making applied to natural hazard assessment and design. This is particularly true if PRA is applied to natural hazards other than seismic loading. Development of a new set of tools and methods that incorporate current knowledge, modern best practice, and state-of-the-art computational resources would lead to more reliable assessment of facility risk and risk insights (e.g., the SSCs and accident sequences that are most risk-significant), with less uncertainty and reduced conservatisms.

  11. Fracture risk assessed by Fracture Risk Assessment Tool (FRAX) compared with fracture risk derived from population fracture rates

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Abrahamsen, Bo; Hermann, Anne Pernille

    2011-01-01

    Purpose: To evaluate the performance of the Swedish version of Fracture Risk Assessment Tool (FRAX)) without bone mass density (BMD) in a Danish population to examine the possibility of applying this version to Danish women. METHODS: From the Danish National Register of social security numbers, we...

  12. Aqueduct: an interactive tool to empower global water risk assessment

    Science.gov (United States)

    Reig, Paul; Gassert, Francis

    2013-04-01

    The Aqueduct Water Risk Atlas (Aqueduct) is a publicly available, global database and interactive tool that maps indicators of water related risks for decision makers worldwide. Aqueduct makes use of the latest geo-statistical modeling techniques to compute a composite index and translate the most recently available hydrological data into practical information on water related risks for companies, investors, and governments alike. Twelve global indicators are grouped into a Water Risk Framework designed in response to the growing concerns from private sector actors around water scarcity, water quality, climate change, and increasing demand for freshwater. The Aqueduct framework includes indicators of water stress, variability in supply, storage, flood, drought, groundwater, water quality and social conflict, addressing both spatial and temporal variation in water hazards. It organizes indicators into three categories of risk that bring together multiple dimensions of water related risk into comprehensive aggregated scores, which allow for dynamic weighting to capture users' unique exposure to water hazards. All information is compiled into an online, open access platform, from which decision-makers can view indicators, scores, and maps, conduct global risk assessments, and export data and shape files for further analysis. Companies can use this tool to evaluate their exposure to water risks across operations and supply chains, investors to assess water-related risks in their portfolio, and public-sector actors to better understand water security. Additionally, the open nature of the data and maps allow other organizations to build off of this effort with new research, for example in the areas of water-energy or water-food relationships. This presentation will showcase the Aqueduct Water Risk Atlas online tool and the features and functionalities it offers, as well as explain how it can be used for both private and public sector applications. The session will

  13. A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.

    Science.gov (United States)

    Townsend, Ann B; Valle-Ortiz, Marisol; Sansweet, Tracy

    2016-11-01

    Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls. We retrospectively reviewed ED fall data for each quarter of 2013, which included risk assessments scores, the total number of falls, and the circumstances of each fall. Using Kotter's framework to guide a successful change process, we implemented the KINDER 1 to assess fall risk. During the first 4 weeks of the project, 937 patients (27%) were identified as high risk for falls using the KINDER 1. During the subsequent 3 quarters, the total number of falls decreased; reported falls without injuries dropped from 0.21 to 0.07 per 1000 patients, and falls with injuries were reduced from 0.21 to 0.0 per 1000 patients. The results of this project represented a valuable step toward achieving our goal to keep ED patients safe from injuries as a result of falls. The findings add to the body of nursing knowledge on the application of clinical-based performance improvement projects to improve patient outcomes and to provide data on the use of the KINDER 1 tool, which has not been extensively tested. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  14. Use of reliability engineering tools in safety and risk assessment of nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Raso, Amanda Laureano; Vasconcelos, Vanderley de; Marques, Raíssa Oliveira; Soares, Wellington Antonio; Mesquita, Amir Zacarias, E-mail: amandaraso@hotmail.com, E-mail: vasconv@cdtn.br, E-mail: raissaomarques@gmail.com, E-mail: soaresw@cdtn.br, E-mail: amir@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Serviço de Tecnologia de Reatores

    2017-07-01

    Safety, reliability and availability are fundamental criteria in design, construction and operation of nuclear facilities, as nuclear power plants. Deterministic and probabilistic risk assessments of such facilities are required by regulatory authorities in order to meet licensing regulations, contributing to assure safety, as well as reduce costs and environmental impacts. Probabilistic Risk Assessment has become an important part of licensing requirements of the nuclear power plants in Brazil and in the world. Risk can be defined as a qualitative and/or quantitative assessment of accident sequence frequencies (or probabilities) and their consequences. Risk management is a systematic application of management policies, procedures and practices to identify, analyze, plan, implement, control, communicate and document risks. Several tools and computer codes must be combined, in order to estimate both probabilities and consequences of accidents. Event Tree Analysis (ETA), Fault Tree Analysis (FTA), Reliability Block Diagrams (RBD), and Markov models are examples of evaluation tools that can support the safety and risk assessment for analyzing process systems, identifying potential accidents, and estimating consequences. Because of complexity of such analyzes, specialized computer codes are required, such as the reliability engineering software develop by Reliasoft® Corporation. BlockSim (FTA, RBD and Markov models), RENO (ETA and consequence assessment), Weibull++ (life data and uncertainty analysis), and Xfmea (qualitative risk assessment) are some codes that can be highlighted. This work describes an integrated approach using these tools and software to carry out reliability, safety, and risk assessment of nuclear facilities, as well as, and application example. (author)

  15. Use of reliability engineering tools in safety and risk assessment of nuclear facilities

    International Nuclear Information System (INIS)

    Raso, Amanda Laureano; Vasconcelos, Vanderley de; Marques, Raíssa Oliveira; Soares, Wellington Antonio; Mesquita, Amir Zacarias

    2017-01-01

    Safety, reliability and availability are fundamental criteria in design, construction and operation of nuclear facilities, as nuclear power plants. Deterministic and probabilistic risk assessments of such facilities are required by regulatory authorities in order to meet licensing regulations, contributing to assure safety, as well as reduce costs and environmental impacts. Probabilistic Risk Assessment has become an important part of licensing requirements of the nuclear power plants in Brazil and in the world. Risk can be defined as a qualitative and/or quantitative assessment of accident sequence frequencies (or probabilities) and their consequences. Risk management is a systematic application of management policies, procedures and practices to identify, analyze, plan, implement, control, communicate and document risks. Several tools and computer codes must be combined, in order to estimate both probabilities and consequences of accidents. Event Tree Analysis (ETA), Fault Tree Analysis (FTA), Reliability Block Diagrams (RBD), and Markov models are examples of evaluation tools that can support the safety and risk assessment for analyzing process systems, identifying potential accidents, and estimating consequences. Because of complexity of such analyzes, specialized computer codes are required, such as the reliability engineering software develop by Reliasoft® Corporation. BlockSim (FTA, RBD and Markov models), RENO (ETA and consequence assessment), Weibull++ (life data and uncertainty analysis), and Xfmea (qualitative risk assessment) are some codes that can be highlighted. This work describes an integrated approach using these tools and software to carry out reliability, safety, and risk assessment of nuclear facilities, as well as, and application example. (author)

  16. The Efficacy of Violence Prediction: A Meta-Analytic Comparison of Nine Risk Assessment Tools

    Science.gov (United States)

    Yang, Min; Wong, Stephen C. P.; Coid, Jeremy

    2010-01-01

    Actuarial risk assessment tools are used extensively to predict future violence, but previous studies comparing their predictive accuracies have produced inconsistent findings as a result of various methodological issues. We conducted meta-analyses of the effect sizes of 9 commonly used risk assessment tools and their subscales to compare their…

  17. Chemical Risk Assessment Screening Tool of a Global Chemical Company

    OpenAIRE

    Evelyn Tjoe-Nij; Christophe Rochin; Nathalie Berne; Alessandro Sassi; Antoine Leplay

    2018-01-01

    Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES), developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL) or occupational exposure band (OEB). The inhalation exposure i...

  18. Influence of bone mineral density measurement on fracture risk assessment tool® scores in postmenopausal Indian women.

    Science.gov (United States)

    Daswani, Bhavna; Desai, Meena; Mitra, Sumegha; Gavali, Shubhangi; Patil, Anushree; Kukreja, Subhash; Khatkhatay, M Ikram

    2016-03-01

    Fracture risk assessment tool® calculations can be performed with or without addition of bone mineral density; however, the impact of this addition on fracture risk assessment tool® scores has not been studied in Indian women. Given the limited availability and high cost of bone mineral density testing in India, it is important to know the influence of bone mineral density on fracture risk assessment tool® scores in Indian women. Therefore, our aim was to assess the contribution of bone mineral density in fracture risk assessment tool® outcome in Indian women. Apparently healthy postmenopausal Indian women (n = 506), aged 40-72 years, without clinical risk factors for bone disease, were retrospectively selected, and their fracture risk assessment tool® scores calculated with and without bone mineral density were compared. Based on WHO criteria, 30% women were osteoporotic, 42.9% were osteopenic and 27.1% had normal bone mineral density. Fracture risk assessment tool® scores for risk of both major osteoporotic fracture and hip fracture significantly increased on including bone mineral density (P women eligible without bone mineral density was 0 and with bone mineral density was 1, P > 0.05, whereas, for hip fracture risk number of women eligible without bone mineral density was 2 and with bone mineral density was 17, P Indian women. © The Author(s) 2016.

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

    International Nuclear Information System (INIS)

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

    2000-12-01

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

  20. An integrated risk assessment tool for team-based periodontal disease management.

    Science.gov (United States)

    Thyvalikakath, Thankam P; Padman, Rema; Gupta, Sugandh

    2013-01-01

    Mounting evidence suggests a potential association of periodontal disease with systemic diseases such as diabetes, cardiovascular disease, cancer and stroke. The objective of this study is to develop an integrated risk assessment tool that displays a patients' risk for periodontal disease in the context of their systemic disease, social habits and oral health. Such a tool will be used by not just dental professionals but also by care providers who participate in the team-based care for chronic disease management. Displaying relationships between risk factors and its influence on the patient's general health could be a powerful educational and disease management tool for patients and clinicians. It may also improve the coordination of care provided by the provider-members of a chronic care team.

  1. Primary care physicians’ perspectives on computer-based health risk assessment tools for chronic diseases: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Teja Voruganti

    2015-09-01

    Full Text Available Background Health risk assessment tools compute an individual’s risk of developing a disease. Routine use of such tools by primary care physicians (PCPs is potentially useful in chronic disease prevention. We sought physicians’ awareness and perceptions of the usefulness, usability and feasibility of performing assessments with computer-based risk assessment tools in primary care settings.Methods Focus groups and usability testing with a computer-based risk assessment tool were conducted with PCPs from both university-affiliated and community-based practices. Analysis was derived from grounded theory methodology.Results PCPs (n = 30 were aware of several risk assessment tools although only select tools were used routinely. The decision to use a tool depended on how use impacted practice workflow and whether the tool had credibility. Participants felt that embedding tools in the electronic medical records (EMRs system might allow for health information from the medical record to auto-populate into the tool. User comprehension of risk could also be improved with computer-based interfaces that present risk in different formats.Conclusions In this study, PCPs chose to use certain tools more regularly because of usability and credibility. Despite there being differences in the particular tools a clinical practice used, there was general appreciation for the usefulness of tools for different clinical situations. Participants characterised particular features of an ideal tool, feeling strongly that embedding risk assessment tools in the EMR would maximise accessibility and use of the tool for chronic disease management. However, appropriate practice workflow integration and features that facilitate patient understanding at point-of-care are also essential. 

  2. Assess/Mitigate Risk through the Use of Computer-Aided Software Engineering (CASE) Tools

    Science.gov (United States)

    Aguilar, Michael L.

    2013-01-01

    The NASA Engineering and Safety Center (NESC) was requested to perform an independent assessment of the mitigation of the Constellation Program (CxP) Risk 4421 through the use of computer-aided software engineering (CASE) tools. With the cancellation of the CxP, the assessment goals were modified to capture lessons learned and best practices in the use of CASE tools. The assessment goal was to prepare the next program for the use of these CASE tools. The outcome of the assessment is contained in this document.

  3. The development of a practical tool for risk assessment of manual work – the HAT-tool

    NARCIS (Netherlands)

    Kraker, H. de; Douwes, M.

    2008-01-01

    For the Dutch Ministry of Social Affairs and Employment we developed a tool to assess the risks of developing complaints of the arm, neck or shoulders during manual work. The tool was developed for every type of organization and is easy to use, does not require measurements other than time and can

  4. Above, Beyond, and Over the Side rails: Evaluating the New Memorial Emergency Department Fall-Risk-Assessment Tool.

    Science.gov (United States)

    Scott, Robin A; Oman, Kathleen S; Flarity, Kathleen; Comer, Jennifer L

    2018-03-06

    Patient falls are a significant issue in hospitalized patients and financially costly to hospitals. The Joint Commission requires that patients be assessed for fall risk and interventions in place to mitigate the risk of falls. It is imperative to have a patient population/setting specific fall risk assessment tool to identify patients at risk for falling. The purpose of this study was to evaluate the reliability and validity of the 2013 Memorial ED Fall Risk Assessment tool (MEDFRAT) specifically designed for the ED population. A two-phase prospective design was used for this study. Phase one determined the interrater reliability of the MEDFRAT. Phase two assessed the validity of the MEDFRAT in an emergency department (ED) within a 600-bed academic/teaching institution; Level II Trauma Center with >100,000 annual patient visits. The Memorial ED Fall Risk Assessment Tool was validated in this ED setting. The tool demonstrated positive interrater reliability (k=0.701) and when implemented with a falls prevention strategy and staff education demonstrated a 48% decrease in ED fall rate (0.57 falls/1000 patient visits) post implementation during the study period. The MEDFRAT, an evidenced based ED-specific fall risk tool was implemented on the basis of the risk factors consistently identified in the literature: prior fall history, impaired mobility, altered mental status, altered elimination, and the use of sedative medication. The Memorial ED Fall Risk Assessment Tool demonstrated to be a valid tool for this hospital system. Copyright © 2018 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  5. Surging Seas Risk Finder: A Tool for Local-Scale Flood Risk Assessments in Coastal Cities

    Science.gov (United States)

    Kulp, S. A.; Strauss, B.

    2015-12-01

    Local decision makers in coastal cities require accurate, accessible, and thorough assessments of flood exposure risk within their individual municipality, in their efforts to mitigate against damage due to future sea level rise. To fill this need, we have developed Climate Central's Surging Seas Risk Finder, an interactive data toolkit which presents our sea level rise and storm surge analysis for every coastal town, city, county, and state within the USA. Using this tool, policy makers can easily zoom in on their local place of interest to receive a detailed flood risk assessment, which synthesizes a wide range of features including total population, socially vulnerable population, housing, property value, road miles, power plants, schools, hospitals, and many other critical facilities. Risk Finder can also be used to identify specific points of interest in danger of exposure at different flood levels. Additionally, this tool provides localized storm surge probabilities and sea level rise projections at tidal gauges along the coast, so that users can quickly understand the risk of flooding in their area over the coming decades.

  6. Longitudinal Evaluation of Johns Hopkins Fall Risk Assessment Tool and Nurses' Experience.

    Science.gov (United States)

    Hur, Eun Young; Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

    The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is relatively new in Korea, and it has not been fully evaluated. This study revealed that the JHFRAT had good predictive validity throughout the hospitalization period. However, 2 items (fall history and elimination patterns) on the tool were not determinants of falls in this population. Interestingly, the nurses indicated those 2 items were the most difficult items to assess and needed further training to develop the assessment skills.

  7. Predicting complication risk in spine surgery: a prospective analysis of a novel risk assessment tool.

    Science.gov (United States)

    Veeravagu, Anand; Li, Amy; Swinney, Christian; Tian, Lu; Moraff, Adrienne; Azad, Tej D; Cheng, Ivan; Alamin, Todd; Hu, Serena S; Anderson, Robert L; Shuer, Lawrence; Desai, Atman; Park, Jon; Olshen, Richard A; Ratliff, John K

    2017-07-01

    OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period. Prospectively collected data were used to compare the RAT to the Charlson Comorbidity Index (CCI) and the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator. Study end point was occurrence and type of complication after spine surgery. RESULTS The authors identified 69 patients (73 procedures) who experienced a complication over the prospective study period. Cardiac complications were most common (10.2%). Receiver operating characteristic (ROC) curves were calculated to compare complication outcomes using the different assessment tools. Area under the curve (AUC) analysis showed comparable predictive accuracy between the RAT and the ACS NSQIP calculator (0.670 [95% CI 0.60-0.74] in RAT, 0.669 [95% CI 0.60-0.74] in NSQIP). The CCI was not accurate in predicting complication occurrence (0.55 [95% CI 0.48-0.62]). The RAT produced mean probabilities of 34.6% for patients who had a complication and 24% for patients who did not (p = 0.0003). The generated predicted values were stratified into low, medium, and high rates. For the RAT, the predicted complication rate was 10.1% in the low-risk group (observed rate 12.8%), 21.9% in the medium-risk group (observed 31.8%), and 49.7% in the high-risk group (observed 41.2%). The ACS NSQIP calculator consistently

  8. EIF onshore discharges : a quantitative environmental risk assessment tool for onshore facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hagemann, R.; Smit, M.G.D.; Frost, T.K. [Statoil ASA, Stavenger (Norway); Firth, S.K. [Firth Consultants, Bristol (United Kingdom); Stone, K. [WorleyParsons, Victoria, BC (Canada)

    2009-07-01

    The proper management of environmental risk is a key requirement of StatoilHydro's governing documents and is a key consideration in all phases of StatoilHydro's activities. In order to help manage risks in an effective and sustainable manner, StatoilHydro has led the development of the environmental impact factor (EIF) risk assessment tool. The EIF is utilized by all operators on the Norwegian Continental Shelf for reporting continuous improvements in produced water management to the authorities. The EIF concept has also been applied to evaluate environmental risk from air emissions, offshore oil spills and drilling discharges, discharges from onshore facilities to sea and discharges and spills from onshore installations. In order to identify the remaining hypothetical risk from a new facility, optimized with respect to environmental protection, this paper presented a case study, where the tool was applied to an oil sands steam assisted gravity drainage facility in Alberta. The paper discussed the EIF model and results of the case study. It was concluded that as a result of the use of generic principles for environmental risk assessment, combined with databases with parameter information for common soil and aquifer types, the EIF tool could be applied to any site ranging from wetlands to deserts. 5 refs., 2 tabs., 3 figs.

  9. Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

    Science.gov (United States)

    Renfro, Mindy Oxman; Fehrer, Steven

    2011-01-01

    Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

  10. ROBIS: A new tool to assess risk of bias in systematic reviews was developed.

    Science.gov (United States)

    Whiting, Penny; Savović, Jelena; Higgins, Julian P T; Caldwell, Deborah M; Reeves, Barnaby C; Shea, Beverley; Davies, Philippa; Kleijnen, Jos; Churchill, Rachel

    2016-01-01

    To develop ROBIS, a new tool for assessing the risk of bias in systematic reviews (rather than in primary studies). We used four-stage approach to develop ROBIS: define the scope, review the evidence base, hold a face-to-face meeting, and refine the tool through piloting. ROBIS is currently aimed at four broad categories of reviews mainly within health care settings: interventions, diagnosis, prognosis, and etiology. The target audience of ROBIS is primarily guideline developers, authors of overviews of systematic reviews ("reviews of reviews"), and review authors who might want to assess or avoid risk of bias in their reviews. The tool is completed in three phases: (1) assess relevance (optional), (2) identify concerns with the review process, and (3) judge risk of bias. Phase 2 covers four domains through which bias may be introduced into a systematic review: study eligibility criteria; identification and selection of studies; data collection and study appraisal; and synthesis and findings. Phase 3 assesses the overall risk of bias in the interpretation of review findings and whether this considered limitations identified in any of the phase 2 domains. Signaling questions are included to help judge concerns with the review process (phase 2) and the overall risk of bias in the review (phase 3); these questions flag aspects of review design related to the potential for bias and aim to help assessors judge risk of bias in the review process, results, and conclusions. ROBIS is the first rigorously developed tool designed specifically to assess the risk of bias in systematic reviews. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  11. [Development of HIV infection risk assessment tool for men who have sex with men based on Delphi method].

    Science.gov (United States)

    Li, L L; Jiang, Z; Song, W L; Ding, Y Y; Xu, J; He, N

    2017-10-10

    Objective: To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method. Methods: After an exhaustive literature review, we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists. Results: The positivity coefficient through first and second round specialist consultation was 100.0 % and 94.1 % , respectively. The mean of authority coefficients ( Cr ) was 0.86. Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (χ(2)=84.426, P risk assessment tool for MSM has 8 items. Conclusions: The HIV infection risk assessment tool for MSM, developed under the Delphi method, can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention. However, the reliability and validity of this risk assessment tool need to be further evaluated.

  12. Clinicians' use of breast cancer risk assessment tools according to their perceived importance of breast cancer risk factors: an international survey.

    Science.gov (United States)

    Brédart, Anne; Kop, Jean-Luc; Antoniou, Antonis C; Cunningham, Alex P; De Pauw, Antoine; Tischkowitz, Marc; Ehrencrona, Hans; Schmidt, Marjanka K; Dolbeault, Sylvie; Rhiem, Kerstin; Easton, Douglas F; Devilee, Peter; Stoppa-Lyonnet, Dominique; Schmutlzer, Rita

    2018-03-05

    The BOADICEA breast cancer (BC) risk assessment model and its associated Web Application v3 (BWA) tool are being extended to incorporate additional genetic and non-genetic BC risk factors. From an online survey through the BOADICEA website and UK, Dutch, French and Swedish national genetic societies, we explored the relationships between the usage frequencies of the BWA and six other common BC risk assessment tools and respondents' perceived importance of BC risk factors. Respondents (N = 443) varied in age, country and clinical seniority but comprised mainly genetics health professionals (82%) and BWA users (93%). Oncology professionals perceived reproductive, hormonal (exogenous) and lifestyle BC risk factors as more important in BC risk assessment compared to genetics professionals (p values personal BC history as BC risk factors. BWA use was positively related to the weight given to hormonal BC risk factors. The importance attributed to lifestyle and BMI BC risk factors was not associated with the use of BWA or any of the other tools. Next version of the BWA encompassing additional BC risk factors will facilitate more comprehensive BC risk assessment in genetics and oncology practice.

  13. Treatment thresholds for osteoporosis and reimbursability criteria: perspectives associated with fracture risk-assessment tools.

    Science.gov (United States)

    Adami, Silvano; Bertoldo, Francesco; Gatti, Davide; Minisola, Giovanni; Rossini, Maurizio; Sinigaglia, Luigi; Varenna, Massimo

    2013-09-01

    The definition of osteoporosis was based for several years on bone mineral density values, which were used by most guidelines for defining treatment thresholds. The availability of tools for the estimation of fracture risk, such as FRAX™ or its adapted Italian version, DeFRA, is providing a way to grade osteoporosis severity. By applying these new tools, the criteria identified in Italy for treatment reimbursability (e.g., "Nota 79") are confirmed as extremely conservative. The new fracture risk-assessment tools provide continuous risk values that can be used by health authorities (or "payers") for identifying treatment thresholds. FRAX estimates the risk for "major osteoporotic fractures," which are not counted in registered fracture trials. Here, we elaborate an algorithm to convert vertebral and nonvertebral fractures to the "major fractures" of FRAX, and this allows a cost-effectiveness assessment for each drug.

  14. Using an Internet-Based Breast Cancer Risk Assessment Tool to Improve Social-Cognitive Precursors of Physical Activity.

    Science.gov (United States)

    Fowler, Stephanie L; Klein, William M P; Ball, Linda; McGuire, Jaclyn; Colditz, Graham A; Waters, Erika A

    2017-08-01

    Internet-based cancer risk assessment tools might serve as a strategy for translating epidemiological risk prediction research into public health practice. Understanding how such tools affect key social-cognitive precursors of behavior change is crucial for leveraging their potential into effective interventions. To test the effects of a publicly available, Internet-based, breast cancer risk assessment tool on social-cognitive precursors of physical activity. Women (N = 132) aged 40-78 with no personal cancer history indicated their perceived risk of breast cancer and were randomly assigned to receive personalized ( www.yourdiseaserisk.wustl.edu ) or nonpersonalized breast cancer risk information. Immediately thereafter, breast cancer risk perceptions and physical activity-related behavioral intentions, self-efficacy, and response efficacy were assessed. Personalized information elicited higher intentions, self-efficacy, and response efficacy than nonpersonalized information, P values Internet-based risk assessment tools can produce beneficial effects on important social-cognitive precursors of behavior change, but lingering skepticism, possibly due to defensive processing, needs to be addressed before the effects can be maximized.

  15. Psychometric validation of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool for older Chinese inpatients.

    Science.gov (United States)

    Zhang, Junhong; Wang, Min; Liu, Yu

    2016-10-01

    To culturally adapt and evaluate the reliability and validity of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool among older inpatients in the mainland of China. Patient falls are an important safety consideration within hospitals among older inpatients. Nurses need specific risk assessment tools for older inpatients to reliably identify at-risk populations and guide interventions that highlight fixable risk factors for falls and consequent injuries. In China, a few tools have been developed to measure fall risk. However, they lack the solid psychometric development necessary to establish their validity and reliability, and they are not widely used for elderly inpatients. A cross-sectional study. A convenient sampling was used to recruit 201 older inpatients from two tertiary-level hospitals in Beijing and Xiamen, China. The Johns Hopkins Fall Risk Assessment Tool was translated using forward and backward translation procedures and was administered to these 201 older inpatients. Reliability of the tool was calculated by inter-rater reliability and Cronbach's alpha. Validity was analysed through content validity index and construct validity. The Inter-rater reliability of Chinese version of Johns Hopkins Fall Risk Assessment Tool was 97·14% agreement with Cohen's Kappa of 0·903. Cronbach's α was 0·703. Content of Validity Index was 0·833. Two factors represented intrinsic and extrinsic risk factors were explored that together explained 58·89% of the variance. This study provided evidence that Johns Hopkins Fall Risk Assessment Tool is an acceptable, valid and reliable tool to identify older inpatients at risk of falls and falls with injury. Further psychometric testing on criterion validity and evaluation of its advanced utility in geriatric clinical settings are warranted. The Chinese version of Johns Hopkins Fall Risk Assessment Tool may be useful for health care personnel to identify older Chinese inpatients at risk of falls and falls

  16. A new tool for risk analysis and assessment in petrochemical plants

    Directory of Open Access Journals (Sweden)

    El-Arkam Mechhoud

    2016-09-01

    Full Text Available The aim of our work was the implementation of a new automated tool dedicated to risk analysis and assessment in petrochemical plants, based on a combination of two analysis methods: HAZOP (HAZard and OPerability and FMEA (Failure Mode and Effect Analysis. Assessment of accident scenarios is also considered. The principal advantage of the two analysis methods is to speed-up hazard identification and risk assessment and forecast the nature and impact of such accidents. Plant parameters are analyzed under a graphical interface to facilitate the exploitation of our developed approach. This automated analysis brings out the different deviations of the operating parameters of any system in the plant. Possible causes of these deviations, their consequences and preventive actions are identified. The result is risk minimization and dependability enhancement of the considered system.

  17. Validation of an early childhood caries risk assessment tool in a low-income Hispanic population.

    Science.gov (United States)

    Custodio-Lumsden, Christie L; Wolf, Randi L; Contento, Isobel R; Basch, Charles E; Zybert, Patricia A; Koch, Pamela A; Edelstein, Burton L

    2016-03-01

    There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of "MySmileBuddy" (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC). One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression. MSB diet risk scores were significantly positively associated with salivary mutans (P valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions. © 2015 American Association of Public Health Dentistry.

  18. Increased fracture risk assessed by fracture risk assessment tool in Greek patients with Crohn's disease.

    Science.gov (United States)

    Terzoudis, Sotirios; Zavos, Christos; Damilakis, John; Neratzoulakis, John; Dimitriadi, Daphne Anna; Roussomoustakaki, Maria; Kouroumalis, Elias A; Koutroubakis, Ioannis E

    2013-01-01

    The World Health Organization has recently developed the fracture risk assessment tool (FRAX) based on clinical risk factors and bone mineral density (BMD) for evaluation of the 10-year probability of a hip or a major osteoporotic fracture. The aim of this study was to evaluate the use of the FRAX tool in Greek patients with inflammatory bowel disease (IBD). FRAX scores were applied to 134 IBD patients [68 Crohn's disease (CD); 66 ulcerative colitis (UC)] who underwent dual-energy X-ray absorptiometry scans at the femoral neck and lumbar spine during the period 2007-2012. Calculation of the FRAX scores, with or without BMD, was made through a web-based probability model used to compute individual fracture probabilities according to specific clinical risk factors. The median 10-year probability of a major osteoporotic fracture for IBD patients based on clinical data was 7.1%, and including the BMD was 6.2%. A significant overestimation with the first method was found (P = 0.01). Both scores with and without BMD were significantly higher in CD patients compared with UC patients (P = 0.02 and P = 0.005, respectively). The median 10-year probability of hip fracture based on clinical data was 0.8%, and including the BMD was 0.9%. The score with use of BMD was significantly higher in CD compared with UC patients (P = 0.04). CD patients have significantly higher FRAX scores and possibly fracture risk compared with UC patients. The clinical FRAX score alone seems to overestimate the risk of osteoporotic fracture in Greek IBD patients.

  19. Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a prospective study.

    Science.gov (United States)

    da Costa, Bruno R; Beckett, Brooke; Diaz, Alison; Resta, Nina M; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

    2017-03-03

    The Cochrane risk of bias tool is commonly criticized for having a low reliability. We aimed to investigate whether training of raters, with objective and standardized instructions on how to assess risk of bias, can improve the reliability of the Cochrane risk of bias tool. In this pilot study, four raters inexperienced in risk of bias assessment were randomly allocated to minimal or intensive standardized training for risk of bias assessment of randomized trials of physical therapy treatments for patients with knee osteoarthritis pain. Two raters were experienced risk of bias assessors who served as reference. The primary outcome of our study was between-group reliability, defined as the agreement of the risk of bias assessments of inexperienced raters with the reference assessments of experienced raters. Consensus-based assessments were used for this purpose. The secondary outcome was within-group reliability, defined as the agreement of assessments within pairs of inexperienced raters. We calculated the chance-corrected weighted Kappa to quantify agreement within and between groups of raters for each of the domains of the risk of bias tool. A total of 56 trials were included in our analysis. The Kappa for the agreement of inexperienced raters with reference across items of the risk of bias tool ranged from 0.10 to 0.81 for the minimal training group and from 0.41 to 0.90 for the standardized training group. The Kappa values for the agreement within pairs of inexperienced raters across the items of the risk of bias tool ranged from 0 to 0.38 for the minimal training group and from 0.93 to 1 for the standardized training group. Between-group differences in Kappa for the agreement of inexperienced raters with reference always favored the standardized training group and was most pronounced for incomplete outcome data (difference in Kappa 0.52, p training on risk of bias assessment may significantly improve the reliability of the Cochrane risk of bias tool.

  20. Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service.

    Science.gov (United States)

    Rabito, Estela Iraci; Marcadenti, Aline; da Silva Fink, Jaqueline; Figueira, Luciane; Silva, Flávia Moraes

    2017-08-01

    There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality. A specific questionnaire was administered to complete the 4 screening tools. Outcomes measures included length of hospital stay, transfer to the intensive care unit, presence of infection, and incidence of death. A total of 752 patients were included. The nutrition risk was 29.3%, 37.1%, 33.6%, and 31.3% according to the NRS-2002, MUST, MST, and SNAQ, respectively. All screening tools showed satisfactory performance to identify patients at nutrition risk (area under the receiver operating characteristic curve between 0.765-0.808). Patients at nutrition risk showed higher risk of very long length of hospital stay as compared with those not at nutrition risk, independent of the tool applied (relative risk, 1.35-1.78). Increased risk of mortality (2.34 times) was detected by the MUST. The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.

  1. Validity and Reliability of Persian Version of Johns Hopkins Fall Risk Assessment Tool among Aged People

    Directory of Open Access Journals (Sweden)

    hadi hojati

    2018-04-01

    Full Text Available Background & Aim: It is crucial to identify aged patients in risk of falls in clinical settings. Johns Hopkins Fall Risk Assessment Tool (JHFRAT is one of most applied international instrument to assess elderly patients for the risk of falls. The aim of this study was to evaluate reliability and internal consistency of the JHFRAT. Methods & Materials: In this cross-sectional study for validity assessment of the tool, WHO’s standard protocol was applied for translation-back translation of the tool. Face and content validity of the tool was confirmed by ten person of expert faculty members for its applicability in clinical setting. In this pilot study, the inclusion criteria were being 60 or more years old, hospitalized in the last 8 hours prior to assessment and in proper cognitive condition assessed by MMSE. Subjects of the study were (n=70 elderly patients who were newly hospitalized in Shahroud Emam Hossein Hospital. Data were analyzed using SPSS software- version 16. Internal consistency of the tool was calculated by Cronbach’s alpha. Results: According to the results of the study Persian version of JHFRAT was a valid tool for application on clinical setting. The Persian version of the tool had Cronbach’s alpha equal to 0/733. Conclusion: Based on the findings of the current study, it can be concluded that Persian version of the JHFRAT is a valid and reliable tool to be applied for assessment of elderly senior citizens on admission in any clinical settings.

  2. In silico tools to aid risk assessment of endocrine disrupting chemicals

    International Nuclear Information System (INIS)

    Jacobs, M.N.

    2004-01-01

    In silico or computational tools could be used more effectively in endocrine disruptor risk assessment for prescreening potential endocrine disruptors, improving experimental in vitro screening assay design and facilitating more thorough data analyses. The in silico tools reviewed here are three-fold and include the use of: (1) nuclear receptor (NR) crystal structures and homology models to examine potential modes of ligand binding by different representative compounds; (2) multivariate principal component analyses (PCA) techniques to select best predicted cell lines for endocrine disrupting chemicals (EDC) risk assessment purposes; (3) NR quantitative structure-activity relationships (QSARs) that can be constructed from varied biological data sources, using multivariate partial least squares (PLS) techniques and specific descriptors. The cytosolic and NR examples discussed here include the Ah receptor (AhR), the human oestrogen receptor α (hERα) and the human pregnane X receptor (PXR). The varied biological data sets can be compared to give a more integrated dimension to receptor cross talk mechanisms, with further support from molecular modelling studies

  3. Development of risk assessment simulation tool for optimal control of a low probability-high consequence disaster

    International Nuclear Information System (INIS)

    Yotsumoto, Hiroki; Yoshida, Kikuo; Genchi, Hiroshi

    2011-01-01

    In order to control low probability-high consequence disaster which causes huge social and economic damage, it is necessary to develop simultaneous risk assessment simulation tool based on the scheme of disaster risk including diverse effects of primary disaster and secondary damages. We propose the scheme of this risk simulation tool. (author)

  4. Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?

    Science.gov (United States)

    Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Chiari, Lorenzo

    2015-01-01

    Falls are a common, serious threat to the health and self-confidence of the elderly. Assessment of fall risk is an important aspect of effective fall prevention programs. In order to test whether it is possible to outperform current prognostic tools for falls, we analyzed 1010 variables pertaining to mobility collected from 976 elderly subjects (InCHIANTI study). We trained and validated a data-driven model that issues probabilistic predictions about future falls. We benchmarked the model against other fall risk indicators: history of falls, gait speed, Short Physical Performance Battery (Guralnik et al. 1994), and the literature-based fall risk assessment tool FRAT-up (Cattelani et al. 2015). Parsimony in the number of variables included in a tool is often considered a proxy for ease of administration. We studied how constraints on the number of variables affect predictive accuracy. The proposed model and FRAT-up both attained the same discriminative ability; the area under the Receiver Operating Characteristic (ROC) curve (AUC) for multiple falls was 0.71. They outperformed the other risk scores, which reported AUCs for multiple falls between 0.64 and 0.65. Thus, it appears that both data-driven and literature-based approaches are better at estimating fall risk than commonly used fall risk indicators. The accuracy-parsimony analysis revealed that tools with a small number of predictors (~1-5) were suboptimal. Increasing the number of variables improved the predictive accuracy, reaching a plateau at ~20-30, which we can consider as the best trade-off between accuracy and parsimony. Obtaining the values of these ~20-30 variables does not compromise usability, since they are usually available in comprehensive geriatric assessments.

  5. Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?

    Directory of Open Access Journals (Sweden)

    Pierpaolo Palumbo

    Full Text Available Falls are a common, serious threat to the health and self-confidence of the elderly. Assessment of fall risk is an important aspect of effective fall prevention programs.In order to test whether it is possible to outperform current prognostic tools for falls, we analyzed 1010 variables pertaining to mobility collected from 976 elderly subjects (InCHIANTI study. We trained and validated a data-driven model that issues probabilistic predictions about future falls. We benchmarked the model against other fall risk indicators: history of falls, gait speed, Short Physical Performance Battery (Guralnik et al. 1994, and the literature-based fall risk assessment tool FRAT-up (Cattelani et al. 2015. Parsimony in the number of variables included in a tool is often considered a proxy for ease of administration. We studied how constraints on the number of variables affect predictive accuracy.The proposed model and FRAT-up both attained the same discriminative ability; the area under the Receiver Operating Characteristic (ROC curve (AUC for multiple falls was 0.71. They outperformed the other risk scores, which reported AUCs for multiple falls between 0.64 and 0.65. Thus, it appears that both data-driven and literature-based approaches are better at estimating fall risk than commonly used fall risk indicators. The accuracy-parsimony analysis revealed that tools with a small number of predictors (~1-5 were suboptimal. Increasing the number of variables improved the predictive accuracy, reaching a plateau at ~20-30, which we can consider as the best trade-off between accuracy and parsimony. Obtaining the values of these ~20-30 variables does not compromise usability, since they are usually available in comprehensive geriatric assessments.

  6. Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a study protocol.

    Science.gov (United States)

    da Costa, Bruno R; Resta, Nina M; Beckett, Brooke; Israel-Stahre, Nicholas; Diaz, Alison; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

    2014-12-13

    The Cochrane risk of bias (RoB) tool has been widely embraced by the systematic review community, but several studies have reported that its reliability is low. We aim to investigate whether training of raters, including objective and standardized instructions on how to assess risk of bias, can improve the reliability of this tool. We describe the methods that will be used in this investigation and present an intensive standardized training package for risk of bias assessment that could be used by contributors to the Cochrane Collaboration and other reviewers. This is a pilot study. We will first perform a systematic literature review to identify randomized clinical trials (RCTs) that will be used for risk of bias assessment. Using the identified RCTs, we will then do a randomized experiment, where raters will be allocated to two different training schemes: minimal training and intensive standardized training. We will calculate the chance-corrected weighted Kappa with 95% confidence intervals to quantify within- and between-group Kappa agreement for each of the domains of the risk of bias tool. To calculate between-group Kappa agreement, we will use risk of bias assessments from pairs of raters after resolution of disagreements. Between-group Kappa agreement will quantify the agreement between the risk of bias assessment of raters in the training groups and the risk of bias assessment of experienced raters. To compare agreement of raters under different training conditions, we will calculate differences between Kappa values with 95% confidence intervals. This study will investigate whether the reliability of the risk of bias tool can be improved by training raters using standardized instructions for risk of bias assessment. One group of inexperienced raters will receive intensive training on risk of bias assessment and the other will receive minimal training. By including a control group with minimal training, we will attempt to mimic what many review authors

  7. A novel tool for the communication of ecological risk assessment information in an urbanized watershed

    International Nuclear Information System (INIS)

    Zandbergen, P.

    1995-01-01

    A tool was developed for the communication of ecological risk assessment information on various types of point and nonpoint source pollution in the Brunette River watershed, an urbanized watershed in the Lower Mainland of British Columbia. The communication of ecological risks is a complex task, since the outcomes of quantitative ecological risk assessments are often not well understood by interested parties, and the results of the scientific analysis are generally quite different from the public perception of risk. Scientists should try to assist in the effective communication of their analysis by presenting it in a form more accessible to a variety of stakeholders, exposing the assessment process itself and the uncertainties in the analysis. This was attempted in developing a tool for the effective communication of ecological risk assessment information and management alternatives to the community in the watershed. Longstanding concerns over various forms of point and non-point sources of pollution in the watershed have resulted in a major effort to document the releases of pollutants, the exposure pathways, and the consequences for aquatic life. Extensive monitoring of ecosystem parameters, data-integration by means of a Geographic Information System, and the use of numerous databases and sub-models have resulted in the ecological risk assessment of four types of pollution in the watershed: petroleum fuels, metals, pesticides and basic industrial chemicals. Results will be presented of the attempts to integrate this information into a communication tool, which will demonstrate the principles, values and assumptions underlying the scientific analysis, as well as the quantitative end results and inherent uncertainties. The tool has been developed in close cooperation with several scientists who did most of the original data collection and with the feedback from some of the stakeholders in the community

  8. Probabilistic earthquake risk assessment as a tool to improve safety and explanatory adequacy

    International Nuclear Information System (INIS)

    Itoi, Tatsuya

    2015-01-01

    This paper explains the concept of probabilistic earthquake risk assessment, mainly from the viewpoint as a tool to improve safety and explanatory adequacy. The definition of risk is the expected value of undesirable effect in an engineering meaning that is likely to occur in the future, and it is defined in risk management as the triplet of scenario (what can happen), frequency, and impact. As for the earthquake risk assessment of a nuclear power plant, the fragility of structure / system / component (SSC) against earthquake (so-called earthquake fragility) is assessed, and by combining with the earthquake hazard that has been separately obtained, the occurrence frequency and impact of the accident are obtained. From the view of the authors, earthquake risk assessment is for the purpose of decision-making, and is not intended to calculate the probability in a scientifically rigorous manner. For ensuring the quality of risk assessment, the table of 'Expert utilization standards for the evaluation of epistemological uncertainty' is used. Sole quantitative risk assessment is not necessarily sufficient for risk management. It would be important to find how to build the 'framework for comprehensive decision-making.' (A.O.)

  9. Fracture risk assessment in postmenopausal women with diabetes: comparison between DeFRA and FRAX tools.

    Science.gov (United States)

    Bonaccorsi, Gloria; Messina, Carmelo; Cervellati, Carlo; Maietti, Elisa; Medini, Matilde; Rossini, Maurizio; Massari, Leo; Greco, Pantaleo

    2018-05-01

    This study aimed to compare the performance of Fracture Risk Assessment Tool (FRAX) with that of Derived FRAX (DeFRA) in estimating fracture risk in a cohort of type-2 diabetes mellitus (T2DM) postmenopausal women. One hundred nineteen T2DM postmenopausal women and 118 consecutive healthy postmenopausal women were enrolled. Fracture risk was assessed with FRAX (adjusted or non- for trabecular bone score, TBS) and DeFRA. Bone mineral density (BMD) and TBS were evaluated by dual-energy X-ray absorptiometry (DXA). The outcome was the presence of vertebral/non-vertebral fragility fractures (FFs). T2DM women showed higher spinal BMD T-score (p < .05), but lower TBS (p < .05), than controls. Diabetic patients had higher prevalence of FFs compared to controls (p < .05), but no significant difference were found in the scores of any of the predictor tools. Differently, in the T2DM group, the scores of DeFRA, FRAX and adjusted-FRAX were significantly (p < .01 for all) higher in fractured compared with non-fractured women. DeFRA showed the best discriminative power among all fracture risk predictor tools (area under curves: DeFra: 0.89; adjusted FRAX: 0.80; non-adjusted FRAX: 0.73). In summary, all fracture risk assessment tools appeared to be effective in predicting bone fractures in T2DM postmenopausal women, with DeFRA showing a slightly better diagnostic accuracy.

  10. The Development and Validation of the Contextualized Assessment Tool for Risk and Protection Management (CAT-RPM)

    Science.gov (United States)

    Bower, Julie M.; Carroll, Annemaree; Ashman, Adrian

    2014-01-01

    Traditional resources for ascertaining risk and protection for disengaged youth are often unsuitable, due to the stamina and skill required to complete them. Many of these tools assess risk without considering participants' potential for personal growth. The present study outlines the development and initial validation of a tool titled the…

  11. A generic rabies risk assessment tool to support surveillance.

    Science.gov (United States)

    Ward, Michael P; Hernández-Jover, Marta

    2015-06-01

    The continued spread of rabies in Indonesia poses a risk to human and animal populations in the remaining free islands, as well as the neighbouring rabies-free countries of Timor Leste, Papua New Guinea and Australia. Here we describe the development of a generic risk assessment tool which can be used to rapidly determine the vulnerability of rabies-free islands, so that scarce resources can be targeted to surveillance activities and the sensitivity of surveillance systems increased. The tool was developed by integrating information on the historical spread of rabies, anthropological studies, and the opinions of local animal health experts. The resulting tool is based on eight critical parameters that can be estimated from the literature, expert opinion, observational studies and information generated from routine surveillance. In the case study presented, results generated by this tool were most sensitive to the probability that dogs are present on private and fishing boats and it was predicted that rabies-infection (one infected case) might occur in a rabies-free island (upper 95% prediction interval) with a volume of 1000 boats movements. With 25,000 boat movements, the median of the probability distribution would be equal to one infected case, with an upper 95% prediction interval of six infected cases. This tool could also be used at the national-level to guide control and eradication plans. An initial recommendation from this study is to develop a surveillance programme to determine the likelihood that boats transport dogs, for example by port surveillance or regularly conducted surveys of fisherman and passenger ferries. However, the illegal nature of dog transportation from rabies-infected to rabies-free islands is a challenge for developing such surveillance. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. [Safety Walkround as a risk assessment tool: the first Italian experience].

    Science.gov (United States)

    Levati, A; Amato, S; Adrario, E; De Flaviis, C; Delia, C; Milesi, S; Petrini, F; Bevilacqua, L

    2009-01-01

    In 2007 the Study Group "Clinical Risk Management" of the Italian Society of Anaesthesia and Intensive Care Unit (SIAARTI) performed a multicentric study in Intensive Care Unit (ICU) to assess the feasibility and efficacy of the Safety WalkRound (SWR) as a tool for the risk assessment. As the environment and organization of ICU are more complex than anaesthesia ones, mainly due to the severity of patients, high number of involved healthcare givers and different kinds of procedures, the Study Group decided that a check list is not fit for ICU and , after a careful review of the literature, chose to test the Safety WalkRound. in four Italian General ICUs. The SWR was born in 2003 when Frankel plans a structured interview of 15 questions (about 50% open) to collect operators' opinion about rate and type of errors, near misses, communication, problems regarding the report of adverse events and suggestions to increase patient safety. Consequently SWR is a tool of risk assessment alternative to the Incident Reporting which is marked by a diffuse underreporting of operators. Although the SWR is a new tool not validated in Italian language neither published in Italy on PubMed journals , the Study Group has decided that it might be fit for the organization of Italian Healthcare System. A back translation of the validated model of Joint Commission was provided and the translated version has been lightly changed to be employed in hospitals with and without Incident Reporting . The questions have been changed or introduced on the basis of the organization vulnerabilities detected with observational techniques or Focus Group. The interview performed in Italy contains 16 questions classified into five groups: a) error, b) error prevention, c) communication, teamwork and leadership, d) error discussion and e) relationship with patients and their families. The answers collected have been analyzed to detect the vulnerabilities in the organizations and specify the improvements to

  13. Implementation of a risk assessment tool based on a probabilistic safety assessment developed for radiotherapy practices

    International Nuclear Information System (INIS)

    Paz, A.; Godinez, V.; Lopez, R.

    2010-10-01

    The present work describes the implementation process and main results of the risk assessment to the radiotherapy practices with Linear Accelerators (Linac), with cobalt 60, and with brachytherapy. These evaluations were made throughout the risk assessment tool for radiotherapy practices SEVRRA (risk evaluation system for radiotherapy), developed at the Mexican National Commission in Nuclear Safety and Safeguards derived from the outcome obtained with the Probabilistic Safety Analysis developed at the Ibero-American Regulators Forum for these radiotherapy facilities. The methodology used is supported by risk matrices method, a mathematical tool that estimates the risk to the patient, radiation workers and public from mechanical failures, mis calibration of the devices, human mistakes, and so. The initiating events are defined as those undesirable events that, together with other failures, can produce a delivery of an over-dose or an under-dose of the medical prescribed dose, to the planned target volume, or a significant dose to non prescribed human organs. Initiating events frequency and reducer of its frequency (actions intended to avoid the accident) are estimated as well as robustness of barriers to those actions, such as mechanical switches, which detect and prevent the accident from occurring. The spectrum of the consequences is parameterized, and the actions performed to reduce the consequences are identified. Based on this analysis, a software tool was developed in order to simplify the evaluations to radiotherapy installations and it has been applied as a first step forward to some Mexican installations, as part of a national implementation process, the final goal is evaluation of all Mexican facilities in the near future. The main target and benefits of the SEVRRA implementation are presented in this paper. (Author)

  14. Implementation of a risk assessment tool based on a probabilistic safety assessment developed for radiotherapy practices

    Energy Technology Data Exchange (ETDEWEB)

    Paz, A.; Godinez, V.; Lopez, R., E-mail: abpaz@cnsns.gob.m [Comision Nacional de Seguridad Nuclear y Salvaguardias, Dr. Barragan No. 779, Col. Narvarte, 03020 Mexico D. F. (Mexico)

    2010-10-15

    The present work describes the implementation process and main results of the risk assessment to the radiotherapy practices with Linear Accelerators (Linac), with cobalt 60, and with brachytherapy. These evaluations were made throughout the risk assessment tool for radiotherapy practices SEVRRA (risk evaluation system for radiotherapy), developed at the Mexican National Commission in Nuclear Safety and Safeguards derived from the outcome obtained with the Probabilistic Safety Analysis developed at the Ibero-American Regulators Forum for these radiotherapy facilities. The methodology used is supported by risk matrices method, a mathematical tool that estimates the risk to the patient, radiation workers and public from mechanical failures, mis calibration of the devices, human mistakes, and so. The initiating events are defined as those undesirable events that, together with other failures, can produce a delivery of an over-dose or an under-dose of the medical prescribed dose, to the planned target volume, or a significant dose to non prescribed human organs. Initiating events frequency and reducer of its frequency (actions intended to avoid the accident) are estimated as well as robustness of barriers to those actions, such as mechanical switches, which detect and prevent the accident from occurring. The spectrum of the consequences is parameterized, and the actions performed to reduce the consequences are identified. Based on this analysis, a software tool was developed in order to simplify the evaluations to radiotherapy installations and it has been applied as a first step forward to some Mexican installations, as part of a national implementation process, the final goal is evaluation of all Mexican facilities in the near future. The main target and benefits of the SEVRRA implementation are presented in this paper. (Author)

  15. The Pink Underside: The Commercialization of Medical Risk Assessment and Decision-Making Tools for Hereditary Breast Cancer Risk.

    Science.gov (United States)

    Hesse-Biber, Sharlene; Flynn, Bailey; Farrelly, Keeva

    2018-04-01

    The growth of the Internet since the millennium has opened up a myriad of opportunities for education, particularly in medicine. Although those looking for health care information used to have to turn to a face-to-face doctor's visit, an immense library of medical advice is now available at their fingertips. The BRCA genetic predispositions (mutations of the BRCA1 and BRCA2 breast cancer genes) which expose men and women to greater risk of breast, ovarian, and other cancers can be researched extensively online. Several nonprofit organizations now offer online risk assessment and decision-making tools meant to supplement conversation with medical professionals, which in actuality are quickly replacing it. We argue here through a critical qualitative template analysis of several such tools that the discursive frameworks utilized are prone to fearmongering, commercialization, and questionable validity. Left unchecked, these assessment tools could do more harm than good in driving young women especially to take unnecessary extreme surgical action.

  16. Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

    Science.gov (United States)

    Martinez, Maria Carmen; Iwamoto, Viviane Ernesto; Latorre, Maria do Rosário Dias de Oliveira; Noronha, Adriana Moreira; Oliveira, Ana Paula de Sousa; Cardoso, Carlos Eduardo Alves; Marques, Ifigenia Augusta Braga; Vendramim, Patrícia; Lopes, Paula Cristina; Sant'Ana, Thais Helena Saes de

    2016-08-29

    to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil. the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index. Nurses tested the tool. the scale's translated version went through two evaluation rounds by the judges, based on which, the items with unsatisfactory performance were changed. The content validity index for the items was ≥80.0% and the global index 97.1%. The experimental application showed the scale is user-friendly. the scale presents valid content for the assessment of fall risk and risk of fall-related injuries and is easy to use, with the potential to contribute to the proper identification of risks and the establishment of care actions. realizar a adaptação transcultural para uso no Brasil e a avaliação da validade de conteúdo da Johns Hopkins Fall Risk Assessment Tool para avaliação de risco de quedas e de danos por quedas em pacientes adultos hospitalizados. adaptação transcultural consistiu na tradução da escala para a língua portuguesa (Brasil), retrotradução para a língua de origem, versão de consenso e análise da equivalência transcultural por um comitê de especialistas. A avaliação do conteúdo foi realizada por meio de um comitê de juízes, finalizando com o cálculo do índice de validade de conteúdo dos itens e da escala. Foi realizada a aplicação experimental do instrumento por enfermeiros. a versão traduzida da escala passou por duas rodadas de avaliação pelos juízes, a partir das quais os itens com desempenho insatisfatório foram modificados

  17. Suicide Risk Screening Tools and the Youth Population.

    Science.gov (United States)

    Patterson, Sharon

    2016-08-01

    The use of suicide risk screening tools is a critical component of a comprehensive approach to suicide risk assessment. Since nurses frequently spend more time with patients than any other healthcare professional, they are in key positions to detect and prevent suicidal behavior in youth. To inform nurses about suicide risk screening tools for the youth population. Suicide risk screening tools are research-based standardized instruments that are used to identify people who may be at risk for suicide. A literature search was performed using the Athabasca University Library Resource, the databases of the Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, and Google Scholar. Nurses are cautioned to utilize suicide risk screening tools as only part of the suicide risk assessment in youth populations and avoid the danger of relying on tools that may result in a blind application of evidence to the detriment of clinical experience and judgement. © 2016 Wiley Periodicals, Inc.

  18. Assessment of the risk of African swine fever introduction into Finland using NORA-a rapid tool for semiquantitative assessment of the risk.

    Science.gov (United States)

    Kyyrö, J; Sahlström, L; Lyytikäinen, T

    2017-12-01

    The NORA rapid risk assessment tool was developed for situations where there is a change in the disease status of easily transmissible animal diseases in neighbouring countries or in countries with significant interactions with Finland. The goal was to develop a tool that is quick to use and will provide consistent results to support risk management decisions. The model contains 63 questions that define the potential for entry and exposure by nine different pathways. The magnitude of the consequences is defined by 23 statements. The weight of different pathways is defined according to the properties of the assessed disease. The model was built as an Excel spreadsheet and is intended for use by animal health control administrators. As an outcome, the model gives the possible pathways of disease entry into the country, an overall approximation for the probability of entry and the subsequent exposure, an overall estimate for the consequences and a combined overall risk estimate (probability multiplied by magnitude of consequences). Model validity was assessed by expert panels. Outside Africa, African swine fever is currently established in Russia and Sardinia. In addition, there have been cases in both wild boar and domestic pigs in Latvia, Lithuania, Poland and Estonia. Finland has frequent contacts with Russia and Estonia, especially through passengers. The risk of African swine fever (ASF) introduction into Finland was tested with NORA for the situation in December 2015, when ASF was endemic in many parts of Russia, Africa and Sardinia and was present in Baltic countries and in Poland. African swine fever was assessed to have a high probability of entry into Finland, with high consequences and therefore a high overall risk. © 2017 Blackwell Verlag GmbH.

  19. State of the art of contaminated site management in The Netherlands: Policy framework and risk assessment tools

    International Nuclear Information System (INIS)

    Swartjes, F.A.; Rutgers, M.; Lijzen, J.P.A.; Janssen, P.J.C.M.; Otte, P.F.; Wintersen, A.; Brand, E.; Posthuma, L.

    2012-01-01

    This paper presents the policy framework of contaminated site management in The Netherlands and the corresponding risk assessment tools, including innovations that have taken place since an overview was published in 1999. According to the Dutch Soil Protection Act assessment framework, soils are subdivided into three quality classes: clean, slightly contaminated and seriously contaminated. Historic cases of slightly contaminated soils are managed in a sustainable way by re-use of soil material within a region on the basis of risk-based and land use specific Maximal Values and Background Values. In case of serious soil contamination remediation is in principle necessary and the urgency of remediation has to be determined based on site-specific risks for human health, the ecosystem and groundwater. The major risk assessment tools in The Netherlands are the CSOIL exposure model (human health risks and food safety), Species Sensitivity Distributions and the Soil Quality Triad (ecological risks), along with a procedure to assess the risks due to contaminant spreading to and in the groundwater. Following the principle ‘simple if possible, complex when necessary’, tiered approaches are used. Contaminated site practices are supported with web-based decision support systems. - Highlights: ► The Dutch Soil Protection Act distinguishes three quality classes: clean, slightly contaminated and seriously contaminated. ► Serious soil contamination in principle compels remediation and the determination of the urgency of remediation. ► The relevant protection targets in The Netherlands are human health, ecosystems, groundwater and food safety. ► Important risk assessment tools are the CSOIL and VOLASOIL exposure models, SSDs and the TRIAD approach. ► Under the principle ‘simple when possible, complex when necessary’ tiered approaches are used.

  20. Tools of an assessment of the budgetary risks of the Udmurt Republic

    Directory of Open Access Journals (Sweden)

    Zhelnova Christina Vladimirovna

    2015-05-01

    Full Text Available In the present article the essence of the budgetary risk and a problem of management of the budgetary process is investigated. The tools of definition of the budgetary risks on the basis of execution of the income and expenses of the budget are considered. Calculation of the budgetary risks on the example of the consolidated budget of the Udmurt Republic for 2013-2014 is presented., which didn't reveal cases of high risk level of budget performance according to the income and expenses. The received results of an assessment will be important and useful to bodies executive and legislature, including promoting increase of a level of quality of the budgetary management.

  1. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

    Science.gov (United States)

    Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

    2018-01-01

    Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

  2. The Development of a Plant Risk Evaluation (PRE) Tool for Assessing the Invasive Potential of Ornamental Plants

    OpenAIRE

    Conser, Christiana; Seebacher, Lizbeth; Fujino, David W.; Reichard, Sarah; DiTomaso, Joseph M.

    2015-01-01

    Weed Risk Assessment (WRA) methods for evaluating invasiveness in plants have evolved rapidly in the last two decades. Many WRA tools exist, but none were specifically designed to screen ornamental plants prior to being released into the environment. To be accepted as a tool to evaluate ornamental plants for the nursery industry, it is critical that a WRA tool accurately predicts non-invasiveness without falsely categorizing them as invasive. We developed a new Plant Risk Evaluation (PRE) too...

  3. Molecular profiling--a tool for addressing emerging gaps in the comparative risk assessment of GMOs.

    Science.gov (United States)

    Heinemann, Jack A; Kurenbach, Brigitta; Quist, David

    2011-10-01

    Assessing the risks of genetically modified organisms (GMOs) is required by both international agreement and domestic legislation. Many view the use of the "omics" tools for profiling classes of molecules as useful in risk assessment, but no consensus has formed on the need or value of these techniques for assessing the risks of all GMOs. In this and many other cases, experts support case-by-case use of molecular profiling techniques for risk assessment. We review the latest research on the applicability and usefulness of molecular profiling techniques for GMO risk assessment. As more and more kinds of GMOs and traits are developed, broader use of molecular profiling in a risk assessment may be required to supplement the comparative approach to risk assessment. The literature-based discussions on the use of profiling appear to have settled on two findings: 1. profiling techniques are reliable and relevant, at least no less so than other techniques used in risk assessment; and 2. although not required routinely, regulators should be aware of when they are needed. The dismissal of routine molecular profiling may be confusing to regulators who then lack guidance on when molecular profiling might be worthwhile. Molecular profiling is an important way to increase confidence in risk assessments if the profiles are properly designed to address relevant risks and are applied at the correct stage of the assessment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Validation of three tools for identifying painful new osteoporotic vertebral fractures in older Chinese men: bone mineral density, Osteoporosis Self-Assessment Tool for Asians, and fracture risk assessment tool.

    Science.gov (United States)

    Lin, JiSheng; Yang, Yong; Fei, Qi; Zhang, XiaoDong; Ma, Zhao; Wang, Qi; Li, JinJun; Li, Dong; Meng, Qian; Wang, BingQiang

    2016-01-01

    This cross-sectional study compared three tools for predicting painful new osteoporotic vertebral fractures (PNOVFs) in older Chinese men: bone mineral density (BMD), the Osteoporosis Self-Assessment Tool for Asians (OSTA), and the World Health Organization fracture risk assessment tool (FRAX) (without BMD). Men aged ≥50 years were apportioned to a group for men with fractures who had undergone percutaneous vertebroplasty (n=111), or a control group of healthy men (n=385). Fractures were verified on X-ray and magnetic resonance imaging. BMD T-scores were determined by dual energy X-ray absorptiometry. Diagnosis of osteoporosis was determined by a BMD T-score of ≤2.5 standard deviations below the average for a young adult at peak bone density at the femoral neck, total hip, or L1-L4. Demographic and clinical risk factor data were self-reported through a questionnaire. BMD, OSTA, and FRAX scores were assessed for identifying PNOVFs via receiver-operating characteristic (ROC) curves. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Between the men with fractures and the control group, there were significant differences in BMD T-scores (at femoral neck, total hip, and L1-L4), and OSTA and FRAX scores. In those with fractures, only 53.15% satisfied the criteria for osteoporosis. Compared to BMD or OSTA, the FRAX score had the best predictive value for PNOVFs: the AUC of the FRAX score (cutoff =2.9%) was 0.738, and the sensitivity and specificity were 82% and 62%, respectively. FRAX may be a valuable tool for identifying PNOVFs in older Chinese men.

  5. Applicability of the Existing CVD Risk Assessment Tools to Type II Diabetics in Oman: A Review

    Directory of Open Access Journals (Sweden)

    Abdulhakeem Al-Rawahi

    2015-09-01

    Full Text Available Patients with type II diabetes (T2DM have an elevated risk for cardiovascular disease (CVD, and it is considered to be a leading cause of morbidity and premature mortality in these patients. Many traditional risk factors such as age, male sex, hypertension, dyslipidemia, glycemic control, diabetes duration, renal dysfunction, obesity, and smoking have been studied and identified as independent factors for CVD. Quantifying the risk of CVD among diabetics using the common risk factors in order to plan the treatment and preventive measures is important in the management of these patients as recommended by many clinical guidelines. Therefore, several risk assessment tools have been developed in different parts of the world for this purpose. These include the tools that have been developed for general populations and considered T2DM as a risk factor, and the tools that have been developed for T2DM populations specifically. However, due to the differences in sociodemographic factors and lifestyle patterns, as well as the differences in the distribution of various CVD risk factors in different diabetic populations, the external applicability of these tools on different populations is questionable. This review aims to address the applicability of the existing CVD risk models to the Omani diabetic population.

  6. Risk assessment and cost-benefit techniques as management tools for oil spill prevention

    International Nuclear Information System (INIS)

    Diller, S.

    1998-01-01

    In the last 15 years, and especially after remarkable large technological accidents like Bhopal, San Juanico, Tacoa, Piper Alpha, Exxon Valdez, Sea Empress, etc, the risk assessment tools have become a must for design engineers and also have been growing popular since more reliable oil spill accident analysis data has been gathered in the last ten years. On the other hand the large investments that have been necessary to execute in order to adequate and improve old facilities, equipment, etc., and the total loss control enhancements in new projects, have created some concern on how safe is safe and how much money is it necessary to spend in order to be sufficiently preventative without getting into financial trouble and being technologically sound according to the growing global concern about environmental issues. Concepts are presented in risk prevention and oil spill risk assessment, and examples are developed in order to understand the link between different oil spill risk prevention options and the management finance decision making process. (author)

  7. Risk determination after an acute myocardial infarction: review of 3 clinical risk prediction tools.

    Science.gov (United States)

    Scruth, Elizabeth Ann; Page, Karen; Cheng, Eugene; Campbell, Michelle; Worrall-Carter, Linda

    2012-01-01

    The objective of the study was to provide comprehensive information for the clinical nurse specialist (CNS) on commonly used clinical prediction (risk assessment) tools used to estimate risk of a secondary cardiac or noncardiac event and mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). The evolution and widespread adoption of primary PCI represent major advances in the treatment of acute myocardial infarction, specifically STEMI. The American College of Cardiology and the American Heart Association have recommended early risk stratification for patients presenting with acute coronary syndromes using several clinical risk scores to identify patients' mortality and secondary event risk after PCI. Clinical nurse specialists are integral to any performance improvement strategy. Their knowledge and understandings of clinical prediction tools will be essential in carrying out important assessment, identifying and managing risk in patients who have sustained a STEMI, and enhancing discharge education including counseling on medications and lifestyle changes. Over the past 2 decades, risk scores have been developed from clinical trials to facilitate risk assessment. There are several risk scores that can be used to determine in-hospital and short-term survival. This article critiques the most common tools: the Thrombolytic in Myocardial Infarction risk score, the Global Registry of Acute Coronary Events risk score, and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications risk score. The importance of incorporating risk screening assessment tools (that are important for clinical prediction models) to guide therapeutic management of patients cannot be underestimated. The ability to forecast secondary risk after a STEMI will assist in determining which patients would require the most aggressive level of treatment and monitoring postintervention including

  8. Does the Risk Assessment and Prediction Tool Predict Discharge Disposition After Joint Replacement?

    DEFF Research Database (Denmark)

    Hansen, Viktor J.; Gromov, Kirill; Lebrun, Lauren M

    2015-01-01

    BACKGROUND: Payers of health services and policymakers place a major focus on cost containment in health care. Studies have shown that early planning of discharge is essential in reducing length of stay and achieving financial benefit; tools that can help predict discharge disposition would...... populations is unknown. A low RAPT score is reported to indicate a high risk of needing any form of inpatient rehabilitation after TJA, including short-term nursing facilities. QUESTIONS/PURPOSES: This study attempts (1) to assess predictive accuracy of the RAPT on US patients undergoing total hip and knee....... Based on our findings, the risk categories in our populations should be high risk intermediate risk 7 to 10, and low risk > 10. CONCLUSIONS: The RAPT accurately predicted discharge disposition for high- and low-risk patients in our cohort. Based on our data, intermediate-risk patients should...

  9. Evaluation of the validity of osteoporosis and fracture risk assessment tools (IOF One Minute Test, SCORE, and FRAX) in postmenopausal Palestinian women.

    Science.gov (United States)

    Kharroubi, Akram; Saba, Elias; Ghannam, Ibrahim; Darwish, Hisham

    2017-12-01

    The need for simple self-assessment tools is necessary to predict women at high risk for developing osteoporosis. In this study, tools like the IOF One Minute Test, Fracture Risk Assessment Tool (FRAX), and Simple Calculated Osteoporosis Risk Estimation (SCORE) were found to be valid for Palestinian women. The threshold for predicting women at risk for each tool was estimated. The purpose of this study is to evaluate the validity of the updated IOF (International Osteoporosis Foundation) One Minute Osteoporosis Risk Assessment Test, FRAX, SCORE as well as age alone to detect the risk of developing osteoporosis in postmenopausal Palestinian women. Three hundred eighty-two women 45 years and older were recruited including 131 women with osteoporosis and 251 controls following bone mineral density (BMD) measurement, 287 completed questionnaires of the different risk assessment tools. Receiver operating characteristic (ROC) curves were evaluated for each tool using bone BMD as the gold standard for osteoporosis. The area under the ROC curve (AUC) was the highest for FRAX calculated with BMD for predicting hip fractures (0.897) followed by FRAX for major fractures (0.826) with cut-off values ˃1.5 and ˃7.8%, respectively. The IOF One Minute Test AUC (0.629) was the lowest compared to other tested tools but with sufficient accuracy for predicting the risk of developing osteoporosis with a cut-off value ˃4 total yes questions out of 18. SCORE test and age alone were also as good predictors of risk for developing osteoporosis. According to the ROC curve for age, women ≥64 years had a higher risk of developing osteoporosis. Higher percentage of women with low BMD (T-score ≤-1.5) or osteoporosis (T-score ≤-2.5) was found among women who were not exposed to the sun, who had menopause before the age of 45 years, or had lower body mass index (BMI) compared to controls. Women who often fall had lower BMI and approximately 27% of the recruited postmenopausal

  10. Exploring probabilistic tools for the development of a platform for Quantitative Risk Assessment (QRA) of hydro-meteorological hazards in Europe

    Science.gov (United States)

    Zumpano, V.; Hussin, H. Y.; Breinl, K.

    2012-04-01

    Mass-movements and floods are hydro-meteorological hazards that can have catastrophic effects on communities living in mountainous areas prone to these disastrous events. Environmental, climate and socio-economic changes are expected to affect the tempo-spatial patterns of hydro-meteorological hazards and associated risks in Europe. These changes and their effects on the occurrence of future hazards need to be analyzed and modeled using probabilistic hazard and risk assessment methods in order to assist stakeholders in disaster management strategies and policy making. Quantitative Risk Assessment (QRA) using probabilistic methods can further calculate damage and losses to multi-hazards and determine the uncertainties related to all the probabilistic components of the hazard and the vulnerability of the elements at risk. Therefore, in order to develop an effective platform that can quantitatively calculate the risk of mass-movements and floods in several European test sites, an extensive inventory and analysis has been carried out of the available tools and software related to the probabilistic risk assessment of single and multi-hazards. The tools have been reviewed based on whether they are open source and freely available, their required input data, the availability and type of hazard and vulnerability modules, transparency of methods used, their validation and calibration techniques, the inclusion of uncertainties and their state of the art. The analysis also specially focused on the applicability of the tools to European study areas. The findings showed that assumptions and simplifications are made when assessing and quantifying the hazards. The interaction between multiple hazards, like cascading effects are not assessed in most tools and some consider the hazard and vulnerability as qualitative components, rather than quantitative ones. This analysis of hazard and risk assessment tools and software will give future developers and experts a better overview of

  11. FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

    Science.gov (United States)

    Cattelani, Luca; Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Becker, Clemens; Chesani, Federico; Chiari, Lorenzo

    2015-02-18

    About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. FRAT-up is based on the assumption that a subject's fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer

  12. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    Science.gov (United States)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  13. RESRAD for Radiological Risk Assessment. Comparison with EPA CERCLA Tools - PRG and DCC Calculators

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C. [Argonne National Lab. (ANL), Argonne, IL (United States); Cheng, J. -J. [Argonne National Lab. (ANL), Argonne, IL (United States); Kamboj, S. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-07-01

    The purpose of this report is two-fold. First, the risk assessment methodology for both RESRAD and the EPA’s tools is reviewed. This includes a review of the EPA’s justification for 2 using a dose-to-risk conversion factor to reduce the dose-based protective ARAR from 15 to 12 mrem/yr. Second, the models and parameters used in RESRAD and the EPA PRG and DCC Calculators are compared in detail, and the results are summarized and discussed. Although there are suites of software tools in the RESRAD family of codes and the EPA Calculators, the scope of this report is limited to the RESRAD (onsite) code for soil contamination and the EPA’s PRG and DCC Calculators also for soil contamination.

  14. Modelling tools for assessing bioremediation performance and risk of chlorinated solvents in clay tills

    DEFF Research Database (Denmark)

    Chambon, Julie Claire Claudia

    design are challenging. This thesis presents the development and application of analytical and numerical models to improve our understanding of transport and degradation processes in clay tills, which is crucial for assessing bioremediation performance and risk to groundwater. A set of modelling tools...... to groundwater and bioremediation performance in low-permeability media....

  15. Development of caries risk assessment tool for Iranian preschoolers: A primary validation study

    Directory of Open Access Journals (Sweden)

    Shiva Mortazavi

    2017-01-01

    Full Text Available Background: The aim of the present study was to develop a dental caries risk assessment tool for Iranian preschoolers. Methods: In a validation and cross-sectional study, a random sample of 150 preschool children was involved. This study was conducted in three phases: questionnaire design (expert panel and peer evaluation, questionnaire testing (pilot evaluation and field testing, and validation study. The initial assessments include interview, dental examination, and laboratory investigations. Validity and reliability indices, content validity index (CVI, content validity ratio (CVR, impact score, and test-retest and Cronbach's alpha were measured. Decayed, missing, filled teeth (dmft scores were calculated according to the WHO guidelines. Results: The Iranian version of caries risk assessment (CRA questionnaire contained 17 items. Cronbach's alpha coefficient (0.86 indicated a suitable internal consistency. The mean scores for the CVI and the CVR were 0.87 and 0.78, respectively. The prevalence rate of dental caries in the study group was 69.3%, and the mean dmft was 4.57 (range 0–19. Conclusions: The Persian version of CRA questionnaire was adapted to the Iranian population. The findings demonstrated overall acceptable validity and also reliability in the application of test-retest. The results of the present study provide initial evidence that the designed CRA form could be a useful tool for CRA in the Iranian preschoolers.

  16. Sudden Cardiac Arrest (SCA) Risk Assessment

    Science.gov (United States)

    ... HRS Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... people of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

  17. Development of methodological tools for assessing enterprise credit worthiness taking into account off-balance sheet risks

    Directory of Open Access Journals (Sweden)

    N.G. Vygovska

    2017-12-01

    Full Text Available The article is devoted to the improvement of methodical tools for assessing the credit worthiness of enterprises’ legal entities taking into account the impact of off-balance-sheet risks on the definite integral class of a debtor-borrower. The authors substantiate that the non-accounting of off-balance sheet commitments in assessing the borrower’s credit worthiness leads to false managerial decisions on granting a loan and increasing the level of credit risk of the bank. The purpose of the article is to study the questions of methodical tools for assessing the credit worthiness of economic entities and develop directions for improving its analytical support taking into account the impact of off-balance-sheet risks. The object of the research is the analytical support for assessing the credit worthiness of a borrower-legal entity taking into account off-balance-sheet risks. The authors put forward and proved the hypothesis that, acting as the guarantor or principal of another enterprise, the assessment of the borrower's credit worthiness undergoes significant changes. The coefficient analysis of the methodological provision for assessing the borrower's credit rating by the current method number 351 is carried out, as a result of which the influence on the integral index and the debtor class is proved. When determining the reliability class of the borrower, the most affected are solvency ratios (especially for short-term loans and financial sustainability (for long-term loans to the borrower. The current methodology for defining these indicators does not take into account the effect of off-balance sheet risks, which is due to the use of financial reporting data, which does not include data on off-balance sheet instruments. The methodological support of credit-worthiness analysis is proposed, taking into account the impact of off-balance sheet risks on it. The prospects for further research should be formulated in the direction of improving the

  18. Climate risk screening tools and their application: A guide to the guidance

    Energy Technology Data Exchange (ETDEWEB)

    Traerup, S.; Olhoff, A.

    2011-07-01

    Climate risk screening is an integral part of efforts to ascertain current and future vulnerabilities and risks related to climate change. It is a prerequisite for identifying and designing adaptation measures, and an important element in the process of integrating, or mainstreaming, climate change adaptation into development project, planning and policy processes. There is an increasing demand and attention among national stakeholders in developing countries to take into account potential implications of climate variability and change for planning and prioritizing of development strategies and activities. Subsequently, there is a need for user friendly guidance on climate risk screening tools and their potentials for application that targets developing country stakeholders. This need is amplified by the sheer volume of climate change mainstreaming guidance documents and risk screening and assessment tools available and currently under development. Against this background, this paper sets out to provide potential users in developing countries, including project and programme developers and managers, with an informational entry point to climate risk screening tools. The emphasis in this report is on providing: 1) An overview of available climate risk screening and assessment tools along with indications of the tools available and relevant for specific purposes and contexts (Section 3). 2) Examples of application of climate risk screening and assessment tools along with links to further information (Section 4). Before turning to the respective sections on available climate risk screening tools and examples of their application, a delimitation of the tools included in this paper is included in Section 2. This section also provides a brief overview of how climate screening and related tools fit into decision making steps at various planning and decision making levels in conjunction with an outline of overall considerations to make when choosing a tool. The paper is

  19. Risk analysis tools for force protection and infrastructure/asset protection

    International Nuclear Information System (INIS)

    Jaeger, C.D.; Duggan, R.A.; Paulus, W.K.

    1998-01-01

    The Security Systems and Technology Center at Sandia National Laboratories has for many years been involved in the development and use of vulnerability assessment and risk analysis tools. In particular, two of these tools, ASSESS and JTS, have been used extensively for Department of Energy facilities. Increasingly, Sandia has been called upon to evaluate critical assets and infrastructures, support DoD force protection activities and assist in the protection of facilities from terrorist attacks using weapons of mass destruction. Sandia is involved in many different activities related to security and force protection and is expanding its capabilities by developing new risk analysis tools to support a variety of users. One tool, in the very early stages of development, is EnSURE, Engineered Surety Using the Risk Equation. EnSURE addresses all of the risk equation and integrates the many components into a single, tool-supported process to help determine the most cost-effective ways to reduce risk. This paper will briefly discuss some of these risk analysis tools within the EnSURE framework

  20. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  1. A framework for evaluating innovative statistical and risk assessment tools to solve environment restoration problems

    International Nuclear Information System (INIS)

    Hassig, N.L.; Gilbert, R.O.; Pulsipher, B.A.

    1991-09-01

    Environmental restoration activities at the US Department of Energy (DOE) Hanford site face complex issues due to history of varied past contaminant disposal practices. Data collection and analysis required for site characterization, pathway modeling, and remediation selection decisions must deal with inherent uncertainties and unique problems associated with the restoration. A framework for working through the statistical aspects of the site characterization and remediation selection problems is needed. This framework would facilitate the selection of appropriate statistical tools for solving unique aspects of the environmental restoration problem. This paper presents a framework for selecting appropriate statistical and risk assessment methods. The following points will be made: (1) pathway modelers and risk assessors often recognize that ''some type'' of statistical methods are required but don't work with statisticians on tools development in the early planning phases of the project; (2) statistical tools selection and development are problem-specific and often site-specific, further indicating a need for up-front involvement of statisticians; and (3) the right tool, applied in the right way can minimize sampling costs, get as much information as possible out of the data that does exist, provide consistency and defensibility for the results, and given structure and quantitative measures to decision risks and uncertainties

  2. Mini-Nutritional Assessment, Malnutrition Universal Screening Tool, and Nutrition Risk Screening Tool for the Nutritional Evaluation of Older Nursing Home Residents.

    Science.gov (United States)

    Donini, Lorenzo M; Poggiogalle, Eleonora; Molfino, Alessio; Rosano, Aldo; Lenzi, Andrea; Rossi Fanelli, Filippo; Muscaritoli, Maurizio

    2016-10-01

    Malnutrition plays a major role in clinical and functional impairment in older adults. The use of validated, user-friendly and rapid screening tools for malnutrition in the elderly may improve the diagnosis and, possibly, the prognosis. The aim of this study was to assess the agreement between Mini-Nutritional Assessment (MNA), considered as a reference tool, MNA short form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and Nutrition Risk Screening (NRS-2002) in elderly institutionalized participants. Participants were enrolled among nursing home residents and underwent a multidimensional evaluation. Predictive value and survival analysis were performed to compare the nutritional classifications obtained from the different tools. A total of 246 participants (164 women, age: 82.3 ± 9 years, and 82 men, age: 76.5 ± 11 years) were enrolled. Based on MNA, 22.6% of females and 17% of males were classified as malnourished; 56.7% of women and 61% of men were at risk of malnutrition. Agreement between MNA and MUST or NRS-2002 was classified as "fair" (k = 0.270 and 0.291, respectively; P < .001), whereas the agreement between MNA and MNA-SF was classified as "moderate" (k = 0.588; P < .001). Because of the high percentage of false negative participants, MUST and NRS-2002 presented a low overall predictive value compared with MNA and MNA-SF. Clinical parameters were significantly different in false negative participants with MUST or NRS-2002 from true negative and true positive individuals using the reference tool. For all screening tools, there was a significant association between malnutrition and mortality. MNA showed the best predictive value for survival among well-nourished participants. Functional, psychological, and cognitive parameters, not considered in MUST and NRS-2002 tools, are probably more important risk factors for malnutrition than acute illness in geriatric long-term care inpatient settings and may account for the low predictive

  3. New Tools and Methods for Assessing Risk-Management Strategies

    National Research Council Canada - National Science Library

    Vendlinski, Terry P; Munro, Allen; Chung, Gregory K; De la Cruz, Girlie C; Pizzini, Quentin A; Bewley, William L; Stuart, Gale; Baker, Eva L

    2004-01-01

    .... The Decision Analysis Tool (DAT) allowed subjects to use Expected Value and Multi-attribute Utility Theories to evaluate the risks and benefits of various acquisition alternatives, and allowed us to monitor the process subjects used...

  4. Risk indicators as a tool for risk control

    International Nuclear Information System (INIS)

    Oien, K.

    2001-01-01

    This paper presents a general methodology for the establishment of risk indicators that can be used as a tool for risk control during operation of offshore petroleum installations. The risk indicators established are based on the platform specific quantitative risk analysis (QRA). The general methodology is evaluated against comparable approaches both in offshore and nuclear industry. There are two distinct features of this methodology. The first is that it is truly risk-based with the intention of covering the total risk picture. The second is that the identification of the risk factors contributing most to the total risk is based on realistic changes of each factor assessed by the platform personnel, not a theoretically assumed change. The set of risk indicators for one specific installation is presented along with test results

  5. Work-related stress risk assessment in Italy: the validation study of health safety and executive indicator tool.

    Science.gov (United States)

    Rondinone, Bruna Maria; Persechino, Benedetta; Castaldi, Tiziana; Valenti, Antonio; Ferrante, Pierpaolo; Ronchetti, Matteo; Iavicoli, Sergio

    2012-01-01

    In compliance with the Italian occupational health and safety regulatory framework, as provided by the Lgs. Decree 81/2008, the "work-related stress" risk assessment should follow the same principles as other risk assessments, in accordance with the European Agreement of 8 October 2004; therefore, validated and scientifically proven methodological tools are needed to conduct an adequate work-related stress risk assessment. The UK's Health Safety and Executive (HSE) Indicator Tool (IT) is used for assessing the risk of work-related stress. The aim of this study is to test the factor structure of IT as a measure of work-related stress in a sample of Italian workers. Data collected from 65 Italian organizations (6378 workers) was used for a Confirmatory Factor Analysis (CFA) on the 35-item seven-factor model. The results showed acceptable fit to the data (CFI .90; TLI .89, RMSEA .045). A second CFA was done to test a 35-item six-factor model (CFI .89, TLI .87, RMSEA .047). Both models were tested after removing six items (factor loadings less than .50.), resulting in a 29-item model. Here again, there was an acceptable fit to the data (29-item seven-factor model: CFI .93, TLI .91, RMSEA .044; 29-item six-factor model: CFI .92, TLI .90, RMSEA .046). These findings show that the HSE model satisfactorily adapts to use in a sample of Italian workers. One of the most important innovations introduced in the assessment of work-related stress with the HSE IT is the global approach for identifying work-related stress risk factors, aimed at establishing the best strategy from the viewpoints of prevention officers and also of workers.

  6. Prevention of MSD by means of ergonomic risk assessment (tools) in all phases of the vehicle development process.

    Science.gov (United States)

    Karlheinz, Schaub; Michaela, Kugler; Max, Bierwirth; Andrea, Sinn-Behrendt; Ralph, Bruder

    2012-01-01

    In industrialized countries musculoskeletal disorders (MSD) play an import role and are often responsible for almost one third of the total sick leave. The changes in the demographic profiles, i.e. aging work forces might even worsen this situation in the future. For a highly productive and sustainable use of human resources in production systems, ergonomics offers high potentials. In the recent years the authors have developed several ergonomic risk assessment tools, especially for the use in automotive industries. These methods may be used during the planning phases in the Tech Centers as well as during the production phase at shop floor level. The tools might also be used for a standardized communication in between the Tech Center and the plants to improve the effects of "lessons learned" for the design and layout of workstations and processes and the optimization of vehicle components. This paper describes suitable risk assessment tools as well as the integration of these tools into the vehicle development process. It introduces a comprehensive management approach for the integration of ergonomics into the management of production systems.

  7. Systematic Review: Concept and Tool Development with Application in the Integrated Risk Information System (IRIS) Assessment Process

    Science.gov (United States)

    Systematic Review: Concept and tool development with application to the National Toxicology Program (NTP) and the Integrated Risk Information System (IRIS) Assessment Processes. There is growing interest within the environmental health community to incorporate systematic review m...

  8. Probabilistic Flood Defence Assessment Tools

    Directory of Open Access Journals (Sweden)

    Slomp Robert

    2016-01-01

    Full Text Available The WTI2017 project is responsible for the development of flood defence assessment tools for the 3600 km of Dutch primary flood defences, dikes/levees, dunes and hydraulic structures. These tools are necessary, as per January 1st 2017, the new flood risk management policy for the Netherlands will be implemented. Then, the seven decades old design practice (maximum water level methodology of 1958 and two decades old safety standards (and maximum hydraulic load methodology of 1996 will formally be replaced by a more risked based approach for the national policy in flood risk management. The formal flood defence assessment is an important part of this new policy, especially for flood defence managers, since national and regional funding for reinforcement is based on this assessment. This new flood defence policy is based on a maximum allowable probability of flooding. For this, a maximum acceptable individual risk was determined at 1/100 000 per year, this is the probability of life loss of for every protected area in the Netherlands. Safety standards of flood defences were then determined based on this acceptable individual risk. The results were adjusted based on information from cost -benefit analysis, societal risk and large scale societal disruption due to the failure of critical infrastructure e.g. power stations. The resulting riskbased flood defence safety standards range from a 300 to a 100 000 year return period for failure. Two policy studies, WV21 (Safety from floods in the 21st century and VNK-2 (the National Flood Risk in 2010 provided the essential information to determine the new risk based safety standards for flood defences. The WTI2017 project will provide the safety assessment tools based on these new standards and is thus an essential element for the implementation of this policy change. A major issue to be tackled was the development of user-friendly tools, as the new assessment is to be carried out by personnel of the

  9. Tools used by the insurance industry to assess risk from hydroclimatic extremes

    Science.gov (United States)

    Higgs, Stephanie; McMullan, Caroline

    2016-04-01

    Probabilistic catastrophe models are widely used within the insurance industry to assess and price the risk of natural hazards to individual residences through to portfolios of millions of properties. Over the relatively short period that catastrophe models have been available (almost 30 years), the insurance industry has built up a financial resilience to key natural hazards in certain areas (e.g. US tropical cyclone, European extra-tropical cyclone and flood). However, due the rapidly expanding global population and increase in wealth, together with uncertainties in the behaviour of meteorological phenomena introduced by climate change, the domain in which natural hazards impact society is growing. As a result, the insurance industry faces new challenges in assessing the risk and uncertainty from natural hazards. As a catastrophe modelling company, AIR Worldwide has a toolbox of options available to help the insurance industry assess extreme climatic events and their associated uncertainty. Here we discuss several of these tools: from helping analysts understand how uncertainty is inherently built in to probabilistic catastrophe models, to understanding alternative stochastic catalogs for tropical cyclone based on climate conditioning. Through the use of stochastic extreme disaster events such as those provided through AIR's catalogs or through the Lloyds of London marketplace (RDS's) to provide useful benchmarks for the loss probability exceedence and tail-at-risk metrics outputted from catastrophe models; to the visualisation of 1000+ year event footprints and hazard intensity maps. Ultimately the increased transparency of catastrophe models and flexibility of a software platform that allows for customisation of modelled and non-modelled risks will drive a greater understanding of extreme hydroclimatic events within the insurance industry.

  10. Pressure ulcers: effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial).

    Science.gov (United States)

    Webster, Joan; Coleman, Kerrie; Mudge, Alison; Marquart, Louise; Gardner, Glenn; Stankiewicz, Monica; Kirby, Julie; Vellacott, Catherine; Horton-Breshears, Margaret; McClymont, Alice

    2011-04-01

    To evaluate the effectiveness of two pressure-ulcer screening tools against clinical judgement in preventing pressure ulcers. A single blind randomised controlled trial. A large metropolitan tertiary hospital. 1231 patients admitted to internal medicine or oncology wards. Patients were excluded if their hospital stay was expected to be 2 days or less. Participants allocated to either a Waterlow (n=410) or Ramstadius (n=411) screening tool group or to a clinical judgement group (n=410) where no formal risk screening instrument was used. Incidence of hospital acquired pressure ulcers ascertained by regular direct observation. Use of any devices for the prevention of pressure ulcers, documentation of a pressure plan and any dietetic or specialist skin integrity review were recorded. On admission, 71 (5.8%) patients had an existing pressure ulcer. The incidence of hospital-acquired pressure ulcers was similar between groups (clinical judgement 28/410 (6.8%); Waterlow 31/411 (7.5%); Ramstadius 22/410 (5.4%), p=0.44). Significant associations with pressure injury in regression modelling included requiring a dietetic referral, being admitted from a location other than home and age over 65 years. The authors found no evidence to show that two common pressure-ulcer risk-assessment tools are superior to clinical judgement to prevent pressure injury. Resources associated with use of these tools might be better spent on careful daily skin inspection and improving management targetted at specific risks. The trial was registered with the Australian and New Zealand Clinicat Trials Registry (ACTRN 12608000541303).

  11. Draught risk index tool for building energy simulations

    DEFF Research Database (Denmark)

    Vorre, Mette Havgaard; Jensen, Rasmus Lund; Nielsen, Peter V.

    2014-01-01

    Flow elements combined with a building energy simulation tool can be used to indicate areas and periods when there is a risk of draught in a room. The study tests this concept by making a tool for post-processing of data from building energy simulations. The objective is to show indications...... of draught risk during a whole year, giving building designers a tool for the design stage of a building. The tool uses simple one-at-a-time calculations of flow elements and assesses the uncertainty of the result by counting the number of overlapping flow elements. The calculation time is low, making...... it usable in the early design stage to optimise the building layout. The tool provides an overview of the general draught pattern over a period, e.g. a whole year, and of how often there is a draught risk....

  12. Cognitive mapping tools: review and risk management needs.

    Science.gov (United States)

    Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

    2012-08-01

    Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.

  13. Assessment of health risks of policies

    International Nuclear Information System (INIS)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

    2014-01-01

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

  14. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  15. The fracture risk assessment tool (FRAX® score in subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Polovina Snežana

    2015-01-01

    Full Text Available Background/Aim. The Fracture Risk Assessment Tool (FRAX® score is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA. The aim of this cross-sectional study was to elucidate the ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA, thyroid stimulating hormone (TSH level, free thyroxine (fT4 level, thyroid peroxidase antibodies (TPOAb titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ± 7.83 years, body mass index (BMI 27.89 ± 3.46 kg/m2, menopause onset in 46.88 ± 10.21 years] and 51 matched euthyroid controls (age 59.69 ± 5.72 years, BMI 27.68 ± 4.66 kg/m2, menopause onset in 48.53 ± 4.58 years. The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX® score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX® score was significantly higher than in the controls (6.50 ± 1.58 vs 4.35 ± 1.56 respectively; p = 0.015. The FRAX® score for hip was also higher in the evaluated group than in the controls (1.33 ± 3.92 vs 0.50 ± 0.46 respectively; p = 0.022. There was no correlations between low TSH and fracture risk (p > 0.05. The ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001 is presented by the area under the curve (AUC plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX® scores and thus

  16. Development of a risk assessment tool for volcanic urban environments: RiskScape and the Auckland Volcanic Field, New Zealand

    Science.gov (United States)

    Deligne, N. I.; Leonard, G.; King, A.; Wilson, G.; Wilson, T.; Lindsay, J. M.

    2013-12-01

    Auckland city, home to a third of New Zealand's population, is situated on top of the Auckland Volcanic Field (AVF), which last erupted roughly 500 years ago. Since 2008, the Determining Volcanic Risk in Auckland (DEVORA) program has investigated the geologic context of the AVF, improved timing constraints of past eruptions, explored possible tempo-spatial-volume eruption trends, and identified likely styles and hazards of future eruptions. DEVORA is now moving into development of risk and societal models for Auckland. The volcanic module of RiskScape, a multi-hazard risk assessment tool developed by Crown Research Institutes GNS Science and NIWA, will be expanded and used to model risk and impact to the built environment and population caused by a future AVF eruption. RiskScape models casualties, damage and disruption caused by various hazards, the resulting reduced functionality of assets, and associated clean up costs. A strength of RiskScape is that the effect of various mitigation strategies can be explored by strengthening asset attributes and examining resulting changes in the output risk evaluation. We present our framework for building a volcano hazard exposure module for RiskScape along with our approach for assessing asset vulnerability through the development of fragility functions. We also present the framework for engagement with regional Auckland stakeholders, including representatives of local and regional governments and utility companies, to identify complementary needs to ensure that final risk products are relevant and useable by end users.

  17. Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study.

    Science.gov (United States)

    Raghu, Arvind; Praveen, Devarsetty; Peiris, David; Tarassenko, Lionel; Clifford, Gari

    2015-04-29

    The incidence of chronic diseases in low- and middle-income countries is rapidly increasing both in urban and rural regions. A major challenge for health systems globally is to develop innovative solutions for the prevention and control of these diseases. This paper discusses the development and pilot testing of SMARTHealth, a mobile-based, point-of-care Clinical Decision Support (CDS) tool to assess and manage cardiovascular disease (CVD) risk in resource-constrained settings. Through pilot testing, the preliminary acceptability, utility, and efficiency of the CDS tool was obtained. The CDS tool was part of an mHealth system comprising a mobile application that consisted of an evidence-based risk prediction and management algorithm, and a server-side electronic medical record system. Through an agile development process and user-centred design approach, key features of the mobile application that fitted the requirements of the end users and environment were obtained. A comprehensive analytics framework facilitated a data-driven approach to investigate four areas, namely, system efficiency, end-user variability, manual data entry errors, and usefulness of point-of-care management recommendations to the healthcare worker. A four-point Likert scale was used at the end of every risk assessment to gauge ease-of-use of the system. The system was field-tested with eleven village healthcare workers and three Primary Health Centre doctors, who screened a total of 292 adults aged 40 years and above. 34% of participants screened by health workers were identified by the CDS tool to be high CVD risk and referred to a doctor. In-depth analysis of user interactions found the CDS tool feasible for use and easily integrable into the workflow of healthcare workers. Following completion of the pilot, further technical enhancements were implemented to improve uptake of the mHealth platform. It will then be evaluated for effectiveness and cost-effectiveness in a cluster randomized

  18. New approaches for improving cardiovascular risk assessment.

    Science.gov (United States)

    Paredes, Simão; Rocha, Teresa; Mendes, Diana; Carvalho, Paulo; Henriques, Jorge; Morais, João; Ferreira, Jorge; Mendes, Miguel

    2016-01-01

    Clinical guidelines recommend the use of cardiovascular risk assessment tools (risk scores) to predict the risk of events such as cardiovascular death, since these scores can aid clinical decision-making and thereby reduce the social and economic costs of cardiovascular disease (CVD). However, despite their importance, risk scores present important weaknesses that can diminish their reliability in clinical contexts. This study presents a new framework, based on current risk assessment tools, that aims to minimize these limitations. Appropriate application and combination of existing knowledge is the main focus of this work. Two different methodologies are applied: (i) a combination scheme that enables data to be extracted and processed from various sources of information, including current risk assessment tools and the contributions of the physician; and (ii) a personalization scheme based on the creation of patient groups with the purpose of identifying the most suitable risk assessment tool to assess the risk of a specific patient. Validation was performed based on a real patient dataset of 460 patients at Santa Cruz Hospital, Lisbon, Portugal, diagnosed with non-ST-segment elevation acute coronary syndrome. Promising results were obtained with both approaches, which achieved sensitivity, specificity and geometric mean of 78.79%, 73.07% and 75.87%, and 75.69%, 69.79% and 72.71%, respectively. The proposed approaches present better performances than current CVD risk scores; however, additional datasets are required to back up these findings. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  19. Exposure Assessment Tools by Chemical Classes - Nanomaterials

    Science.gov (United States)

    EPA ExpoBox is a toolbox for exposure assessors. Its purpose is to provide a compendium of exposure assessment and risk characterization tools that will present comprehensive step-by-step guidance and links to relevant exposure assessment data bases

  20. A Screening Tool for Assessing Alcohol Use Risk among Medically Vulnerable Youth.

    Science.gov (United States)

    Levy, Sharon; Dedeoglu, Fatma; Gaffin, Jonathan M; Garvey, Katharine C; Harstad, Elizabeth; MacGinnitie, Andrew; Rufo, Paul A; Huang, Qian; Ziemnik, Rosemary E; Wisk, Lauren E; Weitzman, Elissa R

    2016-01-01

    In an effort to reduce barriers to screening for alcohol use in pediatric primary care, the National Institute on Alcoholism and Alcohol Abuse (NIAAA) developed a two-question Youth Alcohol Screening Tool derived from population-based survey data. It is unknown whether this screening tool, designed for use with general populations, accurately identifies risk among youth with chronic medical conditions (YCMC). This growing population, which comprises nearly one in four youth in the US, faces a unique constellation of drinking-related risks. To validate the NIAAA Youth Alcohol Screening Tool in a population of YCMC, we performed a cross-sectional validation study with a sample of 388 youth ages 9-18 years presenting for routine subspecialty care at a large children's hospital for type 1 diabetes, persistent asthma, cystic fibrosis, inflammatory bowel disease, or juvenile idiopathic arthritis. Participants self-administered the NIAAA Youth Alcohol Screening Tool and the Diagnostic Interview Schedule for Children as a criterion standard measure of alcohol use disorders (AUD). Receiver operating curve analysis was used to determine cut points for identifying youth at moderate and highest risk for an AUD. Nearly one third of participants (n = 118; 30.4%) reported alcohol use in the past year; 86.4% (106) of past year drinkers did not endorse any AUD criteria, 6.8% (n = 8) of drinkers endorsed a single criterion, and 6.8% of drinkers met criteria for an AUD. Using the NIAAA tool, optimal cut points found to identify youth at moderate and highest risk for an AUD were ≥ 6 and ≥12 drinking days in the past year, respectively. The NIAAA Youth Alcohol Screening Tool is highly efficient for detecting alcohol use and discriminating disordered use among YCMC. This brief screen appears feasible for use in specialty care to ascertain alcohol-related risk that may impact adversely on health status and disease management.

  1. Integral statistical eco-indices - effective complementary tool for assessment of ecological state of and ecological risks for water ecosystems

    International Nuclear Information System (INIS)

    Bashamkova, I

    2010-01-01

    Eco-indices are successfully used for assessment of the ecological state and risks of water reservoirs. They allow, already at early stages, to detect negative effects on water ecosystems caused by progressive anthropogenic impacts and widening of the spectrum of pollutants, and to quantitatively evaluate ecological risks and damage for water reservoirs. Implementing these modern tools to water quality assessment is one of the lines to make decisions concerning challenging environmental problems.

  2. Exposure Assessment Tools by Tiers and Types - Deterministic and Probabilistic Assessments

    Science.gov (United States)

    EPA ExpoBox is a toolbox for exposure assessors. Its purpose is to provide a compendium of exposure assessment and risk characterization tools that will present comprehensive step-by-step guidance and links to relevant exposure assessment data bases

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

    Energy Technology Data Exchange (ETDEWEB)

    Miles McQueen; Wayne Boyer; Mark Flynn; Sam Alessi

    2006-03-01

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

  4. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    Science.gov (United States)

    Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

  5. Development Methodology of a Cyber Security Risk Analysis and Assessment Tool for Digital I and C Systems in Nuclear Power Plant

    International Nuclear Information System (INIS)

    Cha, K. H.; Lee, C. K.; Song, J. G.; Lee, Y. J.; Kim, J. Y.; Lee, J. W.; Lee, D. Y.

    2011-01-01

    With the use of digital computers and communication networks the hot issues on cyber security were raised about 10 years ago. The scope of cyber security application has now been extended from the safety Instrumentation and Control (I and C) system to safety important systems, plant security system, and emergency preparedness system. Therefore, cyber security should be assessed and managed systematically throughout the development life cycle of I and C systems in order for their digital assets to be protected from cyber attacks. Fig. 1 shows the concept of a cyber security risk management of digital I and C systems in nuclear power plants (NPPs). A lot of cyber security risk assessment methods, techniques, and supported tools have been developed for Information Technology (IT) systems, but they have not been utilized widely for cyber security risk assessments of the digital I and C systems in NPPs. The main reason is a difference in goals between IT systems and nuclear I and C systems. Confidentiality is important in IT systems, but availability and integrity are important in nuclear I and C systems. Last year, it was started to develop a software tool to be specialized for the development process of nuclear I and C systems. This paper presents a development methodology of the Cyber Security Risk analysis and Assessment Tool (CSRAT) for the digital I and C systems in NPP

  6. Development Methodology of a Cyber Security Risk Analysis and Assessment Tool for Digital I and C Systems in Nuclear Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Cha, K. H.; Lee, C. K.; Song, J. G.; Lee, Y. J.; Kim, J. Y.; Lee, J. W.; Lee, D. Y. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-05-15

    With the use of digital computers and communication networks the hot issues on cyber security were raised about 10 years ago. The scope of cyber security application has now been extended from the safety Instrumentation and Control (I and C) system to safety important systems, plant security system, and emergency preparedness system. Therefore, cyber security should be assessed and managed systematically throughout the development life cycle of I and C systems in order for their digital assets to be protected from cyber attacks. Fig. 1 shows the concept of a cyber security risk management of digital I and C systems in nuclear power plants (NPPs). A lot of cyber security risk assessment methods, techniques, and supported tools have been developed for Information Technology (IT) systems, but they have not been utilized widely for cyber security risk assessments of the digital I and C systems in NPPs. The main reason is a difference in goals between IT systems and nuclear I and C systems. Confidentiality is important in IT systems, but availability and integrity are important in nuclear I and C systems. Last year, it was started to develop a software tool to be specialized for the development process of nuclear I and C systems. This paper presents a development methodology of the Cyber Security Risk analysis and Assessment Tool (CSRAT) for the digital I and C systems in NPP

  7. Taking the Risk Out of Risk Assessment

    Science.gov (United States)

    2005-01-01

    The ability to understand risks and have the right strategies in place when risky events occur is essential in the workplace. More and more organizations are being confronted with concerns over how to measure their risks or what kind of risks they can take when certain events transpire that could have a negative impact. NASA is one organization that faces these challenges on a daily basis, as effective risk management is critical to the success of its missions especially the Space Shuttle missions. On July 29, 1996, former NASA Administrator Daniel Goldin charged NASA s Office of Safety and Mission Assurance with developing a probabilistic risk assessment (PRA) tool to support decisions on the funding of Space Shuttle upgrades. When issuing the directive, Goldin said, "Since I came to NASA [in 1992], we've spent billions of dollars on Shuttle upgrades without knowing how much they improve safety. I want a tool to help base upgrade decisions on risk." Work on the PRA tool began immediately. The resulting prototype, the Quantitative Risk Assessment System (QRAS) Version 1.0, was jointly developed by NASA s Marshall Space Flight Center, its Office of Safety and Mission Assurance, and researchers at the University of Maryland. QRAS software automatically expands the reliability logic models of systems to evaluate the probability of highly detrimental outcomes occurring in complex systems that are subject to potential accident scenarios. Even in its earliest forms, QRAS was used to begin PRA modeling of the Space Shuttle. In parallel, the development of QRAS continued, with the goal of making it a world-class tool, one that was especially suited to NASA s unique needs. From the beginning, an important conceptual goal in the development of QRAS was for it to help bridge the gap between the professional risk analyst and the design engineer. In the past, only the professional risk analyst could perform, modify, use, and perhaps even adequately understand PRA. NASA wanted

  8. Systematic analysis of natural hazards along infrastructure networks using a GIS-tool for risk assessment

    Science.gov (United States)

    Baruffini, Mirko

    2010-05-01

    Due to the topographical conditions in Switzerland, the highways and the railway lines are frequently exposed to natural hazards as rockfalls, debris flows, landslides, avalanches and others. With the rising incidence of those natural hazards, protection measures become an important political issue. However, they are costly, and maximal protection is most probably not economically feasible. Furthermore risks are distributed in space and time. Consequently, important decision problems to the public sector decision makers are derived. This asks for a high level of surveillance and preservation along the transalpine lines. Efficient protection alternatives can be obtained consequently considering the concept of integral risk management. Risk analysis, as the central part of risk management, has become gradually a generally accepted approach for the assessment of current and future scenarios (Loat & Zimmermann 2004). The procedure aims at risk reduction which can be reached by conventional mitigation on one hand and the implementation of land-use planning on the other hand: a combination of active and passive mitigation measures is applied to prevent damage to buildings, people and infrastructures. With a Geographical Information System adapted to run with a tool developed to manage Risk analysis it is possible to survey the data in time and space, obtaining an important system for managing natural risks. As a framework, we adopt the Swiss system for risk analysis of gravitational natural hazards (BUWAL 1999). It offers a complete framework for the analysis and assessment of risks due to natural hazards, ranging from hazard assessment for gravitational natural hazards, such as landslides, collapses, rockfalls, floodings, debris flows and avalanches, to vulnerability assessment and risk analysis, and the integration into land use planning at the cantonal and municipality level. The scheme is limited to the direct consequences of natural hazards. Thus, we develop a

  9. Combining operational models and data into a dynamic vessel risk assessment tool for coastal regions

    Science.gov (United States)

    Fernandes, R.; Braunschweig, F.; Lourenço, F.; Neves, R.

    2016-02-01

    The technological evolution in terms of computational capacity, data acquisition systems, numerical modelling and operational oceanography is supplying opportunities for designing and building holistic approaches and complex tools for newer and more efficient management (planning, prevention and response) of coastal water pollution risk events. A combined methodology to dynamically estimate time and space variable individual vessel accident risk levels and shoreline contamination risk from ships has been developed, integrating numerical metocean forecasts and oil spill simulations with vessel tracking automatic identification systems (AIS). The risk rating combines the likelihood of an oil spill occurring from a vessel navigating in a study area - the Portuguese continental shelf - with the assessed consequences to the shoreline. The spill likelihood is based on dynamic marine weather conditions and statistical information from previous accidents. The shoreline consequences reflect the virtual spilled oil amount reaching shoreline and its environmental and socio-economic vulnerabilities. The oil reaching shoreline is quantified with an oil spill fate and behaviour model running multiple virtual spills from vessels along time, or as an alternative, a correction factor based on vessel distance from coast. Shoreline risks can be computed in real time or from previously obtained data. Results show the ability of the proposed methodology to estimate the risk properly sensitive to dynamic metocean conditions and to oil transport behaviour. The integration of meteo-oceanic + oil spill models with coastal vulnerability and AIS data in the quantification of risk enhances the maritime situational awareness and the decision support model, providing a more realistic approach in the assessment of shoreline impacts. The risk assessment from historical data can help finding typical risk patterns ("hot spots") or developing sensitivity analysis to specific conditions, whereas real

  10. A Screening Tool for Assessing Alcohol Use Risk among Medically Vulnerable Youth.

    Directory of Open Access Journals (Sweden)

    Sharon Levy

    Full Text Available In an effort to reduce barriers to screening for alcohol use in pediatric primary care, the National Institute on Alcoholism and Alcohol Abuse (NIAAA developed a two-question Youth Alcohol Screening Tool derived from population-based survey data. It is unknown whether this screening tool, designed for use with general populations, accurately identifies risk among youth with chronic medical conditions (YCMC. This growing population, which comprises nearly one in four youth in the US, faces a unique constellation of drinking-related risks.To validate the NIAAA Youth Alcohol Screening Tool in a population of YCMC, we performed a cross-sectional validation study with a sample of 388 youth ages 9-18 years presenting for routine subspecialty care at a large children's hospital for type 1 diabetes, persistent asthma, cystic fibrosis, inflammatory bowel disease, or juvenile idiopathic arthritis. Participants self-administered the NIAAA Youth Alcohol Screening Tool and the Diagnostic Interview Schedule for Children as a criterion standard measure of alcohol use disorders (AUD. Receiver operating curve analysis was used to determine cut points for identifying youth at moderate and highest risk for an AUD.Nearly one third of participants (n = 118; 30.4% reported alcohol use in the past year; 86.4% (106 of past year drinkers did not endorse any AUD criteria, 6.8% (n = 8 of drinkers endorsed a single criterion, and 6.8% of drinkers met criteria for an AUD. Using the NIAAA tool, optimal cut points found to identify youth at moderate and highest risk for an AUD were ≥ 6 and ≥12 drinking days in the past year, respectively.The NIAAA Youth Alcohol Screening Tool is highly efficient for detecting alcohol use and discriminating disordered use among YCMC. This brief screen appears feasible for use in specialty care to ascertain alcohol-related risk that may impact adversely on health status and disease management.

  11. The Risk Assessment at the Workplace of Assembly Operation

    Directory of Open Access Journals (Sweden)

    Marek Burda

    2014-01-01

    Full Text Available Risk Assessment Process by FMEA method involve hazard identification, risk assessment and risk control processes and their input is fundamental to a successful EH&S system. This Risk assessment tool follows the general process and requirements of the Health and Safety Risk Assessment Procedure.

  12. PRECIS -- A probabilistic risk assessment system

    International Nuclear Information System (INIS)

    Peterson, D.M.; Knowlton, R.G. Jr.

    1996-01-01

    A series of computer tools has been developed to conduct the exposure assessment and risk characterization phases of human health risk assessments within a probabilistic framework. The tools are collectively referred to as the Probabilistic Risk Evaluation and Characterization Investigation System (PRECIS). With this system, a risk assessor can calculate the doses and risks associated with multiple environmental and exposure pathways, for both chemicals and radioactive contaminants. Exposure assessment models in the system account for transport of contaminants to receptor points from a source zone originating in unsaturated soils above the water table. In addition to performing calculations of dose and risk based on initial concentrations, PRECIS can also be used in an inverse manner to compute soil concentrations in the source area that must not be exceeded if prescribed limits on dose or risk are to be met. Such soil contaminant levels, referred to as soil guidelines, are computed for both single contaminants and chemical mixtures and can be used as action levels or cleanup levels. Probabilistic estimates of risk, dose and soil guidelines are derived using Monte Carlo techniques

  13. A Comparison of the Nutritional Risk Screening 2002 Tool With the Subjective Global Assessment Tool to Detect Nutritional Status in Chinese Patients Undergoing Surgery With Gastrointestinal Cancer.

    Science.gov (United States)

    Chi, Juntao; Yin, Shaohua; Zhu, Yongjian; Gao, Fengli; Song, Xinna; Song, Zhenlan; Lv, Junying; Li, Miaomiao

    The objectives of this study were to describe the nutritional status of Chinese patients with gastrointestinal cancer undergoing surgery and to compare the ease of use, diversity, and concordance of the Nutritional Risk Screening 2002 with the Subjective Global Assessment in the same patients. A total of 280 gastrointestinal cancer patients admitted for elective surgery were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) tools within 48 hours of admission from April to October 2012. Related opinions about ease of using the tools were obtained from 10 nurses. The prevalence of patients at nutritional risk with the SGA and NRS 2002 was 33.9% and 53.2% on admission. In the total group, ≤70 age group, and >70 age group, respectively, consistency was observed in 214 (76.4%), 175 (91.1%), and 39 (44.3%); and kappa values were 0.54 (p 70 age group (p nutritional status of patients with gastrointestinal cancer undergoing surgery, but it appeared to detect more patients at nutritional risk in the >70 age group.

  14. The MARINA Risk Assessment Strategy: A Flexible Strategy for Efficient Information Collection and Risk Assessment of Nanomaterials.

    Science.gov (United States)

    Bos, Peter M J; Gottardo, Stefania; Scott-Fordsmand, Janeck J; van Tongeren, Martie; Semenzin, Elena; Fernandes, Teresa F; Hristozov, Danail; Hund-Rinke, Kerstin; Hunt, Neil; Irfan, Muhammad-Adeel; Landsiedel, Robert; Peijnenburg, Willie J G M; Sánchez Jiménez, Araceli; van Kesteren, Petra C E; Oomen, Agnes G

    2015-11-27

    An engineered nanomaterial (ENM) may actually consist of a population of primary particles, aggregates and agglomerates of various sizes. Furthermore, their physico-chemical characteristics may change during the various life-cycle stages. It will probably not be feasible to test all varieties of all ENMs for possible health and environmental risks. There is therefore a need to further develop the approaches for risk assessment of ENMs. Within the EU FP7 project Managing Risks of Nanoparticles (MARINA) a two-phase risk assessment strategy has been developed. In Phase 1 (Problem framing) a base set of information is considered, relevant exposure scenarios (RESs) are identified and the scope for Phase 2 (Risk assessment) is established. The relevance of an RES is indicated by information on exposure, fate/kinetics and/or hazard; these three domains are included as separate pillars that contain specific tools. Phase 2 consists of an iterative process of risk characterization, identification of data needs and integrated collection and evaluation of data on the three domains, until sufficient information is obtained to conclude on possible risks in a RES. Only data are generated that are considered to be needed for the purpose of risk assessment. A fourth pillar, risk characterization, is defined and it contains risk assessment tools. This strategy describes a flexible and efficient approach for data collection and risk assessment which is essential to ensure safety of ENMs. Further developments are needed to provide guidance and make the MARINA Risk Assessment Strategy operational. Case studies will be needed to refine the strategy.

  15. The MARINA Risk Assessment Strategy: A Flexible Strategy for Efficient Information Collection and Risk Assessment of Nanomaterials

    Directory of Open Access Journals (Sweden)

    Peter M. J. Bos

    2015-11-01

    Full Text Available An engineered nanomaterial (ENM may actually consist of a population of primary particles, aggregates and agglomerates of various sizes. Furthermore, their physico-chemical characteristics may change during the various life-cycle stages. It will probably not be feasible to test all varieties of all ENMs for possible health and environmental risks. There is therefore a need to further develop the approaches for risk assessment of ENMs. Within the EU FP7 project Managing Risks of Nanoparticles (MARINA a two-phase risk assessment strategy has been developed. In Phase 1 (Problem framing a base set of information is considered, relevant exposure scenarios (RESs are identified and the scope for Phase 2 (Risk assessment is established. The relevance of an RES is indicated by information on exposure, fate/kinetics and/or hazard; these three domains are included as separate pillars that contain specific tools. Phase 2 consists of an iterative process of risk characterization, identification of data needs and integrated collection and evaluation of data on the three domains, until sufficient information is obtained to conclude on possible risks in a RES. Only data are generated that are considered to be needed for the purpose of risk assessment. A fourth pillar, risk characterization, is defined and it contains risk assessment tools. This strategy describes a flexible and efficient approach for data collection and risk assessment which is essential to ensure safety of ENMs. Further developments are needed to provide guidance and make the MARINA Risk Assessment Strategy operational. Case studies will be needed to refine the strategy.

  16. Risk based decision tool for space exploration missions

    Science.gov (United States)

    Meshkat, Leila; Cornford, Steve; Moran, Terrence

    2003-01-01

    This paper presents an approach and corresponding tool to assess and analyze the risks involved in a mission during the pre-phase A design process. This approach is based on creating a risk template for each subsystem expert involved in the mission design process and defining appropriate interactions between the templates.

  17. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    International Nuclear Information System (INIS)

    Skandamis, Panagiotis N.; Andritsos, Nikolaos; Psomas, Antonios; Paramythiotis, Spyridon

    2015-01-01

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total ‘failure’ that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user

  18. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Skandamis, Panagiotis N., E-mail: pskan@aua.gr; Andritsos, Nikolaos, E-mail: pskan@aua.gr; Psomas, Antonios, E-mail: pskan@aua.gr; Paramythiotis, Spyridon, E-mail: pskan@aua.gr [Laboratory of Food Quality Control and Hygiene, Department of Food Science and Technology, Agricultural University of Athens, Iera Odos 75, 118 55, Athens (Greece)

    2015-01-22

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total ‘failure’ that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user

  19. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    Science.gov (United States)

    Skandamis, Panagiotis N.; Andritsos, Nikolaos; Psomas, Antonios; Paramythiotis, Spyridon

    2015-01-01

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total `failure' that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user-friendly softwares

  20. 77 FR 28894 - Maritime Vulnerability Self-Assessment Tool

    Science.gov (United States)

    2012-05-16

    ... DEPARTMENT OF HOMELAND SECURITY Transportation Security Administration Maritime Vulnerability Self... maritime vulnerability self- assessment tool. SUMMARY: The Transportation Security Administration (TSA) announces that the TSA Maritime Self-Assessment Risk Module (TMSARM), developed to support the United States...

  1. Globe of Natural Hazard - A new assessment tool for risk managers

    Science.gov (United States)

    Siebert, A. C.

    2009-04-01

    A large number of tropical cyclones and the earthquake in Sichuan made 2008 one of the most devastating years on record. Throughout the world, more than 220,000 people died as a result of natural catastrophes this year. Overall losses totaled some US 200bn (2007: US 82bn). Insured losses in 2008 rose to US 45bn, about 50% higher than in the previous year. Mainly driven by high losses from weather-related natural catastrophes, 2008 was - on the basis of figures adjusted for inflation - even the third most expensive year on record for the insurance industry, exceeded only by the hurricane year of 2005 and by 1995, the year of the Kobe earthquake. Munich Re, a worldwide operating reinsurance company, is a world leader in terms of investigating risks from natural hazards of all kinds. 2008 has again shown the insurance industry how important it is to analyse risks like natural hazards and climate change in all their facets and to manage the insurance business accordingly. An excellent example of the wealth of knowledge Munich Re has developed in natural hazard assessment is the DVD "Globe of Natural Hazards". It combines the geoscientific data and findings Munich Re has accumulated over a period of 35 years. First devised as a wall-map in 1978, the product has established itself as a standard work for the identification, exposure assessment and risk management of natural hazards. Over 80,000 copies of the CD-ROM version of 2000 have been provided to clients - a mark achieved by no other service product in Munich Re's history. Since the beginning of 2009, the fully updated fourth-generation version has been available. The bilingual DVD (German and English) shows natural hazards and climate effects at a glance: the global maps are presented on a 3D globe, underlaid with satellite images. The hazard complexes of hail, tornado and winter storms have been completely revised and flood incorporated as a new hazard. Users can intuitively home in on and enlarge any location on

  2. Quantitative risk assessment: an emerging tool for emerging foodborne pathogens.

    OpenAIRE

    Lammerding, A. M.; Paoli, G. M.

    1997-01-01

    New challenges to the safety of the food supply require new strategies for evaluating and managing food safety risks. Changes in pathogens, food preparation, distribution, and consumption, and population immunity have the potential to adversely affect human health. Risk assessment offers a framework for predicting the impact of changes and trends on the provision of safe food. Risk assessment models facilitate the evaluation of active or passive changes in how foods are produced, processed, d...

  3. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    Science.gov (United States)

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

  4. An ensemble model of QSAR tools for regulatory risk assessment.

    Science.gov (United States)

    Pradeep, Prachi; Povinelli, Richard J; White, Shannon; Merrill, Stephen J

    2016-01-01

    Quantitative structure activity relationships (QSARs) are theoretical models that relate a quantitative measure of chemical structure to a physical property or a biological effect. QSAR predictions can be used for chemical risk assessment for protection of human and environmental health, which makes them interesting to regulators, especially in the absence of experimental data. For compatibility with regulatory use, QSAR models should be transparent, reproducible and optimized to minimize the number of false negatives. In silico QSAR tools are gaining wide acceptance as a faster alternative to otherwise time-consuming clinical and animal testing methods. However, different QSAR tools often make conflicting predictions for a given chemical and may also vary in their predictive performance across different chemical datasets. In a regulatory context, conflicting predictions raise interpretation, validation and adequacy concerns. To address these concerns, ensemble learning techniques in the machine learning paradigm can be used to integrate predictions from multiple tools. By leveraging various underlying QSAR algorithms and training datasets, the resulting consensus prediction should yield better overall predictive ability. We present a novel ensemble QSAR model using Bayesian classification. The model allows for varying a cut-off parameter that allows for a selection in the desirable trade-off between model sensitivity and specificity. The predictive performance of the ensemble model is compared with four in silico tools (Toxtree, Lazar, OECD Toolbox, and Danish QSAR) to predict carcinogenicity for a dataset of air toxins (332 chemicals) and a subset of the gold carcinogenic potency database (480 chemicals). Leave-one-out cross validation results show that the ensemble model achieves the best trade-off between sensitivity and specificity (accuracy: 83.8 % and 80.4 %, and balanced accuracy: 80.6 % and 80.8 %) and highest inter-rater agreement [kappa ( κ ): 0

  5. Colon Cancer Risk Assessment - Gauss Program

    Science.gov (United States)

    An executable file (in GAUSS) that projects absolute colon cancer risk (with confidence intervals) according to NCI’s Colorectal Cancer Risk Assessment Tool (CCRAT) algorithm. GAUSS is not needed to run the program.

  6. Risk assessment as a management tool used to assess the effect of pesticide use in an irrigation system, situated in a semi-desert region

    CSIR Research Space (South Africa)

    Raschke, AM

    1997-01-01

    Full Text Available be used as a predictive tool to determine as accurately as possible from the data available if a complete scientific health risk assessment study is justified. The actual amounts of pesticides sold in the Vaalharts area by two major pesticide manufacturers...

  7. Integrating Risk Analyses and Tools at the DOE Hanford Site

    International Nuclear Information System (INIS)

    LOBER, R.W.

    2002-01-01

    Risk assessment and environmental impact analysis at the U.S. Department of Energy (DOE) Hanford Site in Washington State has made significant progress in refining the strategy for using risk analysis to support closing of several hundred waste sites plus 149 single-shell tanks at the Hanford Site. A Single-Shell Tank System Closure Work Plan outlines the current basis for closing the single-shell tank systems. An analogous site approach has been developed to address closure of aggregated groups of similar waste sites. Because of the complexity, decision time frames, proximity of non-tank farm waste sites to tank farms, scale, and regulatory considerations, various projects are providing integrated assessments to support risk analyses and decision-making. Projects and the tools that are being developed and applied at Hanford to support retrieval and cleanup decisions include: (1) Life Cycle Model (LCM) and Risk Receptor Model (RRM)--A site-level set of tools to support strategic analyses through scoping level risk management to assess different alternatives and options for tank closure. (2) Systems Assessment Capability for Integrated Groundwater Nadose Zone (SAC) and the Site-Wide Groundwater Model (SWGM)--A site-wide groundwater modeling system coupled with a risk-based uncertainty analysis of inventory, vadose zone, groundwater, and river interactions for evaluating cumulative impacts from individual and aggregate waste sites. (3) Retrieval Performance Evaluation (RPE)--A site-specific, risk-based methodology developed to evaluate performance of waste retrieval, leak detection and closure on a tank-specific basis as a function of past tank Leaks, potential leakage during retrieval operations, and remaining residual waste inventories following completion of retrieval operations. (4) Field Investigation Report (FIR)--A corrective action program to investigate the nature and extent of past tank leaks through characterization activities and assess future impacts to

  8. Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine.

    Science.gov (United States)

    Herath, Herath M Meththananda; Weerarathna, Thilak Priyantha; Umesha, Dilini

    2015-01-01

    Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied. This study was designed to evaluate the performance of two cardiac risk assessments tools; WHO/ISH charts and UK Prospective Diabetes Study (UKPDS) risk engine. Cardiac risk assessments were done in 2,432 patients with T2DM attending a diabetes clinic in Southern Sri Lanka using the two risk assessment tools. Validity of two assessment tools was further assessed by their ability to recognize individuals with raised low-density lipoprotein (LDL) and raised diastolic blood pressure in a cohort of newly diagnosed T2DM patients (n=332). WHO/ISH charts identified 78.4% of subjects as low cardiac risk whereas the UKPDS risk engine categorized 52.3% as low cardiac risk (Pengine identified higher proportions of patients (28%) compared to WHO/ISH charts (7%). Approximately 6% of subjects were classified as low cardiac risk (20%. Agreement between the two tools was poor (κ value =0.144, Pengine. Risk assessment by both assessment tools demonstrated poor sensitivity in identifying those with treatable levels of LDL cholesterol and diastolic blood pressure.

  9. Combining web-based tools for transparent evaluation of data for risk assessment: developmental effects of bisphenol A on the mammary gland as a case study.

    Science.gov (United States)

    Molander, Linda; Hanberg, Annika; Rudén, Christina; Ågerstrand, Marlene; Beronius, Anna

    2017-03-01

    Different tools have been developed that facilitate systematic and transparent evaluation and handling of toxicity data in the risk assessment process. The present paper sets out to explore the combined use of two web-based tools for study evaluation and identification of reliable data relevant to health risk assessment. For this purpose, a case study was performed using in vivo toxicity studies investigating low-dose effects of bisphenol A on mammary gland development. The reliability of the mammary gland studies was evaluated using the Science in Risk Assessment and Policy (SciRAP) criteria for toxicity studies. The Health Assessment Workspace Collaborative (HAWC) was used for characterizing and visualizing the mammary gland data in terms of type of effects investigated and reported, and the distribution of these effects within the dose interval. It was then investigated whether there was any relationship between study reliability and the type of effects reported and/or their distribution in the dose interval. The combination of the SciRAP and HAWC tools allowed for transparent evaluation and visualization of the studies investigating developmental effects of BPA on the mammary gland. The use of these tools showed that there were no apparent differences in the type of effects and their distribution in the dose interval between the five studies assessed as most reliable and the whole data set. Combining the SciRAP and HAWC tools was found to be a useful approach for evaluating in vivo toxicity studies and identifying reliable and sensitive information relevant to regulatory risk assessment of chemicals. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Pro Et Con Analysis Of Occupational Exposure Assessement Tools And Concepts For nanomaterials

    DEFF Research Database (Denmark)

    Liguori, Biase; Hansen, Steffen Foss; Alstrup Jensen, Keld

    . Examples of these include the "Control Banding Nanotool" developed to assess and control the risks of nanomaterials, the more holistic "Swiss precautionary matrix", and the first order quantitative risk assessment tool, NanoSafer. Here we review these and other tools and we discuss various elements...... of the tools (input data requirements, exposure evaluation and handling to reduce exposure) as well as specific pros and cons. Most of the tools provide a transparent and comprehensible approach to assess occupational exposure, but the majority of them are based on purely qualitative considerations about...... occupational settings. A few methods include specific advice on risk management going well beyond what is normally considered in traditional exposure assessment. A disadvantage in most of the existing concepts is that their data requirements are fairly high. In some cases the technical and scientific...

  11. Assessing impacts of ionizing radiation on non-human biota: the ERICA tool

    International Nuclear Information System (INIS)

    Brown, Justin; Lilanda, Astrid; Hosseini, Ali; Alfonso, B.; Avila, R.; Beresford, N.A.; Proehl, G.; Ulanovsky, A.

    2008-01-01

    There have been significant developments in the last few years concerning methods to explicitly quantify impacts on the environment arising from exposure by ionising radiation. Central to the ERICA integrated approach is the quantification of environmental risk whereby data on environmental transfer and dosimetry are combined to provide a measure of exposure which is compared to exposure levels at which detrimental effects are known to occur. In view of the large data sets underpinning the assessment approach and the potential to introduce errors when performing numerous calculations manually, a supporting computer-based tool (the ERICA Tool) has been developed. The ERICA Tool is a computerised, flexible software system that has a structure based upon the ERICA Integrated Assessment tiered approach to assessing the radiological risk to biota. The user is guided through the assessment process, recording information and decisions as the assessment progresses. The tool allows the necessary calculations to be performed to estimate risks to selected biota. Tier 1 assessments use pre-calculated environmental media concentration limits to estimate risk quotients and require inputs in the form of media concentrations. At Tier 2 dose-rates are calculated but at this stage, the user is allowed to examine and edit most of the parameters used in the calculation. For Tier 3 assessments, the same flexibility as Tier 2 is allowed but assessments may be run probability if the underling parameter probability distribution functions are defined. Results from the tool can be put into context using incorporated data on dose-effects relationships and background dose-rates. (author)

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

    Science.gov (United States)

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

    2013-07-01

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

  13. Exposure Assessment Tools by Lifestages and Populations - General Population

    Science.gov (United States)

    EPA ExpoBox is a toolbox for exposure assessors. Its purpose is to provide a compendium of exposure assessment and risk characterization tools that will present comprehensive step-by-step guidance and links to relevant exposure assessment data bases

  14. Comparison of Oncotype DX® Recurrence Score® with other risk assessment tools including the Nottingham Prognostic Index in the identification of patients with low-risk invasive breast cancer.

    Science.gov (United States)

    Cotter, Maura Bríd; Dakin, Alex; Maguire, Aoife; Walshe, Janice M; Kennedy, M John; Dunne, Barbara; Riain, Ciarán Ó; Quinn, Cecily M

    2017-09-01

    Oncotype DX® is a gene expression assay that quantifies the risk of distant recurrence in patients with hormone receptor positive early breast cancer, publicly funded in Ireland since 2011. The aim of this study was to correlate Oncotype DX® risk groupings with traditional histopathological parameters and the results of other risk assessment tools including Recurrence Score-Pathology-Clinical (RSPC), Adjuvant Risk Index (Adj RI), Nottingham Prognostic Index (NPI) and the Adjuvant! Online 10-year score (AO). Patients were retrospectively identified from the histopathology databases of two Irish hospitals and patient and tumour characteristics collated. Associations between categorical variables were evaluated with Pearson's chi-square test. Correlations were calculated using Spearman's correlation coefficient and concordance using Lin's concordance correlation coefficient. Statistical analysis was performed using SPSS software, version 22.0.In our 300 patient cohort, Oncotype DX® classified 59.7% (n = 179) as low, 30% (n = 90) as intermediate, and 10.3% (n = 31) as high risk. Overall concordance between the RS and RSPC, Adj RI, NPI, and AO was 67.3% (n = 202), 56.3% (n = 169), 59% (n = 177), and 36.3% (n = 109), respectively. All risk assessment tools classified the majority of patients as low risk apart from the AO 10-year score, with RSPC classifying the highest number of patients as low risk. This study demonstrates that there is good correlation between the RS and scores obtained using alternative risk tools. Concordance with NPI is strong, particularly in the low-risk group. NPI, calculated from traditional clinicopathological characteristics, is a reliable alternative to Oncotype DX® in the identification of low-risk patients who may avoid adjuvant chemotherapy.

  15. An employee/trade union perspective to risk assessment

    International Nuclear Information System (INIS)

    Aro, Pekka O.

    1992-01-01

    Risk assessment does not easily lend itself to precise description. In some of its current forms of application, it is little more than a modern way of throwing bones or looking at tea leaves or the entrails of sheep, like our ancestors used to do not so many centuries ago (the only real difference being perhaps that laboratory rats are cheaper and less messy than sheep). A its best, however, risk assessment can be used as a good tool to identify the needs for changes required to reduce hazards and to prevent accidents to humans or damage to the environment. This paper approaches risk assessment as a tool, highlighting the need and usefulness as well as the right of employees and their representatives to participate in all the steps involved in assessing the risks of the workplace and its environment

  16. The implication of assessing a polymorphism in estrogen receptor alpha gene in the risk assessment of osteoporosis using a screening tool for osteoporosis in Asians.

    Science.gov (United States)

    Ongphiphadhanakul, Boonsong; Chanprasertyothin, Suwannee; Payattikul, Penpan; Saetung, Sunee; Rajatanavin, Rajata

    2003-10-01

    Both genetic and environmental factors interact to determine bone mass and the risk for developing postmenopausal osteoporosis. Recently, an Asian-specific tool, the Osteoporosis Self-Assessment Tool for Asians (OSTA), has been developed to assess the risk of osteoporosis in women. An index is calculated by multiplying the difference in body weight in kilograms and age in years by 0.2 and disregarding the decimal digits. The risk of osteoporosis is classified as high, intermediate or low according to the OSTA index less than -4, -4 to -1 and greater than -1. In the present study we examined how a single nucleotide polymorphism (SNP) in exon 8 of the estrogen receptor alpha (ERalpha) gene affected the predictive value of the OSTA index. Subjects consisted of 358 postmenopausal women who were at least 55 years old. BMDs were measured by DXA, and the SNP in the ERalpha gene was assessed by PCR-RFLP. When considering both the OSTA index and ERalpha genotype in a logistic regression model, it was found that both the OSTA index and the ERalpha genotype independently contributed to the risk of osteoporosis. The odds ratios were 1.58 (95% CI 1.26-1.91) and 2.51 (95% CI 1.42-4.44) for one unit decrement in the OSTA index and each copy of the A allele of the ERalpha genotype, respectively. The joint effect conformed more to a multiplicative model of interaction than an additive model. This suggests that persons with the high-risk genotype are at far greater risk of developing osteoporosis with advancing age or decreasing body weight, the two variables from which the OSTA index is derived. Targeting preventive measures for osteoporosis subjects with risk factors and also disease-susceptibility alleles is likely to be more cost effective.

  17. Simulation for Prediction of Entry Article Demise (SPEAD): An Analysis Tool for Spacecraft Safety Analysis and Ascent/Reentry Risk Assessment

    Science.gov (United States)

    Ling, Lisa

    2014-01-01

    For the purpose of performing safety analysis and risk assessment for a potential off-nominal atmospheric reentry resulting in vehicle breakup, a synthesis of trajectory propagation coupled with thermal analysis and the evaluation of node failure is required to predict the sequence of events, the timeline, and the progressive demise of spacecraft components. To provide this capability, the Simulation for Prediction of Entry Article Demise (SPEAD) analysis tool was developed. The software and methodology have been validated against actual flights, telemetry data, and validated software, and safety/risk analyses were performed for various programs using SPEAD. This report discusses the capabilities, modeling, validation, and application of the SPEAD analysis tool.

  18. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

    Science.gov (United States)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela; Bach, Flemming W; Bendix, Tom; Jensen, Troels Staehelin

    2013-01-01

    Objectives An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. Design The design was an observational prospective study of risk factors embedded in a randomised controlled study. Setting Acute whiplash patients from units, general practitioners in four Danish counties were referred to two research centres. Participants During a 2-year inclusion period, acute consecutive whiplash-injured (age 18–70 years, rear-end or frontal-end car accident and WAD (whiplash-associated disorders) grades I–III, symptoms within 72 h, examination prior to 10 days postinjury, capable of written/spoken Danish, without other injuries/fractures, pre-existing significant somatic/psychiatric disorder, drug/alcohol abuse and previous significant pain/headache). 688 (438 women and 250 men) participants were interviewed and examined by a study nurse after 5 days; 605 were completed after 1 year. A risk score which included items of initial neck pain/headache intensity, a number of non-painful complaints and active neck mobility was applied. The primary outcome parameter was 1-year work disability. Results The risk score and number of sick-listing days were related (Kruskal-Wallis, pwhiplash. Neck-mobility was a strong predictor in this study; however, it was a more inconsistent predictor in other studies. Conclusions Application of the risk assessment score and use of the risk strata system may be beneficial in future studies and may be considered as a valuable tool to assess return-to-work following injuries; however, further studies are needed. PMID:23370009

  19. Use and clinical efficacy of standard and health information technology fall risk assessment tools.

    Science.gov (United States)

    Teh, Ruth C; Wilson, Anne; Ranasinghe, Damith; Visvanathan, Renuka

    2017-12-01

    To evaluate the health information technology (HIT) compared to Fall Risk for Older Persons (FROP) tool in fall risk screening. A HIT tool trial was conducted on the geriatric evaluation and management (GEM, n = 111) and acute medical units (AMU, n = 424). Health information technology and FROP scores were higher on GEM versus AMU, with no differences between people who fell and people who did not fall. Both score completion rates were similar, and their values correlated marginally (Spearman's correlation coefficient 0.33, P falls. Hospital fall rates trended towards reduction on AMU (4.20 vs 6.96, P = 0.15) and increase on GEM (10.98 vs 6.52, P = 0.54) with HIT tool implementation. Health information technology tool acceptability and scoring were comparable to FROP screening, with mixed effects on fall rate with HIT tool implementation. Clinician partnership remains key to effective tool development. © 2017 AJA Inc.

  20. Effectiveness of FISK, an invasiveness screening tool for non-native freshwater fishes, to perform risk identification assessments in the Iberian Peninsula.

    Science.gov (United States)

    Almeida, David; Ribeiro, Filipe; Leunda, Pedro M; Vilizzi, Lorenzo; Copp, Gordon H

    2013-08-01

    Risk assessments are crucial for identifying and mitigating impacts from biological invasions. The Fish Invasiveness Scoring Kit (FISK) is a risk identification (screening) tool for freshwater fishes consisting of two subject areas: biogeography/history and biology/ecology. According to the outcomes, species can be classified under particular risk categories. The aim of this study was to apply FISK to the Iberian Peninsula, a Mediterranean climate region highly important for freshwater fish conservation due to a high level of endemism. In total, 89 fish species were assessed by three independent assessors. Results from receiver operating characteristic analysis showed that FISK can discriminate reliably between noninvasive and invasive fishes for Iberia, with a threshold of 20.25, similar to those obtained in several regions around the world. Based on mean scores, no species was categorized as "low risk," 50 species as "medium risk," 17 as "moderately high risk," 11 as "high risk," and 11 as "very high risk." The highest scoring species was goldfish Carassius auratus. Mean certainty in response was above the category "mostly certain," ranging from tinfoil barb Barbonymus schwanenfeldii with the lowest certainty to eastern mosquitofish Gambusia holbrooki with the highest level. Pair-wise comparison showed significant differences between one assessor and the other two on mean certainty, with these two assessors showing a high coincidence rate for the species categorization. Overall, the results suggest that FISK is a useful and viable tool for assessing risks posed by non-native fish in the Iberian Peninsula and contributes to a "watch list" in this region. © 2013 Crown copyright This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

  1. Insurance World in Transition: Changes in Global Risk Taking and Risk Assessment

    Science.gov (United States)

    Michel, Gero; Tiampo, Kristy

    2015-04-01

    Catastrophe insurance risk assessment, risk taking, and regulation has evolved over the last 20 years and is gearing up for significant further change in the years ahead. Changes in regulation and influx of capital have put profit margins for catastrophe risk products under pressure despite the fact that changes in climate as well as increasing insurance penetration is expected to heighten demand. As a result, reinsurance strategies are moving away from catastrophe risk. In addition, lower margins require cheaper and more efficient risk assessment methods and processes which are contrary to evolving analytical tools and methods that had increased expenses in line with growing margins over the last decade. New capital providers are less familiar with and less willing to accept complex supply chains for risk management, relationship-driven business and tedious data exchange and management processes. Risk takers claim new measures and ask for more flexibility in the use of tools. The current concepts of catastrophe insurance risk assessment are hence under thorough scrutiny. This presentation deals with the changing landscape in catastrophe insurance risk assessment and risk hedging and discusses changes in catastrophe risk assessment products and demand. How likely is it that private, small and nimble hazard and risk consulting groups - increasingly emanating from larger science organizations - will replace large established firms in their role to assess risk? What role do public-private academic partnerships play in assuming risk for catastrophe insurance and what role could they play in the future? What are the opportunities and downsides of the current changes in risk taking and hedging? What is needed from the scientific community in order to fill the gaps in risk management and who is likely to take advantage of the current changes?

  2. Risk Assessment and Risk Management in Offenders with Intellectual Disabilities: Are We There Yet?

    Science.gov (United States)

    Pouls, Claudia; Jeandarme, Inge

    2015-01-01

    Research on risk assessment and risk management in offenders with intellectual disabilities (OIDs), although far behind compared to the mainstream offender literature, is now expanding. The current review provides an overview of the predictive value of risk assessment and treatment outcome monitoring tools developed for both mainstream forensic…

  3. Preconception care: a screening tool for health assessment and risk detection.

    NARCIS (Netherlands)

    Weerd, S. de; Bij, A.K. van der; Cikot, R.J.L.M.; Braspenning, J.C.C.; Braat, D.D.M.; Steegers, E.A.P.

    2002-01-01

    BACKGROUND: Identification of risk factors for adverse pregnancy outcome is a main component of preconception care, but requires adequate time and knowledge. This study compares self-administered questionnaires to history taking by a physician to evaluate the reliability of such a screening tool for

  4. Environmental risk assessment: an Australian perspective. Supervising Scientist Report 102

    International Nuclear Information System (INIS)

    Beer, T.; Ziolkowski, F.

    1995-01-01

    Environmental risk assessment can be used as a strategic tool to set environmental priorities and as a tactical tool to set environmental standards. This report is designed to inform Australian environmental managers about the techniques and applications of environmental risk assessment and to familiarize risk analysts with some of the issues that are of concern to environmental managers. The use of risk assessment is illustrated by applying its techniques to five case studies which include: risk from chemicals and from contaminated sites; risk to people and to the natural environment from development, such as uranium mining; climate change; and risk associated with political decision-making. Then, by considering Australian and overseas practice, a generic framework is presented within which environmental risk assessment in Australia can be undertaken, and possible methods of implementation are discussed. refs., 38 figs

  5. Can statistical data qualify assessments of children at risk?

    DEFF Research Database (Denmark)

    Søbjerg, Lene Mosegaard; Villumsen, Anne Marie Anker; Klitbjerg-Nielsen, Christina

    and parents that are already registered in the municipality such as home address and school records. A similar tool is being developed in a social work research project in Denmark. The idea is to include risk and protection factors such as information about health, school absenteeism and family circumstances......Every day municipalities across Europe (and beyond) receive notifications about children at risk. The notifications come from teachers, health professionals, social workers, neighbors, or anyone else who sees a child, which appears not to thrive. The assessment and validation of whether the child...... significantly from case to case. Third, the relative importance of the different risk and protection factors is complex and difficult to assess – especially when the social worker has to assess both immediate danger as well as risk of long term failure-to-thrive. Internationally, different risk assessment tools...

  6. Model based risk assessment - the CORAS framework

    Energy Technology Data Exchange (ETDEWEB)

    Gran, Bjoern Axel; Fredriksen, Rune; Thunem, Atoosa P-J.

    2004-04-15

    Traditional risk analysis and assessment is based on failure-oriented models of the system. In contrast to this, model-based risk assessment (MBRA) utilizes success-oriented models describing all intended system aspects, including functional, operational and organizational aspects of the target. The target models are then used as input sources for complementary risk analysis and assessment techniques, as well as a basis for the documentation of the assessment results. The EU-funded CORAS project developed a tool-supported methodology for the application of MBRA in security-critical systems. The methodology has been tested with successful outcome through a series of seven trial within the telemedicine and ecommerce areas. The CORAS project in general and the CORAS application of MBRA in particular have contributed positively to the visibility of model-based risk assessment and thus to the disclosure of several potentials for further exploitation of various aspects within this important research field. In that connection, the CORAS methodology's possibilities for further improvement towards utilization in more complex architectures and also in other application domains such as the nuclear field can be addressed. The latter calls for adapting the framework to address nuclear standards such as IEC 60880 and IEC 61513. For this development we recommend applying a trial driven approach within the nuclear field. The tool supported approach for combining risk analysis and system development also fits well with the HRP proposal for developing an Integrated Design Environment (IDE) providing efficient methods and tools to support control room systems design. (Author)

  7. Risk Assessment and Life Cycle Assessment, Environmental Strategies, Nordic Workshop, Vedbæk 1999

    DEFF Research Database (Denmark)

    Poll, Christian

    At a Nordic workshop on Product-oriented Environmental Strategies the roles of risk and hazard assessment and life cycle assessment of products in the future regulation of chemicals were discussed by participants representing administration, academia and industry from the Nordic countries....... This report compiles the papers and presentations given at the workshop. The papers present and discuss the different assessment tools and procedures - for individual chemicals through hazard and risk assessments and for products, materials and services through life-cycle assessment. The report also contains......, consultants and private enterprises to consider these well-established tools as individually necessary for the future regulation of the chemical pressure on the environment and to accept them as complementary to each other. Together with other process- or chain oriented tools like Substance or Material Flow...

  8. Breastfeeding assessment tools

    International Nuclear Information System (INIS)

    Bizouerne, Cécile; Kerac, Marko; Macgrath, Marie

    2014-01-01

    Full text: Breastfeeding plays a major role in reducing the global burden of child mortality and under-nutrition. Whilst many programmes aim to support breastfeeding and prevent feeding problems occurring, interventions are also needed once they have developed. In this situation, accurate assessment of a problem is critical to inform prognosis and enables tailored, appropriate treatment. The presentation will present a review, which aims to identify breastfeeding assessment tools/checklists for use in assessing malnourished infants in poor resource settings. The literature review identified 24 breastfeeding assessment tools, and 41 validation studies. Evidence underpinning most of the tools was mainly low quality, and conducted in high-income countries and hospital settings. The presentation will describe the main findings of the literature review and propose recommendations for improving existing tools in order to appropriately assess malnourished infants and enable early, appropriate intervention and treatment of malnutrition. (author)

  9. Correlation of Estradiol Serum Levels with Classification of Osteoporosis Risk OSTA (Osteoporosis Self-Assessment Tools for Asian in Menopause Women

    Directory of Open Access Journals (Sweden)

    Eva Maya Puspita

    2017-01-01

    Full Text Available Background: In postmenopausal women, decreasing estrogen levels is a marker of ovarian dysfunction. Hypoestrogenic state has known increasing the risk of osteoporosis. Objective: To determine the correlation between estradiol serum levels with classification of osteoporosis risk OSTA (Osteoporosis Self-Assessment Tools for Asian in menopausal women. Methods: This study was case series study which examined estradiol serum in menopausal women by ELISA and assess the osteoporosis risk using osteoporosis risk classification OSTA. Total 47 samples was collected at Dr. H.Adam malik, dr. Pirngadi, and RSU Networking in Medan. This research was conducted from May to December 2016. Data were statistically analyzed, and presented with Spearman test. Results: In this study, we found the mean levels of estradiol in menopausal women was 18.62 ± 16.85 ng / ml with OSTA osteoporosis risk score of 2.09 ± 2.45. There was a significant positive correlation between estradiol and risk of osteoporosis OSTA with correlation coefficient r = 0.825 and p <0.05. Conclusion: There is a strong positive correlation between serum levels of estradiol with OSTA osteoporosis risk assessment in menopausal women.

  10. Quantitative risk assessment system (QRAS)

    Science.gov (United States)

    Weinstock, Robert M (Inventor); Smidts, Carol S (Inventor); Mosleh, Ali (Inventor); Chang, Yung-Hsien (Inventor); Swaminathan, Sankaran (Inventor); Groen, Francisco J (Inventor); Tan, Zhibin (Inventor)

    2001-01-01

    A quantitative risk assessment system (QRAS) builds a risk model of a system for which risk of failure is being assessed, then analyzes the risk of the system corresponding to the risk model. The QRAS performs sensitivity analysis of the risk model by altering fundamental components and quantifications built into the risk model, then re-analyzes the risk of the system using the modifications. More particularly, the risk model is built by building a hierarchy, creating a mission timeline, quantifying failure modes, and building/editing event sequence diagrams. Multiplicities, dependencies, and redundancies of the system are included in the risk model. For analysis runs, a fixed baseline is first constructed and stored. This baseline contains the lowest level scenarios, preserved in event tree structure. The analysis runs, at any level of the hierarchy and below, access this baseline for risk quantitative computation as well as ranking of particular risks. A standalone Tool Box capability exists, allowing the user to store application programs within QRAS.

  11. Pushing and pulling: an assessment tool for occupational health and safety practitioners.

    Science.gov (United States)

    Lind, Carl Mikael

    2018-03-01

    A tool has been developed for supporting practitioners when assessing manual pushing and pulling operations based on an initiative by two global companies in the manufacturing industry. The aim of the tool is to support occupational health and safety practitioners in risk assessment and risk management of pushing and pulling operations in the manufacturing and logistics industries. The tool is based on a nine-multiplier equation that includes a wide range of factors affecting an operator's health risk and capacity in pushing and pulling. These multipliers are based on psychophysical, physiological and biomechanical studies in combination with judgments from an expert group consisting of senior researchers and ergonomists. In order to consider usability, more than 50 occupational health and safety practitioners (e.g., ergonomists, managers, safety representatives and production personnel) participated in the development of the tool. An evaluation by 22 ergonomists supports that the push/pull tool is user friendly in general.

  12. The EPA's human exposure research program for assessing cumulative risk in communities.

    Science.gov (United States)

    Zartarian, Valerie G; Schultz, Bradley D

    2010-06-01

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this

  13. Probabilistic risk assessment: Number 219

    International Nuclear Information System (INIS)

    Bari, R.A.

    1985-01-01

    This report describes a methodology for analyzing the safety of nuclear power plants. A historical overview of plants in the US is provided, and past, present, and future nuclear safety and risk assessment are discussed. A primer on nuclear power plants is provided with a discussion of pressurized water reactors (PWR) and boiling water reactors (BWR) and their operation and containment. Probabilistic Risk Assessment (PRA), utilizing both event-tree and fault-tree analysis, is discussed as a tool in reactor safety, decision making, and communications. (FI)

  14. Comparison of occupational exposure assessment tools and concepts for nanomaterials

    DEFF Research Database (Denmark)

    Liguori, Biase; Hansen, Steffen Foss; Baun, Anders

    The development, production and application of engineered nanomaterials have been growing in different fields. This leads to a consequent increased potential of exposure to nanomaterials in the working environment. However to determine the potential exposure risk is a challenging task for risk...... for Nanomaterials”; “NanoSafer vs. 1.1 – A web-based precautionary risk assessment tool for manufactured nanomaterials using first order modeling” Based on the literature information we have analyzed these tools and discussed elements regarding: the domain of application and whether it accounts for the nanospecific...... factor or nano-relevance; the work exposure scenario, for which types of processes they may be used; are the tools using the source-transmission-receptor approach; the input data requirements; whether the tools included qualitative or semi-quantitative or quantitative evaluations of the exposure; whether...

  15. Screening for older emergency department inpatients at risk of prolonged hospital stay: the brief geriatric assessment tool.

    Science.gov (United States)

    Launay, Cyrille P; de Decker, Laure; Kabeshova, Anastasiia; Annweiler, Cédric; Beauchet, Olivier

    2014-01-01

    The aims of this study were 1) to confirm that combinations of brief geriatric assessment (BGA) items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED); and 2) to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS. Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female) recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day), use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year). The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry. Area under receiver operating characteristic (ROC) curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010). Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (PLHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4) and a low likelihood ratio of positive test under 5.6. Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.

  16. Screening for older emergency department inpatients at risk of prolonged hospital stay: the brief geriatric assessment tool.

    Directory of Open Access Journals (Sweden)

    Cyrille P Launay

    Full Text Available The aims of this study were 1 to confirm that combinations of brief geriatric assessment (BGA items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED; and 2 to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS.Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day, use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year. The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry.Area under receiver operating characteristic (ROC curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010. Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003. Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4 and a low likelihood ratio of positive test under 5.6.Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.

  17. Assessing attachment in school-aged children: Do the School-Age Assessment of Attachment and Family Drawings work together as complementary tools?

    Science.gov (United States)

    Carr-Hopkins, Rebecca; De Burca, Calem; Aldridge, Felicity A

    2017-07-01

    Our goal was to identify an assessment package that could improve treatment planning for troubled children and their families. To assess the validity of our tools, we tested the relations among the School-Age Assessment of Attachment, the Family Drawing and children's risk status. We used the Dynamic-Maturational Model of Attachment and Adaptation to interpret the assessments in the hope of identifying a gradient of risk, and explore whether a new coding method improved the validity of Family Drawings and their utility as a tool to complement the School-Age Assessment of Attachment. The participants were 89 children, aged between 5 and 12 years; 32 children were involved with mental health services or child protection. Each child completed a School-Age Assessment of Attachment and a Family Drawing. Both assessments differentiated between clinical and normative referrals with moderate effect sizes when dichotomizing risk versus non-risk attachment. When the analysis incorporated a gradient of six attachment classifications, the effect sizes decreased, but specificity of risk increased. The School-Age Assessment of Attachment had greater validity for discriminating risk, and type of risk, than the Family Drawings. With a School-Age Assessment of Attachment and family history, the Family Drawing can provide information about distress that some children do not provide verbally. Integration of the two assessment tools alongside information about parental and family functioning appears to be the key to formulating children's problems.

  18. Costs Associated with Using the ASA24® Dietary Assessment Tool

    Science.gov (United States)

    As part of its mission to advance measures and methods for monitoring cancer-related behaviors and other risk factors, the Risk Factor Assessment Branch provides tools and resources to the extramural research community.

  19. From Clinical-Developmental Theory to Assessment: The Holistic Student Assessment Tool

    Directory of Open Access Journals (Sweden)

    Gil Noam

    2012-12-01

    Full Text Available A description and test of the Holistic Student Assessment Tool (HSA, an assessment tool to measure children’s and adolescents’ resiliencies in relation to externalizing and internalizing problem behaviors. The HSA is based on the authors’ research-based clinical-developmental Clover Leaf Model of resilience and psychopathology, and is one of the first attempts at closing the gap between risk and resilience approaches in developmental assessment. The HSA was tested in a cross-sectional sample of 423 children and adolescents.The results lend support to the HSA as a valid measure of children’s and adolescents’ resiliencies. Furthermore, the resilience scales mostly exhibited the theoretically expected convergent and divergent relationships with the psychopathology scales. In addition, we show how the resilience scales predict adolescents’ externalizing and internalizing symptoms. We contend that evidence-based intervention to address youth aggression needs to be based on sounddevelopmental assessment.

  20. Thyroid Cancer Risk Assessment Tool

    Science.gov (United States)

    The R package thyroid implements a risk prediction model developed by NCI researchers to calculate the absolute risk of developing a second primary thyroid cancer (SPTC) in individuals who were diagnosed with a cancer during their childhood.

  1. Assessment of fracture risk

    International Nuclear Information System (INIS)

    Kanis, John A.; Johansson, Helena; Oden, Anders; McCloskey, Eugene V.

    2009-01-01

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  2. GEOGLAM Crop Assessment Tool: Adapting from global agricultural monitoring to food security monitoring

    Science.gov (United States)

    Humber, M. L.; Becker-Reshef, I.; Nordling, J.; Barker, B.; McGaughey, K.

    2014-12-01

    The GEOGLAM Crop Monitor's Crop Assessment Tool was released in August 2013 in support of the GEOGLAM Crop Monitor's objective to develop transparent, timely crop condition assessments in primary agricultural production areas, highlighting potential hotspots of stress/bumper crops. The Crop Assessment Tool allows users to view satellite derived products, best available crop masks, and crop calendars (created in collaboration with GEOGLAM Crop Monitor partners), then in turn submit crop assessment entries detailing the crop's condition, drivers, impacts, trends, and other information. Although the Crop Assessment Tool was originally intended to collect data on major crop production at the global scale, the types of data collected are also relevant to the food security and rangelands monitoring communities. In line with the GEOGLAM Countries at Risk philosophy of "foster[ing] the coordination of product delivery and capacity building efforts for national and regional organizations, and the development of harmonized methods and tools", a modified version of the Crop Assessment Tool is being developed for the USAID Famine Early Warning Systems Network (FEWS NET). As a member of the Countries at Risk component of GEOGLAM, FEWS NET provides agricultural monitoring, timely food security assessments, and early warnings of potential significant food shortages focusing specifically on countries at risk of food security emergencies. While the FEWS NET adaptation of the Crop Assessment Tool focuses on crop production in the context of food security rather than large scale production, the data collected is nearly identical to the data collected by the Crop Monitor. If combined, the countries monitored by FEWS NET and GEOGLAM Crop Monitor would encompass over 90 countries representing the most important regions for crop production and food security.

  3. Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

    Directory of Open Access Journals (Sweden)

    Christoph Heesen

    Full Text Available BACKGROUND: Prognostic counseling in multiple sclerosis (MS is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. OBJECTIVE: The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110 and their physicians (n = 6 and compared them with the estimates of OLAP. RESULTS: Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. CONCLUSION: While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic

  4. Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

    Science.gov (United States)

    Heesen, Christoph; Gaissmaier, Wolfgang; Nguyen, Franziska; Stellmann, Jan-Patrick; Kasper, Jürgen; Köpke, Sascha; Lederer, Christian; Neuhaus, Anneke; Daumer, Martin

    2013-01-01

    Prognostic counseling in multiple sclerosis (MS) is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP) tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110) and their physicians (n = 6) and compared them with the estimates of OLAP. Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic estimates and clarify its usefulness for patients and physicians

  5. Association between metabolic syndrome and bone fracture risk: A community-based study using a fracture risk assessment tool.

    Science.gov (United States)

    Yu, Chia-Ying; Chen, Fang-Ping; Chen, Li-Wei; Kuo, Sheng-Fong; Chien, Rong-Nan

    2017-12-01

    Osteoporosis and metabolic syndrome (MS) share similar risk factors. Previous studies of association between bone marrow density (BMD) and MS are controversial. Moreover, some studies revealed that MS is associated with BMD but not with bone fracture. In clinical practice, patients pay more attention to bone fracture risk than BMD values. Hence, this study aimed to evaluate the association between MS and the 10-year bone fracture risk probability using a fracture risk assessment tool (FRAX) from community-based data. From March 2014 to August 2015, 2689 participants (897 men and 1792 women) were enrolled in this study. Inflammatory cytokines, such as tumor necrosis factor alpha and C-reactive protein, and adipokines were included for analysis.The mean age was 60.2 ± 10.7 years in men and 58.9 ± 9.6 years in women. The percentage of MS was 27.6% in men and 27.9% in women. Participants were divided into 2 groups, those with or without MS. Compared with women without MS, women with MS had a higher rate of fracture risk (22.8% vs 16.3%, P = .001). In contrast, men with MS had a lower rate of fracture risk then men without MS (5.6% vs 12.3%, P = .004). However, MS loss the association with a high bone fracture risk in men based on multivariate logistical regression analysis, after adjusting for confounding factor of body mass index (BMI). Conclusively, the result of regression analysis between MS and the bone fracture risk may be different in men and women, and BMI was an important confounding factor to interfere with the regression analysis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  6. Civil migration and risk assessment methodology

    International Nuclear Information System (INIS)

    Onishi, Y.; Brown, S.M.; Olsen, A.R.; Parkhurst, M.A.

    1981-01-01

    To provide a scientific basis for risk assessment and decision making, the Chemical Migration and Risk Assessment (CMRA) Methodology was developed to simulate overland and instream toxic containment migration and fate, and to predict the probability of acute and chronic impacts on aquatic biota. The simulation results indicated that the time between the pesticide application and the subsequent runoff producing event was the most important factor determining the amount of the alachlor. The study also revealed that sediment transport has important effects on contaminant migration when sediment concentrations in receiving streams are high or contaminants are highly susceptible to adsorption by sediment. Although the capabilities of the CMRA methodology were only partially tested in this study, the results demonstrate that methodology can be used as a scientific decision-making tool for toxic chemical regulations, a research tool to evaluate the relative significance of various transport and degradation phenomena, as well as a tool to examine the effectiveness of toxic chemical control practice

  7. Stored CO2 and Methane Leakage Risk Assessment and Monitoring Tool Development: CO2 Capture Project Phase 2 (CCP2)

    Energy Technology Data Exchange (ETDEWEB)

    Dan Kieki

    2008-09-30

    The primary project goal is to develop and test tools for optimization of ECBM recovery and geologic storage of CO{sub 2} in coalbeds, in addition to tools for monitoring CO{sub 2} sequestration in coalbeds to support risk assessment. Three critical topics identified are (1) the integrity of coal bed methane geologic and engineered systems, (2) the optimization of the coal bed storage process, and (3) reliable monitoring and verification systems appropriate to the special conditions of CO{sub 2} storage and flow in coals.

  8. Trabecular bone score as an assessment tool to identify the risk of osteoporosis in axial spondyloarthritis: a case-control study.

    Science.gov (United States)

    Kang, Kwi Young; Goo, Hye Yeon; Park, Sung-Hwan; Hong, Yeon Sik

    2018-03-01

    To compare the trabecular bone score (TBS) between patients with axial spondyloarthritis (axSpA) and matched normal controls and identify risk factors associated with a low TBS. TBS and BMD were assessed in the two groups (axSpA and control) using DXA. Osteoporosis risk factors and inflammatory markers were also assessed. Disease activity and radiographic progression in the sacroiliac joint and spine were evaluated in the axSpA group. Multivariate linear regression analysis was performed to identify risk factors associated with TBS. In the axSpA group, 248 subjects were enrolled; an equal number of age- and sex-matched subjects comprised the control group. The mean TBS was 1.43 (0.08) and 1.38 (0.12) in the control and axSpA groups, respectively (P tool to identify the risk of osteoporosis in patients with axSpA.

  9. Comparison between frailty index of deficit accumulation and fracture risk assessment tool (FRAX) in prediction of risk of fractures.

    Science.gov (United States)

    Li, Guowei; Thabane, Lehana; Papaioannou, Alexandra; Adachi, Jonathan D

    2015-08-01

    A frailty index (FI) of deficit accumulation could quantify and predict the risk of fractures based on the degree of frailty in the elderly. We aimed to compare the predictive powers between the FI and the fracture risk assessment tool (FRAX) in predicting risk of major osteoporotic fracture (hip, upper arm or shoulder, spine, or wrist) and hip fracture, using the data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) 3-year Hamilton cohort. There were 3985 women included in the study, with the mean age of 69.4 years (standard deviation [SD] = 8.89). During the follow-up, there were 149 (3.98%) incident major osteoporotic fractures and 18 (0.48%) hip fractures reported. The FRAX and FI were significantly related to each other. Both FRAX and FI significantly predicted risk of major osteoporotic fracture, with a hazard ratio (HR) of 1.03 (95% confidence interval [CI]: 1.02-1.05) and 1.02 (95% CI: 1.01-1.04) for per-0.01 increment for the FRAX and FI respectively. The HRs were 1.37 (95% CI: 1.19-1.58) and 1.26 (95% CI: 1.12-1.42) for an increase of per-0.10 (approximately one SD) in the FRAX and FI respectively. Similar discriminative ability of the models was found: c-index = 0.62 for the FRAX and c-index = 0.61 for the FI. When cut-points were chosen to trichotomize participants into low-risk, medium-risk and high-risk groups, a significant increase in fracture risk was found in the high-risk group (HR = 2.04, 95% CI: 1.36-3.07) but not in the medium-risk group (HR = 1.23, 95% CI: 0.82-1.84) compared with the low-risk women for the FI, while for FRAX the medium-risk (HR = 2.00, 95% CI: 1.09-3.68) and high-risk groups (HR = 2.61, 95% CI: 1.48-4.58) predicted risk of major osteoporotic fracture significantly only when survival time exceeded 18months (550 days). Similar findings were observed for hip fracture and in sensitivity analyses. In conclusion, the FI is comparable with FRAX in the prediction of risk of future fractures, indicating that

  10. Development of Integrated Code for Risk Assessment (INCORIA) for Physical Protection System

    International Nuclear Information System (INIS)

    Jang, Sung Soon; Seo, Hyung Min; Yoo, Ho Sik

    2010-01-01

    A physical protection system (PPS) integrates people, procedures and equipment for the protection of assets or facilities against theft, sabotage or other malevolent human attacks. Among critical facilities, nuclear facilities and nuclear weapon sites require the highest level of PPS. After the September 11, 2001 terrorist attacks, international communities, including the IAEA, have made substantial efforts to protect nuclear material and nuclear facilities. The international flow on nuclear security is using the concept or risk assessment. The concept of risk assessment is firstly devised by nuclear safety people. They considered nuclear safety including its possible risk, which is the frequency of failure and possible consequence. Nuclear security people also considers security risk, which is the frequency of threat action, vulnerability, and consequences. The concept means that we should protect more when the credible threat exists and the possible radiological consequence is high. Even if there are several risk assessment methods of nuclear security, the application needs the help of tools because of a lot of calculation. It's also hard to find tools for whole phase of risk assessment. Several codes exist for the part of risk assessment. SAVI are used for vulnerability of PPS. Vital area identification code is used for consequence analysis. We are developing Integrated Code for Risk Assessment (INCORIA) to apply risk assessment methods for nuclear facilities. INCORIA evaluates PP-KINAC measures and generation tools for threat scenario. PP-KINAC is risk assessment measures for physical protection system developed by Hosik Yoo and is easy to apply. A threat scenario tool is used to generate threat scenario, which is used as one of input value to PP-KINAC measures

  11. Youth Actuarial Risk Assessment Tool (Y-ARAT): The development of an actuarial risk assessment instrument for predicting general offense recidivism on the basis of police records.

    Science.gov (United States)

    van der Put, Claudia E

    2014-06-01

    Estimating the risk for recidivism is important for many areas of the criminal justice system. In the present study, the Youth Actuarial Risk Assessment Tool (Y-ARAT) was developed for juvenile offenders based solely on police records, with the aim to estimate the risk of general recidivism among large groups of juvenile offenders by police officers without clinical expertise. On the basis of the Y-ARAT, juvenile offenders are classified into five risk groups based on (combinations of) 10 variables including different types of incidents in which the juvenile was a suspect, total number of incidents in which the juvenile was a suspect, total number of other incidents, total number of incidents in which co-occupants at the youth's address were suspects, gender, and age at first incident. The Y-ARAT was developed on a sample of 2,501 juvenile offenders and validated on another sample of 2,499 juvenile offenders, showing moderate predictive accuracy (area under the receiver-operating-characteristic curve = .73), with little variation between the construction and validation sample. The predictive accuracy of the Y-ARAT was considered sufficient to justify its use as a screening instrument for the police. © The Author(s) 2013.

  12. Transparent Global Seismic Hazard and Risk Assessment

    Science.gov (United States)

    Smolka, Anselm; Schneider, John; Pinho, Rui; Crowley, Helen

    2013-04-01

    Vulnerability to earthquakes is increasing, yet advanced reliable risk assessment tools and data are inaccessible to most, despite being a critical basis for managing risk. Also, there are few, if any, global standards that allow us to compare risk between various locations. The Global Earthquake Model (GEM) is a unique collaborative effort that aims to provide organizations and individuals with tools and resources for transparent assessment of earthquake risk anywhere in the world. By pooling data, knowledge and people, GEM acts as an international forum for collaboration and exchange, and leverages the knowledge of leading experts for the benefit of society. Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, open tools and models for seismic hazard and risk assessment. Guided by the needs and experiences of governments, companies and citizens at large, they work in continuous interaction with the wider community. A continuously expanding public-private partnership constitutes the GEM Foundation, which drives the collaborative GEM effort. An integrated and holistic approach to risk is key to GEM's risk assessment platform, OpenQuake, that integrates all above-mentioned contributions and will become available towards the end of 2014. Stakeholders worldwide will be able to calculate, visualise and investigate earthquake risk, capture new data and to share their findings for joint learning. Homogenized information on hazard can be combined with data on exposure (buildings, population) and data on their vulnerability, for loss assessment around the globe. Furthermore, for a true integrated view of seismic risk, users can add social vulnerability and resilience indices to maps and estimate the costs and benefits

  13. Become the PPUPET Master: Mastering Pressure Ulcer Risk Assessment With the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET).

    Science.gov (United States)

    Sterken, David J; Mooney, JoAnn; Ropele, Diana; Kett, Alysha; Vander Laan, Karen J

    2015-01-01

    Hospital acquired pressure ulcers (HAPU) are serious, debilitating, and preventable complications in all inpatient populations. Despite evidence of the development of pressure ulcers in the pediatric population, minimal research has been done. Based on observations gathered during quarterly HAPU audits, bedside nursing staff recognized trends in pressure ulcer locations that were not captured using current pressure ulcer risk assessment tools. Together, bedside nurses and nursing leadership created and conducted multiple research studies to investigate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). Copyright © 2015 Elsevier Inc. All rights reserved.

  14. DYNAMO-HIA--a Dynamic Modeling tool for generic Health Impact Assessments.

    Directory of Open Access Journals (Sweden)

    Stefan K Lhachimi

    Full Text Available BACKGROUND: Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA. A standard tool should comply with three technical criteria (real-life population, dynamic projection, explicit risk-factor states and three usability criteria (modest data requirements, rich model output, generally accessible to be useful in the applied setting of HIA. With DYNAMO-HIA (Dynamic Modeling for Health Impact Assessment, we introduce such a generic software tool specifically designed to facilitate quantification in the assessment of the health impacts of policies. METHODS AND RESULTS: DYNAMO-HIA quantifies the impact of user-specified risk-factor changes on multiple diseases and in turn on overall population health, comparing one reference scenario with one or more intervention scenarios. The Markov-based modeling approach allows for explicit risk-factor states and simulation of a real-life population. A built-in parameter estimation module ensures that only standard population-level epidemiological evidence is required, i.e. data on incidence, prevalence, relative risks, and mortality. DYNAMO-HIA provides a rich output of summary measures--e.g. life expectancy and disease-free life expectancy--and detailed data--e.g. prevalences and mortality/survival rates--by age, sex, and risk-factor status over time. DYNAMO-HIA is controlled via a graphical user interface and is publicly available from the internet, ensuring general accessibility. We illustrate the use of DYNAMO-HIA with two example applications: a policy causing an overall increase in alcohol consumption and quantifying the disease-burden of smoking. CONCLUSION: By combining modest data needs with general accessibility and user friendliness within the causal framework of HIA, DYNAMO-HIA is a potential standard tool for health impact assessment based

  15. Human factors questionnaire as a tool for risk assessment

    International Nuclear Information System (INIS)

    Santos, Isaac J.A.L.; Grecco, Claudio H.S.; Carvalho, Paulo V.R.; Mol, Antonio C.A.; Oliveira, Mauro V.; Augusto, Silas C.

    2009-01-01

    The human factors engineering (HFE) as a discipline, and as a process, seeks to discover and to apply knowledge about human capabilities and limitations to system and equipment design, ensuring that the system design, human tasks and work environment are compatible with the sensory, perceptual, cognitive and physical attributes of the personnel who operates systems and equipment. Risk significance considers the magnitude of the consequences (loss of life, material damage, environmental degradation) and the frequency of occurrence of a particular adverse event. The questionnaire design was based on the following definitions: the score and the classification of the nuclear safety risk. The principal benefit of applying an approach based on the risk significance in the development of the questionnaire is to ensure the identification and evaluation of the features of the projects, related to human factors, which affect the nuclear safety risk, the human actions and the safety of the nuclear plant systems. The human factors questionnaire developed in this study will provide valuable support for risk assessment, making possible the identification of design problems that can influence the evaluation of the nuclear safety risk. (author)

  16. Screening for Psychosocial Risk in Dutch Families of a Child With Cancer: Reliability, Validity, and Usability of the Psychosocial Assessment Tool

    NARCIS (Netherlands)

    Sint Nicolaas, Simone M.; Schepers, Sasja A.; Hoogerbrugge, Peter M.; Caron, Huib N.; Kaspers, Gertjan J. L.; van den Heuvel-Eibrink, Marry M.; Grootenhuis, Martha A.; Verhaak, Chris M.

    2016-01-01

    The Psychosocial Assessment Tool (PAT) was developed to screen for psychosocial risk in families of a child diagnosed with cancer. The current study is the first describing the cross-cultural adaptation, reliability, validity, and usability of the PAT in an European country (Dutch translation).   A

  17. Testing the reliability of the Fall Risk Screening Tool in an elderly ambulatory population.

    Science.gov (United States)

    Fielding, Susan J; McKay, Michael; Hyrkas, Kristiina

    2013-11-01

    To identify and test the reliability of a fall risk screening tool in an ambulatory outpatient clinic. The Fall Risk Screening Tool (Albert Lea Medical Center, MN, USA) was scripted for an interview format. Two interviewers separately screened a convenience sample of 111 patients (age ≥ 65 years) in an ambulatory outpatient clinic in a northeastern US city. The interviewers' scoring of fall risk categories was similar. There was good internal consistency (Cronbach's α = 0.834-0.889) and inter-rater reliability [intra-class correlation coefficients (ICC) = 0.824-0.881] for total, Risk Factor and Client's Health Status subscales. The Physical Environment scores indicated acceptable internal consistency (Cronbach's α = 0.742) and adequate reliability (ICC = 0.688). Two Physical Environment items (furniture and medical equipment condition) had low reliabilities [Kappa (K) = 0.323, P = 0.08; K = -0.078, P = 0.648), respectively. The scripted Fall Risk Screening Tool demonstrated good reliability in this sample. Rewording two Physical Environment items will be considered. A reliable instrument such as the scripted Fall Risk Screening Tool provides a standardised assessment for identifying high fall risk patients. This tool is especially useful because it assesses personal, behavioural and environmental factors specific to community-dwelling patients; the interview format also facilitates patient-provider interaction. © 2013 John Wiley & Sons Ltd.

  18. Risk Assessments by Female Victims of Intimate Partner Violence: Predictors of Risk Perceptions and Comparison to an Actuarial Measure

    Science.gov (United States)

    Connor-Smith, Jennifer K.; Henning, Kris; Moore, Stephanie; Holdford, Robert

    2011-01-01

    Recent studies support the validity of both structured risk assessment tools and victim perceptions as predictors of risk for repeat intimate partner violence (IPV). Combining structured risk assessments and victim risk assessments leads to better predictions of repeat violence than either alone, suggesting that the two forms of assessment provide…

  19. Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology.

    Science.gov (United States)

    Lloyd-Jones, Donald M; Huffman, Mark D; Karmali, Kunal N; Sanghavi, Darshak M; Wright, Janet S; Pelser, Colleen; Gulati, Martha; Masoudi, Frederick A; Goff, David C

    2017-03-28

    The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes-the leading causes of mortality-through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to assess a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the "ABCS" (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation). The purpose of this special report is to describe the development and intended use of the Million Hearts Longitudinal ASCVD Risk Assessment Tool. The Million Hearts Tool reinforces and builds on the "2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk" by allowing clinicians to estimate baseline and updated 10-year ASCVD risk estimates for primary prevention patients adhering to the appropriate ABCS over time, alone or in combination. The tool provides updated risk estimates based on evidence from high-quality systematic reviews and meta-analyses of the ABCS therapies. This novel approach to personalized estimation of benefits from risk-reducing therapies in primary prevention may help target therapies to those in whom they will provide the greatest benefit, and serves as the basis for a Center for Medicare & Medicaid Services program designed to evaluate the Million Hearts Cardiovascular Risk Reduction Model. Copyright © 2017 American Heart Association, Inc., and the American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Systematic review of fall risk screening tools for older patients in acute hospitals.

    Science.gov (United States)

    Matarese, Maria; Ivziku, Dhurata; Bartolozzi, Francesco; Piredda, Michela; De Marinis, Maria Grazia

    2015-06-01

    To determine the most accurate fall risk screening tools for predicting falls among patients aged 65 years or older admitted to acute care hospitals. Falls represent a serious problem in older inpatients due to the potential physical, social, psychological and economic consequences. Older inpatients present with risk factors associated with age-related physiological and psychological changes as well as multiple morbidities. Thus, fall risk screening tools for older adults should include these specific risk factors. There are no published recommendations addressing what tools are appropriate for older hospitalized adults. Systematic review. MEDLINE, CINAHL and Cochrane electronic databases were searched between January 1981-April 2013. Only prospective validation studies reporting sensitivity and specificity values were included. Recommendations of the Cochrane Handbook of Diagnostic Test Accuracy Reviews have been followed. Three fall risk assessment tools were evaluated in seven articles. Due to the limited number of studies, meta-analysis was carried out only for the STRATIFY and Hendrich Fall Risk Model II. In the combined analysis, the Hendrich Fall Risk Model II demonstrated higher sensitivity than STRATIFY, while the STRATIFY showed higher specificity. In both tools, the Youden index showed low prognostic accuracy. The identified tools do not demonstrate predictive values as high as needed for identifying older inpatients at risk for falls. For this reason, no tool can be recommended for fall detection. More research is needed to evaluate fall risk screening tools for older inpatients. © 2014 John Wiley & Sons Ltd.

  1. Selective critique of risk assessments with recommendations for improving methodology and practise

    International Nuclear Information System (INIS)

    Aven, Terje

    2011-01-01

    Risk assessments are often criticised for defending activities that could harm the environment and human health. The risk assessments produce numbers which are used to prove that the risk associated with the activity is acceptable. In this way, risk assessments seem to be a tool generally serving business. Government agencies have based their regulations on the use of risk assessment and the prevailing practise is supported by the regulations. In this paper, we look more closely into this critique. Are risk assessments being misused or are risk assessments simply not a suitable tool for guiding decision-making in the face of risks and uncertainties? Is the use of risk assessments not servicing public interests? We argue that risk assessments may provide useful decision support but the quality of the risk assessments and the associated risk assessment processes need to be improved. In this paper, three main improvement areas (success factors) are identified and discussed: (1) the scientific basis of the risk assessments needs to be strengthened, (2) the risk assessments need to provide a much broader risk picture than what is typically the case today. Separate uncertainty analyses should be carried out, extending the traditional probabilistic-based analyses and (3) the cautionary and precautionary principles need to be seen as rational risk management approaches, and their application would, to a large extent, be based on risk and uncertainty assessments.

  2. Agricultural Supply Chain Risk Assessment in the Caribbean

    OpenAIRE

    Arias Carballo, Diego; Laura, dos Reis

    2013-01-01

    A rapid agricultural supply chain risk assessment, recently developed by the World Bank, constitutes a useful tool for a system-wide approach to identify risks, risk exposure, the severity of potential loses, and options for risk management either by supply chain participants (individually or collectively) or by third parties (government). Supply chain risk management is the systematic pro...

  3. Operationalization Of The Professional Risks Assessment Activity

    Science.gov (United States)

    Ivascu, Victoria Larisa; Cirjaliu, Bianca; Draghici, Anca

    2015-07-01

    Professional risks assessment approach (integration of analysis and evaluation processes) is linked with the general concerns of nowadays companies for their employees' health and safety assurances, in the context of organizations sustainable development. The paper presents an approach for the operationalization of the professional risk assessment activity in companies through the implementation and use of the OnRisk platform (this have been tested in some industrial companies). The short presentation of the relevant technical reports and statistics on OSH management at the European Union level underlines the need for the development of a professional risks assessment. Finally, there have been described the designed and developed OnRisk platform as a web platform together with some case studies that have validate the created tool.

  4. Risk assessment and clinical decision making for colorectal cancer screening.

    Science.gov (United States)

    Schroy, Paul C; Caron, Sarah E; Sherman, Bonnie J; Heeren, Timothy C; Battaglia, Tracy A

    2015-10-01

    Shared decision making (SDM) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (PCPs) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (ACN) provides a rational strategy for reconciling these differences. To assess the importance of risk stratification in PCP decision making related to test preference for average-risk patients and receptivity to use of an electronic risk assessment tool for ACN to facilitate SDM. Mixed methods, including qualitative key informant interviews and a cross-sectional survey. PCPs at an urban, academic safety-net institution. Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool. Nine PCPs participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; P decision making, yet few providers considered risk factors other than age for average-risk patients. Providers were receptive to the use of a risk assessment tool for ACN when recommending an appropriate screening test for select patients. © 2013 John Wiley & Sons Ltd.

  5. Application of the GEM Inventory Data Capture Tools for Dynamic Vulnerability Assessment and Recovery Modelling

    Science.gov (United States)

    Verrucci, Enrica; Bevington, John; Vicini, Alessandro

    2014-05-01

    A set of open-source tools to create building exposure datasets for seismic risk assessment was developed from 2010-13 by the Inventory Data Capture Tools (IDCT) Risk Global Component of the Global Earthquake Model (GEM). The tools were designed to integrate data derived from remotely-sensed imagery, statistically-sampled in-situ field data of buildings to generate per-building and regional exposure data. A number of software tools were created to aid the development of these data, including mobile data capture tools for in-field structural assessment, and the Spatial Inventory Data Developer (SIDD) for creating "mapping schemes" - statistically-inferred distributions of building stock applied to areas of homogeneous urban land use. These tools were made publically available in January 2014. Exemplar implementations in Europe and Central Asia during the IDCT project highlighted several potential application areas beyond the original scope of the project. These are investigated here. We describe and demonstrate how the GEM-IDCT suite can be used extensively within the framework proposed by the EC-FP7 project SENSUM (Framework to integrate Space-based and in-situ sENSing for dynamic vUlnerability and recovery Monitoring). Specifically, applications in the areas of 1) dynamic vulnerability assessment (pre-event), and 2) recovery monitoring and evaluation (post-event) are discussed. Strategies for using the IDC Tools for these purposes are discussed. The results demonstrate the benefits of using advanced technology tools for data capture, especially in a systematic fashion using the taxonomic standards set by GEM. Originally designed for seismic risk assessment, it is clear the IDCT tools have relevance for multi-hazard risk assessment. When combined with a suitable sampling framework and applied to multi-temporal recovery monitoring, data generated from the tools can reveal spatio-temporal patterns in the quality of recovery activities and resilience trends can be

  6. Proposal for the testing of a tool for assessing the risk of dehydration in the elderly patient.

    Science.gov (United States)

    Bulgarelli, Ketty

    2015-09-09

    Dehydration is now the most common fluid and electrolyte disorder in older people. Because it is often associated with high rates of morbidity and mortality, it requires careful control and prevention in the context of a thorough primary care. The main risk factor for dehydration was the low intake of water by mouth for several reasons, such as lack of autonomy, altered mental status, decreased sensation of thirst, social and environmental problems. To this may be added an increase in fluid loss caused by fever, vomiting, diarrhoea, bleeding etc., the use of diuretics or laxatives and the onset of diseases that induce an increase in the loss of urine (e.g. diabetes). This paper aims to locate a tool for assessing the risk among those reported in the literature that is easy to use for the nurse and to experiment with it on a sample of patients. An analysis of the literature showed the reliability of an instrument for assessing the risk of dehydration by the name of "Dehydration Risk Appraisal Checklist." In order to verify its usefulness in identifying the risk of dehydration, 2 groups of elderly persons at the OU Geriatrics and long-term care unit of the Azienda USL of Piacenza and the OU complex Geriatric Clinic of the University Hospital of Parma were investigated. Patients in both groups were assessed on admission by the assessment scale MNA (Mini Nutritional Assessment) and by the sheet of quantitative evaluation of the meal consumed. One group was considered as the "control group". Patients belonging to the other group, which was regarded as the "experimental group", in addition to the two above-mentioned instruments, were also assessed by the "Dehydration risk appraisal checklist". In both groups, the presence or absence of four indicators of dehydration measured at the time of and immediately before discharge was then detected. In the presence of each indicator of dehydration one point was awarded for a comprehensive evaluation. The data collected were

  7. Environmental Comparative Risk Assessment: A Case Study

    International Nuclear Information System (INIS)

    Ali, M.M.

    2007-01-01

    Health and environmental impacts associated with energy production and industrial activities as well as food production and agricultural activities have had great concern in the last decades. Early activities emerged in late 80s of the last century through an Inter- Agency project (lAEA, UNDY, WHO, ... ) on the comparative risk assessment from energy systems and industrial complexes. A work-shop on Risk Assessment and Management in large industrial areas was held in Alexandria Egypt on 20-33 Det 1993, sponsored by IAEA. Several conferences, experts work groups and workshops were held there of Recent trends in determining risks are: 1. Use of probabilistic risk assessment approach to identify hazardous activities and accident scenario. 2. development of data base on failure probabilities and appropriate physical models. 3. Development of related directives and regulations and criteria Comparative risk assessment case study as a tool for comparing risk is emphasized Criteria of exposure to human and ecological risks are addressed

  8. Application of a pilot control banding tool for risk level assessment and control of nanoparticle exposures.

    Science.gov (United States)

    Paik, Samuel Y; Zalk, David M; Swuste, Paul

    2008-08-01

    Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or 'CB Nanotool' that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.

  9. A software tool integrated risk assessment of spent fuel transpotation and storage

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Mi Rae; Almomani, Belal; Ham, Jae Hyun; Kang, Hyun Gook [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Christian, Robby [Dept. of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy (Korea, Republic of); Kim, Bo Gyung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Lee, Sang Hoon [Dept. of Mechanical and Automotive Engineering, Keimyung University, Daegu (Korea, Republic of)

    2017-06-15

    When temporary spent fuel storage pools at nuclear power plants reach their capacity limit, the spent fuel must be moved to an alternative storage facility. However, radioactive materials must be handled and stored carefully to avoid severe consequences to the environment. In this study, the risks of three potential accident scenarios (i.e., maritime transportation, an aircraft crashing into an interim storage facility, and on-site transportation) associated with the spent fuel transportation process were analyzed using a probabilistic approach. For each scenario, the probabilities and the consequences were calculated separately to assess the risks: the probabilities were calculated using existing data and statistical models, and the consequences were calculated using computation models. Risk assessment software was developed to conveniently integrate the three scenarios. The risks were analyzed using the developed software according to the shipment route, building characteristics, and spent fuel handling environment. As a result of the risk analysis with varying accident conditions, transportation and storage strategies with relatively low risk were developed for regulators and licensees. The focus of this study was the risk assessment methodology; however, the applied model and input data have some uncertainties. Further research to reduce these uncertainties will improve the accuracy of this mode.

  10. A software tool integrated risk assessment of spent fuel transpotation and storage

    International Nuclear Information System (INIS)

    Yun, Mi Rae; Almomani, Belal; Ham, Jae Hyun; Kang, Hyun Gook; Christian, Robby; Kim, Bo Gyung; Lee, Sang Hoon

    2017-01-01

    When temporary spent fuel storage pools at nuclear power plants reach their capacity limit, the spent fuel must be moved to an alternative storage facility. However, radioactive materials must be handled and stored carefully to avoid severe consequences to the environment. In this study, the risks of three potential accident scenarios (i.e., maritime transportation, an aircraft crashing into an interim storage facility, and on-site transportation) associated with the spent fuel transportation process were analyzed using a probabilistic approach. For each scenario, the probabilities and the consequences were calculated separately to assess the risks: the probabilities were calculated using existing data and statistical models, and the consequences were calculated using computation models. Risk assessment software was developed to conveniently integrate the three scenarios. The risks were analyzed using the developed software according to the shipment route, building characteristics, and spent fuel handling environment. As a result of the risk analysis with varying accident conditions, transportation and storage strategies with relatively low risk were developed for regulators and licensees. The focus of this study was the risk assessment methodology; however, the applied model and input data have some uncertainties. Further research to reduce these uncertainties will improve the accuracy of this mode

  11. Combined Hydrologic (AGWA-KINEROS2) and Hydraulic (HEC2) Modeling for Post-Fire Runoff and Inundation Risk Assessment through a Set of Python Tools

    Science.gov (United States)

    Barlow, J. E.; Goodrich, D. C.; Guertin, D. P.; Burns, I. S.

    2016-12-01

    Wildfires in the Western United States can alter landscapes by removing vegetation and changing soil properties. These altered landscapes produce more runoff than pre-fire landscapes which can lead to post-fire flooding that can damage infrastructure and impair natural resources. Resources, structures, historical artifacts and others that could be impacted by increased runoff are considered values at risk. .The Automated Geospatial Watershed Assessment tool (AGWA) allows users to quickly set up and execute the Kinematic Runoff and Erosion model (KINEROS2 or K2) in the ESRI ArcMap environment. The AGWA-K2 workflow leverages the visualization capabilities of GIS to facilitate evaluation of rapid watershed assessments for post-fire planning efforts. High relative change in peak discharge, as simulated by K2, provides a visual and numeric indicator to investigate those channels in the watershed that should be evaluated for more detailed analysis, especially if values at risk are within or near that channel. Modeling inundation extent along a channel would provide more specific guidance about risk along a channel. HEC-2 and HEC-RAS can be used for hydraulic modeling efforts at the reach and river system scale. These models have been used to address flood boundaries and, accordingly, flood risk. However, data collection and organization for hydraulic models can be time consuming and therefore a combined hydrologic-hydraulic modeling approach is not often employed for rapid assessments. A simplified approach could streamline this process and provide managers with a simple workflow and tool to perform a quick risk assessment for a single reach. By focusing on a single reach highlighted by large relative change in peak discharge, data collection efforts can be minimized and the hydraulic computations can be performed to supplement risk analysis. The incorporation of hydraulic analysis through a suite of Python tools (as outlined by HEC-2) with AGWA-K2 will allow more rapid

  12. Psychometric Properties of the Psychosocial Assessment Tool-Chronic Pain Version in Families of Children With Headache.

    Science.gov (United States)

    Woods, Kristine; Ostrowski-Delahanty, Sarah

    2017-07-01

    Children with headache disorders are at increased psychosocial risk, and no validated screening measures exist to succinctly assess for risk. This study examined the psychometric properties of the Psychosocial Assessment Tool-Chronic Pain, a previously adapted screening measure of risk, in a retrospective sample of families of children diagnosed with headaches. Participants included 127 children and caregivers presenting for behavioral health evaluation of headache. Children and their primary caregivers completed several psychosocial assessment measures. Internal consistency for the Psychosocial Assessment Tool-Chronic Pain total score was high (α = 0.80), and all subscale scores had moderate to high internal consistency (α = 0.597-0.88), with the exception of the caregiver beliefs subscale (α = 0.443). The total score and the majority of subscale scores on the Psychosocial Assessment Tool-Chronic Pain were correlated with caregiver- and child-reported scores on study measures. The results demonstrate that the Psychosocial Assessment Tool-Chronic Pain has adequate psychometric properties, and because of the brief administration time, ease of scoring, and accessibility of the measure, it is a promising measure of screening for psychosocial risk in this population.

  13. Health impact assessment – A survey on quantifying tools

    Energy Technology Data Exchange (ETDEWEB)

    Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [Fakultaet fuer Gesundheitswissenschaften, Universitaet Bielefeld, Universitaetsstr. 25, 33615 Bielefeld (Germany); Mekel, Odile C.L., E-mail: odile.mekel@lzg.nrw.de [Gesundheitsdaten und analysen, Versorgungsstrukturen, Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Fintan Hurley, J., E-mail: fintan.hurley@iom-world.org [Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, Scotland (United Kingdom); Mackenbach, Johan P., E-mail: j.mackenbach@erasmusmc.nl [Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)

    2016-02-15

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

  14. Health impact assessment – A survey on quantifying tools

    International Nuclear Information System (INIS)

    Fehr, Rainer; Mekel, Odile C.L.; Fintan Hurley, J.; Mackenbach, Johan P.

    2016-01-01

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

  15. Risk assessment and management logistics chains

    Directory of Open Access Journals (Sweden)

    Vladimir Vikulov

    2014-03-01

    Full Text Available Background: In the context of economic globalization and increasing complexity of economic relations enterprises need methods and techniques to improve and sustain their position on the global market. Integration processes offer business new opportunities, but at the same time present new challenges for the management, including the key objectives of the risk management. Method: On the basis of analysis tools known from the pertinent literature (Supply Chain Management and Supply Chain Risk Management methods, methods of probability theory, methods of risk management, methods of statistics the authors of this paper proposed their own risk assessment method and the method of management of logistics chains. The proposed tool is a specific hybrid of solutions known from the literature. Results: The presented method has been successfully used within the frames of economic-mathematical model of industrial enterprises. Indicators of supply chain risks, including risks caused by supplier are considered in this paper. Authors formed a method of optimizing the level of supply chain risk in the integration with suppliers and customers. Conclusion: Every organization, which starting the process of integration with supplier and customers, needs to use tools, methodologies and techniques for identification of "weak links" in the supply chain. The proposed method allows to fix risk origin places in various links of the supply chain and to identify "weak links" of a logistic chain that may occur in the future. The method is a useful tool for managing not only risks and risk situations, but also to improve the efficiency of current assets management by providing the ability to optimize the level of risk in the current assets management of the industrial enterprise.

  16. Development of computerized risk management tool

    International Nuclear Information System (INIS)

    Kil Yoo Kim; Mee Jung Hwang; Seung Cheol Jang; Sang Hoon Han; Tae Woon Kim

    1997-01-01

    The author describes the kinds of efforts for the development of computerized risk management tool; (1) development of a risk monitor, Risk Monster, (2) improvement of McFarm (Missing Cutsets Finding Algorithm for Risk Monitor) and finally (3) development of reliability database management system, KwDBMan. Risk Monster supports for plant operators and maintenance schedulers to monitor plant risk and to avoid high peak risk by rearranging maintenance work schedule. Improved McFarm significantly improved calculation speed of Risk Monster for the cases of supporting system OOS (Out Of Service). KwDBMan manages event data, generic data and CCF (Common Cause Failure) data to support Risk Monster as well as PSA tool, KIRAP (KAERI Integrated Reliability Analysis Package)

  17. A GIS-based generic real-time risk assessment framework and decision tools for chemical spills in the river basin.

    Science.gov (United States)

    Jiang, Jiping; Wang, Peng; Lung, Wu-seng; Guo, Liang; Li, Mei

    2012-08-15

    This paper presents a generic framework and decision tools of real-time risk assessment on Emergency Environmental Decision Support System for response to chemical spills in river basin. The generic "4-step-3-model" framework is able to delineate the warning area and the impact on vulnerable receptors considering four types of hazards referring to functional area, societal impact, and human health and ecology system. Decision tools including the stand-alone system and software components were implemented on GIS platform. A detailed case study on the Songhua River nitrobenzene spill illustrated the goodness of the framework and tool Spill first responders and decision makers of catchment management will benefit from the rich, visual and dynamic hazard information output from the software. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    Science.gov (United States)

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Venous thromboembolism prophylaxis risk assessment in a general surgery cohort: a closed-loop audit.

    Science.gov (United States)

    McGoldrick, D M; Redmond, H P

    2017-08-01

    Venous thromboembolism (VTE) is a potential source of morbidity and mortality in surgical in-patients. A number of guidelines exist that advise on prophylactic measures. We aimed to assess VTE prophylaxis prescribing practices and compliance with a kardex-based risk assessment tool in a general surgery population. Data on general surgery in-patients were collected on two separate wards on two separate days. Drug kardexes were assessed for VTE prophylaxis measures and use of the risk assessment tool. NICE and SIGN guidelines were adopted as a gold standard. The audit results and information on the risk assessment tool were presented as an educational intervention at two separate departmental teaching sessions. A re-audit was completed after 3 months. In Audit A, 74 patients were assessed. 70% were emergency admissions. The risk assessment tool was completed in 2.7%. 75 and 97% of patients were correctly prescribed anti-embolic stockings (AES) and low-molecular weight heparin (LMWH), respectively. 30 patients were included in Audit B, 56% of whom were emergency admissions. 66% had a risk assessment performed, a statistically significant improvement (p audit and intervention.

  20. Dairy farmer use of price risk management tools.

    Science.gov (United States)

    Wolf, C A

    2012-07-01

    Volatility in milk and feed prices can adversely affect dairy farm profitability. Many risk management tools are available for use by US dairy farmers. This research uses surveys of Michigan dairy farmers to examine the extent to which price risk management tools have been used, the farm and operator characteristics that explain the use of these tools, and reasons farmers have not used these tools. A 1999 survey was used to benchmark the degree to which dairy producers had used milk and feed price risk management instruments to compare with 2011 use rates. The surveys collected information about the farm characteristics such as herd size, farmland operated, business organization, and solvency position. Farm operator characteristics collected include age, education, and experience. Dairy farmer use of both milk and feed price risk management tools increased between 1999 and 2011. In 2011, herd size was positively related to the use of milk price risk management tools, whereas farms organized as a sole proprietorship were less likely to use them. Also in 2011, herd size and land operated were positively related to feed price risk management tools, whereas operator age was negatively related. Reasons why farmers had not used price risk management tools included basis risk, cost, lack of management time, cooperative membership, and lack of understanding. Conclusions include the need for educational programming on price risk management tools and a broader exploration of dairy farm risk management programs. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  1. Outage Risk Assessment and Management (ORAM) technology to improve outage safety and economics

    International Nuclear Information System (INIS)

    Kalra, S.P.

    2004-01-01

    The Electric Power Research Institute (EPRI) has undertaken an aggressive program, called ORAM (Outage Risk Assessment and Management), to provide utilities with tools and technology to assist in managing risk during the planning and conduct of outages. The ORAM program consists of the following 6 steps: i) Perform utility surveys and visits on shutdown risk management needs, ii) Perform probabilistic shutdown safety assessments (PSSAs) to identify generic insights that can be incorporated into risk management guidelines and identify selected areas for the development of contingency actions, iii) Develop risk management guidelines (RMG's) that provide a systematic approach to the planning and conduct of outages from a safety perspective. Incorporate insights from the shutdown safety assessments and other operating experience into the RMG's. iv) Develop selected contingency actions including a thermalhydraulic tool kit to address higher risk time periods and activities identified in the shutdown safety assessments, v) Develop computer software that integrates all of the above capability into an easy to use tool for effective shutdown operation management for utilities, vi) Provide assistance in the transfer of this technology and the application of these tools. This paper briefly describes the technical approach and tools developed under EPRI's ORAM program and its applications for improving outage safety and economics. (author)

  2. [Patient safety in antibiotics administration: Risk assessment].

    Science.gov (United States)

    Maqueda Palau, M; Pérez Juan, E

    To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix. A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected. In this period, 257 patients received antimicrobial treatment and 26 antibiotics were evaluated. Variables studied: A risk assessment of each antibiotic using the scale Risk Assessment Tool, of the National Patient Safety Agency, as well as pH, osmolarity, type of catheter recommended for administration, and compatibility and incompatibility with other antibiotics studied. Almost two-thirds (65.3%) of antibiotics had more than 3 risk factors (represented by a yellow stripe), with the remaining 34.7% of antibiotics having between 0 and 2 risk factors (represented by a green stripe). There were no antibiotics with 6 or more risk factors (represented by a red stripe). Most drugs needed reconstitution, additional dilution, and the use of part of the vial to administer the prescribed dose. More than half of the antibiotics studied had a moderate risk level; thus measures should be adopted in order to reduce it. The risk matrix is a useful tool for the assessment and detection of weaknesses associated with the preparation and administration of intravenous antibiotics. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Web-enabling Ecological Risk Assessment for Accessibility and Transparency

    Science.gov (United States)

    Ecological risk methods and tools are necessarily diverse to account for different combinations of receptors, exposure processes, effects estimation, and degree of conservatism/realism necessary to support chemical-based assessments. These tools have been continuously developed s...

  4. Quasi-experimental study designs series-paper 6: risk of bias assessment.

    Science.gov (United States)

    Waddington, Hugh; Aloe, Ariel M; Becker, Betsy Jane; Djimeu, Eric W; Hombrados, Jorge Garcia; Tugwell, Peter; Wells, George; Reeves, Barney

    2017-09-01

    Rigorous and transparent bias assessment is a core component of high-quality systematic reviews. We assess modifications to existing risk of bias approaches to incorporate rigorous quasi-experimental approaches with selection on unobservables. These are nonrandomized studies using design-based approaches to control for unobservable sources of confounding such as difference studies, instrumental variables, interrupted time series, natural experiments, and regression-discontinuity designs. We review existing risk of bias tools. Drawing on these tools, we present domains of bias and suggest directions for evaluation questions. The review suggests that existing risk of bias tools provide, to different degrees, incomplete transparent criteria to assess the validity of these designs. The paper then presents an approach to evaluating the internal validity of quasi-experiments with selection on unobservables. We conclude that tools for nonrandomized studies of interventions need to be further developed to incorporate evaluation questions for quasi-experiments with selection on unobservables. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Risk analysis as a decision tool

    International Nuclear Information System (INIS)

    Yadigaroglu, G.; Chakraborty, S.

    1985-01-01

    From 1983 - 1985 a lecture series entitled ''Risk-benefit analysis'' was held at the Swiss Federal Institute of Technology (ETH), Zurich, in cooperation with the Central Department for the Safety of Nuclear Installations of the Swiss Federal Agency of Energy Economy. In that setting the value of risk-oriented evaluation models as a decision tool in safety questions was discussed on a broad basis. Experts of international reputation from the Federal Republic of Germany, France, Canada, the United States and Switzerland have contributed to report in this joint volume on the uses of such models. Following an introductory synopsis on risk analysis and risk assessment the book deals with practical examples in the fields of medicine, nuclear power, chemistry, transport and civil engineering. Particular attention is paid to the dialogue between analysts and decision makers taking into account the economic-technical aspects and social values. The recent chemical disaster in the Indian city of Bhopal again signals the necessity of such analyses. All the lectures were recorded individually. (orig./HP) [de

  6. Risk assessment of safety violations for coal mines

    Energy Technology Data Exchange (ETDEWEB)

    Megan Orsulaka; Vladislav Kecojevicb; Larry Graysona; Antonio Nietoa [Pennsylvania State University, University Park, PA (United States). Dept of Energy and Mineral Engineering

    2010-09-15

    This article presents an application of a risk assessment approach in characterising the risks associated with safety violations in underground bituminous mines in Pennsylvania using the Mine Safety and Health Administration (MSHA) citation database. The MSHA database on citations provides an opportunity to assess risks in mines through scrutiny of violations of mandatory safety standards. In this study, quantitative risk assessment is performed, which allows determination of the frequency of occurrence of safety violations (through associated citations) as well as the consequences of them in terms of penalty assessments. Focus is on establishing risk matrices on citation experiences of mines, which can give early indication of emerging potentially serious problems. The resulting frequency, consequence and risk rankings present valuable tools for prioritising resource allocations, determining control strategies, and could potentially contribute to more proactive prevention of incidents and injuries.

  7. Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

    Science.gov (United States)

    Wade, Dorothy M; Hankins, Matthew; Smyth, Deborah A; Rhone, Elijah E; Mythen, Michael G; Howell, David C J; Weinman, John A

    2014-09-24

    The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT's concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3 months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P psychological morbidity was good (r =0.4, P psychological morbidity (AUC =0.7). The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.

  8. Overview and Demonstration of USEPA’s Risk-Informed Materials Management (RIMM) Tool System

    Science.gov (United States)

    The Risk-Informed Materials Management (RIMM) Tool System is a data gathering and analysis platform for conducting material disposal and beneficial use assessments. Users can evaluate risks to human and ecological receptors associated with exposures to organic and inorganic chemi...

  9. Frailty screening and assessment tools: a review of characteristics and use in Public Health.

    Science.gov (United States)

    Gilardi, F; Capanna, A; Ferraro, M; Scarcella, P; Marazzi, M C; Palombi, L; Liotta, G

    2018-01-01

    Frailty screening and assessment are a fundamental issue in Public Health in order to plan prevention programs and services. By a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aims to develop an updated framework for the main procedures and measurement tools to assess frailty in older adults, paying attention to the use in the primary care setting. The study selected 10 reviews published between January 2010 and December 2016 that define some characteristics of the main tools used to measure the frailty. Within the selected reviews only one of the described tools met all the criteria (multidimensionality, quick and easy administration, accurate risk prediction of negative outcomes and high sensitivity and specificity) necessary for a screening tool. Accurate risk prediction of negative outcomes could be the appropriate and sufficient criteria to assess a tool aimed to detect frailty in the community-dwelling elderly population. A two-step process (a first short questionnaire to detect frailty and a second longer questionnaire to define the care demand at individual level) could represent the appropriate pathway for planning care services at community level.

  10. Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen.

    Science.gov (United States)

    Barclay, Joshua S; Owens, Justine E; Blackhall, Leslie J

    2014-07-01

    The use of opioids for management of cancer-related pain has increased significantly and has been associated with a substantial rise in rates of substance abuse and diversion. There is a paucity of data not only on the prevalence of substance abuse in cancer patients, but also for issues of drug use and diversion in family caregivers. This study aimed to evaluate the frequency of risk factors for substance abuse and diversion, and abnormal urine drug screens in cancer patients receiving palliative care. A retrospective chart review was performed for patients with cancer who were seen in the University of Virginia Palliative Care Clinic during the month of September 2012. We evaluated Opioid Risk Tool variables and total scores, insurance status, and urine drug screen results. Of the 114 cancer patients seen in September 2012, the mean Opioid Risk Tool score was 3.79, with 43% of patients defined as medium to high risk. Age (16-45 years old, 23%) and a personal history of alcohol (23%) or illicit drugs (21%) were the most common risk factors identified. We obtained a urine drug screen on 40% of patients, noting abnormal findings in 45.65%. Opioids are an effective treatment for cancer-related pain, yet substantial risk for substance abuse exits in the cancer population. Screening tools, such as the Opioid Risk Tool, should be used as part of a complete patient assessment to balance risk with appropriate relief of suffering.

  11. Challenges in Risk Assessment: Quantitative Risk Assessment

    OpenAIRE

    Jacxsens, Liesbeth; Uyttendaele, Mieke; De Meulenaer, Bruno

    2016-01-01

    The process of risk analysis consists out of three components, risk assessment, risk management and risk communication. These components are internationally well spread by Codex Alimentarius Commission as being the basis for setting science based standards, criteria on food safety hazards, e.g. setting maximum limits of mycotoxins in foodstuffs. However, the technical component risk assessment is hard to elaborate and to understand. Key in a risk assessment is the translation of biological or...

  12. Ethics of Risk. Kristin Shrader-Frechette's Philosophical Critique of Risk Assessment

    International Nuclear Information System (INIS)

    Heikkeroe, Topi

    2006-01-01

    This paper addresses risk assessment from a philosophical point of view. It presents and critically reviews the work of Kristin Shrader-Frechette. It introduces the ethical, epistemological, and methodological issues related to risk assessment. The paper focuses on the ethical questions of justice in risk decisions. It opens by framing the relationship between ethics and technology in the modern world. Then the paper turns to a brief description of risk assessment as a central method in technological decision making. It proceeds to show how Shrader-Frechette analyzes ethical and political aspects of risk assessment. The central argumentation In her critique follows RawIsian lines: distributive and participatory inequalities in creating technological constructions need to be justified. To clarify this requirement she formulates the Principle of Prima Facie Political Equity (PPFPE), which is her central tool in most of her ethical criticism, for instance, in relation to the future generations: prima facie. all generations should be treated equally. Brief critical remarks conclude the paper. They touch upon placing Shrader-Frechette's project on the academic chart and her liberal individualist anthropology

  13. Standardised risk analysis as a communication tool

    International Nuclear Information System (INIS)

    Pluess, Ch.; Montanarini, M.; Bernauer, M.

    1998-01-01

    Full text of publication follows: several European countries require a risk analysis for the production, storage or transport a dangerous goods. This requirement imposes considerable administrative effort for some sectors of the industry. In order to minimize the effort of such studies, a generic risk analysis for an industrial sector proved to help. Standardised procedures can consequently be derived for efficient performance of the risk investigations. This procedure was successfully established in Switzerland for natural gas transmission lines and fossil fuel storage plants. The development process of the generic risk analysis involved an intense discussion between industry and authorities about methodology of assessment and the criteria of acceptance. This process finally led to scientific consistent modelling tools for risk analysis and to an improved communication from the industry to the authorities and the public. As a recent example, the Holland-Italy natural gas transmission pipeline is demonstrated, where this method was successfully employed. Although this pipeline traverses densely populated areas in Switzerland, using this established communication method, the risk problems could be solved without delaying the planning process. (authors)

  14. 76 FR 81955 - Assessment Questionnaire-IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT)

    Science.gov (United States)

    2011-12-29

    ... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0069] Assessment Questionnaire--IP Sector... will be posted without alteration at http://www.regulations.gov , including any personal information... managers often volunteer to conduct an automated self risk assessment. The requested questionnaire...

  15. Reinforcement of qualitative risk assessment proposals from computer science

    International Nuclear Information System (INIS)

    Friedlhuber, T.; Hibti, M.; Rauzy, A.

    2013-01-01

    During the last decade a lot of research has been made to evaluate concepts and methos of quantitative risk assessment in order to predict hazards more precisely. Nevertheless, the occurrence of new catastrophes like the Indonesian Tsunami in 2004, the Deepwater Horizon accident in 2010 or recently the Fukushima accidents in 2011 raise the question whether we may underestimate some natural limits of annotative risk assessment or even mistake its significance. Especially in the case of very unlikely events, in combination with uncertainty and severe consequences, may be we would do better to concentrate more on understanding risk than on calculating probability values. In this paper we apply progresses, made in the field of computer science, to tools and modelling concepts used in risk assessment. Regarding computer science, we point out now concepts, that may improve the quality of risk models and the process of model engineering. The goal is to reinforce the importance of qualitative risk assessment with the help of sophisticated tools and modelling. Qualitative risk assessment aims to understand risk and therefore reflects the initial idea of risk assessment. Risk understanding requires understanding systems and relations of components. It is fundamental to comprehend the meaning of components in fault- and event trees, to retrace all applied modifications and to highlight critical aspects. It is important how PSA models are visualized, documented, navigated, how results are presented and how model maintenance, integration and version control are performed. Also, the conjoint usage of different type of models (for example PSA models together with event sequence diagrams) can contribute to quality assurance. We present new concepts for various kind of problems. (author)

  16. Subjective risk assessment for planning conservation projects

    International Nuclear Information System (INIS)

    Game, Edward T; Fitzsimons, James A; Lipsett-Moore, Geoff; McDonald-Madden, Eve

    2013-01-01

    Conservation projects occur under many types of uncertainty. Where this uncertainty can affect achievement of a project’s objectives, there is risk. Understanding risks to project success should influence a range of strategic and tactical decisions in conservation, and yet, formal risk assessment rarely features in the guidance or practice of conservation planning. We describe how subjective risk analysis tools can be framed to facilitate the rapid identification and assessment of risks to conservation projects, and how this information should influence conservation planning. Our approach is illustrated with an assessment of risks to conservation success as part of a conservation plan for the work of The Nature Conservancy in northern Australia. Risks can be both internal and external to a project, and occur across environmental, social, economic and political systems. Based on the relative importance of a risk and the level of certainty in its assessment we propose a series of appropriate, project level responses including research, monitoring, and active amelioration. Explicit identification, prioritization, and where possible, management of risks are important elements of using conservation resources in an informed and accountable manner. (letter)

  17. Using Spatial Multi-Criteria Analysis and Ranking Tool (SMART in earthquake risk assessment: a case study of Delhi region, India

    Directory of Open Access Journals (Sweden)

    Nishant Sinha

    2016-03-01

    Full Text Available This article is aimed at earthquake hazard, vulnerability and risk assessment as a case study to demonstrate the applicability of Spatial Multi-Criteria Analysis and Ranking Tool (SMART, which is based on Saaty's multi-criteria decision analysis (MCDA technique. The three specific study sites of Delhi were chosen for research as it corresponds to a typical patch of the urban environs, completely engrossed with residential, commercial and industrial units. The earthquake hazard affecting components are established in the form of geographic information system data-set layers including seismic zone, peak ground acceleration (PGA, soil characteristics, liquefaction potential, geological characteristics, land use, proximity to fault and epicentre. The physical vulnerability layers comprising building information, namely number of stories, year-built range, area, occupancy and construction type, derived from remote sensing imagery, were only considered for the current research. SMART was developed for earthquake risk assessment, and weights were derived both at component and its element level. Based on weighted overlay techniques, the earthquake hazard and vulnerability layers were created from which the risk maps were derived through multiplicative analysis. The developed risk maps may prove useful in decision-making process and formulating risk mitigation measures.

  18. Risk Assessment Uncertainties in Cybersecurity Investments

    Directory of Open Access Journals (Sweden)

    Andrew Fielder

    2018-06-01

    Full Text Available When undertaking cybersecurity risk assessments, it is important to be able to assign numeric values to metrics to compute the final expected loss that represents the risk that an organization is exposed to due to cyber threats. Even if risk assessment is motivated by real-world observations and data, there is always a high chance of assigning inaccurate values due to different uncertainties involved (e.g., evolving threat landscape, human errors and the natural difficulty of quantifying risk. Existing models empower organizations to compute optimal cybersecurity strategies given their financial constraints, i.e., available cybersecurity budget. Further, a general game-theoretic model with uncertain payoffs (probability-distribution-valued payoffs shows that such uncertainty can be incorporated in the game-theoretic model by allowing payoffs to be random. This paper extends previous work in the field to tackle uncertainties in risk assessment that affect cybersecurity investments. The findings from simulated examples indicate that although uncertainties in cybersecurity risk assessment lead, on average, to different cybersecurity strategies, they do not play a significant role in the final expected loss of the organization when utilising a game-theoretic model and methodology to derive these strategies. The model determines robust defending strategies even when knowledge regarding risk assessment values is not accurate. As a result, it is possible to show that the cybersecurity investments’ tool is capable of providing effective decision support.

  19. Tool-based Risk Assessment of Cloud Infrastructures as Socio-Technical Systems

    DEFF Research Database (Denmark)

    Nidd, Michael; Ivanova, Marieta Georgieva; Probst, Christian W.

    2015-01-01

    Assessing risk in cloud infrastructures is difficult. Typical cloud infrastructures contain potentially thousands of nodes that are highly interconnected and dynamic. Another important component is the set of human actors who get access to data and computing infrastructure. The cloud infrastructure...... exercise for cloud infrastructures using the socio-technical model developed in the TRESPASS project; after showing how to model typical components of a cloud infrastructure, we show how attacks are identified on this model and discuss their connection to risk assessment. The technical part of the model...... is extracted automatically from the configuration of the cloud infrastructure, which is especially important for systems so dynamic and complex....

  20. Development and validation of the FRAGIRE tool for assessment an older person's risk for frailty.

    Science.gov (United States)

    Vernerey, Dewi; Anota, Amelie; Vandel, Pierre; Paget-Bailly, Sophie; Dion, Michele; Bailly, Vanessa; Bonin, Marie; Pozet, Astrid; Foubert, Audrey; Benetkiewicz, Magdalena; Manckoundia, Patrick; Bonnetain, Franck

    2016-11-17

    Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults. A prospective multicenter recruitment of the elderly patients was undertaken in France. The subjects were classified into financially-helped group (FH, with financial assistance) and non-financially helped group (NFH, without any financial assistance), considering FH subjects are more frail than the NFH group and thus representing an acceptable surrogate population for frailty. Psychometric properties of the FRAGIRE grid were assessed including discrimination between the FH and NFH groups. Items reduction was made according to statistical analyses and experts' point of view. The association between items response and tests with "help requested status" was assessed in univariate and multivariate unconditional logistic regression analyses and a prognostic score to become frail was finally proposed for each subject. Between May 2013 and July 2013, 385 subjects were included: 338 (88%) in the FH group and 47 (12%) in the NFH group. The initial FRAGIRE grid included 65 items. After conducting the item selection, the final grid of the FRAGIRE was reduced to 19 items. The final grid showed fair discrimination ability to predict frailty (area under the curve (AUC) = 0.85) and good calibration (Hosmer-Lemeshow P-value = 0.580), reflecting a good agreement between the prediction by the final model and actual observation. The Cronbach's alpha for the developed tool scored as high as 0.69 (95% Confidence Interval: 0.64 to 0.74). The final prognostic score was excellent, with an AUC of 0

  1. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods.

    Science.gov (United States)

    Grossi, Enzo

    2006-05-03

    In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

  2. Requirements for water assessment tools: An automotive industry perspective

    Directory of Open Access Journals (Sweden)

    Sherry A. Mueller

    2015-03-01

    Full Text Available Water availability is one of the greatest global sustainability challenges. Water is not available in adequate quantity and quality in many areas and water shortfalls are expected to increase. Businesses are facing water-related challenges due to inadequate water availability and poor resource management. Identifying and quantifying impacts is key to enabling companies to make effective management decisions. Several water assessment tools have been developed to help companies understand the complex nature of water challenges; however, there remain significant gaps in the datasets and inconsistencies in measurement and reporting of geographic water shortfalls. There is a need for more complete datasets containing information on water withdrawal and discharge, freshwater availability and depletion (spatially and temporally, water quality monitoring, reuse and recycling. We discuss four of the available water assessment tools (Global Water Tool, India Water Tool, Water Risk Filter and Aqueduct and highlight those elements most critical to water-related business decisions.

  3. Validation of the Australian Midwifery Standards Assessment Tool (AMSAT): A tool to assess midwifery competence.

    Science.gov (United States)

    Sweet, Linda; Bazargan, Maryam; McKellar, Lois; Gray, Joanne; Henderson, Amanda

    2018-02-01

    There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning. This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings. A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors. Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9); valid-data extraction loaded predominantly onto one factor; and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n=83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student's practice performance and competence. The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. Identification of risk factors for moral distress in nurses: basis for the development of a new assessment tool.

    Science.gov (United States)

    Schaefer, Rafaela; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

    2016-12-01

    This article proposes to identify risk factors for moral distress from the literature, validate them through expert analysis and provide the basis for a new tool to assess the risk of moral distress among nurses. Moral distress is related to the psychological, emotional and physiological aspects of nursing. It arises from constraints caused by various circumstances and can lead to significant negative consequences. A scoping review and validation through expert analysis were used. The research question guiding this study was as follows: What is known about risk factors for moral distress in nursing? The research was conducted using multiple sources including electronic databases and lists of references from relevant literature. The final sample consisted of 38 studies. A validation analysis was conducted by experts during December 2014 and June 2015. To exclude a risk factor item, at least 80% of the experts had to agree with the exclusion. In total, 53 risk factors for moral distress were identified, reviewed by the experts and grouped to form a new instrument that may help to identify risk for moral distress and to address its consequences. © 2016 John Wiley & Sons Ltd.

  5. Thrombocalc: implementation and uptake of personalized postpartum venous thromboembolism risk assessment in a high-throughput obstetric environment.

    Science.gov (United States)

    O'Shaughnessy, Fergal; Donnelly, Jennifer C; Cooley, Sharon M; Deering, Mary; Raman, Ajita; Gannon, Geraldine; Hickey, Jane; Holland, Alan; Hayes, Niamh; Bennett, Kathleen; Ní Áinle, Fionnuala; Cleary, Brian J

    2017-11-01

    Venous thromboembolism risk assessment (VTERA) is recommended in all pregnant and postpartum women. Our objective was to develop, pilot and implement a user-friendly electronic VTERA tool. We developed "Thrombocalc", an electronic VTERA tool using Microsoft EXCEL ™ . Thrombocalc was designed as a score-based tool to facilitate rapid assessment of all women after childbirth. Calculation of a total score estimated risk of venous thromboembolism in line with consensus guidelines. Recommendations for thromboprophylaxis were included in the VTERA output. Implementation was phased. Uptake of the VTERA tool was assessed prospectively by monitoring the proportion of women who gave birth in our institution and had a completed risk assessment. Factors affecting completion and accuracy of risk assessments were also assessed. Thrombocalc was used prospectively to risk-assess 8380 women between September 2014 and December 2015. Compliance with this tool increased dramatically throughout the study period; over 92% of women were risk-assessed in the last quarter of data collection. Compliance was not adversely affected if delivery took place out of working hours [adjusted odds ratio (aOR) 1.03, 95% confidence interval (CI) 0.93-1.14]. Risk assessment was less likely in the case of cesarean deliveries (aOR 0.66, 95% CI 0.60-0.73) and stillborn infants (aOR 0.48, 95% CI 0.29-0.79). Misclassification of risk factors led to approximately 207 (2.5%) inaccurate thromboprophylaxis recommendations. Our electronic, score-based VTERA tool provides a highly effective mechanism for rapid assessment of individual postpartum venous thromboembolism risk in a high-throughput environment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. RISK IDENTIFICATION TOOLS – POLISH MSMES COMPANIES PRACTICES

    Directory of Open Access Journals (Sweden)

    Iwona Gorzeń-Mitka

    2013-07-01

    Full Text Available The purpose of this study is to present risk identification tools in Polish micro, small and medium-sized enterprises (MSMEs. Risk identification is a key element of the risk management process in companies. Correctly fitting risk identification tools affect the accuracy of management decisions. The result of research is to identify the leading risk identification tools used by MSMEs. The study was conducted in 2010-2012 using a mixed survey-monographic method and questionnaires. The qualitative data were obtained during the study.

  7. Development of Improved Caprock Integrity and Risk Assessment Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bruno, Michael [Geomechanics Technologies, Incorporated, Monrovia, CA (United States)

    2014-09-30

    GeoMechanics Technologies has completed a geomechanical caprock integrity analysis and risk assessment study funded through the US Department of Energy. The project included: a detailed review of historical caprock integrity problems experienced in the natural gas storage industry; a theoretical description and documentation of caprock integrity issues; advanced coupled transport flow modelling and geomechanical simulation of three large-scale potential geologic sequestration sites to estimate geomechanical effects from CO₂ injection; development of a quantitative risk and decision analysis tool to assess caprock integrity risks; and, ultimately the development of recommendations and guidelines for caprock characterization and CO₂ injection operating practices. Historical data from gas storage operations and CO₂ sequestration projects suggest that leakage and containment incident risks are on the order of 10-1 to 10-2, which is higher risk than some previous studies have suggested for CO₂. Geomechanical analysis, as described herein, can be applied to quantify risks and to provide operating guidelines to reduce risks. The risk assessment tool developed for this project has been applied to five areas: The Wilmington Graben offshore Southern California, Kevin Dome in Montana, the Louden Field in Illinois, the Sleipner CO₂ sequestration operation in the North Sea, and the In Salah CO₂ sequestration operation in North Africa. Of these five, the Wilmington Graben area represents the highest relative risk while the Kevin Dome area represents the lowest relative risk.

  8. Development of configuration risk management tool

    International Nuclear Information System (INIS)

    Masuda, Takahiro; Doi, Eiji

    2003-01-01

    Tokyo Electric Power Company (referred to as TEPCO hereinafter), and other Japanese utilities as well, have been trying to improve the capacity factor of their Nuclear Power Plants (NPPs) through modernization of Operation and Maintenance strategy. TEPCO intends to apply risk information to O and M field with maintaining or even improving both safety and production efficiency. Under these situations, TEPCO with some BWR utilities started to develop a Configuration Risk Management (CRM) tool that can estimate risk in various plant conditions due to configuration changes during outage. Moreover, we also intend to apply CRM to on-line maintenance (OLM) in the near future. This tool can calculate the Core Damage Frequency (CDF) according to given plant condition, such as SSCs availability, decay heat level and the inventory of coolant in both outage state and full-power operation. From deterministic viewpoint, whether certain configuration meet the related requirements of Technical Specifications. User-friendly interface is one of the important features of this tool because this enables the site engineers with little experience in PSA to quantify and utilize the risk information by this tool. (author)

  9. Risk D and D Rapid Prototype: Scenario Documentation and Analysis Tool

    International Nuclear Information System (INIS)

    Unwin, Stephen D.; Seiple, Timothy E.

    2009-01-01

    then provide a basis for identification of the optimal sequences. Under this project PNNL has developed a rapid prototype tool to support the systematic analysis of risks associated with project cost variances, schedule variances, and H and S impacts. Oracle's Primavera Risk Analysis(reg s ign) Tool (known formerly, and hereafter referred to as Pertmaster), is risk analysis software used across the DOE complex to analyze project risks. Pertmaster focuses exclusively on risks associated with project schedule and cost variances, where schedule data are supplemented with assessments of schedule/budget uncertainties and risks at the level of individual activities. Monte Carlo methods are then used to integrate activity level uncertainties/risks to produce the aggregate project-level schedule/budget projections. In this project we have produced a custom risk register that interfaces with Pertmaster, incorporating not only project risk data, but also H and S risk information. A risk register is a documentation structure in which hypothetical adverse scenarios are defined along with their prospective impacts (schedule, cost, H and S), likelihoods of occurrence, protective measures, and risk-reduction opportunities. This document outlines our approach to integration of project and H and S risk data, as well as providing instructions for the installation and use of the tool we have developed.

  10. Risk Management and Viability of Public Organizations. Development of a Risk Measurement Tool: The Case of Greece

    Directory of Open Access Journals (Sweden)

    Iordanis Eleftheriadis

    2017-03-01

    Full Text Available Purpose: This paper provides an important contribution towards the development of a valid, reliable and cost-effective instrument that reduces operational and economic risk levels in public sector organizations. Design/methodology/approach: A quantitative methodology based on the collection of primary data via a questionnaire has been adopted in this research. Findings: The research results showed that the measurement tool selected, applied, presented and proposed is comprised of three (3 scales. The reliability analysis proved that all three scales are reliable; therefore, they are suitable for use as a risk measurement instrument. Research limitations/implications: The study's academic contribution is the application and testing of the aforementioned measurement instruments, which can now be utilised by researchers in the field of risk management, to further advance the study of risk management in public organizations in Greece. On the empirical level, the implementation of these three measurement instruments can assist public organizations in Greece via an easy and fast assessment of economic and operational risks. Originality/value: This tool can help public organizations gain insight into the level of risk they face at any given point in time in order plan their actions accordingly. At the same time, central state administration will have the necessary tools to monitor and support the organizations it evaluates.

  11. Agent-Based Modelling for Security Risk Assessment

    NARCIS (Netherlands)

    Janssen, S.A.M.; Sharpans'kykh, Alexei; Bajo, J.; Vale, Z.; Hallenborg, K.; Rocha, A.P.; Mathieu, P.; Pawlewski, P.; Del Val, E.; Novais, P.; Lopes, F.; Duque Méndez, N.D.; Julián, V.; Holmgren, J.

    2017-01-01

    Security Risk Assessment is commonly performed by using traditional methods based on linear probabilistic tools and informal expert judgements. These methods lack the capability to take the inherent dynamic and intelligent nature of attackers into account. To partially address the limitations,

  12. Use of an Integrated Tool for Interpretation of Blood Glucose Data Improves Correctness of Glycemic Risk Assessment in Individuals With Type 1 and Type 2 Diabetes.

    Science.gov (United States)

    Parkin, Christopher G; Schwenke, Stephanie; Ossege, Anna Katharina; Gruchmann, Torsten

    2017-01-01

    Manufacturers now incorporate blood glucose (bG) value interpretation tools into their monitoring systems; however, usability of these support tools has not been well studied. We evaluated the utility and perceived benefits of support tool use by individuals with type 1 (T1D) and type 2 diabetes (T2D). This 3-arm, randomized, simulation study assessed the impact of use of bG value interpretation support tools on participants' ability to correctly interpret bG values, using 1 of 3 tools: a new tool that uses colored scales with target range indicator (TRI), Colors and Smiley icons (already available). Participants assessed 50 bG values without use of any tool and repeated the assessment using 1 of the 3 tool configurations. Changes in percentage of correct responses when using a support tool and user perceptions were assessed. Data sets from 140 participants were analyzed. Increases in correct responses were seen in all study groups but most notably in the TRI group (26%, P .627). Most TRI users felt confident (94%), agreed the tool will help them identify high and low values (96%) and will help them to make correct insulin dosage decisions (80%). Use of the TRI significantly increases users' ability to correctly and confidently determine their glycemic risk when self-monitoring bG levels. This suggests the tool may offer clinical value to individuals with T1D and T2D.

  13. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods

    Directory of Open Access Journals (Sweden)

    Grossi Enzo

    2006-05-01

    Full Text Available Abstract Background In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years Discussion The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. Summary The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

  14. Selecting a risk-based tool to aid in decision making

    Energy Technology Data Exchange (ETDEWEB)

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  15. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population.

    Science.gov (United States)

    Chourdakis, Michael; Hecht, Christina; Gerasimidis, Konstantinos; Joosten, Koen Fm; Karagiozoglou-Lampoudi, Thomais; Koetse, Harma A; Ksiazyk, Janusz; Lazea, Cecilia; Shamir, Raanan; Szajewska, Hania; Koletzko, Berthold; Hulst, Jessie M

    2016-05-01

    Several malnutrition screening tools have been advocated for use in pediatric inpatients. We evaluated how 3 popular pediatric nutrition screening tools [i.e., the Pediatric Yorkhill Malnutrition Score (PYMS), the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and the Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGKIDS)] compared with and were related to anthropometric measures, body composition, and clinical variables in patients who were admitted to tertiary hospitals across Europe. The 3 screening tools were applied in 2567 inpatients at 14 hospitals across 12 European countries. The classification of patients into different nutritional risk groups was compared between tools and related to anthropometric measures and clinical variables [e.g., length of hospital stay (LOS) and infection rates]. A similar rate of completion of the screening tools for each tool was achieved (PYMS: 86%; STAMP: 84%; and STRONGKIDS: 81%). Risk classification differed markedly by tool, with an overall agreement of 41% between tools. Children categorized as high risk (PYMS: 25%; STAMP: 23%; and STRONGKIDS: 10%) had a longer LOS than that of children at low risk (1.4, 1.4, and 1.8 d longer, respectively; P malnutrition risk varied across the pediatric tools used. A considerable portion of children with subnormal anthropometric measures were not identified with all of the tools. The data obtained do not allow recommending the use of any of these screening tools for clinical practice. This study was registered at clinicaltrials.gov as NCT01132742. © 2016 American Society for Nutrition.

  16. Advancing Risk Assessment through the Application of Systems Toxicology

    Science.gov (United States)

    Sauer, John Michael; Kleensang, André; Peitsch, Manuel C.; Hayes, A. Wallace

    2016-01-01

    Risk assessment is the process of quantifying the probability of a harmful effect to individuals or populations from human activities. Mechanistic approaches to risk assessment have been generally referred to as systems toxicology. Systems toxicology makes use of advanced analytical and computational tools to integrate classical toxicology and quantitative analysis of large networks of molecular and functional changes occurring across multiple levels of biological organization. Three presentations including two case studies involving both in vitro and in vivo approaches described the current state of systems toxicology and the potential for its future application in chemical risk assessment. PMID:26977253

  17. Clinical Prediction Model and Tool for Assessing Risk of Persistent Pain After Breast Cancer Surgery

    DEFF Research Database (Denmark)

    Meretoja, Tuomo J; Andersen, Kenneth Geving; Bruce, Julie

    2017-01-01

    are missing. The aim was to develop a clinically applicable risk prediction tool. Methods The prediction models were developed and tested using three prospective data sets from Finland (n = 860), Denmark (n = 453), and Scotland (n = 231). Prediction models for persistent pain of moderate to severe intensity......), high body mass index ( P = .039), axillary lymph node dissection ( P = .008), and more severe acute postoperative pain intensity at the seventh postoperative day ( P = .003) predicted persistent pain in the final prediction model, which performed well in the Danish (ROC-AUC, 0.739) and Scottish (ROC......-AUC, 0.740) cohorts. At the 20% risk level, the model had 32.8% and 47.4% sensitivity and 94.4% and 82.4% specificity in the Danish and Scottish cohorts, respectively. Conclusion Our validated prediction models and an online risk calculator provide clinicians and researchers with a simple tool to screen...

  18. Enhancing the ecological risk assessment process.

    Science.gov (United States)

    Dale, Virginia H; Biddinger, Gregory R; Newman, Michael C; Oris, James T; Suter, Glenn W; Thompson, Timothy; Armitage, Thomas M; Meyer, Judith L; Allen-King, Richelle M; Burton, G Allen; Chapman, Peter M; Conquest, Loveday L; Fernandez, Ivan J; Landis, Wayne G; Master, Lawrence L; Mitsch, William J; Mueller, Thomas C; Rabeni, Charles F; Rodewald, Amanda D; Sanders, James G; van Heerden, Ivor L

    2008-07-01

    be useful to develop case studies and/or standards of practice for interpreting lines of evidence. In addition, tools for cumulative risk assessment should be developed because contaminants are often released into stressed environments.

  19. International physical protection self-assessment tool for chemical facilities.

    Energy Technology Data Exchange (ETDEWEB)

    Tewell, Craig R.; Burdick, Brent A.; Stiles, Linda L.; Lindgren, Eric Richard

    2010-09-01

    This report is the final report for Laboratory Directed Research and Development (LDRD) Project No.130746, International Physical Protection Self-Assessment Tool for Chemical Facilities. The goal of the project was to develop an exportable, low-cost, computer-based risk assessment tool for small to medium size chemical facilities. The tool would assist facilities in improving their physical protection posture, while protecting their proprietary information. In FY2009, the project team proposed a comprehensive evaluation of safety and security regulations in the target geographical area, Southeast Asia. This approach was later modified and the team worked instead on developing a methodology for identifying potential targets at chemical facilities. Milestones proposed for FY2010 included characterizing the international/regional regulatory framework, finalizing the target identification and consequence analysis methodology, and developing, reviewing, and piloting the software tool. The project team accomplished the initial goal of developing potential target categories for chemical facilities; however, the additional milestones proposed for FY2010 were not pursued and the LDRD funding therefore was redirected.

  20. Data Center IT Equipment Energy Assessment Tools: Current State of Commercial Tools, Proposal for a Future Set of Assessment Tools

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Ben D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); National Univ., San Diego, CA (United States). School of Engineering

    2012-06-30

    This research project, which was conducted during the Summer and Fall of 2011, investigated some commercially available assessment tools with a focus on IT equipment to see if such tools could round out the DC Pro tool suite. In this research, the assessment capabilities of the various tools were compiled to help make “non-biased” information available to the public. This research should not be considered to be exhaustive on all existing vendor tools although a number of vendors were contacted. Large IT equipment OEM’s like IBM and Dell provide their proprietary internal automated software which does not work on any other IT equipment. However, found two companies with products that showed promise in performing automated assessments for IT equipment from different OEM vendors. This report documents the research and provides a list of software products reviewed, contacts and websites, product details, discussions with specific companies, a set of recommendations, and next steps. As a result of this research, a simple 3-level approach to an IT assessment tool is proposed along with an example of an assessment using a simple IT equipment data collection tool (Level 1, spreadsheet). The tool has been reviewed with the Green Grid and LBNL staff. The initial feedback has been positive although further refinement to the tool will be necessary. Proposed next steps include a field trial of at least two vendors’ software in two different data centers with an objective to prove the concept, ascertain the extent of energy and computational assessment, ease of installation and opportunities for continuous improvement. Based on the discussions, field trials (or case studies) are proposed with two vendors – JouleX (expected to be completed in 2012) and Sentilla.

  1. Methods and tools to support real time risk-based flood forecasting - a UK pilot application

    Directory of Open Access Journals (Sweden)

    Brown Emma

    2016-01-01

    Full Text Available Flood managers have traditionally used probabilistic models to assess potential flood risk for strategic planning and non-operational applications. Computational restrictions on data volumes and simulation times have meant that information on the risk of flooding has not been available for operational flood forecasting purposes. In practice, however, the operational flood manager has probabilistic questions to answer, which are not completely supported by the outputs of traditional, deterministic flood forecasting systems. In a collaborative approach, HR Wallingford and Deltares have developed methods, tools and techniques to extend existing flood forecasting systems with elements of strategic flood risk analysis, including probabilistic failure analysis, two dimensional flood spreading simulation and the analysis of flood impacts and consequences. This paper presents the results of the application of these new operational flood risk management tools to a pilot catchment in the UK. It discusses the problems of performing probabilistic flood risk assessment in real time and how these have been addressed in this study. It also describes the challenges of the communication of risk to operational flood managers and to the general public, and how these new methods and tools can provide risk-based supporting evidence to assist with this process.

  2. Using Risk Assessment Methodologies to Meet Management Objectives

    Science.gov (United States)

    DeMott, D. L.

    2015-01-01

    Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

  3. Historical Relationship Between Performance Assessment for Radioactive Waste Disposal and Other Types of Risk Assessment in the United States

    Energy Technology Data Exchange (ETDEWEB)

    RECHARD,ROBERT P.

    2000-07-14

    This paper describes the evolution of the process for assessing the hazards of a geologic disposal system for radioactive waste and, similarly, nuclear power reactors, and the relationship of this process with other assessments of risk, particularly assessments of hazards from manufactured carcinogenic chemicals during use and disposal. This perspective reviews the common history of scientific concepts for risk assessment developed to the 1950s. Computational tools and techniques developed in the late 1950s and early 1960s to analyze the reliability of nuclear weapon delivery systems were adopted in the early 1970s for probabilistic risk assessment of nuclear power reactors, a technology for which behavior was unknown. In turn, these analyses became an important foundation for performance assessment of nuclear waste disposal in the late 1970s. The evaluation of risk to human health and the environment from chemical hazards is built upon methods for assessing the dose response of radionuclides in the 1950s. Despite a shared background, however, societal events, often in the form of legislation, have affected the development path for risk assessment for human health, producing dissimilarities between these risk assessments and those for nuclear facilities. An important difference is the regulator's interest in accounting for uncertainty and the tools used to evaluate it.

  4. Historical Relationship Between Performance Assessment for Radioactive Waste Disposal and Other Types of Risk Assessment in the United States

    International Nuclear Information System (INIS)

    Rechard, Robert P.

    2000-01-01

    This paper describes the evolution of the process for assessing the hazards of a geologic disposal system for radioactive waste and, similarly, nuclear power reactors, and the relationship of this process with other assessments of risk, particularly assessments of hazards from manufactured carcinogenic chemicals during use and disposal. This perspective reviews the common history of scientific concepts for risk assessment developed to the 1950s. Computational tools and techniques developed in the late 1950s and early 1960s to analyze the reliability of nuclear weapon delivery systems were adopted in the early 1970s for probabilistic risk assessment of nuclear power reactors, a technology for which behavior was unknown. In turn, these analyses became an important foundation for performance assessment of nuclear waste disposal in the late 1970s. The evaluation of risk to human health and the environment from chemical hazards is built upon methods for assessing the dose response of radionuclides in the 1950s. Despite a shared background, however, societal events, often in the form of legislation, have affected the development path for risk assessment for human health, producing dissimilarities between these risk assessments and those for nuclear facilities. An important difference is the regulator's interest in accounting for uncertainty and the tools used to evaluate it

  5. Usability of the Upper Limb Risk Assessment (UPLIRA Method for Assessing the Risk Factors of Upper Limb Disorders

    Directory of Open Access Journals (Sweden)

    Abd Razak Noor Syafiqa

    2017-01-01

    Full Text Available It is important to design ergonomic methods or assessment with a high usability and good ergonomic features, so the method is easily adaptable to the task and the workplace environment. Usability is a measurement on how well the user can use that functionality. The study converged on testing the usability of the new tools for assessing ULDs namely as Upper Limb Risk Assessment (UPLIRA. The UPLIRA method was evaluated by 6 students (3 undergraduate students and 3 postgraduates students from University Tun Hussein Onn Malaysia (UTHM who are conducting research in ergonomic. From the feedback survey of UPLIRA method, the observers agree that the prototype of UPLIRA tool was applicable to workplace assessment for the wide range of jobs/task (mean 4.00, SD:0.632 with 83% percentage of agreement . They also indicate that UPLIRA method is quick to use (mean 3.67, SD:1.033 with percentage agreement of 67%. The scoring system and action level was rated as easy to understand (mean 3.67, SD:1.211 and (mean 4.17, SD:0.408. Conclusively, the UPLIRA method was rated as straightforward to use, applicable to wide range of tasks, and time saving as assessment can be completed within 10 minutes. In addition, the UPLIRA assessment covers an extensive range of physical, psychosocial, work organizational, and individual risk factors.

  6. Older adult mistreatment risk screening: contribution to the validation of a screening tool in a domestic setting.

    Science.gov (United States)

    Lindenbach, Jeannette M; Larocque, Sylvie; Lavoie, Anne-Marise; Garceau, Marie-Luce

    2012-06-01

    ABSTRACTThe hidden nature of older adult mistreatment renders its detection in the domestic setting particularly challenging. A validated screening instrument that can provide a systematic assessment of risk factors can facilitate this detection. One such instrument, the "expanded Indicators of Abuse" tool, has been previously validated in the Hebrew language in a hospital setting. The present study has contributed to the validation of the "e-IOA" in an English-speaking community setting in Ontario, Canada. It consisted of two phases: (a) a content validity review and adaptation of the instrument by experts throughout Ontario, and (b) an inter-rater reliability assessment by home visiting nurses. The adaptation, the "Mistreatment of Older Adult Risk Factors" tool, offers a comprehensive tool for screening in the home setting. This instrument is significant to professional practice as practitioners working with older adults will be better equipped to assess for risk of mistreatment.

  7. Development of the remedial action priority system: An improved risk assessment tool for prioritizing hazardous and radioactive-mixed waste disposal sites

    International Nuclear Information System (INIS)

    Whelan, G.; Strenge, D.L.; Steelman, B.L.; Hawley, K.A.

    1985-01-01

    The Remedial Action Priority System (RAPS) represents a methodology that prioritizes inactive hazardous and radioactive mixed-waste disposal sites in a scientific and objective manner based on limited site information. This methodology is intended to bridge the technology gap that exists between the initial site evaluation using the Hazard Ranking System (HRS) and the time-consuming process of actual field site characterization, assessment and remediation efforts. The HRS was designed as an initial screening tool to discriminate between hazardous waste sites that do not and those that are likely to power significant problems to human health, safety and/or the environment. The HRS is used by the U.S. EPA to identify sites for nomination to the National Priorities List (NPL). Because the HRS is not designed to evaluate sites containing radionuclides, a modified Hazard Ranking System (mHRS) addressing both hazardous and radioactive mixed wastes was developed by Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). Neither the HRS nor the mHRS was designed to prioritize sites that are nominated to the NPL according to their potential risks. To provide DOE with a better management tool for prioritizing funding and human resource allocations for further investigations and possible remediations at its inactive waste sites, PNL is developing the risk assessment methodology called RAPS. Use of RAPS will help DOE ensure that those sites posing the highest potential risk are addressed first

  8. Reliability of risk assessment measures used in sexually violent predator proceedings.

    Science.gov (United States)

    Miller, Cailey S; Kimonis, Eva R; Otto, Randy K; Kline, Suzonne M; Wasserman, Adam L

    2012-12-01

    The field interrater reliability of three assessment tools frequently used by mental health professionals when evaluating sex offenders' risk for reoffending--the Psychopathy Checklist-Revised (PCL-R), the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R) and the Static-99-was examined within the context of sexually violent predator program proceedings. Rater agreement was highest for the Static--99 (intraclass correlation coefficient [ICC₁] = .78) and lowest for the PCL-R (ICC₁ = .60; MnSOST-R ICC₁ = .74), although all instruments demonstrated lower field reliability than that reported in their test manuals. Findings raise concerns about the reliability of risk assessment tools that are used to inform judgments of risk in high-stake sexually violent predator proceedings. Implications for future research and suggestions for improving evaluator training to increase accuracy when informing legal decision making are discussed.

  9. Screening for Older Emergency Department Inpatients at Risk of Prolonged Hospital Stay: The Brief Geriatric Assessment Tool

    Science.gov (United States)

    Launay, Cyrille P.; de Decker, Laure; Kabeshova, Anastasiia; Annweiler, Cédric; Beauchet, Olivier

    2014-01-01

    Background The aims of this study were 1) to confirm that combinations of brief geriatric assessment (BGA) items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED); and 2) to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS. Methods Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female) recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day), use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year). The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry. Results Area under receiver operating characteristic (ROC) curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010). Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (Prisk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients. PMID:25333271

  10. From Physical Process to Economic Cost - Integrated Approaches of Landslide Risk Assessment

    Science.gov (United States)

    Klose, M.; Damm, B.

    2014-12-01

    The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their

  11. Measurement properties of tools used to assess suicidality in autistic and general population adults: A systematic review.

    Science.gov (United States)

    Cassidy, S A; Bradley, L; Bowen, E; Wigham, S; Rodgers, J

    2018-05-05

    Adults diagnosed with autism are at significantly increased risk of suicidal thoughts, suicidal behaviours and dying by suicide. However, it is unclear whether any validated tools are currently available to effectively assess suicidality in autistic adults in research and clinical practice. This is crucial for understanding and preventing premature death by suicide in this vulnerable group. This two stage systematic review therefore aimed to identify tools used to assess suicidality in autistic and general population adults, evaluate these tools for their appropriateness and measurement properties, and make recommendations for appropriate selection of suicidality assessment tools in research and clinical practice. Three databases were searched (PsycInfo, Medline and Web of Knowledge). Four frequently used suicidality assessment tools were identified, and subsequently rated for quality of the evidence in support of their measurement properties using the COSMIN checklist. Despite studies having explored suicidality in autistic adults, none had utilised a validated tool. Overall, there was lack of evidence in support of suicidality risk assessments successfully predicting future suicide attempts. We recommend adaptations to current suicidality assessment tools and priorities for future research, in order to better conceptualise suicidality and its measurement in autism. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. A lower limb assessment tool for athletes at risk of developing patellar tendinopathy.

    Science.gov (United States)

    Mann, Kerry J; Edwards, Suzi; Drinkwater, Eric J; Bird, Stephen P

    2013-03-01

    Patellar tendon abnormality (PTA) on diagnostic imaging is part of the diagnostic criteria for patellar tendinopathy. PTA and altered landing strategies are primary risk factors that increase the likelihood of asymptomatic athletes developing patellar tendinopathy. Therefore, the aim of this study was to examine the risk factors that are predictors of the presence and severity of a PTA in junior pre-elite athletes. Ten junior pre-elite male basketball athletes with a PTA were matched with 10 athletes with normal patellar tendons. Participants had patellar tendon morphology, Victorian Institute of Sport Assessment (VISA) score, body composition, lower limb flexibility, and maximum vertical jump height measured before performing five successful stop-jump tasks. During each stop-jump task, both two-dimensional and three-dimensional kinematics and ground reaction forces were recorded. Multiple regression analyses were used to identify factors for estimating PTA presence and severity, and discriminate analysis was used to classify PTA presence. Sixty-eight percent of variance for presence of a PTA was accounted for by hip joint range of motion (ROM) and knee joint angle at initial foot-ground contact (IC) during stop-jump task and quadriceps flexibility, whereas hip joint ROM during stop-jump task and VISA score accounted for 62% of variance for PTA severity. Prediction of the presence of a PTA was achieved with 95% accuracy and 95% cross-validation. An easily implemented, reliable, and valid movement screening tool composed of three criteria enables coaches and/or clinicians to predict the presence and severity of a PTA in asymptomatic athletes. This enables identification of asymptomatic athletes at higher risk of developing patellar tendinopathy, which allows the development of effective preventative measures to aid in the reduction of patellar tendinopathy injury prevalence.

  13. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches

  14. The Bristol Radiology Report Assessment Tool (BRRAT): Developing a workplace-based assessment tool for radiology reporting skills

    International Nuclear Information System (INIS)

    Wallis, A.; Edey, A.; Prothero, D.; McCoubrie, P.

    2013-01-01

    Aim: To review the development of a workplace-based assessment tool to assess the quality of written radiology reports and assess its reliability, feasibility, and validity. Materials and methods: A comprehensive literature review and rigorous Delphi study enabled the development of the Bristol Radiology Report Assessment Tool (BRRAT), which consists of 19 questions and a global assessment score. Three assessors applied the assessment tool to 240 radiology reports provided by 24 radiology trainees. Results: The reliability coefficient for the 19 questions was 0.79 and the equivalent coefficient for the global assessment scores was 0.67. Generalizability coefficients demonstrate that higher numbers of assessors and assessments are needed to reach acceptable levels of reliability for summative assessments due to assessor subjectivity. Conclusion: The study methodology gives good validity and strong foundation in best-practice. The assessment tool developed for radiology reporting is reliable and most suited to formative assessments

  15. A Monte Carlo based decision-support tool for assessing generation portfolios in future carbon constrained electricity industries

    International Nuclear Information System (INIS)

    Vithayasrichareon, Peerapat; MacGill, Iain F.

    2012-01-01

    This paper presents a novel decision-support tool for assessing future generation portfolios in an increasingly uncertain electricity industry. The tool combines optimal generation mix concepts with Monte Carlo simulation and portfolio analysis techniques to determine expected overall industry costs, associated cost uncertainty, and expected CO 2 emissions for different generation portfolio mixes. The tool can incorporate complex and correlated probability distributions for estimated future fossil-fuel costs, carbon prices, plant investment costs, and demand, including price elasticity impacts. The intent of this tool is to facilitate risk-weighted generation investment and associated policy decision-making given uncertainties facing the electricity industry. Applications of this tool are demonstrated through a case study of an electricity industry with coal, CCGT, and OCGT facing future uncertainties. Results highlight some significant generation investment challenges, including the impacts of uncertain and correlated carbon and fossil-fuel prices, the role of future demand changes in response to electricity prices, and the impact of construction cost uncertainties on capital intensive generation. The tool can incorporate virtually any type of input probability distribution, and support sophisticated risk assessments of different portfolios, including downside economic risks. It can also assess portfolios against multi-criterion objectives such as greenhouse emissions as well as overall industry costs. - Highlights: ► Present a decision support tool to assist generation investment and policy making under uncertainty. ► Generation portfolios are assessed based on their expected costs, risks, and CO 2 emissions. ► There is tradeoff among expected cost, risks, and CO 2 emissions of generation portfolios. ► Investment challenges include economic impact of uncertainties and the effect of price elasticity. ► CO 2 emissions reduction depends on the mix of

  16. Criticism on Environmental Assessment Tools

    NARCIS (Netherlands)

    Abdalla, G.; Maas, G.J.; Huyghe, J.; Oostra, M.; Saji Baby, xx; Bogdan Zygmunt, xx

    2011-01-01

    Using environmental assessment tools to assess the sustainability of buildings, homes and mixed- use area is increasing. Environmental tools assign scores to projects using some sustainability (sub) aspects according to design and realization documents and evidences. Six European sustainable urban

  17. Assessing ergonomic risks of software: Development of the SEAT.

    Science.gov (United States)

    Peres, S Camille; Mehta, Ranjana K; Ritchey, Paul

    2017-03-01

    Software utilizing interaction designs that require extensive dragging or clicking of icons may increase users' risks for upper extremity cumulative trauma disorders. The purpose of this research is to develop a Self-report Ergonomic Assessment Tool (SEAT) for assessing the risks of software interaction designs and facilitate mitigation of those risks. A 28-item self-report measure was developed by combining and modifying items from existing industrial ergonomic tools. Data were collected from 166 participants after they completed four different tasks that varied by method of input (touch or keyboard and mouse) and type of task (selecting or typing). Principal component analysis found distinct factors associated with stress (i.e., demands) and strain (i.e., response). Repeated measures analyses of variance showed that participants could discriminate the different strain induced by the input methods and tasks. However, participants' ability to discriminate between the stressors associated with that strain was mixed. Further validation of the SEAT is necessary but these results indicate that the SEAT may be a viable method of assessing ergonomics risks presented by software design. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Does diagnosis affect the predictive accuracy of risk assessment tools for juvenile offenders: Conduct Disorder and Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Khanna, Dinesh; Shaw, Jenny; Dolan, Mairead; Lennox, Charlotte

    2014-10-01

    Studies have suggested an increased risk of criminality in juveniles if they suffer from co-morbid Attention Deficit Hyperactivity Disorder (ADHD) along with Conduct Disorder. The Structured Assessment of Violence Risk in Youth (SAVRY), the Psychopathy Checklist Youth Version (PCL:YV), and Youth Level of Service/Case Management Inventory (YLS/CMI) have been shown to be good predictors of violent and non-violent re-offending. The aim was to compare the accuracy of these tools to predict violent and non-violent re-offending in young people with co-morbid ADHD and Conduct Disorder and Conduct Disorder only. The sample included 109 White-British adolescent males in secure settings. Results revealed no significant differences between the groups for re-offending. SAVRY factors had better predictive values than PCL:YV or YLS/CMI. Tools generally had better predictive values for the Conduct Disorder only group than the co-morbid group. Possible reasons for these findings have been discussed along with limitations of the study. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  19. Development, Validation and Deployment of a Real Time 30 Day Hospital Readmission Risk Assessment Tool in the Maine Healthcare Information Exchange.

    Science.gov (United States)

    Hao, Shiying; Wang, Yue; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Zheng, Le; Luo, Jin; Hu, Zhongkai; Fu, Changlin; Dai, Dorothy; Wang, Yicheng; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

    2015-01-01

    Identifying patients at risk of a 30-day readmission can help providers design interventions, and provide targeted care to improve clinical effectiveness. This study developed a risk model to predict a 30-day inpatient hospital readmission for patients in Maine, across all payers, all diseases and all demographic groups. Our objective was to develop a model to determine the risk for inpatient hospital readmission within 30 days post discharge. All patients within the Maine Health Information Exchange (HIE) system were included. The model was retrospectively developed on inpatient encounters between January 1, 2012 to December 31, 2012 from 24 randomly chosen hospitals, and then prospectively validated on inpatient encounters from January 1, 2013 to December 31, 2013 using all HIE patients. A risk assessment tool partitioned the entire HIE population into subgroups that corresponded to probability of hospital readmission as determined by a corresponding positive predictive value (PPV). An overall model c-statistic of 0.72 was achieved. The total 30-day readmission rates in low (score of 0-30), intermediate (score of 30-70) and high (score of 70-100) risk groupings were 8.67%, 24.10% and 74.10%, respectively. A time to event analysis revealed the higher risk groups readmitted to a hospital earlier than the lower risk groups. Six high-risk patient subgroup patterns were revealed through unsupervised clustering. Our model was successfully integrated into the statewide HIE to identify patient readmission risk upon admission and daily during hospitalization or for 30 days subsequently, providing daily risk score updates. The risk model was validated as an effective tool for predicting 30-day readmissions for patients across all payer, disease and demographic groups within the Maine HIE. Exposing the key clinical, demographic and utilization profiles driving each patient's risk of readmission score may be useful to providers in developing individualized post discharge

  20. Control banding tools for occupational exposure assessment of nanomaterials - Ready for use in a regulatory context?

    DEFF Research Database (Denmark)

    Liguori, Biase; Hansen, Steffen Foss; Baun, Anders

    2016-01-01

    area of concern. Therefore, a number of Control Banding (CB)-based tools have been developed in order to assess and manage the potential risks associated with occupational exposure to nanomaterials. In this paper we provide a comparative analysis of different nanomaterial-specific types of control-banding/risk...... developed for different purposes, with different application domains and inclusion criteria. The exposure assessments and derived risk levels are based on different concepts and assumptions and outputs in different formats. The use of requested input parameters for exposure assessment differ greatly among...... the tools. Therefore, direct inter-comparison and combination of the different models into a larger holistic framework is not immediately possible. Harmonization of input parameters and output could allow establishment of an exposure assessment framework with different levels of information requirements....

  1. Development of a non-expert risk assessment method for hand-arm related tasks (HARM)

    NARCIS (Netherlands)

    Douwes, M.; Kraker, H. de

    2014-01-01

    To support health and safety practitioners in their obligation of risk assessment the 'Hand Arm Risk Assessment Method' (HARM) was developed. This tool can be used by any type of company for risk assessment of developing arm, neck or shoulders symptoms (pain) resulting from light manual tasks.This

  2. Clinical assessment tools identify functional deficits in fragility fracture patients

    Directory of Open Access Journals (Sweden)

    Ames TD

    2016-05-01

    Full Text Available Tyler D Ames,1 Corinne E Wee,1 Khoi M Le,1 Tiffany L Wang,1 Julie Y Bishop,2 Laura S Phieffer,2 Carmen E Quatman2 1The Ohio State University College of Medicine, 2Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA Purpose: To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.Patients and methods: Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB, handgrip strength (handheld dynamometer, and lumbopelvic control (iPod Touch Level Belt, which were compared between fragility fracture patients and healthy controls.Results: Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042 and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026 when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020 and total components (P=0.010 of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003.Conclusion: The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. Keywords: fall risk, geriatric fracture, Nintendo Wii Balance Board, Level Belt, fragility fracture

  3. Assessing Risk and Driving Risk Mitigation for First-of-a-Kind Advanced Reactors

    International Nuclear Information System (INIS)

    Collins, John W.

    2011-01-01

    Planning and decision making amidst programmatic and technological risks represent significant challenges for projects. This presentation addresses the four step risk-assessment process needed to determine clear path forward to mature needed technology and design, license, and construct advanced nuclear power plants, which have never been built before, including Small Modular Reactors. This four step process has been carefully applied to the Next Generation Nuclear Plant. STEP 1 - Risk Identification Risks are identified, collected, and categorized as technical risks, programmatic risks, and project risks, each of which result in cost and schedule impacts if realized. These include risks arising from the use of technologies not previously demonstrated in a relevant application. These risks include normal and accident scenarios which the SMR could experience including events that cause the disablement of engineered safety features (typically documented in Phenomena Identification Ranking Tables (PIRT) as produced with the Nuclear Regulatory Commission) and design needs which must be addressed to further detail the design. Product - Project Risk Register contained in a database with sorting, presentation, rollup, risk work off functionality similar to the NGNP Risk Management System . STEP 2 - Risk Quantification The risks contained in the risk register are then scored for probability of occurrence and severity of consequence, if realized. Here the scoring methodology is established and the basis for the scoring is well documented. Product - Quantified project risk register with documented basis for scoring. STEP 3 - Risk Handling Strategy Risks are mitigated by applying a systematic approach to maturing the technology through Research and Development, modeling, test, and design. A Technology Readiness Assessment is performed to determine baseline Technology Readiness Levels (TRL). Tasks needed to mature the technology are developed and documented in a roadmap

  4. Assessing Risk and Driving Risk Mitigation for First-of-a-Kind Advanced Reactors

    Energy Technology Data Exchange (ETDEWEB)

    John W. Collins

    2011-09-01

    Planning and decision making amidst programmatic and technological risks represent significant challenges for projects. This presentation addresses the four step risk-assessment process needed to determine clear path forward to mature needed technology and design, license, and construct advanced nuclear power plants, which have never been built before, including Small Modular Reactors. This four step process has been carefully applied to the Next Generation Nuclear Plant. STEP 1 - Risk Identification Risks are identified, collected, and categorized as technical risks, programmatic risks, and project risks, each of which result in cost and schedule impacts if realized. These include risks arising from the use of technologies not previously demonstrated in a relevant application. These risks include normal and accident scenarios which the SMR could experience including events that cause the disablement of engineered safety features (typically documented in Phenomena Identification Ranking Tables (PIRT) as produced with the Nuclear Regulatory Commission) and design needs which must be addressed to further detail the design. Product - Project Risk Register contained in a database with sorting, presentation, rollup, risk work off functionality similar to the NGNP Risk Management System . STEP 2 - Risk Quantification The risks contained in the risk register are then scored for probability of occurrence and severity of consequence, if realized. Here the scoring methodology is established and the basis for the scoring is well documented. Product - Quantified project risk register with documented basis for scoring. STEP 3 - Risk Handling Strategy Risks are mitigated by applying a systematic approach to maturing the technology through Research and Development, modeling, test, and design. A Technology Readiness Assessment is performed to determine baseline Technology Readiness Levels (TRL). Tasks needed to mature the technology are developed and documented in a roadmap

  5. A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk.

    Science.gov (United States)

    Chin, Kok-Yong

    2017-09-01

    The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.

  6. Handling Interdependencies in Climate Change Risk Assessment

    Directory of Open Access Journals (Sweden)

    Richard J. Dawson

    2015-12-01

    Full Text Available Typically, a climate change risk assessment focuses on individual sectors or hazards. However, interdependencies between climate risks manifest themselves via functional, physical, geographical, economic, policy and social mechanisms. These can occur over a range of spatial or temporal scales and with different strengths of coupling. Three case studies are used to demonstrate how interdependencies can significantly alter the nature and magnitude of risk, and, consequently, investment priorities for adaptation. The three examples explore interdependencies that arise from (1 climate loading dependence; (2 mediation of two climate impacts by physical processes operating over large spatial extents; and, (3 multiple risks that are influenced by shared climatic and socio-economic drivers. Drawing upon learning from these case studies, and other work, a framework for the analysis and consideration of interdependencies in climate change risk assessment has been developed. This is an iterative learning loop that involves defining the system, scoping interaction mechanisms, applying appropriate modelling tools, identifying vulnerabilities and opportunities, and assessing the performance of adaptation interventions.

  7. Ethics of Risk. Kristin Shrader-Frechette's Philosophical Critique of Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Heikkeroe, Topi [Univ. of Helsinki (Finland). Centre for Social Ethics

    2006-09-15

    This paper addresses risk assessment from a philosophical point of view. It presents and critically reviews the work of Kristin Shrader-Frechette. It introduces the ethical, epistemological, and methodological issues related to risk assessment. The paper focuses on the ethical questions of justice in risk decisions. It opens by framing the relationship between ethics and technology in the modern world. Then the paper turns to a brief description of risk assessment as a central method in technological decision making. It proceeds to show how Shrader-Frechette analyzes ethical and political aspects of risk assessment. The central argumentation In her critique follows RawIsian lines: distributive and participatory inequalities in creating technological constructions need to be justified. To clarify this requirement she formulates the Principle of Prima Facie Political Equity (PPFPE), which is her central tool in most of her ethical criticism, for instance, in relation to the future generations: prima facie. all generations should be treated equally. Brief critical remarks conclude the paper. They touch upon placing Shrader-Frechette's project on the academic chart and her liberal individualist anthropology.

  8. The Bristol Radiology Report Assessment Tool (BRRAT): developing a workplace-based assessment tool for radiology reporting skills.

    Science.gov (United States)

    Wallis, A; Edey, A; Prothero, D; McCoubrie, P

    2013-11-01

    To review the development of a workplace-based assessment tool to assess the quality of written radiology reports and assess its reliability, feasibility, and validity. A comprehensive literature review and rigorous Delphi study enabled the development of the Bristol Radiology Report Assessment Tool (BRRAT), which consists of 19 questions and a global assessment score. Three assessors applied the assessment tool to 240 radiology reports provided by 24 radiology trainees. The reliability coefficient for the 19 questions was 0.79 and the equivalent coefficient for the global assessment scores was 0.67. Generalizability coefficients demonstrate that higher numbers of assessors and assessments are needed to reach acceptable levels of reliability for summative assessments due to assessor subjectivity. The study methodology gives good validity and strong foundation in best-practice. The assessment tool developed for radiology reporting is reliable and most suited to formative assessments. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt.

    Science.gov (United States)

    Nour-Eldein, Hebatallah; Abdelsalam, Shimaa A; Nasr, Gamila M; Abdelwahed, Hassan A

    2013-01-01

    The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aiming to improve CV prevention service. The current study is a cross-sectional descriptive analytic. Sixty-five family physicians were asked to respond to, validated anonymous questionnaire to collect data about characteristics of family physicians, their awareness, attitude, current use, barriers, and recommendations of global CV risk assessment. Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis. Awareness of guidelines of global CV risk assessment was relatively higher regarding the American guidelines (30.8%) than that recommended by World Health Organization (WHO) for Egypt (20.2%). 50.8% of participants had favorable attitude. There was statistical significant relationship between attitude scores and physician characteristics; age (P = 0.003), qualification (P = 0.001) and number of patients seen per week (P = 0.009). Routine use of global CV risk assessment tools was reported only (23%) by family physicians. Relative higher attitude scores than use of global CV risk assessment tools in practice. The most frequent barriers were related to lack of resources and shortage in training/skills and the raised suggestions were towards training.

  10. Utility of Eating Assessment Tool-10 in Predicting Aspiration in Patients with Unilateral Vocal Fold Paralysis.

    Science.gov (United States)

    Zuniga, Steven A; Ebersole, Barbara; Jamal, Nausheen

    2018-03-01

    Objective Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self-reported perception of dysphagia. Study Design Case series with chart review. Setting Academic cancer center. Subjects and Methods Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek's Penetration Aspiration Scale. Objective findings were compared to patient perception of dysphagia. Bivariate linear correlation analysis was performed to evaluate correlation between Eating Assessment Tool-10 scores and presence of aspiration. Tests of diagnostic accuracy were calculated to investigate the predictive value of Eating Assessment Tool-10 scores >9 on aspiration risk. Results Of the 35 patients with new-onset unilateral vocal fold immobility were evaluated, 25.7% (9/35) demonstrated tracheal aspiration. Mean ± SD Eating Assessment Tool-10 scores were 19.2 ± 13.7 for aspirators and 7.0 ± 7.8 for nonaspirators ( P = .016). A statistically significant correlation was demonstrated between increasing Eating Assessment Tool-10 scores and Penetration Aspiration Scale scores ( r = 0.511, P = .002). Diagnostic accuracy analysis for aspiration risk in patients with an Eating Assessment Tool-10 score >9 revealed a sensitivity of 77.8% and a specificity of 73.1%. Conclusion Patient perception of swallowing difficulty may have utility in predicting aspiration risk. An EAT-10 of >9 in patients with unilateral vocal fold immobility may portend up to a 5 times greater risk of aspiration. Routine swallow testing to assess for penetration/aspiration may be indicated in patients with unilateral vocal fold immobility.

  11. Risk assessment under deep uncertainty: A methodological comparison

    International Nuclear Information System (INIS)

    Shortridge, Julie; Aven, Terje; Guikema, Seth

    2017-01-01

    Probabilistic Risk Assessment (PRA) has proven to be an invaluable tool for evaluating risks in complex engineered systems. However, there is increasing concern that PRA may not be adequate in situations with little underlying knowledge to support probabilistic representation of uncertainties. As analysts and policy makers turn their attention to deeply uncertain hazards such as climate change, a number of alternatives to traditional PRA have been proposed. This paper systematically compares three diverse approaches for risk analysis under deep uncertainty (qualitative uncertainty factors, probability bounds, and robust decision making) in terms of their representation of uncertain quantities, analytical output, and implications for risk management. A simple example problem is used to highlight differences in the way that each method relates to the traditional risk assessment process and fundamental issues associated with risk assessment and description. We find that the implications for decision making are not necessarily consistent between approaches, and that differences in the representation of uncertain quantities and analytical output suggest contexts in which each method may be most appropriate. Finally, each methodology demonstrates how risk assessment can inform decision making in deeply uncertain contexts, informing more effective responses to risk problems characterized by deep uncertainty. - Highlights: • We compare three diverse approaches to risk assessment under deep uncertainty. • A simple example problem highlights differences in analytical process and results. • Results demonstrate how methodological choices can impact risk assessment results.

  12. Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

    Science.gov (United States)

    Boyer, Roger L.; Hamlin, Teri, L.

    2011-01-01

    This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

  13. [The application of two occupation health risk assessment models in a wooden furniture manufacturing industry].

    Science.gov (United States)

    Wang, A H; Leng, P B; Bian, G L; Li, X H; Mao, G C; Zhang, M B

    2016-10-20

    Objective: To explore the applicability of 2 different models of occupational health risk assessment in wooden furniture manufacturing industry. Methods: American EPA inhalation risk model and ICMM model of occupational health risk assessment were conducted to assess occupational health risk in a small wooden furniture enterprises, respectively. Results: There was poor protective measure and equipment of occupational disease in the plant. The concentration of wood dust in the air of two workshops was over occupational exposure limit (OEL) , and the C TWA was 8.9 mg/m 3 and 3.6 mg/m 3 , respectively. According to EPA model, the workers who exposed to benzene in this plant had high risk (9.7×10 -6 ~34.3×10 -6 ) of leukemia, and who exposed to formaldehyde had high risk (11.4 × 10 -6 ) of squamous cell carcinoma. There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating. There were very high risks to be attacked by rhinocarcinoma of the workers who exposed to wood dust for the tool of calculated risk rating, while high risk for the tool of standard-based matrix. For the workers who exposed to noise, risk of noise-induced deafness was unacceptable and medium risk using two tools, respectively. Conclusion: Both EPA model and ICMM model can appropriately predict and assessthe occupational health risk in wooden furniture manufactory, ICMM due to the relatively simple operation, easy evaluation parameters, assessment of occupational - disease - inductive factors comprehensively, and more suitable for wooden furniture production enterprise.

  14. The challenges of risk society for impact assessment

    DEFF Research Database (Denmark)

    Larsen, Sanne Vammen

    2017-01-01

    , the challenge of delivering assessments and predictions and the challenge of handling differences of opinion and debate. Through a case example of integration of climate change in strategic environmental assessment, the paper uses empirical evidence from a survey and a series of interviews to carry out......This paper takes its point of departure in Ulrich Beck’s theory of risk society and the aspects that characterise this society. The paper puts forward a hypothe- sis, on which theoretical challenges the characteristics of risk society pose to impact assessment as a decision support tool; namely...... a preliminary discussion of how the theoretical challenges are reflected in practice. The case study results show that the challenge of delivering assessments and predictions in a risk society is reflected in the current state of practice, while the challenge of handling differences of opinion and debate...

  15. Potential for MERLIN-Expo, an advanced tool for higher tier exposure assessment, within the EU chemical legislative frameworks

    International Nuclear Information System (INIS)

    Suciu, Nicoleta; Tediosi, Alice; Ciffroy, Philippe; Altenpohl, Annette; Brochot, Céline; Verdonck, Frederik; Ferrari, Federico; Giubilato, Elisa; Capri, Ettore; Fait, Gabriella

    2016-01-01

    MERLIN-Expo merges and integrates advanced exposure assessment methodologies, allowing the building of complex scenarios involving several pollution sources and targets. The assessment of exposure and risks to human health from chemicals is of major concern for policy and ultimately benefits all citizens. The development and operational fusion of the advanced exposure assessment methodologies envisaged in the MERLIN-Expo tool will have a significant impact in the long term on several policies dealing with chemical safety management. There are more than 30 agencies in Europe related to exposure and risk evaluation of chemicals, which have an important role in implementing EU policies, having especially tasks of technical, scientific, operational and/or regulatory nature. The main purpose of the present paper is to introduce MERLIN-Expo and to highlight its potential for being effectively integrated within the group of tools available to assess the risk and exposure of chemicals for EU policy. The main results show that the tool is highly suitable for use in site-specific or local impact assessment, with minor modifications it can also be used for Plant Protection Products (PPPs), biocides and REACH, while major additions would be required for a comprehensive application in the field of consumer and worker exposure assessment. - Highlights: • Exposure and risk evaluation of chemicals • Coupling environmental exposure and pharmacokinetic models • MERLIN-expo as a higher tier exposure tool • MERLIN-expo potential application in EU chemical regulations • EU legislations and policies related to risk assessment and management of chemicals

  16. Potential for MERLIN-Expo, an advanced tool for higher tier exposure assessment, within the EU chemical legislative frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Suciu, Nicoleta, E-mail: nicoleta.suciu@unicatt.it [Università Cattolica del Sacro Cuore, 29122 Piacenza (Italy); Tediosi, Alice [Aeiforia Srl, 29027 Gariga di Podenzano (PC) (Italy); Ciffroy, Philippe [Electricité de France (EDF) R& D, National Hydraulic and Environment Laboratory, 6 quai Watier, 78400 Chatou (France); Altenpohl, Annette [Österreichisches Normungsinstitut/Austrian Standards Institute, Heinestraße 38, 1020 Wien (Austria); Brochot, Céline [INERIS, Parc ALATA, BP2, 60550 Verneuil en Halatte (France); Verdonck, Frederik [ARCHE cvba, Liefkensstraat 35d, 9032 Gent-Wondelgem (Belgium); Ferrari, Federico [Aeiforia Srl, 29027 Gariga di Podenzano (PC) (Italy); Giubilato, Elisa [University Ca Foscari Venice, Department of Environmental Sciences, Informatics and Statistics, via Torino 155, 30172 Mestre-Venice (Italy); Capri, Ettore [Università Cattolica del Sacro Cuore, 29122 Piacenza (Italy); Fait, Gabriella [EFSA, via Carlo Magno 1/a, 43126 Parma (Italy)

    2016-08-15

    MERLIN-Expo merges and integrates advanced exposure assessment methodologies, allowing the building of complex scenarios involving several pollution sources and targets. The assessment of exposure and risks to human health from chemicals is of major concern for policy and ultimately benefits all citizens. The development and operational fusion of the advanced exposure assessment methodologies envisaged in the MERLIN-Expo tool will have a significant impact in the long term on several policies dealing with chemical safety management. There are more than 30 agencies in Europe related to exposure and risk evaluation of chemicals, which have an important role in implementing EU policies, having especially tasks of technical, scientific, operational and/or regulatory nature. The main purpose of the present paper is to introduce MERLIN-Expo and to highlight its potential for being effectively integrated within the group of tools available to assess the risk and exposure of chemicals for EU policy. The main results show that the tool is highly suitable for use in site-specific or local impact assessment, with minor modifications it can also be used for Plant Protection Products (PPPs), biocides and REACH, while major additions would be required for a comprehensive application in the field of consumer and worker exposure assessment. - Highlights: • Exposure and risk evaluation of chemicals • Coupling environmental exposure and pharmacokinetic models • MERLIN-expo as a higher tier exposure tool • MERLIN-expo potential application in EU chemical regulations • EU legislations and policies related to risk assessment and management of chemicals.

  17. A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Daniele Franchi

    2011-02-01

    Full Text Available Daniele Franchi1,2, Davide Cini1, Giorgio Iervasi11Istituto di Fisiologia Clinica, CNR, Pisa, Italy; 2Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, ItalyBackground: Multifactor cardiovascular disease is the leading cause of death; besides well-known cardiovascular risk factors, several emerging factors such as mental stress, diet type, and physical inactivity, have been associated to cardiovascular disease. To date, preventive strategies are based on the concept of absolute risk calculated by different algorithms and scoring systems. However, in general practice the patient's data collection represents a critical issue.Design: A new multipurpose computer-based program has been developed in order to:1 easily calculate and compare the absolute cardiovascular risk by the Framingham, Procam, and Progetto Cuore algorithms; 2 to design a web-based computerized tool for prospective collection of structured data; 3 to support the doctor in the decision-making process for patients at risk according to recent international guidelines.Methods: During a medical consultation the doctor utilizes a common computer connected by Internet to a medical server where all the patient's data and software reside. The program evaluates absolute and relative cardiovascular risk factors, personalized patient's goals, and multiparametric trends, monitors critical parameter values, and generates an automated medical report.Results: In a pilot study on 294 patients (47% males; mean age 60 ± 12 years [± SD] the global time to collect data at first consultation was 13 ± 11 minutes which declined to 8 ± 7 minutes at the subsequent consultation. In 48.2% of cases the program revealed 2 or more primary risk factor parameters outside guideline indications and gave specific clinical suggestions to return altered parameters to target values.Conclusion: The web-based system proposed here may represent a feasible and

  18. Assessment and application of national environmental databases and mapping tools at the local level to two community case studies.

    Science.gov (United States)

    Hammond, Davyda; Conlon, Kathryn; Barzyk, Timothy; Chahine, Teresa; Zartarian, Valerie; Schultz, Brad

    2011-03-01

    Communities are concerned over pollution levels and seek methods to systematically identify and prioritize the environmental stressors in their communities. Geographic information system (GIS) maps of environmental information can be useful tools for communities in their assessment of environmental-pollution-related risks. Databases and mapping tools that supply community-level estimates of ambient concentrations of hazardous pollutants, risk, and potential health impacts can provide relevant information for communities to understand, identify, and prioritize potential exposures and risk from multiple sources. An assessment of existing databases and mapping tools was conducted as part of this study to explore the utility of publicly available databases, and three of these databases were selected for use in a community-level GIS mapping application. Queried data from the U.S. EPA's National-Scale Air Toxics Assessment, Air Quality System, and National Emissions Inventory were mapped at the appropriate spatial and temporal resolutions for identifying risks of exposure to air pollutants in two communities. The maps combine monitored and model-simulated pollutant and health risk estimates, along with local survey results, to assist communities with the identification of potential exposure sources and pollution hot spots. Findings from this case study analysis will provide information to advance the development of new tools to assist communities with environmental risk assessments and hazard prioritization. © 2010 Society for Risk Analysis.

  19. Development of a system utilizing data of risk assessment

    International Nuclear Information System (INIS)

    Nagasaka, Akihiko; Takano, Kenichi; Ebisu, Mitsuhiro; Aikawa, Tadashi; Hayase, Kenichi

    2004-01-01

    This report deals with a concrete method of utilizing data of risk assessment. First, the authors point out the necessity to assess all stages of jobs (planning, meeting with contractors, performing phase of task, etc.) in risk assessment bout jobs in electric power company, because most jobs are performed by contract system and risks of a job are distributed over electric company, contractors and subcontractors. Secondly, risks estimated from past accidents and near-miss events must be included. If these 2 requirements are fulfilled, data of risk assessment can be more useful. Then below 4 forms of present data of risk assessment were developed. A form to be used in job planning stage in electric companies for efficient investment planning in safety measures. A form to be used in meetings between electric companies and contractors for checking accident prevention methods. A form to be used in meetings between contractors and subcontractors for enhancing a shared awareness of risk. A form to be used in tool box meetings for confirming safe condition and inheriting of ability of risk perception. Additionally, a data base system of risk assessment about 4 jobs was developed. This system prints out about 4 forms for each job and is useful for PDCA of safety activities. (author)

  20. The East London glaucoma prediction score: web-based validation of glaucoma risk screening tool

    Science.gov (United States)

    Stephen, Cook; Benjamin, Longo-Mbenza

    2013-01-01

    AIM It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHOD The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described: Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed: Sensitivity = 88%; Positive predictive value = 97%; Specificity = 75%. CONCLUSION Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables. PMID:23550097

  1. New evaluation tool now available to assess research quality | IDRC ...

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

    2016-04-25

    Apr 25, 2016 ... New evaluation tool now available to assess research quality ... Ratings on a scale defined by rubrics, to indicate the level at which a project ... Report: The value-for-money discourse: risks and opportunities for research for development ... Copyright · Open access policy · Privacy policy · Research ethics ...

  2. The Volcanic Hazards Assessment Support System for the Online Hazard Assessment and Risk Mitigation of Quaternary Volcanoes in the World

    Directory of Open Access Journals (Sweden)

    Shinji Takarada

    2017-12-01

    Full Text Available Volcanic hazards assessment tools are essential for risk mitigation of volcanic activities. A number of offline volcanic hazard assessment tools have been provided, but in most cases, they require relatively complex installation procedure and usage. This situation causes limited usage of volcanic hazard assessment tools among volcanologists and volcanic hazards communities. In addition, volcanic eruption chronology and detailed database of each volcano in the world are essential key information for volcanic hazard assessment, but most of them are isolated and not connected to and with each other. The Volcanic Hazard Assessment Support System aims to implement a user-friendly, WebGIS-based, open-access online system for potential hazards assessment and risk-mitigation of Quaternary volcanoes in the world. The users can get up-to-date information such as eruption chronology and geophysical monitoring data of a specific volcano using the direct link system to major volcano databases on the system. Currently, the system provides 3 simple, powerful and notable deterministic modeling simulation codes of volcanic processes, such as Energy Cone, Titan2D and Tephra2. The system provides deterministic tools because probabilistic assessment tools are normally much more computationally demanding. By using the volcano hazard assessment system, the area that would be affected by volcanic eruptions in any location near the volcano can be estimated using numerical simulations. The system is being implemented using the ASTER Global DEM covering 2790 Quaternary volcanoes in the world. The system can be used to evaluate volcanic hazards and move this toward risk-potential by overlaying the estimated distribution of volcanic gravity flows or tephra falls on major roads, houses and evacuation areas using the GIS-enabled systems. The system is developed for all users in the world who need volcanic hazards assessment tools.

  3. Nuclear Computerized Library for Assessing Reactor Risk (NUCLARR)

    International Nuclear Information System (INIS)

    Gilmore, W.E.; Blackman, H.S.; Ryan, T.G.

    1986-01-01

    The Nuclear Computerized Library for Assessing Reactor Risk (NUCLARR) program is a multiyear effort sponsored by the NRC and is being conducted at the Idaho National Engineering Laboratory (INEL). The goal of this program is to establish and operate computerized data base management tools for the human reliability data bank specification developed by Comer and Donovan. The NRC and the risk analysis community recognized that implementing a fully functional library would not be feasible, or practical, without the aid of computerized tools for management and manipulation of its data sources. The end users of the NUCLARR can be classified into three categories according to specific needs. The first category is those users interested in reviewing individual data sources for a given situation. The second category of users selects multiple data sources for a specific case, summarizing the information, and performing comparative studies. The last category of users interfaces the NUCLARR with other programming applications, such as other data banks, and simulation models of risk assessment. Project status is provided in the paper

  4. Bayesian Networks for enterprise risk assessment

    Science.gov (United States)

    Bonafede, C. E.; Giudici, P.

    2007-08-01

    According to different typologies of activity and priority, risks can assume diverse meanings and it can be assessed in different ways. Risk, in general, is measured in terms of a probability combination of an event (frequency) and its consequence (impact). To estimate the frequency and the impact (severity) historical data or expert opinions (either qualitative or quantitative data) are used. Moreover, qualitative data must be converted in numerical values or bounds to be used in the model. In the case of enterprise risk assessment the considered risks are, for instance, strategic, operational, legal and of image, which many times are difficult to be quantified. So in most cases only expert data, gathered by scorecard approaches, are available for risk analysis. The Bayesian Networks (BNs) are a useful tool to integrate different information and in particular to study the risk's joint distribution by using data collected from experts. In this paper we want to show a possible approach for building a BN in the particular case in which only prior probabilities of node states and marginal correlations between nodes are available, and when the variables have only two states.

  5. Probabilistic soil erosion modeling using the Erosion Risk Management Tool (ERMIT) after wildfires

    Science.gov (United States)

    P. R. Robichaud; W. J. Elliot; J. W. Wagenbrenner

    2011-01-01

    The decision of whether or not to apply post-fire hillslope erosion mitigation treatments, and if so, where these treatments are most needed, is a multi-step process. Land managers must assess the risk of damaging runoff and sediment delivery events occurring on the unrecovered burned hillslope. We developed the Erosion Risk Management Tool (ERMiT) to address this need...

  6. Severe accidents risk assessment as a basis for emergency preparedness

    International Nuclear Information System (INIS)

    Sinka, D.; Mikulicic, V.

    2000-01-01

    The paper demonstrates, by example of the Republic of Croatia, the possibilities of implementing risk assessment as basis for nuclear accident emergency preparedness development. Individual risks of severe accidents for citizens of the biggest Croatian population centers, as well as collective risk for entire population have been assessed using the PRONEL method. The assessment covered 90 power reactors located at a distance up to 1.000 km. The conducted assessment shows the risks for various regions of the Republic of Croatia, and comparison between them. If risk would be taken as basic criterion in nuclear emergency planning, the results of assessment would directly indicate the necessary preparation level for each region. Furthermore, the assessment of risks from individual power plants and power plant types indicates to which facilities the greatest attention should be paid in nuclear accidents preparedness development. Risks from groups of power plants formed in accordance with their respective distance from exposure location shows what kind of tools for determining consequences and protective actions during a nuclear accident should be made available. (author)

  7. Validation of assessment tools for identifying trauma symptomatology in young children exposed to trauma

    DEFF Research Database (Denmark)

    Schandorph Løkkegaard, Sille; Elmose, Mette; Elklit, Ask

    There is a lack of Danish validated, developmentally sensitive assessment tools for preschool and young school children exposed to psychological trauma. Consequently, young traumatised children are at risk of not being identified. The purpose of this project is to validate three assessment tools...... that identify trauma symptomatology in young children; a caregiver interview called the Diagnostic Infant and Preschool Assessment (DIPA), a structured play test called the Odense Child Trauma Screening (OCTS), and a child questionnaire called the Darryl Cartoon Test. Three validity studies were conducted...

  8. Toward risk assessment 2.0: Safety supervisory control and model-based hazard monitoring for risk-informed safety interventions

    International Nuclear Information System (INIS)

    Favarò, Francesca M.; Saleh, Joseph H.

    2016-01-01

    Probabilistic Risk Assessment (PRA) is a staple in the engineering risk community, and it has become to some extent synonymous with the entire quantitative risk assessment undertaking. Limitations of PRA continue to occupy researchers, and workarounds are often proposed. After a brief review of this literature, we propose to address some of PRA's limitations by developing a novel framework and analytical tools for model-based system safety, or safety supervisory control, to guide safety interventions and support a dynamic approach to risk assessment and accident prevention. Our work shifts the emphasis from the pervading probabilistic mindset in risk assessment toward the notions of danger indices and hazard temporal contingency. The framework and tools here developed are grounded in Control Theory and make use of the state-space formalism in modeling dynamical systems. We show that the use of state variables enables the definition of metrics for accident escalation, termed hazard levels or danger indices, which measure the “proximity” of the system state to adverse events, and we illustrate the development of such indices. Monitoring of the hazard levels provides diagnostic information to support both on-line and off-line safety interventions. For example, we show how the application of the proposed tools to a rejected takeoff scenario provides new insight to support pilots’ go/no-go decisions. Furthermore, we augment the traditional state-space equations with a hazard equation and use the latter to estimate the times at which critical thresholds for the hazard level are (b)reached. This estimation process provides important prognostic information and produces a proxy for a time-to-accident metric or advance notice for an impending adverse event. The ability to estimate these two hazard coordinates, danger index and time-to-accident, offers many possibilities for informing system control strategies and improving accident prevention and risk mitigation

  9. Dementia Population Risk Tool (DemPoRT): study protocol for a predictive algorithm assessing dementia risk in the community.

    Science.gov (United States)

    Fisher, Stacey; Hsu, Amy; Mojaverian, Nassim; Taljaard, Monica; Huyer, Gregory; Manuel, Douglas G; Tanuseputro, Peter

    2017-10-24

    The burden of disease from dementia is a growing global concern as incidence increases dramatically with age, and average life expectancy has been increasing around the world. Planning for an ageing population requires reliable projections of dementia prevalence; however, existing population projections are simple and have poor predictive accuracy. The Dementia Population Risk Tool (DemPoRT) will predict incidence of dementia in the population setting using multivariable modelling techniques and will be used to project dementia prevalence. The derivation cohort will consist of elderly Ontario respondents of the Canadian Community Health Survey (CCHS) (2001, 2003, 2005 and 2007; 18 764 males and 25 288 females). Prespecified predictors include sociodemographic, general health, behavioural, functional and health condition variables. Incident dementia will be identified through individual linkage of survey respondents to population-level administrative healthcare databases (1797 and 3281 events, and 117 795 and 166 573 person-years of follow-up, for males and females, respectively, until 31 March 2014). Using time of first dementia capture as the primary outcome and death as a competing risk, sex-specific proportional hazards regression models will be estimated. The 2008/2009 CCHS survey will be used for validation (approximately 4600 males and 6300 females). Overall calibration and discrimination will be assessed as well as calibration within predefined subgroups of importance to clinicians and policy makers. Research ethics approval has been granted by the Ottawa Health Science Network Research Ethics Board. DemPoRT results will be submitted for publication in peer-review journals and presented at scientific meetings. The algorithm will be assessable online for both population and individual uses. ClinicalTrials.gov NCT03155815, pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  10. Interactive web visualization tools to the results interpretation of a seismic risk study aimed at the emergency levels definition

    Science.gov (United States)

    Rivas-Medina, A.; Gutierrez, V.; Gaspar-Escribano, J. M.; Benito, B.

    2009-04-01

    Results of a seismic risk assessment study are often applied and interpreted by users unspecialised on the topic or lacking a scientific background. In this context, the availability of tools that help translating essentially scientific contents to broader audiences (such as decision makers or civil defence officials) as well as representing and managing results in a user-friendly fashion, are on indubitable value. On of such tools is the visualization tool VISOR-RISNA, a web tool developed within the RISNA project (financed by the Emergency Agency of Navarre, Spain) for regional seismic risk assessment of Navarre and the subsequent development of emergency plans. The RISNA study included seismic hazard evaluation, geotechnical characterization of soils, incorporation of site effects to expected ground motions, vulnerability distribution assessment and estimation of expected damage distributions for a 10% probability of exceedance in 50 years. The main goal of RISNA was the identification of higher risk area where focusing detailed, local-scale risk studies in the future and the corresponding urban emergency plans. A geographic information system was used to combine different information layers, generate tables of results and represent maps with partial and final results. The visualization tool VISOR-RISNA is intended to facilitate the interpretation and representation of the collection of results, with the ultimate purpose of defining actuation plans. A number of criteria for defining actuation priorities are proposed in this work. They are based on combinations of risk parameters resulting from the risk study (such as expected ground motion and damage and exposed population), as determined by risk assessment specialists. Although the values that these parameters take are a result of the risk study, their distribution in several classes depends on the intervals defined by decision takers or civil defense officials. These criteria provide a ranking of

  11. Effectiveness of a web-based personalized rheumatoid arthritis risk tool with or without a health educator for knowledge of RA risk factors.

    Science.gov (United States)

    Prado, Maria G; Iversen, Maura D; Yu, Zhi; Miller Kroouze, Rachel; Triedman, Nellie A; Kalia, Sarah S; Lu, Bing; Green, Robert C; Karlson, Elizabeth W; Sparks, Jeffrey A

    2018-01-05

    To assess knowledge of rheumatoid arthritis (RA) risk factors among unaffected first-degree relatives (FDRs) and to study whether a personalized RA education tool increases risk factor knowledge. We performed a randomized controlled trial assessing RA educational interventions among 238 FDRs. The web-based Personalized Risk Estimator for RA (PRE-RA) tool displayed personalized RA risk results (genetics, autoantibodies, demographics, and behaviors) and educated about risk factors. Subjects were randomly assigned to: Comparison arm (standard RA education, n=80), PRE-RA arm (PRE-RA alone, n=78), or PRE-RA Plus arm (PRE-RA and a one-on-one session with a trained health educator, n=80). The RA Knowledge Score (RAKS, the number of 8 established RA risk factors identified as related to RA) was calculated at baseline and post-education (immediate/6 weeks/6 months/12 months). We compared RAKS and its components at each post-education point by randomization arm. At baseline before education, few FDRs identified behavioral RA risk factors (15.9% for dental health, 31.9% for smoking, 47.5% for overweight/obesity, and 54.2% for diet). After education, RAKS increased in all arms, higher in PRE-RA and PRE-RA Plus than Comparison at all post-education points (peducation (proportion agreeing smoking is a risk factor at 6 weeks: 83.1% in PRE-RA Plus arm, 71.8% in PRE-RA, and 43.1% in Comparison arms, peducation tool successfully increased RA risk factor knowledge. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. A perspective of PC-based probabilistic risk assessment

    International Nuclear Information System (INIS)

    Sattison, M.B.; Rasmuson, D.M.; Robinson, R.C.; Russell, K.D.; Van Siclen, V.S.

    1987-01-01

    Probabilistic risk assessment (PRA) information has been under-utilized in the past due to the large effort required to input the PRA data and the large expense of the computers needed to run PRA codes. The microcomputer-based Integrated Reliability and Risk Analysis System (IRRAS) and the System Analysis and Risk Assessment (SARA) System, under development at the Idaho National Engineering Laboratory, have greatly enhanced the ability of managers to use PRA techniques in their decision-making. IRRAS is a tool that allows an analyst to create, modify, update, and reanalyze a plant PRA to keep the risk assessment current with the plant's configuration and operation. The SARA system is used to perform sensitivity studies on the results of a PRA. This type of analysis can be used to evaluate proposed changes to a plant or its operation. The success of these two software projects demonstrate that risk information can be made readily available to those that need it. This is the first step in the development of a true risk management capability

  13. Proposals for enhanced health risk assessment and stratification in an integrated care scenario.

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-04-15

    Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Responsible teams for regional data management in the five ACT regions. We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require

  14. Development and validation of the FRAGIRE tool for assessment an older person’s risk for frailty

    Directory of Open Access Journals (Sweden)

    Dewi Vernerey

    2016-11-01

    Full Text Available Abstract Background Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE that accurately predicts the risk for frailty in older adults. Methods A prospective multicenter recruitment of the elderly patients was undertaken in France. The subjects were classified into financially-helped group (FH, with financial assistance and non-financially helped group (NFH, without any financial assistance, considering FH subjects are more frail than the NFH group and thus representing an acceptable surrogate population for frailty. Psychometric properties of the FRAGIRE grid were assessed including discrimination between the FH and NFH groups. Items reduction was made according to statistical analyses and experts’ point of view. The association between items response and tests with “help requested status” was assessed in univariate and multivariate unconditional logistic regression analyses and a prognostic score to become frail was finally proposed for each subject. Results Between May 2013 and July 2013, 385 subjects were included: 338 (88% in the FH group and 47 (12% in the NFH group. The initial FRAGIRE grid included 65 items. After conducting the item selection, the final grid of the FRAGIRE was reduced to 19 items. The final grid showed fair discrimination ability to predict frailty (area under the curve (AUC = 0.85 and good calibration (Hosmer-Lemeshow P-value = 0.580, reflecting a good agreement between the prediction by the final model and actual observation. The Cronbach's alpha for the developed tool scored as high as 0.69 (95% Confidence Interval: 0.64 to 0.74. The final

  15. Iatrogenic Opioid Withdrawal in Critically Ill Patients: A Review of Assessment Tools and Management.

    Science.gov (United States)

    Chiu, Ada W; Contreras, Sofia; Mehta, Sangeeta; Korman, Jennifer; Perreault, Marc M; Williamson, David R; Burry, Lisa D

    2017-12-01

    To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management. Reference list of identified literature was searched for additional references as well as www.clinicaltrials.gov . We restricted articles to those in English and dealing with humans. We identified 2 validated pediatric critically ill opioid withdrawal assessment tools: (1) Withdrawal Assessment Tool-Version 1 (WAT-1) and (2) Sophia Observation Withdrawal Symptoms Scale (SOS). Neither tool differentiated between opioid and benzodiazepine withdrawal. WAT-1 was evaluated in critically ill adults but not found to be valid. No other adult tool was identified. For management, we identified 5 randomized controlled trials, 2 prospective studies, and 2 systematic reviews. Most studies were small and only 2 studies utilized a validated assessment tool. Enteral methadone, α-2 agonists, and protocolized weaning were studied. We identified 2 validated assessment tools for pediatric intensive care unit patients; no valid tool for adults. Management strategies tested in small trials included methadone, α-2 agonists, and protocolized sedation/weaning. We challenge researchers to create validated tools assessing specifically for opioid withdrawal in critically ill children and adults to direct management.

  16. Probabilistic risk assessment of HTGRs

    International Nuclear Information System (INIS)

    Fleming, K.N.; Houghton, W.J.; Hannaman, G.W.; Joksimovic, V.

    1980-08-01

    Probabilistic Risk Assessment methods have been applied to gas-cooled reactors for more than a decade and to HTGRs for more than six years in the programs sponsored by the US Department of Energy. Significant advancements to the development of PRA methodology in these programs are summarized as are the specific applications of the methods to HTGRs. Emphasis here is on PRA as a tool for evaluating HTGR design options. Current work and future directions are also discussed

  17. Risk assessment techniques with applicability in marine engineering

    Science.gov (United States)

    Rudenko, E.; Panaitescu, F. V.; Panaitescu, M.

    2015-11-01

    Nowadays risk management is a carefully planned process. The task of risk management is organically woven into the general problem of increasing the efficiency of business. Passive attitude to risk and awareness of its existence are replaced by active management techniques. Risk assessment is one of the most important stages of risk management, since for risk management it is necessary first to analyze and evaluate risk. There are many definitions of this notion but in general case risk assessment refers to the systematic process of identifying the factors and types of risk and their quantitative assessment, i.e. risk analysis methodology combines mutually complementary quantitative and qualitative approaches. Purpose of the work: In this paper we will consider as risk assessment technique Fault Tree analysis (FTA). The objectives are: understand purpose of FTA, understand and apply rules of Boolean algebra, analyse a simple system using FTA, FTA advantages and disadvantages. Research and methodology: The main purpose is to help identify potential causes of system failures before the failures actually occur. We can evaluate the probability of the Top event.The steps of this analize are: the system's examination from Top to Down, the use of symbols to represent events, the use of mathematical tools for critical areas, the use of Fault tree logic diagrams to identify the cause of the Top event. Results: In the finally of study it will be obtained: critical areas, Fault tree logical diagrams and the probability of the Top event. These results can be used for the risk assessment analyses.

  18. BYMUR software: a free and open source tool for quantifying and visualizing multi-risk analyses

    Science.gov (United States)

    Tonini, Roberto; Selva, Jacopo

    2013-04-01

    The BYMUR software aims to provide an easy-to-use open source tool for both computing multi-risk and managing/visualizing/comparing all the inputs (e.g. hazard, fragilities and exposure) as well as the corresponding results (e.g. risk curves, risk indexes). For all inputs, a complete management of inter-model epistemic uncertainty is considered. The BYMUR software will be one of the final products provided by the homonymous ByMuR project (http://bymur.bo.ingv.it/) funded by Italian Ministry of Education, Universities and Research (MIUR), focused to (i) provide a quantitative and objective general method for a comprehensive long-term multi-risk analysis in a given area, accounting for inter-model epistemic uncertainty through Bayesian methodologies, and (ii) apply the methodology to seismic, volcanic and tsunami risks in Naples (Italy). More specifically, the BYMUR software will be able to separately account for the probabilistic hazard assessment of different kind of hazardous phenomena, the relative (time-dependent/independent) vulnerabilities and exposure data, and their possible (predefined) interactions: the software will analyze these inputs and will use them to estimate both single- and multi- risk associated to a specific target area. In addition, it will be possible to connect the software to further tools (e.g., a full hazard analysis), allowing a dynamic I/O of results. The use of Python programming language guarantees that the final software will be open source and platform independent. Moreover, thanks to the integration of some most popular and rich-featured Python scientific modules (Numpy, Matplotlib, Scipy) with the wxPython graphical user toolkit, the final tool will be equipped with a comprehensive Graphical User Interface (GUI) able to control and visualize (in the form of tables, maps and/or plots) any stage of the multi-risk analysis. The additional features of importing/exporting data in MySQL databases and/or standard XML formats (for

  19. Comparison of two instruments for assessing risk of postoperative nausea and vomiting.

    Science.gov (United States)

    Kapoor, Rachna; Hola, Eric T; Adamson, Robert T; Mathis, A Scott

    2008-03-01

    Two instruments for assessing patients' risk of postoperative nausea and vomiting (PONV) were compared. The existing protocol (protocol 1) assessed PONV risk using 16 weighted risk factors and was used for both adults and pediatric patients. The new protocol (protocol 2) included a form for adults and a pediatric-specific form. The form for adults utilized the simplified risk score, calculated using a validated, nonweighted, 4-point scale, and categorized patients' risk of PONV as low, moderate, or high. The form for pediatric patients used a 7-point, non-weighted scale and categorized patients' risk of PONV as moderate or high. A list was generated of all patients who had surgery during August 2005, for whom protocol 1 was used, and during April 2006, for whom protocol 2 was used. Fifty patients from each time period were randomly selected for data analysis. Data collected included the percentage of the form completed, the development of PONV, the number of PONV risk factors, patient demographics, and the appropriateness of prophylaxis. The mean +/- S.D. number of PONV risk factors was significantly lower in the group treated according to protocol 2 ( p = 0.001), but fewer patients in this group were categorized as low or moderate risk and more patients were identified as high risk (p < 0.001). More patients assessed by protocol 2 received fewer interventions than recommended (p < 0.001); however, the frequency of PONV did not significantly differ between groups. Implementation of a validated and simplified PONV risk-assessment tool appeared to improve form completion rates and appropriate risk assessment; however, the rates of PONV remained similar and fewer patients received appropriate prophylaxis compared with patients assessed by the existing risk-assessment tool.

  20. Terrestrial avoidance behaviour tests as screening tool to assess soil contamination

    International Nuclear Information System (INIS)

    Loureiro, Susana; Soares, Amadeu M.V.M.; Nogueira, Antonio J.A.

    2005-01-01

    To assess soil quality and risk assessment, bioassays can be useful tools to gauge the potential toxicity of contaminants focusing on their bioavailable fraction. A rapid and sublethal avoidance behaviour test was used as a screening tool with the earthworm Eisenia andrei and the isopod Porcellionides pruinosus, where organisms were exposed during 48 h to several chemicals (lindane, dimethoate and copper sulphate, for isopods and carbendazim, benomyl, dimethoate and copper sulphate for earthworms). Both species were also exposed to soils from an abandoned mine. For all bioassays a statistical approach was used to derive EC 50 values. Isopods and earthworms were able to perceive the presence of toxic compounds and escaping from contaminated to clean soil. Furthermore the behaviour parameter was equally or more sensitive then other sublethal parameters (e.g. reproduction or growth), expressing the advantages of Avoidance Behaviour Tests as screening tools in ERA. - Avoidance Behaviour Tests with earthworms and isopods can be used as screening tools in the evaluation of soil contamination

  1. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  2. RISK COMMUNICATION IN ACTION: THE TOOLS OF MESSAGE MAPPING

    Science.gov (United States)

    Risk Communication in Action: The Tools of Message Mapping, is a workbook designed to guide risk communicators in crisis situations. The first part of this workbook will review general guidelines for risk communication. The second part will focus on one of the most robust tools o...

  3. Assessing Violence Risk and Psychopathy in Juvenile and Adult Offenders: A Survey of Clinical Practices

    Science.gov (United States)

    Viljoen, Jodi L.; McLachlan, Kaitlyn; Vincent, Gina M.

    2010-01-01

    This study surveyed 199 forensic clinicians about the practices that they use in assessing violence risk in juvenile and adult offenders. Results indicated that the use of risk assessment and psychopathy tools was common. Although clinicians reported more routine use of psychopathy measures in adult risk assessments compared with juvenile risks…

  4. Web-based self-assessment health tools: who are the users and what is the impact of missing input information?

    Science.gov (United States)

    Neufingerl, Nicole; Cobain, Mark R; Newson, Rachel S

    2014-09-26

    Web-based health applications, such as self-assessment tools, can aid in the early detection and prevention of diseases. However, there are concerns as to whether such tools actually reach users with elevated disease risk (where prevention efforts are still viable), and whether inaccurate or missing information on risk factors may lead to incorrect evaluations. This study aimed to evaluate (1) evaluate whether a Web-based cardiovascular disease (CVD) risk communication tool (Heart Age tool) was reaching users at risk of developing CVD, (2) the impact of awareness of total cholesterol (TC), HDL-cholesterol (HDL-C), and systolic blood pressure (SBP) values on the risk estimates, and (3) the key predictors of awareness and reporting of physiological risk factors. Heart Age is a tool available via a free open access website. Data from 2,744,091 first-time users aged 21-80 years with no prior heart disease were collected from 13 countries in 2009-2011. Users self-reported demographic and CVD risk factor information. Based on these data, an individual's 10-year CVD risk was calculated according to Framingham CVD risk models and translated into a Heart Age. This is the age for which the individual's reported CVD risk would be considered "normal". Depending on the availability of known TC, HDL-C, and SBP values, different algorithms were applied. The impact of awareness of TC, HDL-C, and SBP values on Heart Age was determined using a subsample that had complete risk factor information. Heart Age users (N=2,744,091) were mostly in their 20s (22.76%) and 40s (23.99%), female (56.03%), had multiple (mean 2.9, SD 1.4) risk factors, and a Heart Age exceeding their chronological age (mean 4.00, SD 6.43 years). The proportion of users unaware of their TC, HDL-C, or SBP values was high (77.47%, 93.03%, and 46.55% respectively). Lacking awareness of physiological risk factor values led to overestimation of Heart Age by an average 2.1-4.5 years depending on the (combination of

  5. Updating risk prediction tools: a case study in prostate cancer.

    Science.gov (United States)

    Ankerst, Donna P; Koniarski, Tim; Liang, Yuanyuan; Leach, Robin J; Feng, Ziding; Sanda, Martin G; Partin, Alan W; Chan, Daniel W; Kagan, Jacob; Sokoll, Lori; Wei, John T; Thompson, Ian M

    2012-01-01

    Online risk prediction tools for common cancers are now easily accessible and widely used by patients and doctors for informed decision-making concerning screening and diagnosis. A practical problem is as cancer research moves forward and new biomarkers and risk factors are discovered, there is a need to update the risk algorithms to include them. Typically, the new markers and risk factors cannot be retrospectively measured on the same study participants used to develop the original prediction tool, necessitating the merging of a separate study of different participants, which may be much smaller in sample size and of a different design. Validation of the updated tool on a third independent data set is warranted before the updated tool can go online. This article reports on the application of Bayes rule for updating risk prediction tools to include a set of biomarkers measured in an external study to the original study used to develop the risk prediction tool. The procedure is illustrated in the context of updating the online Prostate Cancer Prevention Trial Risk Calculator to incorporate the new markers %freePSA and [-2]proPSA measured on an external case-control study performed in Texas, U.S.. Recent state-of-the art methods in validation of risk prediction tools and evaluation of the improvement of updated to original tools are implemented using an external validation set provided by the U.S. Early Detection Research Network. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Historical relationship between performance assessment for radioactive waste disposal and other types of risk assessment

    International Nuclear Information System (INIS)

    Rechard, R.P.

    1999-01-01

    This article describes the evolution of the process for assessing the hazards of a geologic disposal system for radioactive waste and, similarly, nuclear power reactors, and the relationship of this process with other assessments of risk, particularly assessments of hazards from manufactured carcinogenic chemicals during use and disposal. This perspective reviews the common history of scientific concepts for risk assessment developed until the 1950s. Computational tools and techniques developed in the late 1950s and early 1960s to analyze the reliability of nuclear weapon delivery systems were adopted in the early 1970s for probabilistic risk assessment of nuclear power reactors, a technology for which behavior was unknown. In turn, these analyses became an important foundation for performance assessment of nuclear waste disposal in the late 1970s. The evaluation of risk to human health and the environment from chemical hazards is built on methods for assessing the dose response of radionuclides in the 1950s. Despite a shared background, however, societal events, often in the form of legislation, have affected the development path for risk assessment for human health, producing dissimilarities between these risk assessments and those for nuclear facilities. An important difference is the regulator's interest in accounting for uncertainty

  7. Osteoporosis risk prediction for bone mineral density assessment of postmenopausal women using machine learning.

    Science.gov (United States)

    Yoo, Tae Keun; Kim, Sung Kean; Kim, Deok Won; Choi, Joon Yul; Lee, Wan Hyung; Oh, Ein; Park, Eun-Cheol

    2013-11-01

    A number of clinical decision tools for osteoporosis risk assessment have been developed to select postmenopausal women for the measurement of bone mineral density. We developed and validated machine learning models with the aim of more accurately identifying the risk of osteoporosis in postmenopausal women compared to the ability of conventional clinical decision tools. We collected medical records from Korean postmenopausal women based on the Korea National Health and Nutrition Examination Surveys. The training data set was used to construct models based on popular machine learning algorithms such as support vector machines (SVM), random forests, artificial neural networks (ANN), and logistic regression (LR) based on simple surveys. The machine learning models were compared to four conventional clinical decision tools: osteoporosis self-assessment tool (OST), osteoporosis risk assessment instrument (ORAI), simple calculated osteoporosis risk estimation (SCORE), and osteoporosis index of risk (OSIRIS). SVM had significantly better area under the curve (AUC) of the receiver operating characteristic than ANN, LR, OST, ORAI, SCORE, and OSIRIS for the training set. SVM predicted osteoporosis risk with an AUC of 0.827, accuracy of 76.7%, sensitivity of 77.8%, and specificity of 76.0% at total hip, femoral neck, or lumbar spine for the testing set. The significant factors selected by SVM were age, height, weight, body mass index, duration of menopause, duration of breast feeding, estrogen therapy, hyperlipidemia, hypertension, osteoarthritis, and diabetes mellitus. Considering various predictors associated with low bone density, the machine learning methods may be effective tools for identifying postmenopausal women at high risk for osteoporosis.

  8. Microbial risk assessment and its implications for risk management in urban water systems

    OpenAIRE

    Westrell, Therese

    2004-01-01

    Infectious disease can be transmitted via various environmental pathways, many of which are incorporated into our water and wastewater systems. Quantitative microbial risk assessment (QMRA) can be a valuable tool in identifying hazard exposure pathways and estimating their associated health impacts. QMRA can be applied to establish standards and guidelines and has been adopted by the World Health Organisation for the management of risks from water-related infectious diseases. This thesis aims...

  9. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions

    OpenAIRE

    Sterne, Jonathan AC; Hern?n, Miguel A; Reeves, Barnaby C; Savovi?, Jelena; Berkman, Nancy D; Viswanathan, Meera; Henry, David; Altman, Douglas G; Ansari, Mohammed T; Boutron, Isabelle; Carpenter, James R; Chan, An-Wen; Churchill, Rachel; Deeks, Jonathan J; Hr?bjartsson, Asbj?rn

    2016-01-01

    Non-randomized studies of the effects of interventions are critical to many areas of health care evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I (“Risk Of Bias In Non-randomized Studies - of Interventions”), a new tool for evaluating risk of bias in estimates of the comparative effectiveness (harm or benefit) of interventions from studies that did not use randomization to allocate units (in...

  10. Understanding the Delamination Risk of a Trilayer Tablet Using Minipiloting Tools.

    Science.gov (United States)

    Tao, Jing; Robertson-Lavalle, Sophia; Pandey, Preetanshu; Badawy, Sherif

    2017-11-01

    A multilayer tablet is one of the formulation options used to mitigate chemical and physical incompatibility between different drug substances. Feasibility studies of multilayer tablets are often conducted using round flat-faced punch tooling. However, the link between different tooling designs and multilayer tablet performance is not well established. This study uses a prototype trilayer tablet and examines tooling design considerations when conducting small-scale studies to gauge the risk of interfacial defects. The impact of tablet weight and dimensions was evaluated to gain understanding of the effect of scale-up/down of tablet size. The factors in tooling selection, including tablet shape, cup depth, and size of embossing were evaluated to gain insight on the impact of tooling design on the interfacial strength of the trilayer tablet. It was found that tablet weight and dimensions can significantly affect the interfacial strength due to their impact on force transmission during compression and the retardation force from the die wall during ejection. Round flat-faced tooling generated trilayer tablets of the strongest interfacial strength compared to typical commercial tablets-oval shaped with concave surfaces. These factors should be accounted for when using round flat compacts to assess the interface risks of a multilayer tablet. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  11. Venous thromboembolism in medical outpatients - a cross-sectional survey of risk assessment and prophylaxis.

    Science.gov (United States)

    Lawall, Holger; Matthiessen, Andreas; Hohmann, Volker; Bramlage, Peter; Haas, Sylvia; Schellong, Sebastian

    2011-01-01

    The degree of thromboprophylaxis in medical outpatients is low despite a substantial risk for venous thromboembolism (VTE). This may be attributable to difficulties in assessing risk. Assessment tools like the Haas' scorecard aid in determining the need for thromboprophylaxis. We aimed at evaluating how the use of this tool may aid physicians in appropriately using anticoagulants. This was an epidemiological, cross-sectional survey of acute medically ill patients with limited mobility treated by general practitioners and internists. Risk assessment for VTE by the treating physician was compared to calculated risk. Of 8,123 patients evaluated between August 2006 and April 2008, 7,271 fulfilled the in- and exclusion criteria. Mean age was 69.4 ± 13.6 years, and 45.2% were male. Of these 82.8% were high risk based on their acute medical condition, 37.9% based on their underlying chronic condition. Immobilisation, heart failure, pneumonia, age, obesity, and major varicosis were the most frequently encountered risk factors. The agreement between the Haas' scorecard and physician indicated risk was high. At least 94.1% of patients with high risk received adequate anticoagulation mostly as low molecular weight heparins for a mean duration of 15.1 ± 30.5 days. There is a substantial risk for VTE in medical outpatients. Using a simple structured scorecard resulted in an overall appropriate risk assessment and high degree of anticoagulation. The scorecard may provide a tool to improve the overall awareness for VTE risk in medical outpatients, substantially improving the degree of prophylaxis in a patient population with largely underestimated risk.

  12. A brief screening tool for assessing psychological trauma in clinical practice: development and validation of the New York PTSD Risk Score.

    Science.gov (United States)

    Boscarino, Joseph A; Kirchner, H Lester; Hoffman, Stuart N; Sartorius, Jennifer; Adams, Richard E; Figley, Charles R

    2011-01-01

    The objective was to develop a brief posttraumatic stress disorder (PTSD) screening instrument that is useful in clinical practice, similar to the Framingham Risk Score used in cardiovascular medicine. We used data collected in New York City after the World Trade Center disaster (WTCD) and other trauma data to develop a new PTSD prediction tool--the New York PTSD Risk Score. We used diagnostic test methods to examine different clinical domains, including PTSD symptoms, trauma exposures, sleep disturbances, suicidal thoughts, depression symptoms, demographic factors and other measures to assess different PTSD prediction models. Using receiver operating curve (ROC) and bootstrap methods, five prediction domains, including core PTSD symptoms, sleep disturbance, access to care status, depression symptoms and trauma history, and five demographic variables, including gender, age, education, race and ethnicity, were identified. For the best prediction model, the area under the ROC curve (AUC) was 0.880 for the Primary Care PTSD Screen alone (specificity=82.2%, sensitivity=93.7%). Adding care status, sleep disturbance, depression and trauma exposure increased the AUC to 0.943 (specificity=85.7%, sensitivity=93.1%), a significant ROC improvement (Pdevelopment and validation samples. The New York PTSD Risk Score is a multifactor prediction tool that includes the Primary Care PTSD Screen, depression symptoms, access to care, sleep disturbance, trauma history and demographic variables and appears to be effective in predicting PTSD among patients seen in healthcare settings. This prediction tool is simple to administer and appears to outperform other screening measures. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Marburg biosafety and biosecurity scale (MBBS): a framework for risk assessment and risk communication.

    Science.gov (United States)

    Dickmann, Petra; Apfel, Franklin; Biedenkopf, Nadine; Eickmann, Markus; Becker, Stephan

    2015-01-01

    Current risk assessment and risk communication of biosafety and biosecurity concerns lack a convenient metric and conceptual framework. The absence of such a systematic tool makes communication more difficult and can lead to ambiguous public perception of and response to laboratory biosafety incidents and biosecurity threats. A new 7-category scoring scale is proposed for incidents and situations in laboratories related to the handling of human and animal pathogens. The scale aims to help clarify risk categories, facilitate coordination and communication, and improve public understanding of risk related to biosafety and biosecurity.

  14. Risk Assessment as an Environmental Management Tool: Considerations for Freshwater Wetlands

    Science.gov (United States)

    A. Dennis Lemly

    1997-01-01

    This paper presents a foundation for improving the risk assessment process for freshwater wetlands. Integrating wetland science, i.e., use of an ecosystem-based approach, is the key concept. Each biotic and abiotic wetland component should be identified and its contribution to ecosystem functions and societal values determined when deciding whether a stressor poses an...

  15. Refinement and cross-validation of nickel bioavailability in PNEC-Pro, a regulatory tool for site-specific risk assessment of metals in surface water.

    Science.gov (United States)

    Verschoor, Anja J; Vijver, Martina G; Vink, Jos P M

    2017-09-01

    The European Water Framework Directive prescribes that the environmental quality standards for nickel in surface waters should be based on bioavailable concentrations. Biotic ligand models (BLMs) are powerful tools to account for site-specific bioavailability within risk assessments. Several BLMs and simplified tools are available. For nickel, most of them are based on the same toxicity dataset and chemical speciation methodology as laid down in the 2008 European Union Environmental Risk Assessment Report (RAR). Since then, further insights into the toxic effects of nickel on aquatic species have been gained, and new data and methodologies have been generated and implemented using the predicted-no-effect-concentration (PNEC)-pro tool. The aim of the present study is to provide maximum transparency on data revisions and how this affects the derived environmental quality standards. A case study with 7 different ecoregions was used to determine differences in species sensitivity distributions and in hazardous concentrations for 5% of the species (HC5) values between the original Ni-RAR BLMs and the PNEC-pro BLMs. The BLM parameters used were pH dependent, which extended the applicability domain of PNEC-pro up to a pH of 8.7 for surface waters. After inclusion of additional species and adjustment for cross-species extrapolation, the HC5s were well within the prediction range of the RAR. Based on the latest data and scientific insights, transfer functions in the user-friendly PNEC-pro tool have been updated accordingly without compromising the original considerations of the Ni-RAR. Environ Toxicol Chem 2017;36:2367-2376. © 2017 SETAC. © 2017 SETAC.

  16. Liquidity risk charges as a macroprudential tool

    NARCIS (Netherlands)

    Perotti, E.; Suarez, J.

    2009-01-01

    Liquidity risk charges were proposed in February 2009 as a new macro-prudential tool to discourage systemic risk creation by banks. A new CEPR Policy Insight refines this proposal in order to clarify challenging issues surrounding the implementation of liquidity risk charges.

  17. Risk assessment model for development of advanced age-related macular degeneration.

    Science.gov (United States)

    Klein, Michael L; Francis, Peter J; Ferris, Frederick L; Hamon, Sara C; Clemons, Traci E

    2011-12-01

    To design a risk assessment model for development of advanced age-related macular degeneration (AMD) incorporating phenotypic, demographic, environmental, and genetic risk factors. We evaluated longitudinal data from 2846 participants in the Age-Related Eye Disease Study. At baseline, these individuals had all levels of AMD, ranging from none to unilateral advanced AMD (neovascular or geographic atrophy). Follow-up averaged 9.3 years. We performed a Cox proportional hazards analysis with demographic, environmental, phenotypic, and genetic covariates and constructed a risk assessment model for development of advanced AMD. Performance of the model was evaluated using the C statistic and the Brier score and externally validated in participants in the Complications of Age-Related Macular Degeneration Prevention Trial. The final model included the following independent variables: age, smoking history, family history of AMD (first-degree member), phenotype based on a modified Age-Related Eye Disease Study simple scale score, and genetic variants CFH Y402H and ARMS2 A69S. The model did well on performance measures, with very good discrimination (C statistic = 0.872) and excellent calibration and overall performance (Brier score at 5 years = 0.08). Successful external validation was performed, and a risk assessment tool was designed for use with or without the genetic component. We constructed a risk assessment model for development of advanced AMD. The model performed well on measures of discrimination, calibration, and overall performance and was successfully externally validated. This risk assessment tool is available for online use.

  18. The risk of bias in systematic reviews tool showed fair reliability and good construct validity.

    Science.gov (United States)

    Bühn, Stefanie; Mathes, Tim; Prengel, Peggy; Wegewitz, Uta; Ostermann, Thomas; Robens, Sibylle; Pieper, Dawid

    2017-11-01

    There is a movement from generic quality checklists toward a more domain-based approach in critical appraisal tools. This study aimed to report on a first experience with the newly developed risk of bias in systematic reviews (ROBIS) tool and compare it with A Measurement Tool to Assess Systematic Reviews (AMSTAR), that is, the most common used tool to assess methodological quality of systematic reviews while assessing validity, reliability, and applicability. Validation study with four reviewers based on 16 systematic reviews in the field of occupational health. Interrater reliability (IRR) of all four raters was highest for domain 2 (Fleiss' kappa κ = 0.56) and lowest for domain 4 (κ = 0.04). For ROBIS, median IRR was κ = 0.52 (range 0.13-0.88) for the experienced pair of raters compared to κ = 0.32 (range 0.12-0.76) for the less experienced pair of raters. The percentage of "yes" scores of each review of ROBIS ratings was strongly correlated with the AMSTAR ratings (r s  = 0.76; P = 0.01). ROBIS has fair reliability and good construct validity to assess the risk of bias in systematic reviews. More validation studies are needed to investigate reliability and applicability, in particular. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Study of Risk Assessment Programs at Federal Agencies and Commercial Industry Related to the Conduct or Regulation of High Hazard Operations

    International Nuclear Information System (INIS)

    Bari, R.; Rosenbloom, S.; O'Brien, J.

    2011-01-01

    In the Department of Energy (DOE) Implementation Plan (IP) for Defense Nuclear Facilities Safety Board's Recommendation 2009-1, the DOE committed to studying the use of quantitative risk assessment methodologies at government agencies and industry. This study consisted of document reviews and interviews of senior management and risk assessment staff at six organizations. Data were collected and analyzed on risk assessment applications, risk assessment tools, and controls and infrastructure supporting the correct usage of risk assessment and risk management tools. The study found that the agencies were in different degrees of maturity in the use of risk assessment to support the analysis of high hazard operations and to support decisions related to these operations. Agencies did not share a simple, 'one size fits all' approach to tools, controls, and infrastructure needs. The agencies recognized that flexibility was warranted to allow use of risk assessment tools in a manner that is commensurate with the complexity of the application. The study also found that, even with the lack of some data, agencies application of the risk analysis structured approach could provide useful insights such as potential system vulnerabilities. This study, in combination with a companion study of risk assessment programs in the DOE Offices involved in high hazard operations, is being used to determine the nature and type of controls and infrastructure needed to support risk assessments at the DOE.

  20. Probabilistic risk assessment of HTGRs

    International Nuclear Information System (INIS)

    Fleming, K.N.; Houghton, W.J.; Hannaman, G.W.; Joksimovic, V.

    1981-01-01

    Probabilistic Risk Assessment methods have been applied to gas-cooled reactors for more than a decade and to HTGRs for more than six years in the programs sponsored by the U.S. Department of Energy. Significant advancements to the development of PRA methodology in these programs are summarized as are the specific applications of the methods to HTGRs. Emphasis here is on PRA as a tool for evaluating HTGR design options. Current work and future directions are also discussed. (author)

  1. SMART: A Propositional Logic-Based Trade Analysis and Risk Assessment Tool for a Complex Mission

    Science.gov (United States)

    Ono, Masahiro; Nicholas, Austin; Alibay, Farah; Parrish, Joseph

    2015-01-01

    This paper introduces a new trade analysis software called the Space Mission Architecture and Risk Analysis Tool (SMART). This tool supports a high-level system trade study on a complex mission, such as a potential Mars Sample Return (MSR) mission, in an intuitive and quantitative manner. In a complex mission, a common approach to increase the probability of success is to have redundancy and prepare backups. Quantitatively evaluating the utility of adding redundancy to a system is important but not straightforward, particularly when the failure of parallel subsystems are correlated.

  2. Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

    Science.gov (United States)

    Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

    2013-04-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

  3. Application of probabilistic risk assessment to reprocessing

    International Nuclear Information System (INIS)

    Perkins, W.C.

    1984-01-01

    The Savannah River Laboratory uses probabilistic methods of risk assessment in safety analyses of reprocessing facilities at the Savannah River Plant. This method uses both the probability of an accident and its consequence to calculate the risks from radiological, chemical, and industrial hazards. The three principal steps in such an assesment are identification of accidents, calculation of frequencies, and consequence quantification. The tools used at SRL include several databanks, logic tree methods, and computer-assisted methods for calculating both frequencies and consequences. 5 figures

  4. Risk assessment

    International Nuclear Information System (INIS)

    Kinchin, G.H.

    1983-01-01

    After defining risk and introducing the concept of individual and societal risk, the author considers each of these, restricting considerations to risk of death. Some probabilities of death arising from various causes are quoted, and attention drawn to the care necessary in making comparisons between sets of data and to the distinction between voluntary and involuntary categories and between early and delayed deaths. The presentation of information on societal risk is discussed and examples given. The history of quantified risk assessment is outlined, particularly related to the nuclear industry, the process of assessing risk discussed: identification of hazard causes, the development of accident chains and the use of event trees, the evaluation of probability through the collection of data and their use with fault trees, and the assessment of consequences of hazards in terms of fatalities. Reference is made to the human element and common-made failures, and to studies supporting the development of reliability assessment techniques. Acceptance criteria are discussed for individual and societal risk in the nuclear field, and it is shown that proposed criteria lead to risks conservative by comparison with risks from day-to-day accidents and other potentially hazardous industries. (U.K.)

  5. Environmental risk assessment of chemicals and nanomaterials--The best foundation for regulatory decision-making?

    Science.gov (United States)

    Syberg, Kristian; Hansen, Steffen Foss

    2016-01-15

    Environmental risk assessment (ERA) is often considered as the most transparent, objective and reliable decision-making tool for informing the risk management of chemicals and nanomaterials. ERAs are based on the assumption that it is possible to provide accurate estimates of hazard and exposure and, subsequently, to quantify risk. In this paper we argue that since the quantification of risk is dominated by uncertainties, ERAs do not provide a transparent or an objective foundation for decision-making and they should therefore not be considered as a "holy grail" for informing risk management. We build this thesis on the analysis of two case studies (of nonylphenol and nanomaterials) as well as a historical analysis in which we address the scientific foundation for ERAs. The analyses show that ERAs do not properly address all aspects of actual risk, such as the mixture effect and the environmentally realistic risk from nanomaterials. Uncertainties have been recognised for decades, and assessment factors are used to compensate for the lack of realism in ERAs. The assessment factors' values were pragmatically determined, thus lowering the scientific accuracy of the ERAs. Furthermore, the default choice of standard assay for assessing a hazard might not always be the most biologically relevant, so we therefore argue that an ERA should be viewed as a pragmatic decision-making tool among several, and it should not have a special status for informing risk management. In relation to other relevant decision-making tools we discuss the use of chemical alternative assessments (CAAs) and the precautionary principle. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. APROBA-Plus: A probabilistic tool to evaluate and express uncertainty in hazard characterization and exposure assessment of substances.

    Science.gov (United States)

    Bokkers, Bas G H; Mengelers, Marcel J; Bakker, Martine I; Chiu, Weihsueh A; Slob, Wout

    2017-12-01

    To facilitate the application of probabilistic risk assessment, the WHO released the APROBA tool. This tool applies lognormal uncertainty distributions to the different aspects of the hazard characterization, resulting in a probabilistic health-based guidance value. The current paper describes an extension, APROBA-Plus, which combines the output from the probabilistic hazard characterization with the probabilistic exposure to rapidly characterize risk and its uncertainty. The uncertainty in exposure is graphically compared with the uncertainty in the target human dose, i.e. the dose that complies with the specified protection goals. APROBA-Plus is applied to several case studies, resulting in distinct outcomes and illustrating that APROBA-Plus could serve as a standard extension of routine risk assessments. By visualizing the uncertainties, APROBA-Plus provides a more transparent and informative outcome than the more usual deterministic approaches, so that risk managers can make better informed decisions. For example, APROBA-Plus can help in deciding whether risk-reducing measures are warranted or that a refined risk assessment would first be needed. If the latter, the tool can be used to prioritize possible refinements. APROBA-Plus may also be used to rank substances into different risk categories, based on potential health risks without being compromised by different levels of conservatism that may be associated with point estimates of risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Fire Risk Assessment in Germany

    International Nuclear Information System (INIS)

    Berg, H. P.

    2000-01-01

    Quantitative fire risk assessment can serve as an additional tool to assess the safety level of a nuclear power plant (NPP) and to set priorities for fire protection improvement measures. The recommended approach to be applied within periodic safety reviews of NPPs in Germany starts with a screening process providing critical fire zones in which a fully developed fire has the potential to both cause an initiating event and impair the function of at least one component or system critical to safety. The second step is to perform a quantitative analysis using a standard event tree has been developed with elements for fire initiation, ventilation of the room, fire detection, fire suppression, and fire propagation. In a final step, the fire induced frequency of initiating events, the main contributors and the calculated hazard state frequency for the fire event are determined. Results of the first quantitative fire risk studies performed in Germany are reported. (author)

  8. Risk Assessment Overview

    Science.gov (United States)

    Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

    2011-01-01

    Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

  9. Review on pen-and-paper-based observational methods for assessing ergonomic risk factors of computer work.

    Science.gov (United States)

    Rahman, Mohd Nasrull Abdol; Mohamad, Siti Shafika

    2017-01-01

    Computer works are associated with Musculoskeletal Disorders (MSDs). There are several methods have been developed to assess computer work risk factor related to MSDs. This review aims to give an overview of current techniques available for pen-and-paper-based observational methods in assessing ergonomic risk factors of computer work. We searched an electronic database for materials from 1992 until 2015. The selected methods were focused on computer work, pen-and-paper observational methods, office risk factors and musculoskeletal disorders. This review was developed to assess the risk factors, reliability and validity of pen-and-paper observational method associated with computer work. Two evaluators independently carried out this review. Seven observational methods used to assess exposure to office risk factor for work-related musculoskeletal disorders were identified. The risk factors involved in current techniques of pen and paper based observational tools were postures, office components, force and repetition. From the seven methods, only five methods had been tested for reliability. They were proven to be reliable and were rated as moderate to good. For the validity testing, from seven methods only four methods were tested and the results are moderate. Many observational tools already exist, but no single tool appears to cover all of the risk factors including working posture, office component, force, repetition and office environment at office workstations and computer work. Although the most important factor in developing tool is proper validation of exposure assessment techniques, the existing observational method did not test reliability and validity. Futhermore, this review could provide the researchers with ways on how to improve the pen-and-paper-based observational method for assessing ergonomic risk factors of computer work.

  10. Children and Young People-Mental Health Safety Assessment Tool (CYP-MH SAT) study: Protocol for the development and psychometric evaluation of an assessment tool to identify immediate risk of self-harm and suicide in children and young people (10–19 years) in acute paediatric hospital settings

    Science.gov (United States)

    Walker, Gemma M; Carter, Tim; Aubeeluck, Aimee; Witchell, Miranda; Coad, Jane

    2018-01-01

    Introduction Currently, no standardised, evidence-based assessment tool for assessing immediate self-harm and suicide in acute paediatric inpatient settings exists. Aim The aim of this study is to develop and test the psychometric properties of an assessment tool that identifies immediate risk of self-harm and suicide in children and young people (10–19 years) in acute paediatric hospital settings. Methods and analysis Development phase: This phase involved a scoping review of the literature to identify and extract items from previously published suicide and self-harm risk assessment scales. Using a modified electronic Delphi approach, these items will then be rated according to their relevance for assessment of immediate suicide or self-harm risk by expert professionals. Inclusion of items will be determined by 65%–70% consensus between raters. Subsequently, a panel of expert members will convene to determine the face validity, appropriate phrasing, item order and response format for the finalised items. Psychometric testing phase: The finalised items will be tested for validity and reliability through a multicentre, psychometric evaluation. Psychometric testing will be undertaken to determine the following: internal consistency, inter-rater reliability, convergent, divergent validity and concurrent validity. Ethics and dissemination Ethical approval was provided by the National Health Service East Midlands—Derby Research Ethics Committee (17/EM/0347) and full governance clearance received by the Health Research Authority and local participating sites. Findings from this study will be disseminated to professionals and the public via peer-reviewed journal publications, popular social media and conference presentations. PMID:29654046

  11. Introduction to risk assessment

    International Nuclear Information System (INIS)

    Raina, V.M.

    2002-01-01

    This paper gives an introduction to risk assessment. It discusses the basic concepts of risk assessment, nuclear risk assessment process and products, the role of risk assessment products in nuclear safety assurance, the relationship between risk assessment and other safety analysis and risk assessment and safe operating envelope

  12. Development and psychometric evaluation of a cardiovascular risk and disease management knowledge assessment tool.

    Science.gov (United States)

    Rosneck, James S; Hughes, Joel; Gunstad, John; Josephson, Richard; Noe, Donald A; Waechter, Donna

    2014-01-01

    This article describes the systematic construction and psychometric analysis of a knowledge assessment instrument for phase II cardiac rehabilitation (CR) patients measuring risk modification disease management knowledge and behavioral outcomes derived from national standards relevant to secondary prevention and management of cardiovascular disease. First, using adult curriculum based on disease-specific learning outcomes and competencies, a systematic test item development process was completed by clinical staff. Second, a panel of educational and clinical experts used an iterative process to identify test content domain and arrive at consensus in selecting items meeting criteria. Third, the resulting 31-question instrument, the Cardiac Knowledge Assessment Tool (CKAT), was piloted in CR patients to ensure use of application. Validity and reliability analyses were performed on 3638 adults before test administrations with additional focused analyses on 1999 individuals completing both pretreatment and posttreatment administrations within 6 months. Evidence of CKAT content validity was substantiated, with 85% agreement among content experts. Evidence of construct validity was demonstrated via factor analysis identifying key underlying factors. Estimates of internal consistency, for example, Cronbach's α = .852 and Spearman-Brown split-half reliability = 0.817 on pretesting, support test reliability. Item analysis, using point biserial correlation, measured relationships between performance on single items and total score (P knowledge instrument specifically designed for an adult CR population was systematically developed and tested in a large representative patient population, satisfying psychometric parameters, including validity and reliability.

  13. OPERATIONAL RISK IN INTERNATIONAL BUSINESS: TAXONOMY AND ASSESSMENT METHODS

    Directory of Open Access Journals (Sweden)

    Marinoiu Ana Maria

    2009-05-01

    Full Text Available The paper aims at presenting the classifications and the assessment methods for operational risk according to international regulations (ie. Basel 2, in the context of its importance as a managerial tool for international business. Considering the growin

  14. Work-related musculoskeletal disorders (WMDs) risk assessment at core assembly production of electronic components manufacturing company

    Science.gov (United States)

    Yahya, N. M.; Zahid, M. N. O.

    2018-03-01

    This study conducted to assess the work-related musculoskeletal disorders (WMDs) among the workers at core assembly production in an electronic components manufacturing company located in Pekan, Pahang, Malaysia. The study is to identify the WMDs risk factor and risk level. A set of questionnaires survey based on modified Nordic Musculoskeletal Disorder Questionnaires have been distributed to respective workers to acquire the WMDs risk factor identification. Then, postural analysis was conducted in order to measure the respective WMDs risk level. The analysis were based on two ergonomics assessment tools; Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). The study found that 30 respondents out of 36 respondents suffered from WMDs especially at shoulder, wrists and lower back. The WMDs risk have been identified from unloading process, pressing process and winding process. In term of the WMDs risk level, REBA and RULA assessment tools have indicated high risk level to unloading and pressing process. Thus, this study had established the WMDs risk factor and risk level of core assembly production in an electronic components manufacturing company at Malaysia environment.

  15. Coach assessment tool

    OpenAIRE

    Härkönen, Niko; Klicznik, Roman

    2014-01-01

    The Coach Assessment Tool was created to assist coaches of all sports for their own development. The starting point to develop the tool is the fact that coaching clinics solely focus on the technical and tactial skills of the sport. The education for coaches is lacking to teach the importance of the coach´s behavior towards their athletes. The question is how to teach properly the task in hand to increase the athlete´s performance considering the coach´s behavior. Nevertheless,...

  16. Advancing effects analysis for integrated, large-scale wildfire risk assessment

    Science.gov (United States)

    Matthew P. Thompson; David E. Calkin; Julie W. Gilbertson-Day; Alan A. Ager

    2011-01-01

    In this article, we describe the design and development of a quantitative, geospatial risk assessment tool intended to facilitate monitoring trends in wildfire risk over time and to provide information useful in prioritizing fuels treatments and mitigation measures. The research effort is designed to develop, from a strategic view, a first approximation of how both...

  17. Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

    Science.gov (United States)

    Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

    2012-10-16

    Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

  18. Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

    Science.gov (United States)

    Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

    2017-06-04

    This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

  19. OpenQuake, a platform for collaborative seismic hazard and risk assessment

    Science.gov (United States)

    Henshaw, Paul; Burton, Christopher; Butler, Lars; Crowley, Helen; Danciu, Laurentiu; Nastasi, Matteo; Monelli, Damiano; Pagani, Marco; Panzeri, Luigi; Simionato, Michele; Silva, Vitor; Vallarelli, Giuseppe; Weatherill, Graeme; Wyss, Ben

    2013-04-01

    Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, tools and models for global seismic hazard and risk assessment, within the context of the Global Earthquake Model (GEM). Guided by the needs and experiences of governments, companies and international organisations, all contributions are being integrated into OpenQuake: a web-based platform that - together with other resources - will become accessible in 2014. With OpenQuake, stakeholders worldwide will be able to calculate, visualize and investigate earthquake hazard and risk, capture new data and share findings for joint learning. The platform is envisaged as a collaborative hub for earthquake risk assessment, used at global and local scales, around which an active network of users has formed. OpenQuake will comprise both online and offline tools, many of which can also be used independently. One of the first steps in OpenQuake development was the creation of open-source software for advanced seismic hazard and risk calculations at any scale, the OpenQuake Engine. Although in continuous development, a command-line version of the software is already being test-driven and used by hundreds worldwide; from non-profits in Central Asia, seismologists in sub-Saharan Africa and companies in South Asia to the European seismic hazard harmonization programme (SHARE). In addition, several technical trainings were organized with scientists from different regions of the world (sub-Saharan Africa, Central Asia, Asia-Pacific) to introduce the engine and other OpenQuake tools to the community, something that will continue to happen over the coming years. Other tools that are being developed of direct interest to the hazard community are: • OpenQuake Modeller; fundamental

  20. Measurement of biofilm thickness. An effective Legionella risk assessment tool

    Energy Technology Data Exchange (ETDEWEB)

    Foret, Christophe [BKG France, Arnage (France); Martemianov, Serguei [Poitiers Univ. (FR). Lab. of Thermal Study (LET); Moscow Univ. (Russian Federation). Frumkin Inst. of Physical Chemistry and Electrochemistry; Hater, Wolfgang [BK Giulini GmbH, Duesseldorf (Germany); Merlet, Nicole; Chaussec, Guenole; Tribollet, Bernard

    2010-02-15

    The best way to prevent the risk of bacterial growth in water systems is to monitor and control the microorganisms (biofilm) attached to pipe walls. Three years of laboratory research led two Centre National de Recherche Scientifique (French National Center for Scientific Research) teams (UMR 6008 and UPR 15) to develop a tool designed to determine the average biofilm thickness. The average biofilm thickness measurements carried out on pilot plants fed with natural water were sufficiently accurate and sensitive to monitor the formation and development of biofilm in a water system and to determine the efficiency of the applied treatments. The implementation of appropriate treatments (type and dose of the treatment product) leads to a significant reduction in or even complete removal of the porous layer on the material surface. A reduction of the attached biomass, measured by the sensor, is connected to a decrease in the density of the bacterial attached to the material (viable flora in the plate count agar environment). (orig.)

  1. Conceptual Framework To Extend Life Cycle Assessment Using Near-Field Human Exposure Modeling and High-Throughput Tools for Chemicals.

    Science.gov (United States)

    Csiszar, Susan A; Meyer, David E; Dionisio, Kathie L; Egeghy, Peter; Isaacs, Kristin K; Price, Paul S; Scanlon, Kelly A; Tan, Yu-Mei; Thomas, Kent; Vallero, Daniel; Bare, Jane C

    2016-11-01

    Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products.

  2. Applicability of the Reactor Safety Study (WASH-1400) to LMFBR risk assessments

    International Nuclear Information System (INIS)

    El-Sheikh, K.A.; Feller, K.G.; Fleischer, L.; Greebler, P.; McDonald, A.; Sultan, P.; Temme, M.I.; Fullwood, R.R.

    1976-01-01

    The feasibility of applying the WASH-1400 methods and data to LMFBR risk assessment is evaluated using the following approach for a selected LMFBR: (1) Structuring the LMFBR risk assessment problem in a modular form similar to WASH-1400; (2) Comparing the predictive tools applicable to each module; (3) Comparing the dependencies among the various modules. It is concluded that the WASH-1400 applicability is limited due to LWR-LMFBR differences in operating environments and accident phenomena. WASH-1400 and LMFBR specific methods applicable to LMFBR risk assessments are indicated

  3. Quantifying risk and assessing outcome in cardiac surgery.

    Science.gov (United States)

    Higgins, T L

    1998-06-01

    Quality improvement, research, and reporting of outcome results can be stratified by preoperative risk by using a logistic regression equation or scores to correct for multiple risk factors. The more than 30-fold mortality differences between lowest and highest risk patients make it critical to stratify outcome results by patient severity. Probabilities are not predictions, however, and caution must be exercised when applying scores to individuals. Outcome assessment will grow in its importance to professionals, initially in the guise of quality reporting and improvement, but increasingly as a tool for risk assessment, patient counseling, and directing therapeutic decisions based on more complete information about patient subgroups. Physicians may be called on for recommendations in choosing systems for their hospitals and communities. Therefore, it is important to have an understanding of how such systems are developed, what factors indicate adequate performance of a system, and how such systems of risk stratification should be applied in practice.

  4. Developing and implementing an oral care policy and assessment tool.

    LENUS (Irish Health Repository)

    Stout, Michelle

    2012-01-09

    Oral hygiene is an essential aspect of nursing care. Poor oral care results in patients experiencing pain and discomfort, puts individuals at risk of nutritional deficiency and infection, and has an adverse effect on quality of life. This article describes how an oral care policy and assessment tool were updated to ensure the implementation of evidence-based practice at one hospital in the Republic of Ireland.

  5. Decision support in addiction: The development of an e-health tool to assess and prevent risk of fatal overdose. The ORION Project.

    Science.gov (United States)

    Baldacchino, A; Crocamo, C; Humphris, G; Neufeind, J; Frisher, M; Scherbaum, N; Carrà, G

    2016-09-01

    The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. In this article, we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore, its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Quantum chemistry in environmental pesticide risk assessment.

    Science.gov (United States)

    Villaverde, Juan J; López-Goti, Carmen; Alcamí, Manuel; Lamsabhi, Al Mokhtar; Alonso-Prados, José L; Sandín-España, Pilar

    2017-11-01

    The scientific community and regulatory bodies worldwide, currently promote the development of non-experimental tests that produce reliable data for pesticide risk assessment. The use of standard quantum chemistry methods could allow the development of tools to perform a first screening of compounds to be considered for the experimental studies, improving the risk assessment. This fact results in a better distribution of resources and in better planning, allowing a more exhaustive study of the pesticides and their metabolic products. The current paper explores the potential of quantum chemistry in modelling toxicity and environmental behaviour of pesticides and their by-products by using electronic descriptors obtained computationally. Quantum chemistry has potential to estimate the physico-chemical properties of pesticides, including certain chemical reaction mechanisms and their degradation pathways, allowing modelling of the environmental behaviour of both pesticides and their by-products. In this sense, theoretical methods can contribute to performing a more focused risk assessment of pesticides used in the market, and may lead to higher quality and safer agricultural products. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  7. Risk assessment of mixtures of pesticides. Current approaches and future strategies

    DEFF Research Database (Denmark)

    Reffstrup, Trine Klein; Larsen, John Christian; Meyer, Otto A.

    2010-01-01

    The risk assessment of pesticide residues in food is based on toxicological evaluation of the single compounds and no internationally accepted procedure exists for evaluation of cumulative exposure to multiple residues of pesticides in crops, except for a few groups of pesticides sharing a group...... several approaches are available for the risk assessment of mixtures of pesticides. However, no single simple approach is available to judge upon potential interactions at the low doses that humans are exposed to from pesticide residues in food. In these cases, PBTK models could be useful as tools...... to assess combined tissue doses and to help predict potential interactions including thresholds for such effects. This would improve the quality of the risk assessment....

  8. Hazard waste risk assessment

    International Nuclear Information System (INIS)

    Hawley, K.A.; Napier, B.A.

    1986-01-01

    Pacific Northwest Laboratory continued to provide technical assistance to the Department of Energy (DOE) Office of Operational Safety (OOS) in the area of risk assessment for hazardous and radioactive-mixed waste management. The overall objective is to provide technical assistance to OOS in developing cost-effective risk assessment tools and strategies for bringing DOE facilities into compliance with the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or Superfund) and the Resource Conservation and Recovery Act (RCRA). Major efforts during FY 1985 included (1) completing the modification of the Environmental Protection Agency (EPA) Hazard Ranking System (HRS) and developing training manuals and courses to assist in field office implementation of the modified Hazard Ranking System (mHRS); (2) initiating the development of a system for reviewing field office HRS/mHRS evaluations for appropriate use of data and appropriate application of the methodology; (3) initiating the development of a data base management system to maintain all field office HRS/mHRS scoring sheets and to support the master OOS environmental data base system; (4) developing implementation guidance for Phase I of the DOE CERCLA Program, Installation Assessment; (5) continuing to develop an objective, scientifically based methodology for DOE management to use in establishing priorities for conducting site assessments under Phase II of the DOE CERCLA Program, Confirmation; and (6) participating in developing the DOE response to EPA on the proposed listing of three sites on the National Priorities List

  9. The VeTOOLS Project: an example of how to strengthen collaboration between scientists and Civil Protections in disaster risk reduction

    Science.gov (United States)

    Marti, Joan; Bartolini, Stefania; Becerril, Laura

    2016-04-01

    VeTOOLS is a project funded by the European Commission's Humanitarian Aid and Civil Protection department (ECHO), and aims at creating an integrated software platform specially designed to assess and manage volcanic risk. The project facilitates interaction and cooperation between scientists and Civil Protection Agencies in order to share, unify, and exchange procedures, methodologies and technologies to effectively reduce the impacts of volcanic disasters. The project aims at 1) improving and developing volcanic risk assessment and management capacities in active volcanic regions; 2) developing universal methodologies, scenario definitions, response strategies and alert protocols to cope with the full range of volcanic threats; 4) improving quantitative methods and tools for vulnerability and risk assessment; and 5) defining thresholds and protocols for civil protection. With these objectives, the VeTOOLS project points to two of the Sendai Framework resolutions for implementing it: i) Provide guidance on methodologies and standards for risk assessments, disaster risk modelling and the use of data; ii) Promote and support the availability and application of science and technology to decision-making, and offers a good example on how a close collaboration between science and civil protection is an effective way to contribute to DRR. European Commission ECHO Grant SI2.695524

  10. Risk Jyouhou Navi (risk information navigator). Web tool for fostering of risk literacy. Set of data

    International Nuclear Information System (INIS)

    Mitsui, Seiichiro

    2003-06-01

    In addition to the conventional public understanding activities, Risk communication study team of Japan Nuclear Cycle Development Institutes (JNC) Tokai Works has started practical studies to promote risk communication with its local communities. Since its establishment in 2001, Risk communication study team has conducted analyses of already available results of public attitude surveys, case studies of domestic and overseas risk communication activities, and development of risk communication tools. A web tool for fostering of risk literacy 'Risk Jyouhou Navi (risk information navigator in English)', was developed as a web content for the official home page of Techno Kouryuu Kan Ricotti (Techno Community Square Ricotti in English)'. The objectives of this content are to provide risk information for public and to provide an electronic platform for promoting risk communication with the local community. To develop 'Risk Jyouhou Navi', the following concepts were considered. 1) To create public interest in risks in daily lives and in global risks. 2) To provide risk knowledge and information. 3) To support risk communication activities in Techno community square ricotti. (author)

  11. Pandora - a simulation tool for safety assessments. Technical description and user's guide

    International Nuclear Information System (INIS)

    Ekstroem, Per-Anders

    2010-12-01

    This report documents a flexible simulation tool, Pandora, used in several post closure safety assessments in both Sweden and Finland to assess the radiological dose to man due to releases from radioactive waste repositories. Pandora allows the user to build compartment models to represent the migration and fate of radionuclides in the environment. The tool simplifies the implementation and simulation of radioecological biosphere models in which there exist a large set of radionuclides and input variables. Based on the well-known technical computing software MATLAB and especially its interactive graphical environment Simulink, Pandora receives many benefits. MATLAB/Simulink is a highly flexible tool used for simulations of practically any type of dynamic system; it is widely used, continuously maintained, and often upgraded. By basing the tool on this commercial software package, we gain both the graphical interface provided by Simulink, as well as the ability to access the advanced numerical equation solving routines in MATLAB. Since these numerical methods are well established and quality assured in their MATLAB implementation, the solution methods used in Pandora can be considered to have high level of quality assurance. The structure of Pandora provides clarity in the model format, which means the model itself assists its own documentation, since the model can be understood by inspecting its structure. With the introduction of the external tool Pandas (Pandora assessment tool), version handling and an integrated way of performing the entire calculation chain has been added. Instead of being dependent on other commercial statistical software as Risk for performing probabilistic assessments, they can now be performed within the tool

  12. A Review on Methods for Assessing Risk Factors of the Upper Limb Disorders among Cashiers in Grocery Retail Industries

    Directory of Open Access Journals (Sweden)

    Ahmad Zuhaidi Muhammad Fareez

    2017-01-01

    Full Text Available This paper provides an overview of the various methods that have been developed for the assessment of risk factors for upper limb disorders among cashiers in grocery retail industries. This paper is essential as upper limb disorders have been known as one of the prime cause of work-related disability in various countries. The methods used for the assessment were the Disabilities of the Arm, Shoulder and Hand (DASH questionnaire, the Assessment of Repetitive Tasks (ART, the Job Strain Index (JSI and the Occupational Repetitive Actions (OCRA Checklist. DASH questionnaire is a structured interview in determining the prevalence of the upper limb disorders, while ART, the JSI and OCRA Checklist act as a direct observation in examining the involvement of risk factors. Basically, these tools dealt with the measurements of symptoms, posture observation, and workplace risk assessment, as they are the most relevant tools for assessing the risk factors faced by the workers in grocery industries. The use of these tools assessed the risk factors and consequently reduces the risk of injuries among the workers.

  13. Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

    Science.gov (United States)

    Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

    2015-06-01

    Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  14. Ecological models and pesticide risk assessment: current modeling practice.

    Science.gov (United States)

    Schmolke, Amelie; Thorbek, Pernille; Chapman, Peter; Grimm, Volker

    2010-04-01

    Ecological risk assessments of pesticides usually focus on risk at the level of individuals, and are carried out by comparing exposure and toxicological endpoints. However, in most cases the protection goal is populations rather than individuals. On the population level, effects of pesticides depend not only on exposure and toxicity, but also on factors such as life history characteristics, population structure, timing of application, presence of refuges in time and space, and landscape structure. Ecological models can integrate such factors and have the potential to become important tools for the prediction of population-level effects of exposure to pesticides, thus allowing extrapolations, for example, from laboratory to field. Indeed, a broad range of ecological models have been applied to chemical risk assessment in the scientific literature, but so far such models have only rarely been used to support regulatory risk assessments of pesticides. To better understand the reasons for this situation, the current modeling practice in this field was assessed in the present study. The scientific literature was searched for relevant models and assessed according to nine characteristics: model type, model complexity, toxicity measure, exposure pattern, other factors, taxonomic group, risk assessment endpoint, parameterization, and model evaluation. The present study found that, although most models were of a high scientific standard, many of them would need modification before they are suitable for regulatory risk assessments. The main shortcomings of currently available models in the context of regulatory pesticide risk assessments were identified. When ecological models are applied to regulatory risk assessments, we recommend reviewing these models according to the nine characteristics evaluated here. (c) 2010 SETAC.

  15. Audit Risk Assessment in the Light of Current European Regulations

    Directory of Open Access Journals (Sweden)

    Ciprian-Costel Munteanu

    2015-06-01

    Full Text Available Recent European reforms on audit regulations have been motivated by efforts to increase audit quality, functioning and performance. We believe the adoption of Directive 2014/56 and Regulation 537/2014 strengthened the role of independent audit and risk committees, which will positively contribute towards audit quality. This paper aims to critically assess the status quo of audit risk assessment in current European standards and regulations, by conducting a theoretical analysis of different aspects of audit risk. Our main objective is to stress the importance of detecting inherent and control risk, which lead to material misstatement at the assertion level. They need to be assessed so as to determine the nature, timing and extent of further audit procedures necessary to obtain sufficient appropriate audit evidence. These pieces of evidence enable the auditor to express an opinion on the financial statements at an acceptably low level of audit risk. Therefore, we point to the fact that researchers as well as practitioners and policymakers have to be careful when using audit tools and assessing risk levels, as their conclusions continuously shape the regulations.

  16. Develop risk-based procurement management tools for SMEs

    NARCIS (Netherlands)

    Staal, Anne; Hagelaar, Geoffrey; Walhof, Gert; Holman, Richard

    2016-01-01

    This paper provides guidance for developing risk-based management tools to improve the procurement (purchasing) performance of SMEs. Extant academic literature only offers little support on developing such tools and does not consider the wide variety of SMEs. The paper defines a procurement tool for

  17. Operational risk assessment.

    Science.gov (United States)

    McKim, Vicky L

    2017-06-01

    In the world of risk management, which encompasses the business continuity disciplines, many types of risk require evaluation. Financial risk is most often the primary focus, followed by product and market risks. Another critical area, which typically lacks a thorough review or may be overlooked, is operational risk. This category encompasses many risk exposure types including those around building structures and systems, environmental issues, nature, neighbours, clients, regulatory compliance, network, data security and so on. At times, insurance carriers will assess internal hazards, but seldom do these assessments include more than a cursory look at other types of operational risk. In heavily regulated environments, risk assessments are required but may not always include thorough assessments of operational exposures. Vulnerabilities may linger or go unnoticed, only to become the catalyst for a business disruption at a later time, some of which are so severe that business recovery becomes nearly impossible. Businesses may suffer loss of clients as the result of a prolonged disruption of services. Comprehensive operational risk assessments can assist in identifying such vulnerabilities, exposures and threats so that the risk can be minimised or removed. This paper lays out how an assessment of this type can be successfully conducted.

  18. Rapid Response Risk Assessment in New Project Development

    Science.gov (United States)

    Graber, Robert R.

    2010-01-01

    A capability for rapidly performing quantitative risk assessments has been developed by JSC Safety and Mission Assurance for use on project design trade studies early in the project life cycle, i.e., concept development through preliminary design phases. A risk assessment tool set has been developed consisting of interactive and integrated software modules that allow a user/project designer to assess the impact of alternative design or programmatic options on the probability of mission success or other risk metrics. The risk and design trade space includes interactive options for selecting parameters and/or metrics for numerous design characteristics including component reliability characteristics, functional redundancy levels, item or system technology readiness levels, and mission event characteristics. This capability is intended for use on any project or system development with a defined mission, and an example project will used for demonstration and descriptive purposes, e.g., landing a robot on the moon. The effects of various alternative design considerations and their impact of these decisions on mission success (or failure) can be measured in real time on a personal computer. This capability provides a high degree of efficiency for quickly providing information in NASA s evolving risk-based decision environment

  19. CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas

    Science.gov (United States)

    Tanguy, M.; Chokmani, K.; Bernier, M.; Poulin, J.

    2013-12-01

    When a flood affects an urban area, the managers and services responsible for public safety need precise and real time information on the localization of the flooded areas, on the submersion heights in those areas, but also on the vulnerability of people exposed to this hazard. Such information is essential for an effective crisis management. Despite a growing interest in this topic over the last 15 years, the development of flood risk assessment tools mainly focused on quantitative modeling of the monetary damages caused by floods to residential buildings or to critical infrastructures. Little attention was paid to the vulnerability of people exposed to flooding but also to the effects of the failure or destruction of critical infrastructures and residential building on people health and security during the disaster. Moreover, these models do not integrate the dynamic features of the flood (extent, submersion heights) and the evolution of human vulnerability in the same mapping tool. Thus, an accurate and precise evaluation of human risk induced by urban flooding is hardly feasible using such models. This study presents CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas, which fills the actual needs in terms of flood risk evaluation and management. This innovative tool integrates a methodology of flood hazard mapping that simulates, for a given discharge, the associated water level, and subsequently determines the extent of the flooded area and the submersion heights at each point of the flooded area, using a DEM. The dynamics of human vulnerability is then mapped at the household level, according to the characteristics of the flood hazard. Three key components of human vulnerability have been identified and are integrated to CADYRI: 1, the intrinsic vulnerability of the population, estimated by specific socio-economic indicators; 2, the vulnerability of buildings, assessed by their structural features; 3, the vulnerability of

  20. Assessing the Invasion Risk of Eucalyptus in the United States Using the Australian Weed Risk Assessment

    Directory of Open Access Journals (Sweden)

    Doria R. Gordon

    2012-01-01

    Full Text Available Many agricultural species have undergone selection for traits that are consistent with those that increase the probability that a species will become invasive. However, the risk of invasion may be accurately predicted for the majority of plant species tested using the Australian Weed Risk Assessment (WRA. This system has been tested in multiple climates and geographies and, on average, correctly identifies 90% of the major plant invaders as having high invasion risk, and 70% of the noninvaders as having low risk. We used this tool to evaluate the invasion risk of 38 Eucalyptus taxa currently being tested and cultivated in the USA for pulp, biofuel, and other purposes. We predict 15 taxa to have low risk of invasion, 14 taxa to have high risk, and 9 taxa to require further information. In addition to a history of naturalization and invasiveness elsewhere, the traits that significantly contribute to a high invasion risk conclusion include having prolific seed production and a short generation time. Selection against these traits should reduce the probability that eucalypts cultivated in the USA will become invasive threats to natural areas and agricultural systems.

  1. Web-based teaching tool incorporating peer assessment and self-assessment

    DEFF Research Database (Denmark)

    McEvoy, Fintan; McEvoy, Peter M.; Svalastoga, Eiliv L.

    2010-01-01

    OBJECTIVE. Our objective was to create an electronic learning tool that incorporates the pedagogic advantages of peer assessment and self-assessment into report-generating skills. CONCLUSION. The tool was created using Web programming software. It was tested with 12 veterinary students and provided...... peer-peer and tutor-student interactions that supported learning. The tool is suited for training any professional concerned with the interpretation of images, particularly resident radiologists....

  2. European Social Work Research Association SIG to Study Decisions, Assessment, and Risk.

    Science.gov (United States)

    Taylor, Brian; Killick, Campbell; Bertotti, Teresa; Enosh, Guy; Gautschi, Joel; Hietamäki, Johanna; Sicora, Alessandro; Whittaker, Andrew

    2018-01-01

    The increasing interest in professional judgement and decision making is often separate from the discourse about "risk," and the time-honored focus on assessment. The need to develop research in and across these topics was recognized in the founding of a Decisions, Assessment, and Risk Special Interest Group (DARSIG) by the European Social Work Research Association in 2014. The Group's interests include cognitive judgements; decision processes with clients, families, other professionals and courts; assessment tools and processes; the assessment, communication, and management of risk; and legal, ethical, and emotional aspects of these. This article outlines the founding and scope of DARSIG; gives an overview of decision making, assessment, and risk for practice; illustrates connections between these; and highlights future research directions. Professional knowledge about decision making, assessment, and risk complements knowledge about effectiveness of interventions. DARSIG promises to be a useful mechanism for the purpose.

  3. Genetic Stratification in Myeloid Diseases: From Risk Assessment to Clinical Decision Support Tool

    Directory of Open Access Journals (Sweden)

    Yishai Ofran

    2014-10-01

    Full Text Available Genetic aberrations have become a dominant factor in the stratification of myeloid malignancies. Cytogenetic and a few mutation studies are the backbone of risk assessment models of myeloid malignancies which are a major consideration in clinical decisions, especially patient assignment for allogeneic stem cell transplantation. Progress in our understanding of the genetic basis of the pathogenesis of myeloid malignancies and the growing capabilities of mass sequencing may add new roles for the clinical usage of genetic data. A few recently identified mutations recognized to be associated with specific diseases or clinical scenarios may soon become part of the diagnostic criteria of such conditions. Mutational studies may also advance our capabilities for a more efficient patient selection process, assigning the most effective therapy at the best timing for each patient. The clinical utility of genetic data is anticipated to advance further with the adoption of deep sequencing and next-generation sequencing techniques. We herein suggest some future potential applications of sequential genetic data to identify pending deteriorations at time points which are the best for aggressive interventions such as allogeneic stem cell transplantation. Genetics is moving from being mostly a prognostic factor to becoming a multitasking decision support tool for hematologists. Physicians must pay attention to advances in molecular hematology as it will soon be accessible and influential for most of our patients.

  4. Sensors vs. experts - a performance comparison of sensor-based fall risk assessment vs. conventional assessment in a sample of geriatric patients.

    Science.gov (United States)

    Marschollek, Michael; Rehwald, Anja; Wolf, Klaus-Hendrik; Gietzelt, Matthias; Nemitz, Gerhard; zu Schwabedissen, Hubertus Meyer; Schulze, Mareike

    2011-06-28

    Fall events contribute significantly to mortality, morbidity and costs in our ageing population. In order to identify persons at risk and to target preventive measures, many scores and assessment tools have been developed. These often require expertise and are costly to implement. Recent research investigates the use of wearable inertial sensors to provide objective data on motion features which can be used to assess individual fall risk automatically. So far it is unknown how well this new method performs in comparison with conventional fall risk assessment tools. The aim of our research is to compare the predictive performance of our new sensor-based method with conventional and established methods, based on prospective data. In a first study phase, 119 inpatients of a geriatric clinic took part in motion measurements using a wireless triaxial accelerometer during a Timed Up&Go (TUG) test and a 20 m walk. Furthermore, the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) was performed, and the multidisciplinary geriatric care team estimated the patients' fall risk. In a second follow-up phase of the study, 46 of the participants were interviewed after one year, including a fall and activity assessment. The predictive performances of the TUG, the STRATIFY and team scores are compared. Furthermore, two automatically induced logistic regression models based on conventional clinical and assessment data (CONV) as well as sensor data (SENSOR) are matched. Among the risk assessment scores, the geriatric team score (sensitivity 56%, specificity 80%) outperforms STRATIFY and TUG. The induced logistic regression models CONV and SENSOR achieve similar performance values (sensitivity 68%/58%, specificity 74%/78%, AUC 0.74/0.72, +LR 2.64/2.61). Both models are able to identify more persons at risk than the simple scores. Sensor-based objective measurements of motion parameters in geriatric patients can be used to assess individual fall risk, and our

  5. PRA (Probabilistic Risk Assessments) Participation versus Validation

    Science.gov (United States)

    DeMott, Diana; Banke, Richard

    2013-01-01

    Probabilistic Risk Assessments (PRAs) are performed for projects or programs where the consequences of failure are highly undesirable. PRAs primarily address the level of risk those projects or programs posed during operations. PRAs are often developed after the design has been completed. Design and operational details used to develop models include approved and accepted design information regarding equipment, components, systems and failure data. This methodology basically validates the risk parameters of the project or system design. For high risk or high dollar projects, using PRA methodologies during the design process provides new opportunities to influence the design early in the project life cycle to identify, eliminate or mitigate potential risks. Identifying risk drivers before the design has been set allows the design engineers to understand the inherent risk of their current design and consider potential risk mitigation changes. This can become an iterative process where the PRA model can be used to determine if the mitigation technique is effective in reducing risk. This can result in more efficient and cost effective design changes. PRA methodology can be used to assess the risk of design alternatives and can demonstrate how major design changes or program modifications impact the overall program or project risk. PRA has been used for the last two decades to validate risk predictions and acceptability. Providing risk information which can positively influence final system and equipment design the PRA tool can also participate in design development, providing a safe and cost effective product.

  6. Integrated national-scale assessment of wildfire risk to human and ecological values

    Science.gov (United States)

    Matthew P. Thompson; David E. Calkin; Mark A. Finney; Alan A. Ager; Julie W. Gilbertson-Day

    2011-01-01

    The spatial, temporal, and social dimensions of wildfire risk are challenging U.S. federal land management agencies to meet societal needs while maintaining the health of the lands they manage. In this paper we present a quantitative, geospatial wildfire risk assessment tool, developed in response to demands for improved risk-based decision frameworks. The methodology...

  7. A prognostic tool to identify adolescents at high risk of becoming daily smokers

    Directory of Open Access Journals (Sweden)

    Paradis Gilles

    2011-08-01

    Full Text Available Abstract Background The American Academy of Pediatrics advocates that pediatricians should be involved in tobacco counseling and has developed guidelines for counseling. We present a prognostic tool for use by health care practitioners in both clinical and non-clinical settings, to identify adolescents at risk of becoming daily smokers. Methods Data were drawn from the Nicotine Dependence in Teens (NDIT Study, a prospective investigation of 1293 adolescents, initially aged 12-13 years, recruited in 10 secondary schools in Montreal, Canada in 1999. Questionnaires were administered every three months for five years. The prognostic tool was developed using estimated coefficients from multivariable logistic models. Model overfitting was corrected using bootstrap cross-validation. Goodness-of-fit and predictive ability of the models were assessed by R2, the c-statistic, and the Hosmer-Lemeshow test. Results The 1-year and 2-year probability of initiating daily smoking was a joint function of seven individual characteristics: age; ever smoked; ever felt like you needed a cigarette; parent(s smoke; sibling(s smoke; friend(s smoke; and ever drank alcohol. The models were characterized by reasonably good fit and predictive ability. They were transformed into user-friendly tables such that the risk of daily smoking can be easily computed by summing points for responses to each item. The prognostic tool is also available on-line at http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php. Conclusions The prognostic tool to identify youth at high risk of daily smoking may eventually be an important component of a comprehensive tobacco control system.

  8. Evaluation of caries risk in a young adult population using a computer-based risk assessment model (Cariogram

    Directory of Open Access Journals (Sweden)

    Ilkay Peker

    2012-06-01

    Conclusions: According to the results of this study, the most important factors for caries risk were the past caries experience, fluoride programs, and S. mutans and Lactobacillus counts in saliva. Cariogram is a helpful method for dentists in clinical practice to assess caries risk, and it can be used as a didactic tool for patient education and motivation.

  9. Framework for economic pluvial flood risk assessment considering climate change effects and adaptation benefits

    DEFF Research Database (Denmark)

    Zhou, Qianqian; Mikkelsen, Peter Steen; Halsnæs, Kirsten

    2012-01-01

    Climate change is likely to affect the water cycle by influencing the precipitation patterns. It is important to integrate the anticipated changes into the design of urban drainage in response to the increased risk level in cities. This paper presents a pluvial flood risk assessment framework...... to identify and assess adaptation options in the urban context. An integrated approach is adopted by incorporating climate change impact assessment, flood inundation modeling, economic tool, and risk assessment, hereby developing a step-by-step process for cost-benefit assessment of climate change adaptation...

  10. Assessing the nutritional status of elderly Chinese lung cancer patients using the Mini-Nutritional Assessment (MNA® tool

    Directory of Open Access Journals (Sweden)

    Zhang L

    2013-03-01

    Full Text Available Lei Zhang,1,* Yanjun Su,1,* Chen Wang,2 Yongsheng Sha,1 Hong Zhu,3 Shumin Xie,4 Sabrina Kwauk,5 Jing Zhang,2 Yunshou Lin,2 Changli Wang1,*1Department of Thoracic Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 2Tianjin Medical University, Tianjin, 3Department of Public Health, Tianjin Medical University, Tianjin, 4Xiangya Medical School of Central-South University, Changsha, People's Republic of China; 5School of Public Health, Harvard University, Boston, Cambridge, MA, USA*These authors contributed equally to this workPurpose: This study assessed the nutritional status of elderly Chinese lung cancer inpatients using a revised version of the Mini-Nutritional Assessment (MNA® tool.Patients and methods: The revised version of the MNA tool was used to assess the nutritional status of 180 elderly Chinese lung cancer inpatients prior to their scheduled surgery between June 2010 and July 2011. Patients' demographic data, anthropometric parameters, and biochemical markers were collected and analyzed.Results: Among the 180 inpatients who underwent the MNA, 9% were malnourished (MNA score < 19, 33% were at risk of malnutrition (MNA score 19–23, and 58% were well nourished (MNA score ≥ 24. There was significant correlation between the MNA scores of patients who were malnourished, at risk of malnutrition, and well nourished (P < 0.001, as well as between total MNA score and most MNA questions. The three patient groups with different nutritional statuses differed significantly in their responses to anthropometrics and global, diet, and subjective assessments.Conclusion: Incidence rates of malnutrition prior to surgery are high among elderly Chinese lung cancer inpatients. The revised MNA is a valid and reliable tool that can be used to assess and prevent malnutrition among these inpatients.Keywords: malnutrition, MNA-SF, nutrition, inpatients, diet

  11. Text mining for literature review and knowledge discovery in cancer risk assessment and research.

    Directory of Open Access Journals (Sweden)

    Anna Korhonen

    Full Text Available Research in biomedical text mining is starting to produce technology which can make information in biomedical literature more accessible for bio-scientists. One of the current challenges is to integrate and refine this technology to support real-life scientific tasks in biomedicine, and to evaluate its usefulness in the context of such tasks. We describe CRAB - a fully integrated text mining tool designed to support chemical health risk assessment. This task is complex and time-consuming, requiring a thorough review of existing scientific data on a particular chemical. Covering human, animal, cellular and other mechanistic data from various fields of biomedicine, this is highly varied and therefore difficult to harvest from literature databases via manual means. Our tool automates the process by extracting relevant scientific data in published literature and classifying it according to multiple qualitative dimensions. Developed in close collaboration with risk assessors, the tool allows navigating the classified dataset in various ways and sharing the data with other users. We present a direct and user-based evaluation which shows that the technology integrated in the tool is highly accurate, and report a number of case studies which demonstrate how the tool can be used to support scientific discovery in cancer risk assessment and research. Our work demonstrates the usefulness of a text mining pipeline in facilitating complex research tasks in biomedicine. We discuss further development and application of our technology to other types of chemical risk assessment in the future.

  12. Online reporting and assessing new occupational health risks in SIGNAAL.

    Science.gov (United States)

    Lenderink, A F; Keirsbilck, S; van der Molen, H F; Godderis, L

    2015-11-01

    Changes in work and working conditions continuously give rise to new work-related health risks. Without sufficient knowledge of these, opportunities for prevention and intervention may be missed. To develop, implement and evaluate an online tool called SIGNAAL for reporting and assessment of new work-related health risks by occupational health physicians and experts in the Netherlands and Belgium. Development and implementation of SIGNAAL to allow both easy and sufficient detailed reporting by occupational health physicians and structured and transparent assessment by occupational health experts. A new work-related health risk is defined as a work-related disease due to specific exposure in a specific work setting not described in the literature before. The online reporting and assessment tool proved to be a feasible means of reporting possible new combinations of health problems and exposures in the work situation. Eleven of the 15 cases reported until October 2014 were fully assessed: one was an entirely new work-related disease, four were known but uncommon work-related diseases, five were known but new in the reported work situation and one was a well-known work-related disease. An online reporting system used in an occupational health setting can provide insight into new work-related health risks by creating a structured way to gather, report and assess new combinations of health problems and exposure in the workplace. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Landslide risk assessment of a slope in Tijuana city, Mexico

    Directory of Open Access Journals (Sweden)

    Aldo Onel Oliva González

    2018-01-01

    Full Text Available Context: Risk reduction and prevention of disasters events produced by landslides on urban slopes, requires an integral assessment considering conditioning and triggering natural and human factors. Such an assessment is a valuable prevention and mitigation tool for communities under risk and also for authorities involved in the process. Method: In this research, a general methodology for the assessment of landslides on an urban slope was studied and applied, considering the relationship between hazard and physical vulnerability in the zone of study. Hazard was determined by probabilistic methods, whereas vulnerability of the exposed elements was obtained taking into account two kinds of buildings and their spatial distribution, their structural integrity state, their foundation depth and the unstable terrain probable mass volume. Results: Safety factors were obtained under allowable levels to warrant stability of the slope under study, and valuation factors of the qualitative analysis indicate that the slope is unstable and that requires urgent maintenance. This confirms and validates the high probability of occurrence in the zone, obtained from historic records. Conclusions: It was found that landslide risk in the slope is high due to the high probability of its occurrence, with three possible movement directions that may impact on several buildings located in the zone. Assessment constitutes a work tool for institutions and authorities related with risk reduction due to landslides, as a way of prevent and mitigate disaster prone events.

  14. Assessing Bleeding Risk in Patients Taking Anticoagulants

    Science.gov (United States)

    Shoeb, Marwa; Fang, Margaret C.

    2013-01-01

    Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism. Although highly effective, they are also associated with significant bleeding risks. Numerous individual clinical factors have been linked to an increased risk of hemorrhage, including older age, anemia, and renal disease. To help quantify hemorrhage risk for individual patients, a number of clinical risk prediction tools have been developed. These risk prediction tools differ in how they were derived and how they identify and weight individual risk factors. At present, their ability to effective predict anticoagulant-associated hemorrhage remains modest. Use of risk prediction tools to estimate bleeding in clinical practice is most influential when applied to patients at the lower spectrum of thromboembolic risk, when the risk of hemorrhage will more strongly affect clinical decisions about anticoagulation. Using risk tools may also help counsel and inform patients about their potential risk for hemorrhage while on anticoagulants, and can identify patients who might benefit from more careful management of anticoagulation. PMID:23479259

  15. BASINS and WEPP Climate Assessment Tools (CAT): Case ...

    Science.gov (United States)

    This draft report supports application of two recently developed water modeling tools, the BASINS and WEPP climate assessment tools. The report presents a series of short case studies designed to illustrate the capabilities of these tools for conducting scenario based assessments of the potential future effects of climate change on water resources. This report presents a series of short, illustrative case studies using the BASINS and WEPP climate assessment tools.

  16. Hepatitis Risk Assessment

    Science.gov (United States)

    ... please visit this page: About CDC.gov . Hepatitis Risk Assessment Recommend on Facebook Tweet Share Compartir Viral Hepatitis. Are you at risk? Take this 5 minute Hepatitis Risk Assessment developed ...

  17. Science-based risk assessments for rare events in a changing climate

    Science.gov (United States)

    Sobel, A. H.; Tippett, M. K.; Camargo, S. J.; Lee, C. Y.; Allen, J. T.

    2014-12-01

    History shows that substantial investments in protection against any specific type of natural disaster usually occur only after (usually shortly after) that specific type of disaster has happened in a given place. This is true even when it was well known before the event that there was a significant risk that it could occur. Presumably what psychologists Kahneman and Tversky have called "availability bias" is responsible, at least in part, for these failures to act on known but out-of-sample risks. While understandable, this human tendency prepares us poorly for events which are very rare (on the time scales of human lives) and even more poorly for a changing climate, as historical records become a poorer guide. A more forward-thinking and rational approach would require scientific risk assessments that can place meaningful probabilities on events that are rare enough to be absent from the historical record, and that can account for the influences of both anthropogenic climate change and low-frequency natural climate variability. The set of tools available for doing such risk assessments is still quite limited, particularly for some of the most extreme events such as tropical cyclones and tornadoes. We will briefly assess the state of the art for these events in particular, and describe some of our ongoing research to develop new tools for quantitative risk assessment using hybrids of statistical methods and physical understanding of the hazards.

  18. Challenge Course Facilitator Technical Skills Assessment Tool Mark

    Science.gov (United States)

    Wagstaff, William Quinn

    2007-01-01

    A study was conducted to develop a technical skills assessment tool for the training and development of challenge course facilitators. Researchers accessed two professional on-line listserves to collect a sample size of twenty-seven currently used technical skills assessment tools. The assessment tools were critically analysed by three independent…

  19. Can systematic reviews inform GMO risk assessment and risk management?

    Directory of Open Access Journals (Sweden)

    Christian eKohl

    2015-08-01

    Full Text Available Systematic reviews represent powerful tools to identify, collect, synthesize and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a gold standard for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper we 1 consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO and 2 critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  20. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    Science.gov (United States)

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  1. Validation and inter-rater reliability of a three item falls risk screening tool

    Directory of Open Access Journals (Sweden)

    Catherine Maree Said

    2017-11-01

    Full Text Available Abstract Background Falls screening tools are routinely used in hospital settings and the psychometric properties of tools should be examined in the setting in which they are used. The aim of this study was to explore the concurrent and predictive validity of the Austin Health Falls Risk Screening Tool (AHFRST, compared with The Northern Hospital Modified St Thomas’s Risk Assessment Tool (TNH-STRATIFY, and the inter-rater reliability of the AHFRST. Methods A research physiotherapist used the AHFRST and TNH-STRATIFY to classify 130 participants admitted to Austin Health (five acute wards, n = 115 two subacute wards n = 15; median length of stay 6 days IQR 3–12 as ‘High’ or ‘Low’ falls risk. The AHFRST was also completed by nursing staff on patient admission. Falls data was collected from the hospital incident reporting system. Results Six falls occurred during the study period (fall rate of 4.6 falls per 1000 bed days. There was substantial agreement between the AHFRST and the TNH-STRATIFY (Kappa = 0.68, 95% CI 0.52–0.78. Both tools had poor predictive validity, with low specificity (AHFRST 46.0%, 95% CI 37.0–55.1; TNH-STRATIFY 34.7%, 95% CI 26.4–43.7 and positive predictive values (AHFRST 5.6%, 95% CI 1.6–13.8; TNH-STRATIFY 6.9%, 95% CI 2.6–14.4. The AHFRST showed moderate inter-rater reliability (Kappa = 0.54, 95% CI = 0.36–0.67, p < 0.001 although 18 patients did not have the AHFRST completed by nursing staff. Conclusions There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification. However, both tools demonstrated limited predictive validity in the Austin Health population. The results highlight the importance of evaluating the validity of falls screening tools, and the clinical utility of these tools should be reconsidered.

  2. Dementia Population Risk Tool (DemPoRT): study protocol for a predictive algorithm assessing dementia risk in the community

    OpenAIRE

    Fisher, Stacey; Hsu, Amy; Mojaverian, Nassim; Taljaard, Monica; Huyer, Gregory; Manuel, Douglas G; Tanuseputro, Peter

    2017-01-01

    Introduction The burden of disease from dementia is a growing global concern as incidence increases dramatically with age, and average life expectancy has been increasing around the world. Planning for an ageing population requires reliable projections of dementia prevalence; however, existing population projections are simple and have poor predictive accuracy. The Dementia Population Risk Tool (DemPoRT) will predict incidence of dementia in the population setting using multivariable modellin...

  3. Numerical tool for tsunami risk assessment in the southern coast of Dominican Republic

    Science.gov (United States)

    Macias Sanchez, J.; Llorente Isidro, M.; Ortega, S.; Gonzalez Vida, J. M., Sr.; Castro, M. J.

    2016-12-01

    The southern coast of Dominican Republic is a very populated region, with several important cities including Santo Domingo, its capital. Important activities are rooted in the southern coast including tourism, industry, commercial ports, and, energy facilities, among others. According to historical reports, it has been impacted by big earthquakes accompanied by tsunamis as in Azua in 1751 and recently Pedernales in 2010, but their sources are not clearly identified. The aim of the present work is to develop a numerical tool to simulate the impact in the southern coast of the Dominican Republic of tsunamis generated in the Caribbean Sea. This tool, based on the Tsunami-HySEA model from EDANYA group (University of Malaga, Spain), could be used in the framework of a Tsunami Early Warning Systems due the very short computing times when only propagation is computed or it could be used to assess inundation impact, computing inundation with a initial 5 meter resolution. Numerical results corresponding to three theoretical sources are used to test the numerical tool.

  4. Results of a recent crud/corrosion fuel risk assessment at a U.S. PWR

    International Nuclear Information System (INIS)

    Lamanna, Larry; Pop, Mike; Gregorich, Carola; Harne, Richard; Jones, John

    2012-09-01

    In order to avoid potential fuel reliability issues, specifically crud-related issues, it is necessary to achieve and maintain a crud safe environment. Therefore, the ability to confidently predict risks associated with crud deposition on fuel becomes critically important. AREVA is applying its cutting-edge PWR Fuel Crud (Primary System corrosion products)/Corrosion Tools, i.e. COBRA-FLX (subchannel-by-subchannel T/H tool) coupled with FDIC (crud deposition tool) to subsequently perform PWR Fuel Crud /Corrosion risk assessments for operating plants in the US. After describing the method, the result of one of these assessments is presented for an operating plant in the US that has experienced recent crud observations/concerns. Both Crud Induced Localized Corrosion (CILC) and Crud Induced Power Shift (CIPS) risk assessment methods, as applied to the upcoming cycle (Cycle N), were compared to the current/on-going cycle (Cycle N-1) and to the previous cycle (Cycle N-2). The results allowed the Utility to consider crud risk management changes associated with the upcoming cycle (Cycle-N). Benchmarking of the AREVA tools, using the plant-specific crud information gained from the crud sampling/characterization for the Unit will be presented. The CIPS analysis references boron loading and the amount of insoluble iron-nickel-borates predicted for Cycles N-2, N-1, and N. The results of the CILC evaluation reference FDIC-predicted crud thickness, cladding temperature under deposit, evolution of CILC bearing species and lithium concentration in the zirconium oxide layer. The approach taken by AREVA during the evaluation was to consider both 'risk' and 'margin' to fuel performance impact caused by crud deposits. The conclusion of the assessment, illustrated by the results presented in this paper, is that the example Plant has sufficient margin in worst case conditions for CIPS and CILC risk in Cycle N, based on Cycle N-1 and Cycle N-2 conditions and behavior

  5. EPRI nuclear fuel-cycle accident risk assessment

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    The present results of the nuclear fuel-cycle accident risk assessment conducted by the Electric Power Research Institute show that the total risk contribution of the nuclear fuel cycle is only approx. 1% of the accident risk of the power plant; hence, with little error, the accident risk of nuclear electric power is essentially that of the power plant itself. The power-plant risk, assuming a very large usage of nuclear power by the year 2005 is only approx. 0.5% of the radiological risk of natural background. The smallness of the fuel-cycle risk relative to the power-plant risk may be attributed to the lack of internal energy to drive an accident and the small amount of dispersible material. This work aims at a realistic assessment of the process hazards, the effectiveness of confinement and mitigation systems and procedures, and the associated likelihood of errors and the estimated size of errors. The primary probabilistic estimation tool is fault-tree analysis, with the release source terms calculated using physicochemical processes. Doses and health effects are calculated with CRAC (Consequences of Reactor Accident Code). No evacuation or mitigation is considered; source terms may be conservative through the assumption of high fuel burnup (40,000 MWd/t) and short cooling period (90 to 150 d); high-efficiency particulate air filter efficiencies are derived from experiments

  6. Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

    Science.gov (United States)

    Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

    2017-10-27

    Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

  7. Uncertainty assessment of climate change adaptation using an economic pluvial flood risk framework

    DEFF Research Database (Denmark)

    Zhou, Qianqian; Arnbjerg-Nielsen, Karsten

    2012-01-01

    It is anticipated that climate change is likely to lead to an increasing risk level of flooding in cities in northern Europe. One challenging question is how to best address the increasing flood risk and assess the costs and benefits of adapting to such changes. We established an integrated...... approach for identification and assessment of climate change adaptation options by incorporating climate change impacts, flood inundation modelling, economic tool and risk assessment and management. The framework is further extended and adapted by embedding a Monte Carlo simulation to estimate the total...

  8. Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland.

    Science.gov (United States)

    Johansen, E; Moore, Z; van Etten, M; Strapp, H

    2014-07-01

    To explore similarities and differences in nurses' views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients' risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland). A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland. Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies. Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further. This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.

  9. GM Risk Assessment

    Science.gov (United States)

    Sparrow, Penny A. C.

    GM risk assessments play an important role in the decision-making process surrounding the regulation, notification and permission to handle Genetically Modified Organisms (GMOs). Ultimately the role of a GM risk assessment will be to ensure the safe handling and containment of the GMO; and to assess any potential impacts on the environment and human health. A risk assessment should answer all ‘what if’ scenarios, based on scientific evidence.

  10. Effectiveness of Weather Derivatives as a Risk Management Tool in Food Retail: The Case of Croatia

    Directory of Open Access Journals (Sweden)

    Ivana Štulec

    2017-01-01

    Full Text Available Non-catastrophic weather risk is gaining importance as climate change becomes more pronounced and economic crisis forces companies to strengthen their cost control. Recent literature proposes weather derivatives as flexible weather risk mitigating tools. Only a handful of studies analysed the feasibility of weather derivatives in industries other than agriculture and energy. The purpose of this paper is to review available weather risk management solutions in retail, present weather derivatives as non-catastrophic weather risk management tools, empirically demonstrate the process of designing weather derivatives and assess their effectiveness as risk mitigating tools in retail. Empirical analysis is performed on beverage sales in 60 large food stores in Croatia, and performance of monthly temperature put options during the summer season is examined. For weather sensitivity analysis of sales, the method of panel regression was used. Results show that weather has a statistically significant effect on beverage sales and that weather derivatives prove to be effective in beverage sales uncertainty reduction. Their effectiveness differs between covered periods and cities.

  11. Safety Culture Assessment Tools in Nuclear and Non-Nuclear Domains

    International Nuclear Information System (INIS)

    Mkrtchyan, L.; Turcanu, C.

    2012-01-01

    Over the last decades, in many domains especially in high risk industries, the authorities paid increasing attention to safety management systems and, in particular, to safety culture. Consequently, in the applied and academic literature a huge amount of studies explored the main challenges, issues and obstacles related with safety culture. We undertake a survey of safety culture experiences in the main safety-critical industries such as nuclear, railways, offshore, aviation, airlines, health care, etc. We review both academic and applied literature up to the year 2011. Our results help to establish a comprehensive view on the subject, its main terminologies, existing tools, and main difficulties. The purpose of this report is to raise awareness about the current tools of safety culture assessment, both in the nuclear as well as in the non-nuclear domain. The report provides also practical recommendations about the possible use of each tool given different circumstances and different factors. We do not aim to rank the tools pointing the best one, but we highlight instead the unique features of these tools, pointing their strong and weak sides

  12. Safety Culture Assessment Tools in Nuclear and Non-Nuclear Domains

    Energy Technology Data Exchange (ETDEWEB)

    Mkrtchyan, L; Turcanu, C

    2012-03-15

    Over the last decades, in many domains especially in high risk industries, the authorities paid increasing attention to safety management systems and, in particular, to safety culture. Consequently, in the applied and academic literature a huge amount of studies explored the main challenges, issues and obstacles related with safety culture. We undertake a survey of safety culture experiences in the main safety-critical industries such as nuclear, railways, offshore, aviation, airlines, health care, etc. We review both academic and applied literature up to the year 2011. Our results help to establish a comprehensive view on the subject, its main terminologies, existing tools, and main difficulties. The purpose of this report is to raise awareness about the current tools of safety culture assessment, both in the nuclear as well as in the non-nuclear domain. The report provides also practical recommendations about the possible use of each tool given different circumstances and different factors. We do not aim to rank the tools pointing the best one, but we highlight instead the unique features of these tools, pointing their strong and weak sides.

  13. Visual Impairment/Intracranial Pressure Risk Assessment

    Science.gov (United States)

    Fogarty, Jennifer A.; Durham, T.; Otto, C.; Grounds, D.; Davis, J. R.

    2010-01-01

    Since 2006 there have been 6 reported cases of altered visual acuity and intracranial pressure (ICP) in long duration astronauts. In order to document this risk and develop an integrated approach to its mitigation, the NASA Space Life Sciences Directorate (SLSD) and Human Research Program (HRP) have chosen to use the Human System Risk Board (HSRB) and the risk management analysis tool (RMAT). The HSRB is the venue in which the stakeholders and customers discuss and vet the evidence and the RMAT is the tool that facilitates documentation and comparison of the evidence across mission profiles as well as identification of risk factors, and documentation of mitigation strategies. This process allows for information to be brought forward and dispositioned so that it may be properly incorporated into the RMAT and contribute to the design of the research and mitigation plans. The evidence thus far has resulted in the identification of a visual impairment/intracranial pressure (VIIP) project team, updating of both short and long duration medical requirements designed to assess visual acuity, and a research plan to characterize this issue further. In order to understand this issue more completely, a plan to develop an Accelerated Research Collaboration (ARC) has been approved by the HSRB. The ARC is a novel research model pioneered by the Myelin Repair Foundation. It is a patient centered research model that brings together researchers and clinicians, under the guidance of a scientific advisory panel, to collaborate and produce results much quickly than accomplished through traditional research models. The data and evidence from the updated medical requirements and the VIIP ARC will be reviewed at the HSRB on a regular basis. Each review package presented to the HSRB will include an assessment and recommendation with respect to continuation of research, countermeasure development, occupational surveillance modalities, selection criteria, etc. This process will determine the

  14. Dynamical systems probabilistic risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ames, Arlo Leroy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-03-01

    Probabilistic Risk Assessment (PRA) is the primary tool used to risk-inform nuclear power regulatory and licensing activities. Risk-informed regulations are intended to reduce inherent conservatism in regulatory metrics (e.g., allowable operating conditions and technical specifications) which are built into the regulatory framework by quantifying both the total risk profile as well as the change in the risk profile caused by an event or action (e.g., in-service inspection procedures or power uprates). Dynamical Systems (DS) analysis has been used to understand unintended time-dependent feedbacks in both industrial and organizational settings. In dynamical systems analysis, feedback loops can be characterized and studied as a function of time to describe the changes to the reliability of plant Structures, Systems and Components (SSCs). While DS has been used in many subject areas, some even within the PRA community, it has not been applied toward creating long-time horizon, dynamic PRAs (with time scales ranging between days and decades depending upon the analysis). Understanding slowly developing dynamic effects, such as wear-out, on SSC reliabilities may be instrumental in ensuring a safely and reliably operating nuclear fleet. Improving the estimation of a plant's continuously changing risk profile will allow for more meaningful risk insights, greater stakeholder confidence in risk insights, and increased operational flexibility.

  15. Development of reliability and probabilistic safety assessment program RiskA

    International Nuclear Information System (INIS)

    Wu, Yican

    2015-01-01

    Highlights: • There are four parts in the structure of RiskA. User input part lets users input the PSA model and some necessary data by GUI or model transformation tool. In calculation engine part, fault tree analysis, event tree analysis, uncertainty analysis, sensitivity analysis, importance analysis and failure mode and effects analysis are supplied. User output part outputs the analysis results, user customized reports and some other data. The last part includes reliability database, some other common tools and help documents. • RiskA has several advanced features. Extensible framework makes it easy to add any new functions, making RiskA to be a large platform of reliability and probabilistic safety assessment. It is very fast to analysis fault tree in RiskA because many advanced algorithm improvement were made. Many model formats can be imported and exported, which made the PSA model in the commercial software can be easily transformed to adapt RiskA platform. Web-based co-modeling let several users in different places work together whenever they are online. • The comparison between RiskA and other mature PSA codes (e.g. CAFTA, RiskSpectrum, XFTA) has demonstrated that the calculation and analysis of RiskA is correct and efficient. Based on the development of this code package, many applications of safety and reliability analysis of some research reactors and nuclear power plants were performed. The development of RiskA appears to be of realistic and potential value for academic research and practical operation safety management of nuclear power plants in China and abroad. - Abstract: PSA (probabilistic safety assessment) software, the indispensable tool in nuclear safety assessment, has been widely used. An integrated reliability and PSA program named RiskA has been developed by FDS Team. RiskA supplies several standard PSA modules including fault tree analysis, event tree analysis, uncertainty analysis, failure mode and effect analysis and reliability

  16. The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

    Science.gov (United States)

    Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

    2014-01-01

    Objective To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Design and setting Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Participants Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Interventions Not applicable. Main outcome measure(s) Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales’ classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. Results A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. PMID:24849795

  17. Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

    Science.gov (United States)

    Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung; Kim, Soon-Kyung

    2015-10-01

    Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.

  18. Construction of a risk assessment system for chemical residues in agricultural products.

    Science.gov (United States)

    Choi, Shinai; Hong, Jiyeon; Lee, Dayeon; Paik, Minkyoung

    2014-01-01

    Continuous monitoring of chemical residues in agricultural and food products has been performed by various government bodies in South Korea. These bodies have made attempts to systematically manage this information by creating a monitoring database system as well as a system based on these data with which to assess the health risk of chemical residues in agricultural products. Meanwhile, a database system is being constructed consisting of information about monitoring and, following this, a demand for convenience has led to the need for an evaluation tool to be constructed with the data processing system. Also, in order to create a systematic and effective tool for the risk assessment of chemical residues in foods and agricultural products, various evaluation models are being developed, both domestically and abroad. Overseas, systems such as Dietary Exposure Evaluation Model: Food Commodity Intake Database and Cumulative and Aggregate Risk Evaluation System are being used; these use the US Environmental Protection Agency as a focus, while the EU has developed Pesticide Residue Intake Model for assessments of pesticide exposure through food intake. Following this, the National Academy of Agricultural Science (NAAS) created the Agricultural Products Risk Assessment System (APRAS) which supports the use and storage of monitoring information and risk assessments. APRAS efficiently manages the monitoring data produced by NAAS and creates an extraction feature included in the database system. Also, the database system in APRAS consists of a monitoring database system held by the NAAS and food consumption database system. Food consumption data is based on Korea National Health and Nutrition Examination Survey. This system is aimed at exposure and risk assessments for chemical residues in agricultural products with regards to different exposure scenarios.

  19. The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation.

    Science.gov (United States)

    Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

    2014-12-01

    To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Not applicable. Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales' classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively). An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. © The Author(s) 2014.

  20. Assessing Breast Cancer Risk Estimates Based on the Gail Model and Its Predictors in Qatari Women.

    Science.gov (United States)

    Bener, Abdulbari; Çatan, Funda; El Ayoubi, Hanadi R; Acar, Ahmet; Ibrahim, Wanis H

    2017-07-01

    The Gail model is the most widely used breast cancer risk assessment tool. An accurate assessment of individual's breast cancer risk is very important for prevention of the disease and for the health care providers to make decision on taking chemoprevention for high-risk women in clinical practice in Qatar. To assess the breast cancer risk among Arab women population in Qatar using the Gail model and provide a global comparison of risk assessment. In this cross-sectional study of 1488 women (aged 35 years and older), we used the Gail Risk Assessment Tool to assess the risk of developing breast cancer. Sociodemographic features such as age, lifestyle habits, body mass index, breast-feeding duration, consanguinity among parents, and family history of breast cancer were considered as possible risks. The mean age of the study population was 47.8 ± 10.8 years. Qatari women and Arab women constituted 64.7% and 35.3% of the study population, respectively. The mean 5-year and lifetime breast cancer risks were 1.12 ± 0.52 and 10.57 ± 3.1, respectively. Consanguineous marriage among parents was seen in 30.6% of participants. We found a relationship between the 5-year and lifetime risks of breast cancer and variables such as age, age at menarche, gravidity, parity, body mass index, family history of cancer, menopause age, occupation, and level of education. The linear regression analysis identified the predictors for breast cancer in women such as age, age at menarche, age of first birth, family history and age of menopausal were considered the strong predictors and significant contributing risk factors for breast cancer after adjusting for ethnicity, parity and other variables. The current study is the first to evaluate the performance of the Gail model for Arab women population in the Gulf Cooperation Council. Gail model is an appropriate breast cancer risk assessment tool for female population in Qatar.

  1. New developments in quantitative risk assessment of campylobacteriosis

    DEFF Research Database (Denmark)

    Havelaar, Arie; Nauta, Maarten

    meat to ready-to-eat foods is the main pathway of consumer exposure. Undercooking appears to be of minor importance. However, this conclusion may need to be reconsidered in the light of increasing consumption of minced meat preparations. Five QMRA models have been compared in detail, and detailed......Quantitative microbiological risk assessment (QMRA) is now broadly accepted as an important decision support tool in food safety risk management. It has been used to support decision making at the global level (Codex Alimentarius, FAO and WHO), at the European level (European Food Safety Authority...

  2. How strategic environmental assessment can inform lenders about potential environmental risks

    DEFF Research Database (Denmark)

    Banhalmi-Zakar, Zsuzsa; Larsen, Sanne Vammen

    2015-01-01

    at a time when it can be used as an input to bank lending decisions, which can assist banks in making lending decisions with better environmental outcomes. For these reasons, we argue that in some circumstances, and particularly for project finance transactions, SEA may be a more useful environmental......In this paper, we explore the potential for strategic environmental assessment (SEA) to be a useful tool for banks to manage environmental risks and inform lending decisions. SEA is an environmental assessment tool that was developed to assist strategic-level decision-makers, such as policy...

  3. Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians

    Directory of Open Access Journals (Sweden)

    Shillinglaw Benjamin

    2012-01-01

    Full Text Available Abstract Background Global coronary heart disease (CHD risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US physicians' awareness, use, and attitudes regarding global CHD risk assessment in clinical practice, and how these vary by provider specialty. Methods Using a web-based survey of US family physicians, general internists, and cardiologists, we examined awareness of tools available to calculate CHD risk, method and use of CHD risk assessment, attitudes towards CHD risk assessment, and frequency of using CHD risk assessment to guide recommendations of aspirin, lipid-lowering and blood pressure (BP lowering therapies for primary prevention. Characteristics of physicians indicating they use CHD risk assessments were compared in unadjusted and adjusted analyses. Results A total of 952 physicians completed the questionnaire, with 92% reporting awareness of tools available to calculate CHD global risk. Among those aware of such tools, over 80% agreed that CHD risk calculation is useful, improves patient care, and leads to better decisions about recommending preventive therapies. However, only 41% use CHD risk assessment in practice. The most commonly reported barrier to CHD risk assessment is that it is too time consuming. Among respondents who calculate global CHD risk, 69% indicated they use it to guide lipid lowering therapy recommendations; 54% use it to guide aspirin therapy recommendations; and 48% use it to guide BP lowering therapy. Only 40% of respondents who use global CHD risk routinely tell patients their risk. Use of a personal digital assistant or smart phone was associated with reported use of CHD risk assessment (adjusted OR 1.58; 95% CI 1.17-2.12. Conclusions Reported awareness of tools to calculate global CHD risk appears high, but the majority of physicians in this sample do not

  4. Offshore risk assessment

    CERN Document Server

    Vinnem, Jan-Erik

    2014-01-01

      Offshore Risk Assessment was the first book to deal with quantified risk assessment (QRA) as applied specifically to offshore installations and operations. Risk assessment techniques have been used for more than three decades in the offshore oil and gas industry, and their use is set to expand increasingly as the industry moves into new areas and faces new challenges in older regions.   This updated and expanded third edition has been informed by a major R&D program on offshore risk assessment in Norway and summarizes research from 2006 to the present day. Rooted with a thorough discussion of risk metrics and risk analysis methodology,  subsequent chapters are devoted to analytical approaches to escalation, escape, evacuation and rescue analysis of safety and emergency systems.   Separate chapters analyze the main hazards of offshore structures: fire, explosion, collision, and falling objects as well as structural and marine hazards. Risk mitigation and control are discussed, as well as an illustrat...

  5. Development and application of a living probabilistic safety assessment tool: Multi-objective multi-dimensional optimization of surveillance requirements in NPPs considering their ageing

    International Nuclear Information System (INIS)

    Kančev, Duško; Čepin, Marko; Gjorgiev, Blaže

    2014-01-01

    The benefits of utilizing the probabilistic safety assessment towards improvement of nuclear power plant safety are presented in this paper. Namely, a nuclear power plant risk reduction can be achieved by risk-informed optimization of the deterministically-determined surveillance requirements. A living probabilistic safety assessment tool for time-dependent risk analysis on component, system and plant level is developed. The study herein focuses on the application of this living probabilistic safety assessment tool as a computer platform for multi-objective multi-dimensional optimization of the surveillance requirements of selected safety equipment seen from the aspect of the risk-informed reasoning. The living probabilistic safety assessment tool is based on a newly developed model for calculating time-dependent unavailability of ageing safety equipment within nuclear power plants. By coupling the time-dependent unavailability model with a commercial software used for probabilistic safety assessment modelling on plant level, the frames of the new platform i.e. the living probabilistic safety assessment tool are established. In such way, the time-dependent core damage frequency is obtained and is further on utilized as first objective function within a multi-objective multi-dimensional optimization case study presented within this paper. The test and maintenance costs are designated as the second and the incurred dose due to performing the test and maintenance activities as the third objective function. The obtained results underline, in general, the usefulness and importance of a living probabilistic safety assessment, seen as a dynamic probabilistic safety assessment tool opposing the conventional, time-averaged unavailability-based, probabilistic safety assessment. The results of the optimization, in particular, indicate that test intervals derived as optimal differ from the deterministically-determined ones defined within the existing technical specifications

  6. Family history assessment for colorectal cancer (CRC) risk analysis - comparison of diagram- and questionnaire-based web interfaces.

    Science.gov (United States)

    Schultz, Michael; Seo, Steven Bohwan; Holt, Alec; Regenbrecht, Holger

    2015-11-18

    Colorectal cancer (CRC) has a high incidence, especially in New Zealand. The reasons for this are unknown. While most cancers develop sporadically, a positive family history, determined by the number and age at diagnosis of affected first and second degree relatives with CRC is one of the major factors, which may increase an individual's lifetime risk. Before a patient can be enrolled in a surveillance program a detailed assessment and documentation of the family history is important but time consuming and often inaccurate. The documentation is usually paper-based. Our aim was therefore to develop and validate the usability and efficacy of a web-based family history assessment tool for CRC suitable for the general population. The tool was also to calculate the risk and make a recommendation for surveillance. Two versions of an electronic assessment tool, diagram-based and questionnaire-based, were developed with the risk analysis and recommendations for surveillance based on the New Zealand Guidelines Group recommendations. Accuracy of our tool was tested prior to the study by comparing risk calculations based on family history by experienced gastroenterologists with the electronic assessment. The general public, visiting a local science fair were asked to use and comment on the usability of the two interfaces. Ninety people assessed and commented on the two interfaces. Both interfaces were effective in assessing the risk to develop CRC through their familial history for CRC. However, the questionnaire-based interface performed with significantly better satisfaction (p = 0.001) than the diagram-based interface. There was no difference in efficacy though. We conclude that a web-based questionnaire tool can assist in the accurate documentation and analysis of the family history relevant to determine the individual risk of CRC based on local guidelines. The calculator is now implemented and assessable through the web-page of a local charity for colorectal cancer

  7. Environmental impact assessment screening tool

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities. 2 figs. 7 refs.

  8. Environmental impact assessment screening tool

    International Nuclear Information System (INIS)

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities

  9. Mortality Risk After Transcatheter Aortic Valve Implantation: Analysis of the Predictive Accuracy of the Transcatheter Valve Therapy Registry Risk Assessment Model.

    Science.gov (United States)

    Codner, Pablo; Malick, Waqas; Kouz, Remi; Patel, Amisha; Chen, Cheng-Han; Terre, Juan; Landes, Uri; Vahl, Torsten Peter; George, Isaac; Nazif, Tamim; Kirtane, Ajay J; Khalique, Omar K; Hahn, Rebecca T; Leon, Martin B; Kodali, Susheel

    2018-05-08

    Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients. In hospital and 30-day all-cause mortality rates were 1.3% and 2.9%, respectively. The ACC/TVT risk stratification tool scored higher for patients who died in-hospital than in those who survived the index hospitalization (6.4 ± 4.6 vs. 3.5 ± 1.6, p = 0.03; respectively). The ACC/TVT score showed a high level of discrimination, C-index for in-hospital mortality 0.74, 95% CI [0.59 - 0.88]. There were no significant differences between the performance of the ACC/TVT registry risk score, the EuroSCORE II and the STS-PROM for in hospital and 30-day mortality rates. The ACC/TVT registry risk model is a dedicated tool to aid in the prediction of in-hospital mortality risk after TAVI.

  10. Cost-effectiveness of electronic training in domestic violence risk assessment: ODARA 101.

    Science.gov (United States)

    Hilton, N Zoe; Ham, Elke

    2015-03-01

    The need for domestic violence training has increased with the development of evidence-based risk assessment tools, which must be scored correctly for valid application. Emerging research indicates that training in domestic violence risk assessment can increase scoring accuracy, but despite the increasing popularity of electronic training, it is not yet known whether it can be an effective method of risk assessment training. In the present study, 87 assessors from various professions had training in the Ontario Domestic Assault Risk Assessment either face-to-face or using an electronic training program. The two conditions were equally effective, as measured by performance on a post-training skill acquisition test. Completion rates were 100% for face-to-face and 86% for electronic training, an improvement over a previously evaluated manual-only condition. The estimated per-trainee cost of electronic training was one third that of face-to-face training and expected to decrease. More rigorous evaluations of electronic training for risk assessment are recommended. © The Author(s) 2014.

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

    Science.gov (United States)

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

    2016-02-01

    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. 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. 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. 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.

  12. ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

    Science.gov (United States)

    Johnson, Paul W.

    2008-01-01

    ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

  13. Environmental Tools and Radiological Assessment

    Science.gov (United States)

    This presentation details two tools (SADA and FRAMES) available for use in environmental assessments of chemicals that can also be used for radiological assessments of the environment. Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporate...

  14. Evaluation of three physiologically based pharmacokinetic (PBPK) modeling tools for emergency risk assessment after acute dichloromethane exposure

    NARCIS (Netherlands)

    Boerleider, R. Z.; Olie, J. D N; van Eijkeren, J. C H; Bos, P. M J; Hof, B. G H; de Vries, I.; Bessems, J. G M; Meulenbelt, J.; Hunault, C. C.

    2015-01-01

    Introduction: Physiologically based pharmacokinetic (PBPK) models may be useful in emergency risk assessment, after acute exposure to chemicals, such as dichloromethane (DCM). We evaluated the applicability of three PBPK models for human risk assessment following a single exposure to DCM: one model

  15. Assessing Suicide Risk in Veterans: The Role of the Nurse Practitioner

    OpenAIRE

    Kathy Puskar; Giuliana Mazza

    2012-01-01

    Background: Statistics have shown that veteran men and women are at greater risk for suicide than the general population. In order to decrease the incidence of suicide in veterans, nurse practitioners (NPs) and other health care professionals must not only become more aware of the risk factors for veteran suicides but also develop strong psychiatric interviewing skills. Purpose: To discuss the risk factors associated with veteran suicide, the assessment tools to ensure a comprehensive...

  16. Systemic Assessment as a New Tool for Assessing Students ...

    African Journals Online (AJOL)

    Systemic Assessment as a New Tool for Assessing Students Learning in Chemistry using SATL Methods: Systemic Matching, Systemic Synthesis, Systemic Analysis, Systemic Synthetic – Analytic, as Systemic Question Types.

  17. Slope Hazard and Risk Assessment in the Tropics: Malaysia' Experience

    Science.gov (United States)

    Mohamad, Zakaria; Azahari Razak, Khamarrul; Ahmad, Ferdaus; Manap, Mohamad Abdul; Ramli, Zamri; Ahmad, Azhari; Mohamed, Zainab

    2015-04-01

    The increasing number of geological hazards in Malaysia has often resulted in casualties and extensive devastation with high mitigation cost. Given the destructive capacity and high frequency of disaster, Malaysia has taken a step forward to address the multi-scale landslide risk reduction emphasizing pre-disaster action rather than post-disaster reaction. Slope hazard and risk assessment in a quantitative manner at regional and national scales remains challenging in Malaysia. This paper presents the comprehensive methodology framework and operational needs driven by modern and advanced geospatial technology to address the aforementioned issues in the tropics. The Slope Hazard and Risk Mapping, the first national project in Malaysia utilizing the multi-sensor LIDAR has been critically implemented with the support of multi- and trans-disciplinary partners. The methodological model has been formulated and evaluated given the complexity of risk scenarios in this knowledge driven project. Instability slope problems in the urban, mountainous and tectonic landscape are amongst them, and their spatial information is of crucial for regional landslide assessment. We develop standard procedures with optimal parameterization for susceptibility, hazard and risk assessment in the selected regions. Remarkably, we are aiming at producing an utmost complete landslide inventory in both space and time. With the updated reliable terrain and landscape models, the landslide conditioning factor maps can be accurately derived depending on the landslide types and failure mechanisms which crucial for hazard and risk assessment. We also aim to improve the generation of elements at risk for landslide and promote integrated approaches for a better disaster risk analysis. As a result, a new tool, notably multi-sensor LIDAR technology is a very promising tool for an old geological problem and its derivative data for hazard and risk analysis is an effective preventive measure in Malaysia

  18. RAPID-N: Assessing and mapping the risk of natural-hazard impact at industrial installations

    Science.gov (United States)

    Girgin, Serkan; Krausmann, Elisabeth

    2015-04-01

    Natural hazard-triggered technological accidents (so-called Natech accidents) at hazardous installations can have major consequences due to the potential for release of hazardous materials, fires and explosions. Effective Natech risk reduction requires the identification of areas where this risk is high. However, recent studies have shown that there are hardly any methodologies and tools that would allow authorities to identify these areas. To work towards closing this gap, the European Commission's Joint Research Centre has developed the rapid Natech risk assessment and mapping framework RAPID-N. The tool, which is implemented in an online web-based environment, is unique in that it contains all functionalities required for running a full Natech risk analysis simulation (natural hazards severity estimation, equipment damage probability and severity calculation, modeling of the consequences of loss of containment scenarios) and for visualizing its results. The output of RAPID-N are risk summary reports and interactive risk maps which can be used for decision making. Currently, the tool focuses on Natech risk due to earthquakes at industrial installations. However, it will be extended to also analyse and map Natech risk due to floods in the near future. RAPID-N is available at http://rapidn.jrc.ec.europa.eu. This presentation will discuss the results of case-study calculations performed for selected flammable and toxic substances to test the capabilities of RAPID-N both for single- and multi-site earthquake Natech risk assessment. For this purpose, an Istanbul earthquake scenario provided by the Turkish government was used. The results of the exercise show that RAPID-N is a valuable decision-support tool that assesses the Natech risk and maps the consequence end-point distances. These end-point distances are currently defined by 7 kPa overpressure for Vapour Cloud Explosions, 2nd degree burns for pool fire (which is equivalent to a heat radiation of 5 kW/m2 for 40s

  19. Managing industrial risk--having a tested and proven system to prevent and assess risk.

    Science.gov (United States)

    Heller, Stephen

    2006-03-17

    Some relatively easy techniques exist to improve the risk picture/profile to aid in preventing losses. Today with the advent of computer system resources, focusing on specific aspects of risk through systematic scoring and comparison, the risk analysis can be relatively easy to achieve. Techniques like these demonstrate how working experience and common sense can be combined mathematically into a flexible risk management tool or risk model for analyzing risk. The risk assessment methodology provided by companies today is no longer the ideas and practices of one group or even one company. It is reflective of the practice of many companies, as well as the ideas and expertise of academia and government regulators. The use of multi-criteria decision making (MCDM) techniques for making critical decisions has been recognized for many years for a variety of purposes. In today's computer age, the easy accessing and user-friendly nature for using these techniques, makes them a favorable choice for use in the risk assessment environment. The new user of these methodologies should find many ideas directly applicable to his or her needs when approaching risk decision making. The user should find their ideas readily adapted, with slight modification, to accurately reflect a specific situation using MCDM techniques. This makes them an attractive feature for use in assessment and risk modeling. The main advantage of decision making techniques, such as MCDM, is that in the early stages of a risk assessment, accurate data on industrial risk, and failures are lacking. In most cases, it is still insufficient to perform a thorough risk assessment using purely statistical concepts. The practical advantages towards deviating from strict data-driven protocol seem to outweigh the drawbacks. Industry failure data often comes at a high cost when a loss occurs. We can benefit from this unfortunate acquisition of data through the continuous refining of our decisions by incorporating this new

  20. Site remediation guided by risk assessment

    International Nuclear Information System (INIS)

    McBean, E.A.; Gowing, A.; Pieczonka, G.

    2002-01-01

    'Full text:' Risk assessment (RA) provides an effective tool for identifying hazards with respect to human health and ecological receptors, hazards that arise from contaminants in the environment. Risk assessment relies upon: hazard identification/problem formulation; toxicity assessment; exposure assessment; and risk characterization. Hence, risk assessment provides an effective guide for site remediation through the identification of the associated risks arising from pre- and potential post-remediation activities. As a demonstration of this decision-making process, a site-specific risk assessment (SSRA) was performed on a chemical producing facility. Historical waste practices during the production of DDT compounds resulted in impacted site soils and sediment and soils of the creek passing through the facility. The purpose of the SSRA was to derive site-specific cleanup values for the impacted on-site soils, creek sediments, and embankment soils, incorporating human and ecological receptors associated with the environmental media. The human exposure pathways considered were dermal contact, incidental ingestion, and inhalation of the various soils. The potential human receptors were industrial workers, construction workers, trespassers, and off-site residents. Ingestion of fish from the creek by residents was also evaluated in the human health risk assessment (HHRA). Food web analyses were used to evaluate the impact of exposure to chemical compounds in aquatic sediments and related soils by ecological receptors such as the great blue heron, raccoon, and mink. The SSRA involved modelling the daily chemical intake by receptors and the transfer of chemicals to identified secondary media (e.g., ambient air or animal tissues) that are also potential exposure media. These models, while using the site-specific chemical data in the source media, possess uncertainties associated with default parameters that are only approximations and not site-specific (e.g., soil

  1. Quantitative flood risk assessment for Polders

    International Nuclear Information System (INIS)

    Manen, Sipke E. van; Brinkhuis, Martine

    2005-01-01

    In the Netherlands, the design of dikes and other water retaining structures is based on an acceptable probability (frequency) of overtopping. In 1993 a new safety concept was introduced based on total flood risk. Risk was defined as the product of probability and consequences. In recent years advanced tools have become available to calculate the actual flood risk of a polder. This paper describes the application of these tools to an existing lowland river area. The complete chain of calculations necessary to estimate the risk of flooding of a polder (or dike ring) is presented. The difficulties in applying the present day tools and the largest uncertainties in the calculations are shown

  2. Quantitative flood risk assessment for Polders

    Energy Technology Data Exchange (ETDEWEB)

    Manen, Sipke E. van [Ministry of Transport, Public Works and Water Management, Bouwdienst Rijkswaterstaat, Griffioenlaan 2, Utrecht 3526 (Netherlands)]. E-mail: s.e.vmanen@bwd.rws.minvenw.nl; Brinkhuis, Martine [Ministry of Transport, Public Works and Water Management, Delft (Netherlands)

    2005-12-01

    In the Netherlands, the design of dikes and other water retaining structures is based on an acceptable probability (frequency) of overtopping. In 1993 a new safety concept was introduced based on total flood risk. Risk was defined as the product of probability and consequences. In recent years advanced tools have become available to calculate the actual flood risk of a polder. This paper describes the application of these tools to an existing lowland river area. The complete chain of calculations necessary to estimate the risk of flooding of a polder (or dike ring) is presented. The difficulties in applying the present day tools and the largest uncertainties in the calculations are shown.

  3. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment.

    Science.gov (United States)

    Baumgart, Leigh A; Postula, Kristen J Vogel; Knaus, William A

    2016-04-01

    Personal and family health histories remain important independent risk factors for cancer; however they are currently not being well collected or used effectively. Health Heritage was designed to address this need. The purpose of this study was to validate the ability of Health Heritage to identify patients appropriate for further genetic evaluation and to accurately stratify cancer risk. A retrospective chart review was conducted on 100 random patients seen at an adult genetics clinic presenting with concern for an inherited predisposition to cancer. Relevant personal and family history obtained from the patients' medical records was entered into Health Heritage. Recommendations by Health Heritage were compared to national guidelines of eligibility for genetic evaluation. Agreement between Health Heritage referral for genetic evaluation and guideline eligibility for genetic evaluation was 97% (sensitivity 98% and specificity 88%). Risk stratification for cancer was also compared between Health Heritage and those documented by a geneticist. For patients at increased risk for breast, ovarian, or colorectal cancer as determined by the geneticist, risk stratification by Health Heritage agreed 90, 93, and 75%, respectively. Discordances in risk stratification were attributed to both complex situations better handled by the geneticist and Health Heritage's adherence to incorporating all information into its algorithms. Health Heritage is a clinically valid tool to identify patients appropriate for further genetic evaluation and to encourage them to confirm the assessment and management recommendations with cancer genetic experts. Health Heritage also provides an estimate of cancer risk that is complementary to a genetics team.

  4. A mathematical model for environmental risk assessment in manufacturing industry

    Institute of Scientific and Technical Information of China (English)

    何莉萍; 徐盛明; 陈大川; 党创寅

    2002-01-01

    Environmental conscious manufacturing has become an important issue in industry because of market pressure and environmental regulations. An environmental risk assessment model was developed based on the network analytic method and fuzzy set theory. The "interval analysis method" was applied to deal with the on-site monitoring data as basic information for assessment. In addition, the fuzzy set theory was employed to allow uncertain, interactive and dynamic information to be effectively incorporated into the environmental risk assessment. This model is a simple, practical and effective tool for evaluating the environmental risk of manufacturing industry and for analyzing the relative impacts of emission wastes, which are hazardous to both human and ecosystem health. Furthermore, the model is considered useful for design engineers and decision-maker to design and select processes when the costs, environmental impacts and performances of a product are taken into consideration.

  5. Concept of risk: risk assessment and nuclear safety

    International Nuclear Information System (INIS)

    Thompson, P.B.

    1980-01-01

    The dissertation is a critical examination of risk assessment and its role in public policy. Nuclear power safety safety issues are selected as the primary source of illustrations and examples. The dissertation examines how risk assessment studies develop a concept of risk which becomes decisive for policy choices. Risk-assessment techniques are interpreted as instruments which secure an evaluation of risk which, in turn, figures prominently in technical reports on nuclear power. The philosophical critique is mounted on two levels. First, an epistemological critique surveys distinctions between the technical concept of risk and more familiar senses of risk. The critique shows that utilization of risk assessment re-structures the concept of risk. The technical concept is contrasted to the function of risk within a decision-maker's conceptual agenda and hierarchy of values. Second, an ethical critique exposes the value commitments of risk assessment recommendations. Although some of these values might be defended for policy decisions, the technical character of risk assessment obfuscates normative issues. Risk assessment is shown to be a form of factual enquiry which, nonetheless, represents a commitment to a specific selection of ethical and social values. Risk assessment should not be interpreted as a primary guide to decision unless the specific values incorporated into its concept of risk are stated explicitly and justified philosophically. Such a statement would allow value questions which have been sublimated by the factual tone of the analytic techniques to be debated on clear, social and ethical grounds

  6. WE-B-BRC-00: Concepts in Risk-Based Assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology

  7. WE-B-BRC-01: Current Methodologies in Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rath, F. [University of Wisconsin Madison (United States)

    2016-06-15

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology

  8. WE-B-BRC-01: Current Methodologies in Risk Assessment

    International Nuclear Information System (INIS)

    Rath, F.

    2016-01-01

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology

  9. WE-B-BRC-00: Concepts in Risk-Based Assessment

    International Nuclear Information System (INIS)

    2016-01-01

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology

  10. A GIS-based tool for an integrated assessment of spatial planning trade-offs with aquaculture.

    Science.gov (United States)

    Gimpel, Antje; Stelzenmüller, Vanessa; Töpsch, Sandra; Galparsoro, Ibon; Gubbins, Matthew; Miller, David; Murillas, Arantza; Murray, Alexander G; Pınarbaşı, Kemal; Roca, Guillem; Watret, Robert

    2018-06-15

    The increasing demand for protein from aquaculture will trigger a global expansion of the sector in coastal and offshore waters. While contributing to food security, potential conflicts with other traditional activities such as fisheries or tourism are inevitable, thus calling for decision-support tools to assess aquaculture planning scenarios in a multi-use context. Here we introduce the AquaSpace tool, one of the first Geographic Information System (GIS)-based planning tools empowering an integrated assessment and mapping of 30 indicators reflecting economic, environmental, inter-sectorial and socio-cultural risks and opportunities for proposed aquaculture systems in a marine environment. A bottom-up process consulting more than 350 stakeholders from 10 countries across southern and northern Europe enabled the direct consideration of stakeholder needs when developing the GIS AddIn. The AquaSpace tool is an open source product and builds in the prospective use of open source datasets at a European scale, hence aiming to improve reproducibility and collaboration in aquaculture science and research. Tool outputs comprise detailed reports and graphics allowing key stakeholders such as planners or licensing authorities to evaluate and communicate alternative planning scenarios and to take more informed decisions. With the help of the German North Sea case study we demonstrate here the tool application at multiple spatial scales with different aquaculture systems and under a range of space-related development constraints. The computation of these aquaculture planning scenarios and the assessment of their trade-offs showed that it is entirely possible to identify aquaculture sites, that correspondent to multifarious potential challenges, for instance by a low conflict potential, a low risk of disease spread, a comparable high economic profit and a low impact on touristic attractions. We believe that a transparent visualisation of risks and opportunities of aquaculture

  11. Operational tools to build a multicriteria territorial risk scale with multiple stakeholders

    International Nuclear Information System (INIS)

    Cailloux, Olivier; Mayag, Brice; Meyer, Patrick; Mousseau, Vincent

    2013-01-01

    Evaluating and comparing the threats and vulnerabilities associated with territorial zones according to multiple criteria (industrial activity, population, etc.) can be a time-consuming task and often requires the participation of several stakeholders. Rather than a direct evaluation of these zones, building a risk assessment scale and using it in a formal procedure permits to automate the assessment and therefore to apply it in a repeated way and in large-scale contexts and, provided the chosen procedure and scale are accepted, to make it objective. One of the main difficulties of building such a formal evaluation procedure is to account for the multiple decision makers' preferences. The procedure used in this article, ELECTRE TRI, uses the performances of each territorial zone on multiple criteria, together with preferential parameters from multiple decision makers, to qualitatively assess their associated risk level. We also present operational tools in order to implement such a procedure in practice, and show their use on a detailed example

  12. Environmental risk assessment of white phosphorus from the use of munitions - a probabilistic approach.

    Science.gov (United States)

    Voie, Øyvind Albert; Johnsen, Arnt; Strømseng, Arnljot; Longva, Kjetil Sager

    2010-03-15

    White phosphorus (P(4)) is a highly toxic compound used in various pyrotechnic products. Ammunitions containing P(4) are widely used in military training areas where the unburned products of P(4) contaminate soil and local ponds. Traditional risk assessment methods presuppose a homogeneous spatial distribution of pollutants. The distribution of P(4) in military training areas is heterogeneous, which reduces the probability of potential receptors being exposed to the P(4) by ingestion, for example. The current approach to assess the environmental risk from the use of P(4) suggests a Bayesian network (Bn) as a risk assessment tool. The probabilistic reasoning supported by a Bn allows us to take into account the heterogeneous distribution of P(4). Furthermore, one can combine empirical data and expert knowledge, which allows the inclusion of all kinds of data that are relevant to the problem. The current work includes an example of the use of the Bn as a risk assessment tool where the risk for P(4) poisoning in humans and grazing animals at a military shooting range in Northern Norway was calculated. P(4) was detected in several craters on the range at concentrations up to 5.7g/kg. The risk to human health was considered acceptable under the current land use. The risk for grazing animals such as sheep, however, was higher, suggesting that precautionary measures may be advisable.

  13. The Role of Cumulative Risk Assessment in Decisions about Environmental Justice

    Directory of Open Access Journals (Sweden)

    Ken Sexton

    2010-11-01

    Full Text Available There is strong presumptive evidence that people living in poverty and certain racial and ethnic groups bear a disproportionate burden of environmental health risk. Many have argued that conducting formal assessments of the health risk experienced by affected communities is both unnecessary and counterproductive—that instead of analyzing the situation our efforts should be devoted to fixing obvious problems and rectifying observable wrongs. We contend that formal assessment of cumulative health risks from combined effects of chemical and nonchemical stressors is a valuable tool to aid decision makers in choosing risk management options that are effective, efficient, and equitable. If used properly, cumulative risk assessment need not impair decision makers’ discretion, nor should it be used as an excuse for doing nothing in the face of evident harm. Good policy decisions require more than good intentions; they necessitate analysis of risk-related information along with careful consideration of economic issues, ethical and moral principles, legal precedents, political realities, cultural beliefs, societal values, and bureaucratic impediments. Cumulative risk assessment can provide a systematic and impartial means for informing policy decisions about environmental justice.

  14. Development and validation of the Learning Disabilities Needs Assessment Tool (LDNAT), a HoNOS-based needs assessment tool for use with people with intellectual disability.

    Science.gov (United States)

    Painter, J; Trevithick, L; Hastings, R P; Ingham, B; Roy, A

    2016-12-01

    In meeting the needs of individuals with intellectual disabilities (ID) who access health services, a brief, holistic assessment of need is useful. This study outlines the development and testing of the Learning Disabilities Needs Assessment Tool (LDNAT), a tool intended for this purpose. An existing mental health (MH) tool was extended by a multidisciplinary group of ID practitioners. Additional scales were drafted to capture needs across six ID treatment domains that the group identified. LDNAT ratings were analysed for the following: item redundancy, relevance, construct validity and internal consistency (n = 1692); test-retest reliability (n = 27); and concurrent validity (n = 160). All LDNAT scales were deemed clinically relevant with little redundancy apparent. Principal component analysis indicated three components (developmental needs, challenging behaviour, MH and well-being). Internal consistency was good (Cronbach alpha 0.80). Individual item test-retest reliability was substantial-near perfect for 20 scales and slight-fair for three scales. Overall reliability was near perfect (intra-class correlation = 0.91). There were significant associations with five of six condition-specific measures, i.e. the Waisman Activities of Daily Living Scale (general ability/disability), Threshold Assessment Grid (risk), Behaviour Problems Inventory for Individuals with Intellectual Disabilities-Short Form (challenging behaviour) Social Communication Questionnaire (autism) and a bespoke physical health questionnaire. Additionally, the statistically significant correlations between these tools and the LDNAT components made sense clinically. There were no statistically significant correlations with the Psychiatric Assessment Schedules for Adults with Developmental Disabilities (a measure of MH symptoms in people with ID). The LDNAT had clinically utility when rating the needs of people with ID prior to condition-specific assessment(s). Analyses of internal

  15. Monte Carlo Risk Assessment (MCRA) software: maintenance and management 2016

    NARCIS (Netherlands)

    Boon PE; van der Voet H; Boer WJ; Kruisselbrink J; van Lenthe M; van Klaveren JD; VVH; V&Z

    2017-01-01

    This report shows the adjustments in the Monte Carlo Risk Assessment (MCRA) computational model implemented by RIVM and Wageningen UR Biometris in 2016. MCRA is a computational tool that presently gives the most realistic chemical intake via food. The model is available for registered users via the

  16. 76 FR 63308 - Data and Data Needs To Advance Risk Assessment for Emerging Infectious Diseases Relevant to Blood...

    Science.gov (United States)

    2011-10-12

    ...] Data and Data Needs To Advance Risk Assessment for Emerging Infectious Diseases Relevant to Blood and... Needs to Advance Risk Assessment for Emerging Infectious Diseases Relevant to Blood and Blood Products... an important tool for evaluating the risks associated with new emerging infectious diseases (EIDs...

  17. Qualitative risk assessment: a conceptual context and three diverse applications

    International Nuclear Information System (INIS)

    Elsea, K.J.; Conger, D.S.

    1992-01-01

    Risk is defined as the probability of an occurrence multiplied by the consequences of that occurrence. Such a definition implies a quantitative or at least a mathematical operation. However, qualitative uses of risk have proved useful tools in incident investigation and management decision making. This paper provides a conceptual context for qualitative risk assessment and discusses three efforts at subject organizations [an aerospace firm, a US Department of Energy weapons-related facility, and a commercial nuclear reactor] that have applied qualitative risk techniques for different uses and with different results. A lessons-learned section summarizes and provides future direction

  18. Compared assessment of chemical risk and radiological risk for the environment

    International Nuclear Information System (INIS)

    Beaugelin-Seiller, K.; Garnier-Laplace, J.

    2007-01-01

    The environmental protection is today a global issue that concerns all the human activities. The challenge is to be able to prove their compatibility with the protection of the natural environment, but also if required to manage adequately a potential or established risk, generally in the context of ever strict regulations. Regarding the chemical aspects, known methods are available for the assessment of the associated risk for the environment. From the radiological point of view, the necessity to have such tools recently became more apparent, in order to justify for the public and with a full transparency the release of radioactive substances into the environment, to meet the requirements of the new regulations in terms of environmental protection and finally to harmonize the approaches between human and environmental radioprotection as well as between chemical and radioactive pollutants, simultaneously present for example in routine releases from nuclear power plants. At this end of harmonization, the assessment methodologies of the environmental risk linked to radionuclides or chemical substances are exposed from the theory to their comparative application, a new approach under development from which the first results are summarised. (authors)

  19. Protection goals in environmental risk assessment: a practical approach.

    Science.gov (United States)

    Garcia-Alonso, Monica; Raybould, Alan

    2014-12-01

    Policy protection goals are set up in most countries to minimise harm to the environment, humans and animals caused by human activities. Decisions on whether to approve new agricultural products, like pesticides or genetically modified (GM) crops, take into account these policy protection goals. To support decision-making, applications for approval of commercial uses of GM crops usually comprise an environmental risk assessment (ERA). These risk assessments are analytical tools, based on science, that follow a conceptual model that includes a problem formulation step where policy protection goals are considered. However, in most countries, risk assessors face major problems in that policy protection goals set in the legislation are stated in very broad terms and are too ambiguous to be directly applicable in ERAs. This means that risk assessors often have to interpret policy protection goals without clear guidance on what effects would be considered harmful. In this paper we propose a practical approach that may help risk assessors to translate policy protection goals into unambiguous (i.e., operational) protection goals and to establish relevant assessment endpoints and risk hypotheses that can be used in ERAs. Examples are provided to show how this approach can be applied to two areas of environmental concern relevant to the ERAs of GM crops.

  20. Development and Pilot Testing of a Bilingual Environmental Health Assessment Tool to Promote Asthma-friendly Childcares.

    Science.gov (United States)

    Evans-Agnew, Robin A; Postma, Julie; Camacho, Ariana Ochoa; Hershberg, Rachel M; Trujilio, Elsa; Tinajera, Maria

    2018-01-01

    Childhood marks the highest risk for allergic sensitization to asthma triggers. Hispanic/Latino children are at higher risk for hospitalization for asthma than non-Hispanic White children. Childcare providers lack knowledge about reducing asthma triggers. The purpose of this paper is to describe a community-based participatory research (CBPR) initiative aimed at developing and pilot testing a bilingual walk-through assessment tool for asthma-friendly childcare environments. Ten Latina mothers of children with asthma living in the Pacific Northwest collaborated with research partners to develop and pilot test a Childcare Environmental Health (CEH) assessment walk-through survey.Results and Lessons Learned: The women innovated the survey with photography and structural examinations of stress and provision of basic needs. The survey tool identified environmental threats to asthma in all three childcares surveyed. Parents are well-positioned to build trust with childcare providers, assess asthma triggers, and recommend practical mitigation strategies.

  1. Development and pilot feasibility study of a health information technology tool to calculate mortality risk for patients with asymptomatic carotid stenosis: the Carotid Risk Assessment Tool (CARAT)

    OpenAIRE

    Faerber, Adrienne E; Horvath, Rebecca; Stillman, Carey; O?Connell, Melissa L; Hamilton, Amy L; Newhall, Karina A; Likosky, Donald S; Goodney, Philip P

    2015-01-01

    Background Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians? ability to recommend optimal treatments based on an individual?s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assess...

  2. Habitat Modeling and Preferences of Marine Mammals as Function of Oceanographic Characteristics: Development of Predictive Tools for Assessing the Risks and the Impacts Due to Sound Emissions

    Science.gov (United States)

    2011-09-30

    evaluate WEC projects in the perspective of the environmental cost-benefit analysis. Proceedings of the ISOPE 2011, Maui, Hawaii, USA 19-24 June, 2011...Function of Oceanographic Characteristics: Development of Predictive Tools for Assessing the Risks and the Impacts Due to Sound Emissions Dr...detections) and the available environmental predictors; - Creating the knowledge-based background about potential mitigation measures appropriate for

  3. Overheating and Daylighting; Assessment Tool in Early Design of London’s High-Rise Residential Buildings

    Directory of Open Access Journals (Sweden)

    Bachir Nebia

    2017-08-01

    Full Text Available High-rise residential buildings in dense cities, such as London, are a common response to housing shortage. The apartments in these buildings may experience different levels of thermal and visual comfort, depending on their orientation and floor level. This paper aims to develop simplified tools to predict internal temperatures and daylighting levels, and propose a tool to quickly assess overheating risk and daylight performance in London’s high-rise residential buildings. Single- and double-sided apartments in a high-rise building were compared, and the impact of their floor level, glazing ratio, thermal mass, ventilation strategy and orientation was investigated. Using Integrated Environmental Solutions Virtual Environment (IES VE, temperature and daylight factor results of each design variable were used to develop early design tools to predict and assess overheating risks and daylighting levels. The results indicate that apartments that are more exposed to solar radiations, through either orientation or floor level, are more susceptible to overheat in the summer while exceeding the daylighting recommendations. Different design strategies at different levels and orientations are subsequently discussed.

  4. State of risk assessment

    International Nuclear Information System (INIS)

    Conrad, J.

    1978-03-01

    In view of the growing importance assumed in recent years by scientific work on the calculation, quantification, evaluation and acceptance as well as behavior in the face of risks in general and more specifically, the risks of large industrial plants, the report attempts to provide a survey of the current situation, results and evaluation of this new branch of research, risk assessment. The emphasis of the report is on the basic discussion and criticism of the theoretical and methodological approaches used in the field of risk assessment (section 3). It is concerned above all with - methodical problems of determining and quantifying risks (3.1) - questions of the possibility of risk evaluation and comp arison (3.1, 3.2) - the premises of normative and empirical studies on decision making under risk (3.2, 3.3) - investigations into society's acceptance of risks involved in the introduction of new technologies (3.4) - attempts to combine various aspects of the field of risk assessment in a unified concept (3.5, 3.6, 3.7). Because risk assessment is embedded in the framework of decision theory and technology assessment, it can be implicitly evaluated at a more general level within this framework, as far as its possibilities and weaknesses of method and application are concerned (section 4). Sections 2 and 5 deal with the social context of origin and utilization of risk assessment. Finally, an attempt is made at a summary indicating the possible future development of risk assessment. (orig./HP) [de

  5. Landfill waste and recycling: Use of a screening-level risk assessment tool for end-of-life cadmium telluride (CdTe) thin-film photovoltaic (PV) panels

    International Nuclear Information System (INIS)

    Cyrs, William D.; Avens, Heather J.; Capshaw, Zachary A.; Kingsbury, Robert A.; Sahmel, Jennifer; Tvermoes, Brooke E.

    2014-01-01

    Grid-connected solar photovoltaic (PV) power is currently one of the fastest growing power-generation technologies in the world. While PV technologies provide the environmental benefit of zero emissions during use, the use of heavy metals in thin-film PV cells raises important health and environmental concerns regarding the end-of-life disposal of PV panels. To date, there is no published quantitative assessment of the potential human health risk due to cadmium leaching from cadmium telluride (CdTe) PV panels disposed in a landfill. Thus, we used a screening-level risk assessment tool to estimate possible human health risk associated with disposal of CdTe panels into landfills. In addition, we conducted a literature review of potential cadmium release from the recycling process in order to contrast the potential health risks from PV panel disposal in landfills to those from PV panel recycling. Based on the results of our literature review, a meaningful risk comparison cannot be performed at this time. Based on the human health risk estimates generated for PV panel disposal, our assessment indicated that landfill disposal of CdTe panels does not pose a human health hazard at current production volumes, although our results pointed to the importance of CdTe PV panel end-of-life management. - Highlights: • Analysis of possible human health risk posed by disposal of CdTe panels into landfills. • Qualitative comparison of risks associated with landfill disposal and recycling of CdTe panels. • Landfill disposal of CdTe panels does not pose a human health hazard at current production volumes. • There could be potential risks associated with recycling if not properly managed. • Factors other than concerns over toxic substances will likely drive the decisions of how to manage end-of-life PV panels

  6. Cable Hot Shorts and Circuit Analysis in Fire Risk Assessment

    International Nuclear Information System (INIS)

    LaChance, Jeffrey; Nowlen, Steven P.; Wyant, Frank

    1999-01-01

    Under existing methods of probabilistic risk assessment (PRA), the analysis of fire-induced circuit faults has typically been conducted on a simplistic basis. In particular, those hot-short methodologies that have been applied remain controversial in regards to the scope of the assessments, the underlying methods, and the assumptions employed. To address weaknesses in fire PRA methodologies, the USNRC has initiated a fire risk analysis research program that includes a task for improving the tools for performing circuit analysis. The objective of this task is to obtain a better understanding of the mechanisms linking fire-induced cable damage to potentially risk-significant failure modes of power, control, and instrumentation cables. This paper discusses the current status of the circuit analysis task

  7. Assessment of Logistics Risk using Collective Artificial Intelligence

    Directory of Open Access Journals (Sweden)

    Skitsko Volodymyr I.

    2017-12-01

    Full Text Available In substantiating management decisions in logistics, there can be used various economic and mathematical methods and models for quantitative risk assessment constructed with the help of a variety of instruments. Due to the increase in the processing power of computer equipment, economic and mathematical models become more complex, more precise, and the range of modeling tools expands. The current promising area in mathematical modeling is collective artificial intelligence, with the help of which it is possible to effectively solve weakly structured, multi-criteria, multi-purpose, complex economic problems. The mathematical model of the bat algorithm, the basic rules and steps of its functioning are presented, the application of the bat algorithm to solve the multi-index transport problem in the formulation of which the logistics risk is taken into account is shown, and the way to assess the logistics risk using the results of the functioning of the bat algorithm is shown.

  8. Risk assessment and risk management of mycotoxins.

    Science.gov (United States)

    2012-01-01

    Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

  9. The Promise, Practice, and State of Planning Tools to Assess Site Vulnerability to Runoff Phosphorus Loss.

    Science.gov (United States)

    Kleinman, P J A; Sharpley, A N; Buda, A R; Easton, Z M; Lory, J A; Osmond, D L; Radcliffe, D E; Nelson, N O; Veith, T L; Doody, D G

    2017-11-01

    Over the past 20 yr, there has been a proliferation of phosphorus (P) site assessment tools for nutrient management planning, particularly in the United States. The 19 papers that make up this special section on P site assessment include decision support tools ranging from the P Index to fate-and-transport models to weather-forecast-based risk calculators. All require objective evaluation to ensure that they are effective in achieving intended benefits to protecting water quality. In the United States, efforts have been underway to compare, evaluate, and advance an array of P site assessment tools. Efforts to corroborate their performance using water quality monitoring data confirms previously documented discrepancies between different P site assessment tools but also highlights a surprisingly strong performance of many versions of the P Index as a predictor of water quality. At the same time, fate-and-transport models, often considered to be superior in their prediction of hydrology and water quality due to their complexity, reveal limitations when applied to site assessment. Indeed, one consistent theme from recent experience is the need to calibrate highly parameterized models. As P site assessment evolves, so too do routines representing important aspects of P cycling and transport. New classes of P site assessment tools are an opportunity to move P site assessment from general, strategic goals to web-based tools supporting daily, operational decisions. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  10. Biosafety Risk Assessment Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Caskey, Susan Adele [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). International Biological Threat Reduction Program; Gaudioso, Jennifer M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). International Biological Threat Reduction Program; Salerno, Reynolds Mathewson [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). International Biological Threat Reduction Program; Wagner, Stefan M. [Public Health Agency of Canada, Winnipeg, MB (Canada). Canadian Science Centre for Human and Animal Health (CSCHAH); Shigematsu, Mika [National Inst. of Infectious Diseases (NIID), Tokyo (Japan); Risi, George [Infectious Disease Specialists, P.C, Missoula, MT (United States); Kozlovac, Joe [US Dept. of Agriculture (USDA)., Beltsville, MD (United States); Halkjaer-Knudsen, Vibeke [Statens Serum Inst., Copenhagen (Denmark); Prat, Esmeralda [Bayer CropScience, Monheim am Rhein (Germany)

    2010-10-01

    Laboratories that work with biological agents need to manage their safety risks to persons working the laboratories and the human and animal community in the surrounding areas. Biosafety guidance defines a wide variety of biosafety risk mitigation measures, which include measures which fall under the following categories: engineering controls, procedural and administrative controls, and the use of personal protective equipment; the determination of which mitigation measures should be used to address the specific laboratory risks are dependent upon a risk assessment. Ideally, a risk assessment should be conducted in a manner which is standardized and systematic which allows it to be repeatable and comparable. A risk assessment should clearly define the risk being assessed and avoid over complication.

  11. Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon

    International Nuclear Information System (INIS)

    Milan, M.; Pauletto, M.; Boffo, L.; Carrer, C.; Sorrentino, F.; Ferrari, G.; Pavan, L.; Patarnello, T.; Bargelloni, L.

    2015-01-01

    The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. - Highlights: • Growing need to develop new resources for the evaluation of the environmental status. • Identification of gene expression markers associated to chemical contamination. • Employment of genomics to evaluate the environmental status of Venice lagoon areas. • Hurdles and future outlooks of genomic tools in environmental risk assessment. - Genomics in risk assessment of Venice lagoon

  12. Mesocosm soil ecological risk assessment tool for GMO 2nd tier studies

    DEFF Research Database (Denmark)

    D'Annibale, Alessandra; Maraldo, Kristine; Larsen, Thomas

    Ecological Risk Assessment (ERA) of GMO is basically identical to ERA of chemical substances, when it comes to assessing specific effects of the GMO plant material on the soil ecosystem. The tiered approach always includes the option of studying more complex but still realistic ecosystem level...... effects in 2nd tier caged experimental systems, cf. the new GMO ERA guidance: EFSA Journal 2010; 8(11):1879. We propose to perform a trophic structure analysis, TSA, and include the trophic structure as an ecological endpoint to gain more direct insight into the change in interactions between species, i.......e. the food-web structure, instead of relying only on the indirect evidence from population abundances. The approach was applied for effect assessment in the agro-ecosystem where we combined factors of elevated CO2, viz. global climate change, and GMO plant effects. A multi-species (Collembola, Acari...

  13. SafetyBarrierManager, a software tool to perform risk analysis using ARAMIS's principles

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2017-01-01

    of the ARAMIS project, Risø National Laboratory started developing a tool that could implement these methodologies, leading to SafetyBarrierManager. The tool is based on the principles of “safety‐barrier diagrams”, which are very similar to “bowties”, with the possibility of performing quantitative analysis......The ARAMIS project resulted in a number of methodologies, dealing with among others: the development of standard fault trees and “bowties”; the identification and classification of safety barriers; and including the quality of safety management into the quantified risk assessment. After conclusion....... The tool allows constructing comprehensive fault trees, event trees and safety‐barrier diagrams. The tool implements the ARAMIS idea of a set of safety barrier types, to which a number of safety management issues can be linked. By rating the quality of these management issues, the operational probability...

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

    Science.gov (United States)

    Marasova, Daniela; Andrejiova, Miriam; Grincova, Anna

    2017-03-01

    Risk management facilitates risk identification, evaluation, control, and by means of appropriate set of measures, risk reduction or complete elimination. Therefore, the risk management becomes a strategic factor for a company's success. Properly implemented risk management system does not represent a tool to avoid the risk; it is used to understand the risk and provide the bases for strategic decision-making. Risk management represents a key factor for the supply chain operations. Managing the risks is crucial for achieving the customer satisfaction and thus also a company's success. The subject-matter of the article is the assessment of the supply chain in the automobile industry, in terms of risks. The topicality of this problem is even higher, as after the economic crisis it is necessary to revaluate the readiness of the supply chain for prospective risk conditions. One advantage of this article is the use of the Saaty method as a tool for the risk management within the supply chain.

  15. The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

    Science.gov (United States)

    Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

    2011-12-01

    Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

  16. 2007 TOXICOLOGY AND RISK ASSESSMENT ...

    Science.gov (United States)

    EPA has announced The 2007 Toxicology and Risk Assessment Conference Cincinnati Marriott North, West Chester (Cincinnati), OHApril 23- 26, 2007 - Click to register!The Annual Toxicology and Risk Assessment Conference is a unique meeting where several Government Agencies come together to discuss toxicology and risk assessment issues that are not only of concern to the government, but also to a broader audience including academia and industry. The theme of this year's conference is Emerging Issues and Challenges in Risk Assessment and the preliminary agenda includes: Plenary Sessions and prominent speakers (tentative) include: Issues of Emerging Chemical ContaminantsUncertainty and Variability in Risk Assessment Use of Mechanistic data in IARC evaluationsParallel Sessions:Uncertainty and Variability in Dose-Response Assessment Recent Advances in Toxicity and Risk Assessment of RDX The Use of Epidemiologic Data for Risk Assessment Applications Cumulative Health Risk Assessment:

  17. Korean risk assessment model for breast cancer risk prediction.

    Science.gov (United States)

    Park, Boyoung; Ma, Seung Hyun; Shin, Aesun; Chang, Myung-Chul; Choi, Ji-Yeob; Kim, Sungwan; Han, Wonshik; Noh, Dong-Young; Ahn, Sei-Hyun; Kang, Daehee; Yoo, Keun-Young; Park, Sue K

    2013-01-01

    We evaluated the performance of the Gail model for a Korean population and developed a Korean breast cancer risk assessment tool (KoBCRAT) based upon equations developed for the Gail model for predicting breast cancer risk. Using 3,789 sets of cases and controls, risk factors for breast cancer among Koreans were identified. Individual probabilities were projected using Gail's equations and Korean hazard data. We compared the 5-year and lifetime risk produced using the modified Gail model which applied Korean incidence and mortality data and the parameter estimators from the original Gail model with those produced using the KoBCRAT. We validated the KoBCRAT based on the expected/observed breast cancer incidence and area under the curve (AUC) using two Korean cohorts: the Korean Multicenter Cancer Cohort (KMCC) and National Cancer Center (NCC) cohort. The major risk factors under the age of 50 were family history, age at menarche, age at first full-term pregnancy, menopausal status, breastfeeding duration, oral contraceptive usage, and exercise, while those at and over the age of 50 were family history, age at menarche, age at menopause, pregnancy experience, body mass index, oral contraceptive usage, and exercise. The modified Gail model produced lower 5-year risk for the cases than for the controls (p = 0.017), while the KoBCRAT produced higher 5-year and lifetime risk for the cases than for the controls (pKorean women, especially urban women.

  18. Environmental risk index: A tool to assess the safety of dams for leachate

    International Nuclear Information System (INIS)

    Colomer Mendoza, Francisco J.; Gallardo Izquierdo, Antonio

    2009-01-01

    Dams for leachate store very toxic substances that contain a large amount of organic material and, probably, heavy metals; they therefore constitute an important threat to the environment. Existing models of environmental risk assessment for landfills do not take into consideration the specific risk that leachate dams may represent for the environment. In this paper a methodology to improve the environmental safety is presented according to the parameters used in their construction and management. In order to do that, the following characteristics of the dam must be known: (1) geotechnical stability, (2) erosion of downstream slope, (3) type of sealing of the dam, (4) overtopping probability, (5) volume of leachate stored inside the dam and (6) pollution load of leachate. Once these parameters have been calculated, they are transformed by means of rating curves into homogeneous units, so as to make it possible to operate between them. From the study and analysis of these parameters an environmental risk index for a dam for leachate can be calculated. If the environmental risk index exceeds an established value then it involves a dam for leachate with high environmental risk, therefore preventive measures in its design, construction and management would be necessary

  19. Risk Assessment

    Science.gov (United States)

    How the EPA conducts risk assessment to protect human health and the environment. Several assessments are included with the guidelines, models, databases, state-based RSL Tables, local contacts and framework documents used to perform these assessments.

  20. Risk management as a modern sustainable development of the enterprise management tool

    Directory of Open Access Journals (Sweden)

    Aikhel K.V.

    2017-01-01

    Full Text Available Actively embedding in the international market processes, domestic industrial enterprises improve their management tools to create competitive structures. Spread one of the modern approaches to Business Engineering defines risk management as the starting point of building processes of the company. Adapting the method of analyzing hierarchies for quantitative risk assessment will increase the efficiency for the implementation of the new management approach, taking into account the existing time limits and the initial data, which in turn will ensure the stability of enterprises operations in the face of uncertainty. From the point of view of prospect of development, stability of the modern enterprises is also reflection of their competitiveness.

  1. Exploration Health Risks: Probabilistic Risk Assessment

    Science.gov (United States)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  2. Pandora - a simulation tool for safety assessments. Technical description and user's guide

    Energy Technology Data Exchange (ETDEWEB)

    Ekstroem, Per-Anders (Facilia AB (Sweden))

    2010-12-15

    This report documents a flexible simulation tool, Pandora, used in several post closure safety assessments in both Sweden and Finland to assess the radiological dose to man due to releases from radioactive waste repositories. Pandora allows the user to build compartment models to represent the migration and fate of radionuclides in the environment. The tool simplifies the implementation and simulation of radioecological biosphere models in which there exist a large set of radionuclides and input variables. Based on the well-known technical computing software MATLAB and especially its interactive graphical environment Simulink, Pandora receives many benefits. MATLAB/Simulink is a highly flexible tool used for simulations of practically any type of dynamic system; it is widely used, continuously maintained, and often upgraded. By basing the tool on this commercial software package, we gain both the graphical interface provided by Simulink, as well as the ability to access the advanced numerical equation solving routines in MATLAB. Since these numerical methods are well established and quality assured in their MATLAB implementation, the solution methods used in Pandora can be considered to have high level of quality assurance. The structure of Pandora provides clarity in the model format, which means the model itself assists its own documentation, since the model can be understood by inspecting its structure. With the introduction of the external tool Pandas (Pandora assessment tool), version handling and an integrated way of performing the entire calculation chain has been added. Instead of being dependent on other commercial statistical software as @Risk for performing probabilistic assessments, they can now be performed within the tool

  3. Risk assessment: tools, techniques, and their applications

    National Research Council Canada - National Science Library

    Ostrom, Lee T; Wilhelmsen, Cheryl A

    2012-01-01

    .... The central task of the risk assessor is predicting the success of a project. This includes isolating the entire spectrum of adverse events that can derail a project or threaten the health and safety of individuals, organizations, and the environment...

  4. Definition of a shortcut methodology for assessing flood-related Na-Tech risk

    Directory of Open Access Journals (Sweden)

    E. Marzo

    2012-11-01

    Full Text Available In this paper a qualitative methodology for the initial assessment of flood-related Na-Tech risk was developed as a screening tool to identify which situations require a much more expensive quantitative risk analysis (QRA. Through the definition of some suitable key hazard indicators (KHIs, the proposed methodology allows the identification of the Na-Tech risk level associated with a given situation; the analytical hierarchy process (AHP was used as a multi-criteria decision tool for the evaluation of such qualitative KHIs. The developed methodology was validated through two case studies by comparing the predicted risk levels with the results of much more detailed QRAs previously presented in literature and then applied to the real flood happened at Spolana a.s., Neratovice, Czech Republic in August 2002.

  5. STOPDVTs: Development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for Deep Vein Thrombosis.

    Science.gov (United States)

    O'Brien, Alanna; Redley, Bernice; Wood, Beverley; Botti, Mari; Hutchinson, Anastasia F

    2018-03-01

    To develop and test a clinical tool to guide nurses' assessment of postoperative patients for Deep Vein Thrombosis. Preventing venous thromboembolism in hospitalised patients is an international patient safety priority. Despite high-level evidence for optimal venous thromboembolism prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis remains high. A two-stage sequential multi-method design was used. In stage 1, the STOPDVTs tool was developed using a review of the literature and focus groups with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical nurses who conducted repeated assessments on a prospective sample of 50 postoperative orthopaedic patients. Stage 1: The focus group members who were members of the nursing leadership team agreed on eight local and systemic signs and symptoms that should be included in a nursing patient assessment tool for early Deep Vein Thrombosis. Local symptoms were pain in the limbs, calf swelling and tightness, changes in the affected limb's skin temperature. Systemic signs included in the tool were as follows: increased shortness of breath, increased respiratory and heart rates, and decreased oxygen saturation. Stage 2: The STOPDVTs tool had acceptable face and content validity, the agreement between the expert nurse and surgical nurses on assessments of individual signs and symptoms varied between 44%-94%. Surgical nurses were less likely than the expert nurse to identify signs indicative of Deep Vein Thrombosis. Despite finding the STOPDVTs clinical assessment tool was a useful guide for nursing assessment, surgical nurses often underestimated the potential importance of clinical signs. The findings reveal a gap in nursing knowledge and skill in assessing for Deep Vein Thrombosis in postoperative orthopaedic patients. This study identified a possible risk to patient safety related to under-recognition of the signs and symptoms of possible Deep Vein Thrombosis (DVT) in

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

    Science.gov (United States)

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

    2018-01-01

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

  7. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  8. NanoSafer vs. 1.1 - Nanomaterial risk assessment using first order modeling

    DEFF Research Database (Denmark)

    Jensen, Keld A.; Saber, Anne T.; Kristensen, Henrik V.

    2013-01-01

    Currently, there are no nanospecific safety data sheets (SDS) fo r manufactured nanomaterials (MN) and there is only limited data available on nanomaterial exposure levels. We have established an advanced control banding tool, NanoSafer, which enables alternative risk assessm ent and guidance...... in the SDS for the closest analogue bulk material for which the requested occupational exposure limit (OEL) is given as well. The emission potential is either given by a constant release rate or the dustiness level determined us ing the EN15051 rotating drum or similar. The exposure assessment is estimated...... of the nearest analogue bulk material a nd the specific surface area. The NanoSafer control banding tool is now available in Danish and English and contains help tools, including a data library with dustiness data and an inspirational nanosafety e learning tool for companies’ risk management. The ability...

  9. A spatially-evaluated methodology for assessing risk to a population from contaminated land

    International Nuclear Information System (INIS)

    Gay, J. Rebecca; Korre, Anna

    2006-01-01

    A methodology is proposed which combines quantitative probabilistic human health risk assessment and spatial statistical methods (geostatistics) to produce an assessment of risks to human health from exposure to contaminated land, in a manner which preserves the spatial distribution of risks and provides a measure of uncertainty in the assessment. Maps of soil contaminant levels, which incorporate uncertainty, are produced from sparse sample data using sequential indicator simulation. A real, age-stratified population is mapped across the contaminated area, and intake of soil contaminants by individuals is calculated probabilistically using an adaptation of the Contaminated Land Exposure Assessment (CLEA) model. An abundance of information is contained in results which can be interrogated at the population and individual level, and mapped to provide a powerful visual tool for risk managers, enabling efficient targeting of risk reduction measures to different locations. - A methodology for calculating and mapping risks to a population from intake of soil contaminants

  10. Evaluating an holistic assessment tool for palliative care practice.

    Science.gov (United States)

    McIlfatrick, Sonja; Hasson, Felicity

    2014-04-01

    To evaluate a holistic assessment tool for palliative care practice. This included identifying patients' needs using the holistic tool and exploring the usability, applicability and barriers and facilitators towards implementation in practice. The delivery of effective holistic palliative care requires a careful assessment of the patients' needs and circumstances. Whilst holistic assessment of palliative care needs is advocated, questions exist around the appropriateness of tools to assist this process. Mixed-method research design. Data collection involved an analysis of piloted holistic assessments undertaken using the tool (n = 132) and two focus groups with healthcare professionals (n = 10). The tool enabled health professionals to identify and gain an understanding of the needs of the patients, specifically in relation to the physical healthcare needs. Differences, however, between the analysis of the tool documentation and focus group responses were identified in particular areas. For example, 59 (68·8%) respondents had discussed preferred priorities of care with the patient; however, focus group comments revealed participants had concerns around this. Similarly, whilst over half of responses (n = 50; 57·5%) had considered a prognostic clinical indicator for the patient as an action, focus group results indicated questions around healthcare professionals' knowledge and perceived usefulness of such indicators. Positive aspects of the tool were that it was easy to understand and captured the needs of individuals. Negative aspects of the tool were that it was repetitive and the experience of assessors required consideration. The tool evaluation identified questions regarding holistic assessment in palliative care practice and the importance of communication. A holistic assessment tool can support patient assessment and identification of patients' needs in the 'real world' of palliative care practice, but the 'tool' is merely an aid to assist professionals to

  11. Trial of risk assessment of a hypothetical nuclear facility

    International Nuclear Information System (INIS)

    Terao, Norichika; Suzuki, Mitsutoshi

    2013-01-01

    An equation for risk assessment in physical protection is shown by a probability of an adversary attack during a period time, P A , a probability of system effectiveness, P E , and consequence value, C. In addition, P E is shown as the multiplication of a probability of interruption of the facility, P I , by a probability of neutralization by response force, P N . In this study, it is assumed that an adversary assaults a hypothetical nuclear facility. The new quantification method about P A and P I in risk evaluation formula is devised, and risk assessment is attempted. In case of P A , the possibility of assaults against a nuclear facility is discussed by using terrorism data written in the open source database of terrorism, Global Terrorism Database (GTD), summarized by University of Maryland. In addition, it is discussed about P I by using the way of thinking of a risk assessment tool, EASI, developed by the Sandia National Laboratories (SNL). In the hypothetical nuclear facility, the performance of response force, sensors, and communication is expressed quantitatively by probability distribution based on some assumptions. (author)

  12. The use of current risk analysis tools evaluated towards preventing external domino accidents

    NARCIS (Netherlands)

    Reniers, Genserik L L; Dullaert, W.; Ale, B. J.M.; Soudan, K.

    Risk analysis is an essential tool for company safety policy. Risk analysis consists of identifying and evaluating all possible risks. The efficiency of risk analysis tools depends on the rigueur of identifying and evaluating all possible risks. The diversity in risk analysis procedures is such that

  13. 'What on earth can this possibly mean'? French reentry courts and experts' risk assessment.

    Science.gov (United States)

    Herzog-Evans, Martine

    2016-01-01

    Against the backdrop of ten years of punitive criminal justice policies, the number of cases in which risk assessments by psychiatrist experts are mandatory has considerably increased in France. Because of complex and deeply ingrained cultural factors, most experts and academics oppose the use of actuarial or other structured judgement tools, which they assimilate to these policy changes. Parallel to this, the reentry judges in charge of making release and other community sentence decisions have maintained a strong rehabilitative and desistance-focused culture. Drawing on interviews with these judges and experts, the author wanted to assess the judges' expectations of experts' reports, their opinion on actuarial tools, and how they perceived experts and their aptitude to assess risk. The study showed that French reentry judges manage to keep experts' conclusions at bay when they do not fit with their desistance goals, as they can draw upon their own expertise and that of probation services. They do not have much faith in the professionalism and methodology of experts, and would like them to better demonstrate how they reach their conclusions. Moreover, criminogenic needs assessment would be much more useful to them than static risk assessment, which raises the issue as to why this is not the French probation services' role. Reentry judges who never encountered a report which uses a structured tool are influenced by the French ideological debate; those who have read such reports are unanimously in favour of such tools. It thus seems clear that they would like experts to be more strongly guided by science, but are not yet fully aware of what this entails. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert S. Balch; Ron Broadhead

    2005-03-01

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

  15. Incorporating biomarkers in ecological risk assessment of chemical contaminants of soils

    Directory of Open Access Journals (Sweden)

    A. J. Reinecke

    2007-09-01

    Full Text Available Soil is an important but complex natural resource which is increasingly used as sink for chemicals. The monitoring of soil quality and the assessment of risks posed by contaminants have become crucial. This study deals with the potential use of biomarkers in the monitoring of soils and the assessment of risk resulting from contamination. Apart from an overview of the existing literature on biomarkers, the results of various of our field experiments in South African soils are discussed. Biomarkers may have potential in the assessment of risk because they can indicate at an early stage that exposure has taken place and that a toxic response has been initiated. It is therefore expected that early biomarkers will play an increasing role as diagnostic tools for determining exposure to chemicals and the resulting effects. They may have predictive value that can assist in the prevention or minimising of risks. The aim of this study was to investigate the possibilities of using our results on biomarker responses of soil dwelling organisms to predict changes at higher organisational levels (which may have ecological implications. Our recent experimental results on the evaluation of various biomarkers in both the laboratory and the field are interpreted and placed in perspective within the broader framework of response biology. The aim was further to contribute to the development and application of biomarkers in regulatory risk assessment schemes of soils. This critical review of our own and recent literature on biomarkers in ecotoxicology leads to the conclusion that biomarkers can, under certain conditions, be useful tools in risk assessment. Clear relationships between contamination loads in soil organisms and certain biomarker responses were determined in woodlice, earthworms and terrestrial snails. Clear correlations were also established in field experiments between biomarker responses and changes at the population level. This indicated that, in

  16. Risk Assessment of the Main Control Room Fire Using Fire Simulations

    International Nuclear Information System (INIS)

    Kang, Dae Il; Kim, Kilyoo; Jang, Seung Cheol

    2013-01-01

    KAERI is performing a fire PSA for a reference plant, Ulchin Unit 3, as part of developing the Korean site risk profile (KSRP). Fire simulations of the MCR fire were conducted using the CFAST (Consolidated Fire Growth and Smoke Transport) model and FDS (fire dynamic simulator) to improve the uncertainty in the MCR fire risk analysis. Using the fire simulation results, the MCR abandonment risk was evaluated. Level 1 PSA (probabilistic safety assessment) results of Ulchin Unit 3 using the EPRI PRA (probabilistic risk assessment) implementation guide showed that the MCR (main control room) fire was the main contributor to the core damage frequency. Recently, U. S. NRC and EPRI developed NUREG/CR-6850 to provide state-of-the-art methods, tools, and data for the conduct of a fire PSA for a commercial NPP

  17. Risk management & organizational uncertainty implications for the assessment of high consequence organizations

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.T.

    1995-02-23

    Post hoc analyses have demonstrated clearly that macro-system, organizational processes have played important roles in such major catastrophes as Three Mile Island, Bhopal, Exxon Valdez, Chernobyl, and Piper Alpha. How can managers of such high-consequence organizations as nuclear power plants and nuclear explosives handling facilities be sure that similar macro-system processes are not operating in their plants? To date, macro-system effects have not been integrated into risk assessments. Part of the reason for not using macro-system analyses to assess risk may be the impression that standard organizational measurement tools do not provide hard data that can be managed effectively. In this paper, I argue that organizational dimensions, like those in ISO 9000, can be quantified and integrated into standard risk assessments.

  18. Relapse Risk Assessment for Schizophrenia Patients (RASP): A New Self-Report Screening Tool.

    Science.gov (United States)

    Velligan, Dawn; Carpenter, William; Waters, Heidi C; Gerlanc, Nicole M; Legacy, Susan N; Ruetsch, Charles

    2018-01-01

    The Relapse Assessment for Schizophrenia Patients (RASP) was developed as a six-question self-report screener that measures indicators of Increased Anxiety and Social Isolation to assess patient stability and predict imminent relapse. This paper describes the development and psychometric characteristics of the RASP. The RASP and Positive and Negative Syndrome Scale (PANSS) were administered to patients with schizophrenia (n=166) three separate times. Chart data were collected on a subsample of patients (n=81). Psychometric analyses of RASP included tests of reliability, construct validity, and concurrent validity of items. Factors from RASP were correlated with subscales from PANSS (sensitivity to change and criterion validity [agreement between RASP and evidence of relapse]). Test-retest reliability returned modest to strong agreement at the item level and strong agreement at the questionnaire level. RASP showed good item response curves and internal consistency for the total instrument and within each of the two subscales (Increased Anxiety and Social Isolation). RASP Total Score and subscales showed good concurrent validity when correlated with PANSS Total Score, Positive, Excitement, and Anxiety subscales. RASP correctly predicted relapse in 67% of cases, with good specificity and negative predictive power and acceptable positive predictive power and sensitivity. The reliability and validity data presented support the use of RASP in settings where addition of a brief self-report assessment of relapse risk among patients with schizophrenia may be of benefit. Ease of use and scoring, and the ability to administer without clinical supervision allows for routine administration and assessment of relapse risk.

  19. Chemical and biochemical tools to assess pollution exposure in cultured fish

    International Nuclear Information System (INIS)

    Fernandes, Denise; Zanuy, Silvia; Bebianno, Maria Joao; Porte, Cinta

    2008-01-01

    There is little information regarding pollutant levels in farmed fish, and the risks associated to consumption. This study was designed to assess levels of exposure to metals, organochlorinated compounds, polycyclic aromatic hydrocarbons (PAHs) and alkylphenols (APEs) in farmed sea bass Dicentrarchus labrax from five aquacultures located in Southern Europe. Additionally, several biochemical responses (metallothionein, 7-ethoxyresorufin O-deethylase, vitellogenin) were determined as complementary tools. The obtained data indicate that pollutants exposure in farmed fish is similar to the levels reported in wild specimens from the area. Nonetheless, some biochemical responses were observed in the studied organisms, viz. metallothionein induction in Cu exposed organisms, and 7-ethoxyresorufin O-deethylase (EROD) and vitellogenin induction in PAHs and APEs exposed ones. The study further supports the usefulness of the biomarker approach as a first screening method to discriminate between basal and high levels of exposure in cultured fish. - Pollution assessment in cultured fish: chemical and biochemical tools

  20. Work-related stress risk assessment in Italy: a methodological proposal adapted to regulatory guidelines.

    Science.gov (United States)

    Persechino, Benedetta; Valenti, Antonio; Ronchetti, Matteo; Rondinone, Bruna Maria; Di Tecco, Cristina; Vitali, Sara; Iavicoli, Sergio

    2013-06-01

    Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. After close analysis of the Italian and European reference regulatory framework and work-related stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons.