WorldWideScience

Sample records for risk emergent patterns

  1. Homelessness: patterns of emergency department use and risk factors for re-presentation.

    Science.gov (United States)

    Moore, G; Gerdtz, M F; Hepworth, G; Manias, E

    2011-05-01

    To describe patterns of service use and to predict risk factors for re-presentation to a metropolitan emergency department (ED) among people who are homeless. A retrospective cohort analysis was undertaken over a 24-month period from a principal referral hospital in Melbourne, Australia. All ED visits relating to people classified as homeless were included. A predictive model for risk of re-presentation was developed using logistic regression with random effects. Rates of re-presentation, defined as the total number of visits to the same ED within 28 days of discharge, were measured. The study period was 1 January 2003 to 31 December 2004. The re-presentation rate for homeless people was 47.8% (3199/6689) of ED visits and 45.5% (725/1595) of the patients. The final predictive model included risk factors, which incorporated both hospital and community service use. Those characteristics that resulted in significantly increased odds of re-presentation were leaving hospital at own risk (OR 1.31; 95% CI 1.10 to 1.56), treatment in another hospital (OR 1.45, 95% CI 1.23 to 1.72) and being in receipt of community-based case management (OR 1.31, 95% CI 1.11 to 1.54) or pension (OR 1.34, 95% CI 1.12 to 1.62). The predictive model identified nine risk factors of re-presentation to the ED for people who are homeless. Early identification of these factors among homeless people may alert clinicians to the complexity of issues influencing an individual ED visit. This information can be used at admission and discharge by ensuring that homeless people have access to services commensurate with their health needs. Improved linkage between community and hospital services must be underscored by the capacity to provide safe and secure housing.

  2. Patterns of Flux Emergence

    Science.gov (United States)

    Title, A.; Cheung, M.

    2008-05-01

    The high spatial resolution and high cadence of the Solar Optical Telescope on the JAXA Hinode spacecraft have allowed capturing many examples of magnetic flux emergence from the scale of granulation to active regions. The observed patterns of emergence are quite similar. Flux emerges as a array of small bipoles on scales from 1 to 5 arc seconds throughout the region that the flux eventually condenses. Because the fields emerging from the underlying flux rope my appear many in small segments and the total flux (absolute sum) is not a conserved quantity the amount of total flux on the surface may vary significantly during the emergence process. Numerical simulations of flux emergence exhibit patterns similar to observations. Movies of both observations and numerical simulations will be presented.

  3. Monitoring new and emerging risks

    NARCIS (Netherlands)

    Houtman, I.L.D.; Douwes, M.; Zondervan, E.; Jongen, M.

    2014-01-01

    This article, based on recent literature, will identify, define and discuss new and emerging OSH-risks together with the driving forces behind these risks. Emerging risks will be described as being related to physical load and musculoskeletal disorders [MSDs], psychosocial risks, and dangerous subst

  4. Monitoring new and emerging risks

    NARCIS (Netherlands)

    Houtman, I.L.D.; Douwes, M.; Zondervan, E.; Jongen, M.

    2014-01-01

    This article, based on recent literature, will identify, define and discuss new and emerging OSH-risks together with the driving forces behind these risks. Emerging risks will be described as being related to physical load and musculoskeletal disorders [MSDs], psychosocial risks, and dangerous

  5. Pattern Formation and Complexity Emergence

    Science.gov (United States)

    Berezin, Alexander A.

    2001-03-01

    Success of nonlinear modelling of pattern formation and self-organization encourages speculations on informational and number theoretical foundations of complexity emergence. Pythagorean "unreasonable effectiveness of integers" in natural processes is perhaps extrapolatable even to universal emergence "out-of-nothing" (Leibniz, Wheeler). Because rational numbers (R = M/N) are everywhere dense on real axis, any digital string (hence any "book" from "Library of Babel" of J.L.Borges) is "recorded" infinitely many times in arbitrary many rationals. Furthermore, within any arbitrary small interval there are infinitely many Rs for which (either or both) integers (Ms and Ns) "carry" any given string of any given length. Because any iterational process (such as generation of fractal features of Mandelbrot Set) is arbitrary closely approximatable with rational numbers, the infinite pattern of integers expresses itself in generation of complexity of the world, as well as in emergence of the world itself. This "tunnelling" from Platonic World ("Platonia" of J.Barbour) to a real (physical) world is modern recast of Leibniz's motto ("for deriving all from nothing there suffices a single principle").

  6. Avian Cholera emergence in Arctic-nesting northern Common Eiders: using community-based, participatory surveillance to delineate disease outbreak patterns and predict transmission risk

    Directory of Open Access Journals (Sweden)

    Samuel A. Iverson

    2016-12-01

    Full Text Available Emerging infectious diseases are a growing concern in wildlife conservation. Documenting outbreak patterns and determining the ecological drivers of transmission risk are fundamental to predicting disease spread and assessing potential impacts on population viability. However, evaluating disease in wildlife populations requires expansive surveillance networks that often do not exist in remote and developing areas. Here, we describe the results of a community-based research initiative conducted in collaboration with indigenous harvesters, the Inuit, in response to a new series of Avian Cholera outbreaks affecting Common Eiders (Somateria mollissima and other comingling species in the Canadian Arctic. Avian Cholera is a virulent disease of birds caused by the bacterium Pasteurella multocida. Common Eiders are a valuable subsistence resource for Inuit, who hunt the birds for meat and visit breeding colonies during the summer to collect eggs and feather down for use in clothing and blankets. We compiled the observations of harvesters about the growing epidemic and with their assistance undertook field investigation of 131 colonies distributed over >1200 km of coastline in the affected region. Thirteen locations were identified where Avian Cholera outbreaks have occurred since 2004. Mortality rates ranged from 1% to 43% of the local breeding population at these locations. Using a species-habitat model (Maxent, we determined that the distribution of outbreak events has not been random within the study area and that colony size, vegetation cover, and a measure of host crowding in shared wetlands were significantly correlated to outbreak risk. In addition, outbreak locations have been spatially structured with respect to hypothesized introduction foci and clustered along the migration corridor linking Arctic breeding areas with wintering areas in Atlantic Canada. At present, Avian Cholera remains a localized threat to Common Eider populations in the

  7. Emergent pattern formation in an interstitial biofilm

    CERN Document Server

    Zachreson, Cameron; Whitchurch, Cynthia; Toth, Milos

    2016-01-01

    Collective behavior of bacterial colonies plays critical roles in adaptability, survivability, biofilm expansion and infection. We employ an individual-based model of an interstitial biofilm to study emergent pattern formation based on the assumptions that rod-shaped bacteria furrow through a viscous environment, and excrete extracellular polymeric substances which bias their rate of motion. Because the bacteria furrow through their environment, the substratum stiffness is a key control parameter behind the formation of distinct morphological patterns. By systematically varying this property (which we quantify with a stiffness coefficient {\\gamma}), we show that subtle changes in the substratum stiffness can give rise to a stable state characterized by a high degree of local order and long-range pattern formation. The ordered state exhibits characteristics typically associated with bacterial fitness advantages, even though it is induced by changes in environmental conditions rather than changes in biological ...

  8. Psychosocial Predictors of Emerging Adults' Risk and Reckless Behaviors.

    Science.gov (United States)

    Bradley, Graham; Wildman, Karen

    2002-01-01

    Studied risk and reckless behavior in 375 emerging adults using self-report measures and a cross-sectional design. Risk behaviors were found to be reliably predicted by sensation seeking, but not by antisocial peer pressure, while the reverse pattern was more true in relation to "reckless" behaviors. (SLD)

  9. Emergent pattern formation in an interstitial biofilm

    Science.gov (United States)

    Zachreson, Cameron; Wolff, Christian; Whitchurch, Cynthia B.; Toth, Milos

    2017-01-01

    Collective behavior of bacterial colonies plays critical roles in adaptability, survivability, biofilm expansion and infection. We employ an individual-based model of an interstitial biofilm to study emergent pattern formation based on the assumptions that rod-shaped bacteria furrow through a viscous environment and excrete extracellular polymeric substances which bias their rate of motion. Because the bacteria furrow through their environment, the substratum stiffness is a key control parameter behind the formation of distinct morphological patterns. By systematically varying this property (which we quantify with a stiffness coefficient γ ), we show that subtle changes in the substratum stiffness can give rise to a stable state characterized by a high degree of local order and long-range pattern formation. The ordered state exhibits characteristics typically associated with bacterial fitness advantages, even though it is induced by changes in environmental conditions rather than changes in biological parameters. Our findings are applicable to a broad range of biofilms and provide insights into the relationship between bacterial movement and their environment, and basic mechanisms behind self-organization of biophysical systems.

  10. Emerging spatial patterns in Antarctic prokaryotes

    Directory of Open Access Journals (Sweden)

    Chun Wie eChong

    2015-09-01

    Full Text Available Recent advances in knowledge of patterns of biogeography in terrestrial eukaryotic organisms have led to a fundamental paradigm shift in understanding of the controls and history of life on land in Antarctica, and its interactions over the long term with the glaciological and geological processes that have shaped the continent. However, while it has long been recognized that the terrestrial ecosystems of Antarctica are dominated by microbes and their processes, knowledge of microbial diversity and distributions has lagged far behind that of the macroscopic eukaryote organisms. Increasing human contact with and activity in the continent is leading to risks of biological contamination and change in a region whose isolation has protected it for millions of years at least; these risks may be particularly acute for microbial communities which have, as yet, received scant recognition and attention. Even a matter apparently as straightforward as Protected Area designation in Antarctica requires robust biodiversity data which, in most parts of the continent, remain almost completely unavailable. A range of important contributing factors mean that it is now timely to reconsider the state of knowledge of Antarctic terrestrial prokaryotes. Rapid advances in molecular biological approaches are increasingly demonstrating that bacterial diversity in Antarctica may be far greater than previously thought, and that there is overlap in the environmental controls affecting both Antarctic prokaryotic and eukaryotic communities. Bacterial dispersal mechanisms and colonization patterns remain largely unaddressed, although evidence for regional evolutionary differentiation is rapidly accruing and, with this, there is increasing appreciation of patterns in regional bacterial biogeography in this large part of the globe. In this review, we set out to describe the state of knowledge of Antarctic prokaryote diversity patterns, drawing analogy with those of eukaryote

  11. Referral patterns in elderly emergency department visits

    Directory of Open Access Journals (Sweden)

    Alessandra Buja

    2013-12-01

    Full Text Available OBJECTIVE: To assess elderly individuals' demand for emergency department (ED care, in terms of the characteristics, processes, outcomes, costs by referral pattern. DATA SOURCE: All ED visits involving patients aged 65 and older, extracted from the 2010 dataset of an Local Health Agency, in North-Eastern Italy (no. = 18 648. STUDY DESIGN: Retrospective cohort study. PRINCIPAL FINDINGS: Patients were referred by primary care professionals (PCPs in 43.1% of cases, 1.4% came from nursing homes (NH, and 55.5% were self-referred (SR. The SR group had a higher adjusted odds ratio (aOR for non-urgent conditions (1.98 CI 1.85-2.12, but a lower aOR for conditions amenable to ambulatory care (0.53 CI 0.48-0.59, and a lower consumption of resources. The SR group tend to occur more frequently out of hours, and to coincide with a shorter stay at the ED, lower observation unit activation rates, lower hospitalization rates and a lower consumption of services than other two groups. The average costs for all procedures were lower for the SR patients (mean = 106.04 € ± SD 84.90 € than for those referred by PCPs (mean = 138.14 € ± SD 101.17 € or NH (mean = 143.48 € ± SD 95.28 €. CONCLUSION: Elderly patients coming in ED have different characteristics, outcomes and recourses consume by referral pattern.

  12. Exploring Risk Perceptions of Emerging Infectious Diseases

    NARCIS (Netherlands)

    O. de Zwart (Onno)

    2009-01-01

    textabstractThis thesis is about risk perception of infectious diseases, with a special focus on the emerging infections SARS and avian influenza, and explores potential determinants of risk perception and the relation of risk perception with precautionary behaviours. In this first chapter I discuss

  13. Nanotechnology risk perceptions and communication: emerging technologies, emerging challenges.

    Science.gov (United States)

    Pidgeon, Nick; Harthorn, Barbara; Satterfield, Terre

    2011-11-01

    Nanotechnology involves the fabrication, manipulation, and control of materials at the atomic level and may also bring novel uncertainties and risks. Potential parallels with other controversial technologies mean there is a need to develop a comprehensive understanding of processes of public perception of nanotechnology uncertainties, risks, and benefits, alongside related communication issues. Study of perceptions, at so early a stage in the development trajectory of a technology, is probably unique in the risk perception and communication field. As such it also brings new methodological and conceptual challenges. These include: dealing with the inherent diversity of the nanotechnology field itself; the unfamiliar and intangible nature of the concept, with few analogies to anchor mental models or risk perceptions; and the ethical and value questions underlying many nanotechnology debates. Utilizing the lens of social amplification of risk, and drawing upon the various contributions to this special issue of Risk Analysis on Nanotechnology Risk Perceptions and Communication, nanotechnology may at present be an attenuated hazard. The generic idea of "upstream public engagement" for emerging technologies such as nanotechnology is also discussed, alongside its importance for future work with emerging technologies in the risk communication field. © 2011 Society for Risk Analysis.

  14. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

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

  15. Emerging Technological Risk Underpinning the Risk of Technology Innovation

    CERN Document Server

    Anderson, Stuart

    2012-01-01

    Classes of socio-technical hazards allow a characterization of the risk in technology innovation and clarify the mechanisms underpinning emergent technological risk. Emerging Technological Risk provides an interdisciplinary account of risk in socio-technical systems including hazards which highlight: ·         How technological risk crosses organizational boundaries, ·         How technological trajectories and evolution develop from resolving tensions emerging between social aspects of organisations and technologies and ·         How social behaviour shapes, and is shaped by, technology. Addressing an audience from a range of academic and professional backgrounds, Emerging Technological Risk is a key source for those who wish to benefit from a detail and methodical exposure to multiple perspectives on technological risk. By providing a synthesis of recent work on risk that captures the complex mechanisms that characterize the emergence of risk in technology innovation, Emerging Tec...

  16. Emergent Risks In Critical Infrastructures

    Science.gov (United States)

    Dynes, Scott

    Firms cannot function successfully without managing a host of internal and external organizational and process interdependencies. Part of this involves business continuity planning, which directly aects how resilient arm and its business sector are in the face of disruptions. This paper presents the results of eld studies related to information risk management practices in the health care and retail sectors. The studies explore information risk management coordinating signals within and across rms in these sectors as well as the potential eects of cyber disruptions on the rms as stand-alone entities and as part of a critical infrastructure. The health care case study investigates the impact of the Zotob worm on the ability to deliver medical care and treatment. The retail study examines the resilience of certain elements of the food supply chain to cyber disruptions.

  17. Risk stratification in emergency patients by copeptin

    DEFF Research Database (Denmark)

    Iversen, Kasper; Gøtze, Jens P; Dalsgaard, Morten

    2014-01-01

    BACKGROUND: Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose of the pre......BACKGROUND: Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose...... to 0.1% (1/693) for patients with normal copeptin concentrations (that is, ≤11.3 pmol/L) (P figures for one-year mortality and for the entire...

  18. Career Development and Emerging Managerial Career Patterns.

    Science.gov (United States)

    Grzeda, Maurice

    1999-01-01

    Career-motivation theory provides a new framework for managerial careers in the context of contemporary career patterns. The framework includes the concepts of career resilience, career insight, and career identity. (SK)

  19. Emerging patterns of somatic mutations in cancer.

    Science.gov (United States)

    Watson, Ian R; Takahashi, Koichi; Futreal, P Andrew; Chin, Lynda

    2013-10-01

    Recent advances in technological tools for massively parallel, high-throughput sequencing of DNA have enabled the comprehensive characterization of somatic mutations in a large number of tumour samples. In this Review, we describe recent cancer genomic studies that have assembled emerging views of the landscapes of somatic mutations through deep-sequencing analyses of the coding exomes and whole genomes in various cancer types. We discuss the comparative genomics of different cancers, including mutation rates and spectra, as well as the roles of environmental insults that influence these processes. We highlight the developing statistical approaches that are used to identify significantly mutated genes, and discuss the emerging biological and clinical insights from such analyses, as well as the future challenges of translating these genomic data into clinical impacts.

  20. Emerging patterns of somatic mutations in cancer

    OpenAIRE

    Watson, Ian R.; Takahashi, Koichi; Futreal, P. Andrew; Chin, Lynda

    2013-01-01

    The advance in technological tools for massively parallel, high-throughput sequencing of DNA has enabled the comprehensive characterization of somatic mutations in large number of tumor samples. Here, we review recent cancer genomic studies that have assembled emerging views of the landscapes of somatic mutations through deep sequencing analyses of the coding exomes and whole genomes in various cancer types. We discuss the comparative genomics of different cancers, including mutation rates, s...

  1. Patterns of expectations for emerging sustainable technologies

    NARCIS (Netherlands)

    Alkemade, F.; Suurs, R.A.A.

    2012-01-01

    Innovation is characterized by uncertainties, high risks, large investments and late returns on investment which make it a complex process. This is particularly true for sustainable innovation where market forces alone cannot be relied upon to realize the desired transitions. Insight in the dynamics

  2. Managing emerging risk the capstone of preparedness

    CERN Document Server

    Burton, Kevin D

    2016-01-01

    From Main Street to Mumbai, Managing Emerging Risk: The Capstone of Preparedness considers the new global drivers behind threats and hazards facing all those tasked with protecting the public and private sector. The text delves into the global mindset of public and private sector emergency managers and presents a new risk landscape vastly different from the one existing ten years ago. The book begins by presenting a series of fictitious scenarios each resulting in mass destruction and fatalities. These are each followed by actual news stories that support the scenarios and demonstrate that the proposed events-seemingly unthinkable-have the potential to occur. Next, the author identifies two drivers in the practice of emergency management and general preparedness today that constitute our view of the future and the new face of risk. The first is the Disaster Halo Effect-the idea that modern threats exhibit more than one event. The second is the worldview of our nation as a Market State focused on the trading o...

  3. Mitochondrial transcription: is a pattern emerging?

    Science.gov (United States)

    Jaehning, J A

    1993-04-01

    Despite the striking similarities of RNA polymerases and transcription signals shared by eubacteria, archaebacteria and eukaryotes, there has been little indication that transcription in mitochondria is related to any previously characterized model. Only in yeast has the subunit structure of the mitochondrial RNA polymerase been determined. The yeast enzyme is composed of a core related to polymerases from bacteriophage T7 and T3, and a promoter recognition factor similar to bacterial sigma factors. Soluble systems for studying mitochondrial transcript initiation in vitro have been described from several organisms, and used to determine consensus sequences at or near transcription start sites. Comparison of these sequences from fungi, plants, and amphibians with the T7/T3 promoter suggests some intriguing similarities. Mammalian mitochondrial promoters do not fit this pattern but instead appear to utilize upstream sites, the target of a transcriptional stimulatory factor, to position the RNA polymerase. The recent identification of a possible homologue of the mammalian upstream factor in yeast mitochondria may indicate that a pattern will eventually be revealed relating the transcriptional machineries of all eukaryotic mitochondria.

  4. Aquatic ecotoxicology: advancing tools for dealing with emerging risks

    National Research Council Canada - National Science Library

    Amiard, J. C; Mouneyrac, Catherine; Amiard-Triquet, C

    2015-01-01

    "Aquatic Ecotoxicology: Advancing Tools for Dealing with Emerging Risks presents a thorough look at recent advances in aquatic ecotoxicology and their application in assessing the risk of well-known and emerging environmental contaminants...

  5. Size-dependent diffusion promotes the emergence of spatiotemporal patterns

    DEFF Research Database (Denmark)

    Zhang, Lai; Thygesen, Uffe Høgsbro; Banerjee, Malay

    2014-01-01

    promotes the formation of spatiotemporal patterns, by creating regular spatiotemporal patterns out of temporal chaos. We also found that size-dependent diffusion can substitute large-amplitude base harmonics with spatiotemporal patterns with lower amplitude oscillations but with enriched harmonics. Finally...... intraspecific physiological variations at the individual level. Here we explore the impacts of size variation within species resulting from individual ontogeny, on the emergence of spatiotemporal patterns in a fully size-structured population model. We found that size dependency of animal's diffusivity greatly...... populations. Due to the ubiquity of individual ontogeny in natural ecosystems we conclude that diffusion variability within populations is a significant driving force for the emergence of spatiotemporal patterns. Our results offer a perspective on self-organized phenomena, and pave a way to understand...

  6. Emergency thoracic ultrasound and clinical risk management

    Science.gov (United States)

    Interrigi, Maria Concetta; Trovato, Francesca M; Catalano, Daniela; Trovato, Guglielmo M

    2017-01-01

    Purpose Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and

  7. Emerging carbon constraints for corporate risk management

    Energy Technology Data Exchange (ETDEWEB)

    Busch, Timo; Hoffmann, Volker H. [Group for Sustainability and Technology, Department for Management, Technology, and Economics, ETH Zurich, Kreuzplatz 5, 8032 Zurich (Switzerland)

    2007-05-15

    While discussions about global sustainability challenges abound, the financial risks that they incur, albeit important, have received less attention. We suggest that corporate risk assessments should include sustainability-related aspects, especially with relation to the natural environment, and encompass the flux of critical materials within a company's value chain. Such a comprehensive risk assessment takes into account input- as well as output-related factors. With this paper, we focus on the flux of carbon and define carbon constraints that emerge due to the disposition of fossil fuels in the input dimension and due to direct and indirect climate change effects in the output dimension. We review the literature regarding the financial consequences of carbon constraints on the macroeconomic, sector, and company level. We conclude that: a) financial consequences seem to be asymmetrically distributed between and within sectors, b) the individual risk exposure of companies depends on the intensity of and dependency on carbon-based materials and energy, and c) financial markets have only started to incorporate these aspects in their valuations. This paper ends with recommendations on how to incorporate our results in an integrated carbon risk management framework. (author)

  8. Emergency thoracic ultrasound and clinical risk management

    Directory of Open Access Journals (Sweden)

    Interrigi MC

    2017-02-01

    Full Text Available Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS has been proposed as an easy-option replacement for chest X-ray (CXR in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion; in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed

  9. Telehone consultations: At the emergency service, Copenhagen County: Analysis of doctor-patient communication patterns

    DEFF Research Database (Denmark)

    Larsen, Jan-Helge; Risør, Ole

    1997-01-01

    Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision......Communications patterns, emergency service, out-of-hours service, telehpone consultations, video-supervision...

  10. Emerging pattern mining to aid toxicological knowledge discovery.

    Science.gov (United States)

    Sherhod, Richard; Judson, Philip N; Hanser, Thierry; Vessey, Jonathan D; Webb, Samuel J; Gillet, Valerie J

    2014-07-28

    Knowledge-based systems for toxicity prediction are typically based on rules, known as structural alerts, that describe relationships between structural features and different toxic effects. The identification of structural features associated with toxicological activity can be a time-consuming process and often requires significant input from domain experts. Here, we describe an emerging pattern mining method for the automated identification of activating structural features in toxicity data sets that is designed to help expedite the process of alert development. We apply the contrast pattern tree mining algorithm to generate a set of emerging patterns of structural fragment descriptors. Using the emerging patterns it is possible to form hierarchical clusters of compounds that are defined by the presence of common structural features and represent distinct chemical classes. The method has been tested on a large public in vitro mutagenicity data set and a public hERG channel inhibition data set and is shown to be effective at identifying common toxic features and recognizable classes of toxicants. We also describe how knowledge developers can use emerging patterns to improve the specificity and sensitivity of an existing expert system.

  11. Dietary Pattern and Risk of Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Mahdi Aloosh

    2012-01-01

    Full Text Available Background:It has been suggested that nutrition might play a role in the etiology of multiple sclerosis (MS. However,dietary patterns associated with MS risk are unknown. This study was conducted to compare the dietary patterns of patients with MS and healthy controls to find the relationship between dietary patterns and MS.Methods:Usual dietary intake of 75 women with relapsing/remitting MS (RRMS and 75 healthy controls were assessed with a food frequency questionnaire consisting of 168 food items. To define major dietary patterns, we used factor analysis. Multivariate logistic regression was used to assess the relationship between dietary patterns and risk of MS.Results:Traditional pattern (high in low-fat dairy products,red meat, vegetable oil, onion, whole grain, soy, refined grains, organ meats, coffee, and legumes was inversely related to the risk of MS [odds ratio (OR = 0.15; 95%confidence interval (CI: 0.03-0.18; P = 0.028]. A similar inverse relationship was noted between MS risk andlacto-vegetarian (high in nuts, fruits, French fries, coffee,sweets and desserts, vegetables, and high-fat dairy products and vegetarian (high in green leafy vegetables, hydrogenated fats, tomato, yellow vegetables, fruit juices, onion, and other vegetablespatterns (OR = 0.31; 95% CI: 0.12-0.82; P = 0.018 and OR = 0.42; 95% CI: 0.19-0.90; P = 0.026, respectively. In contrast, the prevalence of MS was higher in those who had high animal fat dietary pattern (high in animal fats,potato, meat products, sugars, and hydrogenated fats and low in whole grains (OR = 1.99; 95% CI: 1.63-2.94;P < 0.005.Conclusion:Our findings showed that the risk of RRMS can be affected by major dietary patterns.

  12. Injury patterns in children with frequent emergency department visits

    DEFF Research Database (Denmark)

    Laursen, B

    2006-01-01

    OBJECTIVES: To compare injury patterns in children with many and few emergency department (ED) visits in order to reveal the causes for the frequent visits. METHODS: Three cohorts of Danish children (total 579 721 children) were followed for three years when their ages were 0-2, 6-8, and 12...

  13. Emergent patterns of growth controlled by multicellular form and mechanics

    Science.gov (United States)

    Nelson, Celeste M.; Jean, Ronald P.; Tan, John L.; Liu, Wendy F.; Sniadecki, Nathan J.; Spector, Alexander A.; Chen, Christopher S.

    2005-01-01

    Spatial patterns of cellular growth generate mechanical stresses that help to push, fold, expand, and deform tissues into their specific forms. Genetic factors are thought to specify patterns of growth and other behaviors to drive morphogenesis. Here, we show that tissue form itself can feed back to regulate patterns of proliferation. Using microfabrication to control the organization of sheets of cells, we demonstrated the emergence of stable patterns of proliferative foci. Regions of concentrated growth corresponded to regions of high tractional stress generated within the sheet, as predicted by a finite-element model of multicellular mechanics and measured directly by using a micromechanical force sensor array. Inhibiting actomyosin-based tension or cadherin-mediated connections between cells disrupted the spatial pattern of proliferation. These findings demonstrate the existence of patterns of mechanical forces that originate from the contraction of cells, emerge from their multicellular organization, and result in patterns of growth. Thus, tissue form is not only a consequence but also an active regulator of tissue growth. PMID:16049098

  14. Staphylococcus aureus: resistance pattern and risk factors

    Directory of Open Access Journals (Sweden)

    Mohammad Naghavi-Behzad

    2015-03-01

    Full Text Available Introduction: Methicillin resistant Staphylococcus aureus (MRSA has emerged as a nosocomial pathogen of major worldwide importance and is an increasingly frequent cause of community-acquired infections. In this study, different risk factors and MRSA resistance pattern were investigated. Methods: In a 24 months period, all of the patients who were confined to bed in the surgery ward were included in the study. Then they were assessed to find out as if they had MRSA infection when hospitalized and once when they were discharged. Almost 48 h after admission, when patients were discharged, social and medical histories were acquired. Acquired samples were examined. Results: During the present study of 475 patients, 108 patients (22.8% had S. aureus. About frequency of antibiotic resistance among collected S. aureus colonies, erythromycin resistance, was the most frequent antibiotic resistance, also resistance to vancomycin was 0.4% that was the least. Only hospitalization duration had statistically significant correlation with antibiotic resistance, also resistance to erythromycin had statistically significant relation with history of surgery and alcohol consumption. Of all 34 MRSA species, 22 (64.7% samples were resistant to erythromycin, 17 (50.0% resistant to cefoxitin, 5 (14.7% resistant to mupirocin, 1 (2.9% resistant to vancomycin and 1 (2.9% resistant to linezolid. Conclusion: The results of the current study show that among hospitalized patients, there is resistance against methicillin. Since based on results of the study there is resistance against oxacillin and erythromycin in most cases, administering appropriate antibiotics have an important role in minimizing the resistance burden among bacterial species.

  15. Risk factors associated with emergency peripartum hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Jin Rong; Guo Yuna; Chen Yan

    2014-01-01

    Background Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world,and the indications for EPH have changed.The object of this study is to identify risk factors associated with EPH.Methods We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1,2005 and June 30,2013,at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University,School of Medicine (IPMCH).The parametric t-test,chi-square tests and Logistic regression models were used for analysis to identify the risk factors.The results were considered statistically significant when P<0.05.Results There were 89 178 deliveries during the study period.Twenty-one women had an EPH,with an incidence of 24 per 100 000 deliveries.The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6)ml,and that of the control group was (2 040.8±723.5) ml.There was a significant difference of PHH between the EHP group and the control group (P=0.001).Independent risk factors for EPH from a logistic regression model were:disseminated intravascular coagulation (DIC) (OR:9.9,95% CI 2.8-34,P=0.003),previous cesarean section (OR:5.27;95% CI:1.48-17.9,P=0.009),placenta previa (OR:6.9; 95% CI 1.6-2.9,P=0.008),the loss of PPH (OR:1.001; 95% CI 1.001-1.002,P=0.002),placenta accreta (OR:68; 95% CI 10-456,P=0.004),the use of tocolytic agents prenatally (OR:6.55,95%CI 1.34-32.1,P=0.049),and fetal macrosomia (OR:6.9,95% CI 1.25-38,P=0.049).Conclusion Significant risk factors of EPH are DIC,placenta previa,PPH,previous cesarean delivery,and placenta accrete,the use of tocolytic agents prenatally,and fetal macrosomia.

  16. Emergency Response Transport Forecasting Using Historical Wind Field Pattern Matching.

    Science.gov (United States)

    Carter, Roger G.; Keislar, Robert E.

    2000-03-01

    Historical pattern matching, or analog forecasting, is used to generate short-term mesoscale transport forecasts for emergency response at the Idaho National Engineering and Environmental Laboratory. A simple historical pattern-matching algorithm operating on a database from the spatially and temporally dense Eastern Idaho Mesonet is used to generate a wind field forecast, which then is input to an existing puff diffusion model. The forecasts are rated both by a team of meteorologists and by a computer scoring method. Over 60% of the forecasts are rated as acceptable. The forecasts also are compared with a persistence method, using both a subjective human evaluation and root-mean-square error calculations.

  17. Spontaneous emergence of free-space optical and atomic patterns

    CERN Document Server

    Schmittberger, Bonnie L

    2016-01-01

    The spontaneous formation of patterns in dynamical systems is a rich non-equilibrium phenomenon that is studied in fields ranging from atomic physics to cosmology. Here, we report our observation of coupled optical-atomic pattern formation, which results in the creation of self-organized, multimode structures in free-space laser-driven cold atoms. We show that this process gives rise to spontaneous three-dimensional Sisyphus cooling even at very low light intensities and the emergence of self-organized atomic structures on multiple spatial scales.

  18. Global patterns in availability of emergency obstetric care.

    Science.gov (United States)

    Paxton, A; Bailey, P; Lobis, S; Fry, D

    2006-06-01

    This paper examines the availability of basic and comprehensive emergency obstetric care (EmOC), interventions used to treat direct obstetric complications. Determining what interventions are provided in health facilities is the first priority in analyzing a country's capabilities to treat obstetric emergencies. There are eight key interventions, six constitute basic EmOC and all eight comprehensive EmOC. Based on data from 24 needs assessments, the following global patterns emerge: comprehensive EmOC facilities are usually available to meet the recommended minimum number for the size of the population, basic EmOC facilities are consistently not available in sufficient numbers, both in countries with high and moderate levels of maternal mortality, and the majority of facilities offering maternity services provide only some interventions indicating an unrealized potential. Upgrading maternities, health centers and hospitals to at least basic EmOC status would be a major contributing step towards maternal mortality reduction in resource-poor countries.

  19. Emergent motion patterns of delay-coupled swarms

    Science.gov (United States)

    Szwaykowska, Klementyna; Mier-Y-Teran-Romero, Luis; Schwartz, Ira

    Emergent pattern-forming behaviours of aggregates of interacting autonomous agents are a topic of great interest in complex systems research, with applications including biology, environmental monitoring, and defence. We model, and experimentally verify, pattern formation in a swarm of delay-coupled agents, using a simple but general model of agent interactions. Using mean-field dynamics, we perform a thorough analytical study of the bifurcation structure as a function of network connectivity and delay to describe the emergence of pattern formation. We show that swarm motion patterns observed for a homogeneous swarm with all-to-all communication are robust to decreasing network connectivity and to heterogeneity in the parameters governing individual agent behaviours. We perform systematic numerical studies to show where the mean-field theory deviates from simulation and experiment. This research is funded by the Office of Naval Research (ONR) (Contract No. N0001412WX20083 and NRL Base Funding Contract No. N0001414WX00023). KS holds a NRC Research Associateship Award. LMR is a post-doctoral fellow at JHU, supported by NIH.

  20. Alcohol drinking patterns and risk of diabetes

    DEFF Research Database (Denmark)

    Holst, Charlotte; Becker, Ulrik; Jørgensen, Marit E

    2017-01-01

    AIMS/HYPOTHESIS: Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population. METHODS: This cohort study...... was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4.9 years. Self-reported questionnaires were used to obtain information on alcohol drinking patterns......, i.e. frequency of alcohol drinking, frequency of binge drinking, and consumption of wine, beer and spirits, from which we calculated beverage-specific and overall average weekly alcohol intake. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox...

  1. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    Science.gov (United States)

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  2. The equity risk premium : emerging versus developed markets

    NARCIS (Netherlands)

    Salomons, R.M.; Grootveld, H.

    2002-01-01

    This paper gives an empirical view of the ex-post equity risk premium in a number of international markets with special attention to emerging ones. Our study yields interesting implications for finance. Firstly, we find that the equity risk premium in emerging markets is significantly higher than in

  3. A Risk Management Architecture for Emergency Integrated Aircraft Control

    Science.gov (United States)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  4. The topology of African exports: Emerging patterns on spanning trees

    Science.gov (United States)

    Araújo, Tanya; Ferreira, Manuel Ennes

    2016-11-01

    This paper is a contribution to interweaving two lines of research that have progressed in separate ways: network analysis of international trade and the literature on African trade and development. Gathering empirical data on African countries has important limitations and so does the space occupied by African countries in the analysis of trade networks. Here, these limitations are dealt with by the definition of two independent bipartite networks: a destination share network and a commodity share network. These networks-together with their corresponding minimal spanning trees-allow to uncover some ordering emerging from African exports in the broader context of international trade. The emerging patterns help to understand important characteristics of African exports and its binding relations to other economic, geographic and organizational concerns as the recent literature on African trade, development and growth has shown.

  5. Emergent spatial pattern of herpetofauna in Alabama, USA

    Directory of Open Access Journals (Sweden)

    Xiongwen Chen

    2007-11-01

    Full Text Available Analyzing spatial pattern of regional biodiversity and its relationships with environmental factors is important for biodiversity conservation at large scales. The emergent spatial pattern of herpetofauna in Alabama is examined by combining thousands of historical records from 132 species of 24 families and environmental conditions. Our results indicate that species richness of herpetofauna increases with the increase of latitude, while it decreases with the increase of elevation. A negative spatial association exists between amphibians and reptiles on the scale of 10 km2, but 40% of habitats are still shared by amphibians and reptiles at this scale. The highest species richness of herpetofauna is in the Mobile and Baldwin Counties. Power-law relation exists between the county size and the average species richness. Total stream length, and road density are highly correlated with species richness at the county level. With the increase of annual precipitation, species richness decreases. Species richness is higher in the area with the annual average temperature around 17-18 °C. Herpetofaunal diversity in the Coosa/Tallapoosa River, the Alabama River, and the Tombigbee River basins is relatively higher than in the Perdido River and the Escatawpa River basins. The highest species richness exists at the Gulf Coastal Plain, but its species density is the lowest. The highest species richness of herpetofauna exists in the Longleaf-Slash Pine and Loblolly-Shortleaf Pine forests, while lower in Oak- Hickory forest. The emergent spatial pattern may provide important implications for herpetofauna conservation in the face of global climate change and large-scale habitat destruction. The spatial pattern and the possible underlying ecological processes have to be considered for the large scale land zoning and planning.

  6. Discovering structural alerts for mutagenicity using stable emerging molecular patterns.

    Science.gov (United States)

    Métivier, Jean-Philippe; Lepailleur, Alban; Buzmakov, Aleksey; Poezevara, Guillaume; Crémilleux, Bruno; Kuznetsov, Sergei O; Le Goff, Jérémie; Napoli, Amedeo; Bureau, Ronan; Cuissart, Bertrand

    2015-05-26

    This study is dedicated to the introduction of a novel method that automatically extracts potential structural alerts from a data set of molecules. These triggering structures can be further used for knowledge discovery and classification purposes. Computation of the structural alerts results from an implementation of a sophisticated workflow that integrates a graph mining tool guided by growth rate and stability. The growth rate is a well-established measurement of contrast between classes. Moreover, the extracted patterns correspond to formal concepts; the most robust patterns, named the stable emerging patterns (SEPs), can then be identified thanks to their stability, a new notion originating from the domain of formal concept analysis. All of these elements are explained in the paper from the point of view of computation. The method was applied to a molecular data set on mutagenicity. The experimental results demonstrate its efficiency: it automatically outputs a manageable number of structural patterns that are strongly related to mutagenicity. Moreover, a part of the resulting structures corresponds to already known structural alerts. Finally, an in-depth chemical analysis relying on these structures demonstrates how the method can initiate promising processes of chemical knowledge discovery.

  7. Patterns in emergency-department arrivals and length of stay: Input for visualizations of crowding

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2016-01-01

    Crowding is common in emergency departments (EDs) and increases the risk of medical errors, patient dissatisfaction, and clinician stress. The aim of this study is to investigate patterns in patient visits and bottlenecks in ED work in order to discuss the prospects of visualizing such patterns...... to help manage crowding. We analyze two years of data from a Danish ED for patterns in the patient visits and interview six clinicians from the ED about bottlenecks in their work. The hour of the day explains 50% of the variance in the number of patient arrivals. In addition, there are weekly and yearly...... factors important to the evolving balance between the demand for ED services and the available resources. Visualization of the patterns, thus, appears a promising tool in managing ED crowding. However, visualizations presuppose reliable data and are expected by the clinicians to be accurate and prognostic...

  8. Patterns in emergency-department arrivals and length of stay: Input for visualizations of crowding

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2016-01-01

    Crowding is common in emergency departments (EDs) and increases the risk of medical errors, patient dissatisfaction, and clinician stress. The aim of this study is to investigate patterns in patient visits and bottlenecks in ED work in order to discuss the prospects of visualizing such patterns...... to help manage crowding. We analyze two years of data from a Danish ED for patterns in the patient visits and interview six clinicians from the ED about bottlenecks in their work. The hour of the day explains 50% of the variance in the number of patient arrivals. In addition, there are weekly and yearly...... patterns in patient arrivals. With respect to the flow of patients through the ED, length of stay increases from low to medium triage levels and then decreases from medium to high triage levels. Also, length of stay increases with patient age. The bottlenecks in the work in the ED relate to patient input...

  9. Risk communications and the Chemical Stockpile Emergency-Planning Program

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, B.M.; Sorensen, J.H.

    1994-09-01

    The CSEPP (Chemical Stockpile Emergency Preparedness Program) was created to improve emergency planning and response capabilities at the eight sites around the country that store chemical weapons. These weapons are scheduled to be destroyed in the near future. In preparation of the Draft Programmatic Environmental Impact Statement (DPEIS) for the Chemical Stockpile Disposal Program (CSDP), it was proposed that the Army mitigate accidents through an enhanced community emergency preparedness program at the eight storage sites. In 1986, the Army initiated the development of an Emergency Response Concept Plan (ERCP) for the CSDP, one of 12 technical support studies conducted during preparation of the Final Programmatic Environmental Impact Statement (FPEIS). The purpose of this document is to provide a fairly comprehensive source book on risk, risk management, risk communication research and recommended risk communication practices. It does not merely summarize each publication in the risk communication literature, but attempts to synthesize them along the lines of a set of organizing principles. Furthermore, it is not intended to duplicate other guidance manuals (such as Covello et al.`s manual on risk comparison). The source book was developed for the CSEPP in support of the training module on risk communications. Although the examples provided are specific to CSEPP, its use goes beyond that of CSEPP as the findings apply to a broad spectrum of risk communication topics. While the emphasis is on communication in emergency preparedness and response specific to the CSEPP, the materials cover other non-emergency communication settings. 329 refs.

  10. Emergence of river dynamics through changing vegetation patterns

    Science.gov (United States)

    van Oorschot, Mijke; Kleinhans, Maarten; Middelkoop, Hans; Geerling, Gertjan

    2016-04-01

    Riparian vegetation interacts with morphodynamic processes in rivers to create distinct habitat mosaics supporting a large biodiversity. The aim of our work is to quantitatively investigate the emergent patterns in vegetation and river morphology at the river reach scale by dynamically modelling the processes and their interactions. Here, we coupled an advanced morphodynamic model to a novel dynamic riparian vegetation model to study the interaction between vegetation and morphodynamics. Vegetation colonizes bare substrate within the seed dispersal window, passes several growth stages with different properties and can die through flooding, desiccation, uprooting, scour or burial. We have compared river morphology and vegetation patterns of scenarios without vegetation, with static vegetation that does not grow or die and several dynamic vegetation scenarios with a range of vegetation strategies and eco-engineering properties. Results show that dynamic vegetation has a decreased lateral migration of meander bends and maintains its active meandering behavior as opposed to the scenarios without vegetation and with static vegetation. Also the patterns in vegetation and fluvial morphology and the vegetation age distribution mostly resemble the natural situation when compared to aerial photos of the study area. We find that river dynamics, specifically sinuosity and sediment transport, are very sensitive to vegetation properties that determine vegetation density, settlement location and survival. Future work will include the effects of invasive species, addition of silt and the effect of various river management strategies.

  11. Utilization Patterns at a Specialized Children's Comprehensive Psychiatric Emergency Program.

    Science.gov (United States)

    Gerson, Ruth; Havens, Jennifer; Marr, Mollie; Storfer-Isser, Amy; Lee, Mia; Rojas Marcos, Carolena; Liu, Michelle; Horwitz, Sarah McCue

    2017-06-15

    Most youths experiencing a psychiatric crisis present to emergency departments (EDs) that lack the specialized staff to evaluate them, so youths are often discharged without appropriate mental health assessment or treatment. To better understand the needs of this population, this study described clinical details and disposition associated with visits for psychiatric emergencies to a specialized ED staffed 24/7 by child psychiatrists. Through retrospective chart review, 1,180 visits to the ED during its first year of operation were reviewed for clinical characteristics, prior service utilization, and demographic characteristics. Bivariate analyses (chi-square test and Wilcoxon rank sum test) compared differences in disposition (evaluate and release, brief stabilization, and inpatient psychiatric admission) associated with characteristics of the children's first visit (N=885). Measures with bivariate association of p<.10 were further assessed by using multinomial logistic regression analyses. For most visits (59%), children were evaluated and released, 13% were briefly stabilized, and 28% were admitted for psychiatric treatment. Youths with mood or psychotic disorders were more likely to be admitted, as were those with current suicidality or aggression. Many youths who presented with aggression were also identified as having suicidality or self-harm. Clinical factors, especially suicidality, predicted psychiatric admission. Admission rates for youths with suicidality were significantly higher in this study than previously reported, suggesting the availability of child psychiatrists in this ED allowed greater ascertainment of suicide risk (and thus hospitalization to mitigate that risk) than occurs in EDs without such staffing.

  12. Cercarial emergence pattern of Schistosoma haematobium from Libreville, Gabon

    Directory of Open Access Journals (Sweden)

    Mintsa-Nguéma Rodrigue

    2014-01-01

    Full Text Available Although schistosomiasis has been a public health issue in Gabon for nearly a century, little is known about its current transmission dynamics. We analyzed the chronobiology of 137 cercarial emission profiles of Schistosoma haematobium from Libreville, the capital of Gabon, located in an open area for schistosomiasis. We found that 88% of the cercariae were shed between 11 a.m. and 3 p.m. and that the average pattern was of circadian type, with the average peak at 1 p.m., and representing 27% of the total number of cercariae of the day. The rhythms of emergence may be associated with environmental pressures on the parasite, especially those related to their definitive hosts.

  13. Cercarial emergence pattern of Schistosoma haematobium from Libreville, Gabon.

    Science.gov (United States)

    Mintsa-Nguéma, Rodrigue; Moné, Hélène; Ibikounlé, Moudachirou; Mengué-Ngou-Milama, Krystina; Kombila, Maryvonne; Mouahid, Gabriel

    2014-01-01

    Although schistosomiasis has been a public health issue in Gabon for nearly a century, little is known about its current transmission dynamics. We analyzed the chronobiology of 137 cercarial emission profiles of Schistosoma haematobium from Libreville, the capital of Gabon, located in an open area for schistosomiasis. We found that 88% of the cercariae were shed between 11 a.m. and 3 p.m. and that the average pattern was of circadian type, with the average peak at 1 p.m., and representing 27% of the total number of cercariae of the day. The rhythms of emergence may be associated with environmental pressures on the parasite, especially those related to their definitive hosts.

  14. Predicting risk and the emergence of schizophrenia.

    LENUS (Irish Health Repository)

    Clarke, Mary C

    2012-09-01

    This article gives an overview of genetic and environmental risk factors for schizophrenia. The presence of certain molecular, biological, and psychosocial factors at certain points in the life span, has been linked to later development of schizophrenia. All need to be considered in the context of schizophrenia as a lifelong brain disorder. Research interest in schizophrenia is shifting to late childhood\\/early adolescence for screening and preventative measures. This article discusses those environmental risk factors for schizophrenia for which there is the largest evidence base.

  15. International Collaboration Patterns and Effecting Factors of Emerging Technologies

    Science.gov (United States)

    Bai, Xu; Liu, Yun

    2016-01-01

    With the globalization of the world economy, international innovation collaboration has taken place all over the world. This study selects three emerging technologies (3D printing, big data and carbon nanotubes and graphene technology) among 20 countries as the research objects, using three patent-based indicators and network relationship analysis to reflect international collaboration patterns. Then we integrate empirical analyses to show effecting factors of international collaboration degrees by using panel data. The results indicate that while 3D printing technology is associated with a “balanced collaboration” mode, big data technology is more accurately described by a radial pattern, centered on the United States, and carbon nanotubes and graphene technology exhibits “small-world” characteristics in this respect. It also shows that the factors GDP per capita (GPC), R&D expenditure (RDE) and the export of global trade value (ETV) negatively affect the level of international collaboration. It could be useful for China and other developing countries to make international scientific and technological collaboration strategies and policies in the future. PMID:27911926

  16. A Person-Centered Analysis of Risk Factors that Compromise Wellbeing in Emerging Adulthood.

    Science.gov (United States)

    Newcomb-Anjo, Sarah E; Barker, Erin T; Howard, Andrea L

    2016-11-08

    The transition to adulthood is a major life course transition that can pose risk to wellbeing. Research is needed to identify patterns of risk for compromised wellbeing, in order to best identify supports for individuals during this potentially vulnerable transition. The purpose of this study was to identify profiles of risk in an emerging adulthood sample, and to relate these profiles to mental health and subjective and academic wellbeing. Undergraduate emerging adults (N = 903, 82 % female), aged 18-25 years (M = 21.14, SD = 1.75), completed a series of questionnaires about risk factors, mental health, and academic variables. Results from a latent profile analysis identified four distinct risk profiles: Low Risk (76 %), Low Social Support Risk (4 %), Financial Risk (11 %), and Multiple Risk (8 %). The risk profiles were subsequently related to mental health and subjective and academic wellbeing outcomes, using a pseudo-class draws approach. Analyses indicated that the risk-pattern profiles differed in several ways across outcomes. Implications for targeted interventions are discussed.

  17. Planetary boundaries: Governing emerging risks and opportunities

    OpenAIRE

    2016-01-01

    The climate, ecosystems and species, ozone layer, acidity of the oceans, the flow of energy and elements through nature, landscape change, freshwater systems, aerosols, and toxins—these constitute the planetary boundaries within which humanity must find a safe way to live and prosper. These are thresholds that, if we cross them, we run the risk of rapid, non-linear, and irreversible changes to the environment, with severe consequences for human wellbeing. The concept of planetary boundaries, ...

  18. Cardiovascular Disease Risk Factors among Emerging Adults in College

    Science.gov (United States)

    Abshire, Demetrius Alexander

    2014-01-01

    The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

  19. Quantitative risk analysis as a basis for emergency planning

    Energy Technology Data Exchange (ETDEWEB)

    Yogui, Regiane Tiemi Teruya [Bureau Veritas do Brasil, Rio de Janeiro, RJ (Brazil); Macedo, Eduardo Soares de [Instituto de Pesquisas Tecnologicas (IPT), Sao Paulo, SP (Brazil)

    2009-07-01

    Several environmental accidents happened in Brazil and in the world during the 70's and 80's. This strongly motivated the preparation for emergencies in the chemical and petrochemical industries. Environmental accidents affect the environment and the communities that are neighbor to the industrial facilities. The present study aims at subsidizing and providing orientation to develop Emergency Planning from the data obtained on Quantitative Risk Analysis, elaborated according to the Technical Standard P4.261/03 from CETESB (Sao Paulo Environmental Agency). It was observed, during the development of the research, that the data generated on these studies need a complementation and a deeper analysis, so that it is possible to use them on the Emergency Plans. The main issues that were analyzed and discussed on this study were the reevaluation of hazard identification for the emergency plans, the consequences and vulnerability analysis for the response planning, the risk communication, and the preparation to respond to the emergencies of the communities exposed to manageable risks. As a result, the study intends to improve the interpretation and use of the data deriving from the Quantitative Risk Analysis to develop the emergency plans. (author)

  20. Dietary patterns and breast cancer risk among women

    National Research Council Canada - National Science Library

    Karimi, Zeinab; Jessri, Mahsa; Houshiar-Rad, Anahita; Mirzaei, Hamid-Reza; Rashidkhani, Bahram

    2014-01-01

    ... pathogenesis but fewer investigations have addressed the role of dietary patterns. Our main objective was to identify the relationship between major dietary patterns and breast cancer risk among Iranian women...

  1. Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction.

    Science.gov (United States)

    Hanna, Tarek N; Shekhani, Haris; Lamoureux, Christine; Mar, Hanna; Nicola, Refky; Sliker, Clint; Johnson, Jamlik-Omari

    2017-03-01

    To assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. A survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. Response rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with patterns. Annual NS burden is associated with lower job satisfaction and negative health self-perception. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Nanotechnology, risk, and oversight: learning lessons from related emerging technologies.

    Science.gov (United States)

    Kuzma, Jennifer; Priest, Susanna

    2010-11-01

    Emerging technologies are defined by their novelty and thus are accompanied by significant uncertainty in determining appropriate ways to manage risks associated with them. Yet, there is a body of prior knowledge about risk management and oversight policy for other technologies that have already permeated society. Here, we describe two ways in which prospective oversight policy analysis for emerging technologies can draw upon these past experiences. One involves comparing specific products that have already been marketed to similar products of the emerging technology (cognate-product approach). The other treats the emerging technology as a body of products and methods and relates it to another technological field that has already emerged and penetrated markets (whole-technology approach). In this article, we describe our work using these approaches to inform risk and oversight policy for nanotechnology and its products. We draw parallels between biotechnology and nanotechnology as whole fields of development and also between genetically engineered organisms in the food supply and agricultural products of nanotechnology. Through these comparisons, we find that both approaches to historical learning have value and present lessons that could be applied to nanotechnology. © 2010 Society for Risk Analysis.

  3. Dietary consumption patterns and laryngeal cancer risk.

    Science.gov (United States)

    Vlastarakos, Petros V; Vassileiou, Andrianna; Delicha, Evie; Kikidis, Dimitrios; Protopapas, Dimosthenis; Nikolopoulos, Thomas P

    2016-06-01

    intake of riboflavin (p = 0.045). We conclude that the differences in dietary consumption patterns between LC patients and controls indicate a possible role for lifestyle modifications involving nutritional factors as a means of decreasing the risk of laryngeal cancer.

  4. Operational Mechanism and Evaluation System for Emergency Logistics Risks

    Directory of Open Access Journals (Sweden)

    Qi Cheng

    2010-12-01

    Full Text Available Lots of risks existed in the operating process of emergency logistics especially when natural disasters happened. Both operating mechanism and evaluation system research on Emergency Logistics Risks (ELR are the basis of effective recognizing, preventing and responding to risks, so it’s of great theoretical and practical significance to study the formation and influence mechanism and to establish an evaluating index system for ELR. Firstly, some foundation research about ELR was carried out, including definition, characteristics and classification of ELR. The formation and influence mechanism of ELR were discussed. The research of questionnaire survey offered an objective support for theoretical mechanism and index system establishment. Then, the evaluating index system for ELR was established. This system was a multi-level index system, and mainly evaluated by the decision-making risk, dispatching and commanding risk, organizing and coordinating risk, executing and controlling risk, resources supporting risk and their sub index. The establishment principles and significance of the index system were discussed. Then, the fuzzy comprehensive evaluation and Delphi method were used to confirm the index weight and value. Finally, a case analysis on ELR of Yushu earthquake was conducted to demonstrate the evaluating index system and to evaluate the actual risk level.

  5. Patterns and emerging trends in global ocean health.

    Directory of Open Access Journals (Sweden)

    Benjamin S Halpern

    Full Text Available International and regional policies aimed at managing ocean ecosystem health need quantitative and comprehensive indices to synthesize information from a variety of sources, consistently measure progress, and communicate with key constituencies and the public. Here we present the second annual global assessment of the Ocean Health Index, reporting current scores and annual changes since 2012, recalculated using updated methods and data based on the best available science, for 221 coastal countries and territories. The Index measures performance of ten societal goals for healthy oceans on a quantitative scale of increasing health from 0 to 100, and combines these scores into a single Index score, for each country and globally. The global Index score improved one point (from 67 to 68, while many country-level Index and goal scores had larger changes. Per-country Index scores ranged from 41-95 and, on average, improved by 0.06 points (range -8 to +12. Globally, average scores increased for individual goals by as much as 6.5 points (coastal economies and decreased by as much as 1.2 points (natural products. Annual updates of the Index, even when not all input data have been updated, provide valuable information to scientists, policy makers, and resource managers because patterns and trends can emerge from the data that have been updated. Changes of even a few points indicate potential successes (when scores increase that merit recognition, or concerns (when scores decrease that may require mitigative action, with changes of more than 10-20 points representing large shifts that deserve greater attention. Goal scores showed remarkably little covariance across regions, indicating low redundancy in the Index, such that each goal delivers information about a different facet of ocean health. Together these scores provide a snapshot of global ocean health and suggest where countries have made progress and where a need for further improvement exists.

  6. Do helmets worn for hurling fail to protect the ear? Identification of an emerging injury pattern.

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2012-12-01

    Hurling is an Irish national game of stick and ball known for its ferocity, played by 190 000 players. Facial injuries were common but have been significantly reduced by legislation enforcing compulsory helmet wearing. Current standard helmets worn by hurlers do not offer protection to the external ear. Here we describe an emerging pattern of ear injuries and demonstrate the risk of external ear injuries in hurlers complying with current helmet safety standards. A 6-month retrospective analysis was carried out of patients attending Cork University Hospital (CUH) with ear lacerations sustained while hurling. Patient notes were reviewed and helmet manufacturers were interviewed. Seven patients were identified, all of whom sustained complex through ear lacerations while wearing helmets complying with current safety standards. Current helmet design fails to protect the external ear placing it at an increased risk of injury, a potential solution is to include ear protection in the helmet design.

  7. Dietary patterns and breast cancer risk: Results from three cohort studies in the DIETSCAN project

    NARCIS (Netherlands)

    Männistö, S.; Dixon, L.B.; Balder, H.F.; Virtanen, M.J.; Krogh, V.; Khani, B.R.; Berrino, F.; Brandt, P.A. van den; Hartman, A.M.; Pietinen, P.; Tan, F.; Wolk, A.; Goldbohm, R.A.

    2005-01-01

    Objective: Only a few consistent findings on individual foods or nutrients that influence breast cancer risk have emerged thus far. Since people do not consume individual foods but certain combinations of them, the analysis of dietary patterns may offer an additional aspect for assessing

  8. Dietary patterns and breast cancer risk: Results from three cohort studies in the DIETSCAN project

    NARCIS (Netherlands)

    Männistö, S.; Dixon, L.B.; Balder, H.F.; Virtanen, M.J.; Krogh, V.; Khani, B.R.; Berrino, F.; Brandt, P.A. van den; Hartman, A.M.; Pietinen, P.; Tan, F.; Wolk, A.; Goldbohm, R.A.

    2005-01-01

    Objective: Only a few consistent findings on individual foods or nutrients that influence breast cancer risk have emerged thus far. Since people do not consume individual foods but certain combinations of them, the analysis of dietary patterns may offer an additional aspect for assessing association

  9. Emergent Patterns of Social Affiliation in Primates, a Model

    NARCIS (Netherlands)

    Puga-Gonzalez, Ivan; Hildenbrandt, Hanno; Hemelrijk, Charlotte K.

    2009-01-01

    Many patterns of affiliative behaviour have been described for primates, for instance: reciprocation and exchange of grooming, grooming others of similar rank, reconciliation of fights, and preferential reconciliation with more valuable partners. For these patterns several functions and underlying c

  10. Value investing in emerging markets : local macroeconomic risk and extrapolation

    NARCIS (Netherlands)

    Kouwenberg, R.; Salomons, R.M.

    2003-01-01

    Our results confirm the profitability of value investing at the country level in emerging markets. A portfolio of countries with low price-to-book ratios significantly outperforms a portfolio of high price-to-book countries. Global risk factors cannot explain this outperformance. Next we measure a n

  11. Emerging Risk Identification Support : Preparing for present and future hazards

    NARCIS (Netherlands)

    Zandvoort, M.M.J. van

    2013-01-01

    Food and feed companies need to be well-prepared for hazards resulting from their products and production processes. TNO has developed a unique Emerging Risk Identification Support service (ERIS ) that identifies new and unexpected hazards and helps stakeholders make well-considered decisions at an

  12. Emerging Risk Identification Support : Preparing for present and future hazards

    NARCIS (Netherlands)

    Zandvoort, M.M.J. van

    2013-01-01

    Food and feed companies need to be well-prepared for hazards resulting from their products and production processes. TNO has developed a unique Emerging Risk Identification Support service (ERIS ) that identifies new and unexpected hazards and helps stakeholders make well-considered decisions at an

  13. Value investing in emerging markets : local macroeconomic risk and extrapolation

    NARCIS (Netherlands)

    Kouwenberg, R.; Salomons, R.M.

    2003-01-01

    Our results confirm the profitability of value investing at the country level in emerging markets. A portfolio of countries with low price-to-book ratios significantly outperforms a portfolio of high price-to-book countries. Global risk factors cannot explain this outperformance. Next we measure a

  14. Seven Risks Emerging from Life Patents and Corporate Science

    Science.gov (United States)

    Ekberg, Merryn

    2005-01-01

    This article examines some of the controversial issues emerging from the privatization of biomedical research and commercialization of biotechnology. The aim is to identify the dominant social, political, and ethical risks associated with the recent shift from academic to corporate science and from the increasing emphasis on investing in research…

  15. Seven Risks Emerging from Life Patents and Corporate Science

    Science.gov (United States)

    Ekberg, Merryn

    2005-01-01

    This article examines some of the controversial issues emerging from the privatization of biomedical research and commercialization of biotechnology. The aim is to identify the dominant social, political, and ethical risks associated with the recent shift from academic to corporate science and from the increasing emphasis on investing in research…

  16. Perception of nurses regarding risk classification in emergency care units

    Directory of Open Access Journals (Sweden)

    Carmen Lúcia Mottin Duro

    2014-09-01

    Full Text Available This study aimed to assess nurses’ perception regarding the risk classification in emergency care units. It is a descriptive study that used a qualitative approach and that was conducted with 55 nurses from emergency care units in the south of Brazil. Data were collected between July and October, 2011, through open questions, answered in writing. The data collected were submitted to the thematic analysis technique. Results indicate that the risk classification contributes to the organization of the service flow provided to patients, intervening in severe cases and preventing sequelae. Difficulties were described, such as: inadequate physical installations, overcrowding, disagreement in the definition of priorities among doctors and nurses and lack of articulation between the emergency care network and basic health care. It is highlighted the need to improve the physical structure, the quantity of human resources and the implementation of public policies to overcome these challenges.

  17. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome

    Directory of Open Access Journals (Sweden)

    Lovina S.M. Machado

    2011-01-01

    Full Text Available Background: Peripartum hysterectomy is a major operation and is invariably performed in the presence of life threatening hemorrhage during or immediately after abdominal or vaginal deliveries. Material and Methods: A Medline search was conducted to review the recent relevant articles in English literature on emergency peripartum hysterectomy. The incidence, indications, risk factors and outcome of emergency peripartum hysterectomy were reviewed. Results: The incidence of emergency peripartum hysterectomy ranged from 0.24 to 8.7 per 1000 deliveries. Emergency peripartum hysterectomy was found to be more common following cesarean section than vaginal deliveries. The predominant indication for emergency peripartum hysterectomy was abnormal placentation (placenta previa/accreta which was noted in 45 to 73.3%, uterine atony in 20.6 to 43% and uterine rupture in 11.4 to 45.5 %. The risk factors included previous cesarean section, scarred uterus, multiparity, older age group. The maternal morbidity ranged from 26.5 to 31.5% and the mortality from 0 to 12.5% with a mean of 4.8%. The decision of performing total or subtotal hysterectomy was influenced by the patient′s condition. Conclusion: Emergency peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. Antenatal anticipation of the risk factors, involvement of an experienced obstetrician at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in reducing morbidity and mortality.

  18. Do common waterhemp (Amaranthus rudis) seedling emergence patterns meet criteria for herbicide resistance simulation modeling?

    Science.gov (United States)

    A study was conducted to quantify the magnitude of, and sources of variation in, common waterhemp temporal patterns of emergence over 1 yr. In 2008 and 2010, emergence patterns in the absence of soil disturbance were determined for replicated samples of maternal families (progeny from one individua...

  19. Dietary Patterns and Pancreatic Cancer Risk: A Meta-Analysis.

    Science.gov (United States)

    Lu, Pei-Ying; Shu, Long; Shen, Shan-Shan; Chen, Xu-Jiao; Zhang, Xiao-Yan

    2017-01-05

    A number of studies have examined the associations between dietary patterns and pancreatic cancer risk, but the findings have been inconclusive. Herein, we conducted this meta-analysis to assess the associations between dietary patterns and the risk of pancreatic cancer. MEDLINE (provided by the National Library of Medicine) and EBSCO (Elton B. Stephens Company) databases were searched for relevant articles published up to May 2016 that identified common dietary patterns. Thirty-two studies met the inclusion criteria and were finally included in this meta-analysis. A reduced risk of pancreatic cancer was shown for the highest compared with the lowest categories of healthy patterns (odds ratio, OR = 0.86; 95% confidence interval, CI: 0.77-0.95; p = 0.004) and light-moderate drinking patterns (OR = 0.90; 95% CI: 0.83-0.98; p = 0.02). There was evidence of an increased risk for pancreatic cancer in the highest compared with the lowest categories of western-type pattern (OR = 1.24; 95% CI: 1.06-1.45; p = 0.008) and heavy drinking pattern (OR = 1.29; 95% CI: 1.10-1.48; p = 0.002). The results of this meta-analysis demonstrate that healthy and light-moderate drinking patterns may decrease the risk of pancreatic cancer, whereas western-type and heavy drinking patterns may increase the risk of pancreatic cancer. Additional prospective studies are needed to confirm these findings.

  20. Exploring patterns of health service use in older emergency department patients.

    Science.gov (United States)

    Hastings, S Nicole; Horney, Carolyn; Landerman, Lawrence R; Sanders, Linda L; Hocker, Michael B; Schmader, Kenneth E

    2010-10-01

    Study objectives were to identify groups of older patients with similar patterns of health care use in the 12 months preceding an index outpatient emergency department (ED) visit and to identify patient-level predictors of group membership.   Subjects were adults ≥ 65 years of age treated and released from an academic medical center ED. Latent cluster analysis (LCA) models were estimated to identify groups with similar numbers of primary care (PC), specialist, and outpatient ED visits and hospital days within 12 months preceding the index ED visit.   In this sample (n = 308), five groups with distinct patterns of health service use emerged. Low Users (35%) had fewer visits of all types and fewer hospital days compared to sample means. Low Users were more likely to be female and had fewer chronic health conditions relative to the overall sample (p < 0.05). The ED to Supplement Primary Care Provider (PCP) (23%) group had more PCP visits, but also significantly more ED visits. Specialist Heavy (22%) group members had twice as many specialist visits, but no difference in PCP visits. Members of this class were more likely to be white and male (p < 0.05). High Users (15%) received more care in all categories and had more chronic baseline health conditions (p < 0.05) but no differences in demographic characteristics relative to the whole sample. The ED and Hospital as Substitution Care (6%) group had fewer PC and specialist visits, but more ED visits and hospital days.   In this sample of older ED patients, five groups with distinct patterns of health service use were identified. Further study is needed to determine whether identification of these patient groups can add important information to existing risk-assessment methods. © 2010 by the Society for Academic Emergency Medicine.

  1. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours......, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. RESULTS: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use...

  2. Emergence of Strange Spatial Pattern in a Spatial Epidemic Model

    Institute of Scientific and Technical Information of China (English)

    SUN Gui-Quan; JIN Zhen; LIU Quan-Xing; LI Li

    2008-01-01

    Pattern formation of a spatial epidemic model with nonlinear incidence rate kI2 S/ (1 + αI2) is investigated. Our results show that strange spatial dynamics, i.e., filament-like pattern, can be obtained by both mathematical analysis and numerical simulation, which are different from the previous results in the spatial epidemic model such as stripe-like or spotted or coexistence of both pattern and so on. The obtained results well extend the finding of pattern formation in the epidemic model and may well explain the distribution of the infected of some epidemic.

  3. Pattern of atrial fibrillation and risk of outcomes

    DEFF Research Database (Denmark)

    Banerjee, Amitava; Taillandier, Sophie; Olesen, Jonas Bjerring;

    2012-01-01

    BACKGROUND: Risk of stroke and thromboembolism (TE) in patients with non-valvular atrial fibrillation (NVAF) is categorised in stroke risk stratification scores. The role of pattern of NVAF in risk prediction is unclear in contemporary 'real world' cohorts. METHODS AND RESULTS: Patients with NVAF...

  4. Mediterranean dietary pattern and cancer risk in the EPIC cohort

    NARCIS (Netherlands)

    Couto, E.; Boffetta, P.; Lagiou, P.; Ferrari, P.; Buckland, G.; Overvad, K.; Dahm, C. C.; Tjonneland, A.; Olsen, A.; Clavel-Chapelon, F.; Boutron-Ruault, M-C; Cottet, V.; Trichopoulos, D.; Naska, A.; Benetou, V.; Kaaks, R.; Rohrmann, S.; Boeing, H.; von Ruesten, A.; Panico, S.; Pala, V.; Vineis, P.; Palli, D.; Tumino, R.; May, A.; Peeters, P. H.; Bueno-de-Mesquita, H. B.; Buchner, F. L.; Lund, E.; Skeie, G.; Engeset, D.; Gonzalez, C. A.; Navarro, C.; Rodriguez, L.; Sanchez, M-J; Amiano, P.; Barricarte, A.; Hallmans, G.; Johansson, I.; Manjer, J.; Wirfart, E.; Allen, N. E.; Crowe, F.; Khaw, K-T; Wareham, N.; Moskal, A.; Slimani, N.; Jenab, M.; Romaguera, D.; Mouw, T.; Norat, T.; Riboli, E.; Trichopoulou, A.

    2011-01-01

    BACKGROUND: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse. METHODS: We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk

  5. Emergent patterns of social affiliation in primates, a model.

    Directory of Open Access Journals (Sweden)

    Ivan Puga-Gonzalez

    2009-12-01

    Full Text Available Many patterns of affiliative behaviour have been described for primates, for instance: reciprocation and exchange of grooming, grooming others of similar rank, reconciliation of fights, and preferential reconciliation with more valuable partners. For these patterns several functions and underlying cognitive processes have been suggested. It is, however, difficult to imagine how animals may combine these diverse considerations in their mind. Although the co-variation hypothesis, by limiting the social possibilities an individual has, constrains the number of cognitive considerations an individual has to take, it does not present an integrated theory of affiliative patterns either. In the present paper, after surveying patterns of affiliation in egalitarian and despotic macaques, we use an individual-based model with a high potential for self-organisation as a starting point for such an integrative approach. In our model, called GrooFiWorld, individuals group and, upon meeting each other, may perform a dominance interaction of which the outcomes of winning and losing are self-reinforcing. Besides, if individuals think they will be defeated, they consider grooming others. Here, the greater their anxiety is, the greater their "motivation" to groom others. Our model generates patterns similar to many affiliative patterns of empirical data. By merely increasing the intensity of aggression, affiliative patterns in the model change from those resembling egalitarian macaques to those resembling despotic ones. Our model produces such patterns without assuming in the mind of the individual the specific cognitive processes that are usually thought to underlie these patterns (such as recordkeeping of the acts given and received, a tendency to exchange, memory of the former fight, selective attraction to the former opponent, and estimation of the value of a relationship. Our model can be used as a null model to increase our understanding of affiliative

  6. Assessing Risk in Chemical Plant with Pattern Matching

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This paper discusses potential application of fuzzy set theory, more specifically, pattern matching, in assessing risk in chemical plants. Risk factors have been evaluated using linguistic representations of the quantity of the hazardous substance involved, its frequency of interaction with the environment, severity of its impact and the uncertainty involved in its detection in advance. For each linguistic value there is a corresponding membership function ranging over a universe of discourse. The risk scenario created by a hazard/hazardous situation having highest degree of featural value is taken as the known pattern. Each sample pattern of hazard/hazardous situation with their known featural values is then matched with the known pattern. The concept of multifeature pattern matching based on fuzzy logic is used to derive the rank ordering of process hazards. In multifeature pattern recognition/matching, a sample pattern is compared to a number of known data patterns or a known pattern is compared to a number of sample data patterns. The process assesses which known pattern resembles most closely data sample using Wang's approaching degree method. A methodology has been developed and the same has been exemplified by presenting a case example with a limited number of hazards.

  7. Nonsuicidal Self-Injury and Suicidal Risk Among Emerging Adults.

    Science.gov (United States)

    Hamza, Chloe A; Willoughby, Teena

    2016-10-01

    Although nonsuicidal self-injury (NSSI) has been differentiated from suicidal behavior on the basis of nonlethal intent in the Diagnostic and Statistical Manual of Mental Disorders, NSSI often is associated with increased suicidal risk. However, there is a paucity of large-scale longitudinal examinations on the associations among NSSI, suicidal ideation, and suicidal attempts, particularly among community-based samples. In the present study, we examined whether NSSI in first-year university was associated with increased risk for later suicidal ideation and attempts over time among students. Participants included 940 emerging adults (70.8% female, mean age = 19.05 years) from a mid-sized Canadian university who volunteered to participate in a longitudinal research project starting in first-year university (participants were surveyed annually over five waves). Binary logistic regression analyses revealed that the odds of experiencing suicidal ideation across times 2-5 were 2.04 times as high for emerging adults who engaged in NSSI at baseline (even after controlling for suicidal ideation and attempts at baseline) as for individuals who did not engage in NSSI. Furthermore, the odds of attempting suicide across times 2-5 were 3.46 times as high for emerging adults who engaged in NSSI at baseline (even after controlling for suicidal ideation and attempts at baseline) as for individuals who did not engage in NSSI. Findings suggest that the presence of NSSI in first-year university may be an important marker of later suicidal risk, reflecting increased risk for both suicidal ideation and attempts across the university years among emerging adults. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Emerging Comorbidities in Adult Asthma: Risks, Clinical Associations, and Mechanisms

    OpenAIRE

    2016-01-01

    Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Most studies with asthma have been performed in patients being otherwise healthy. However, in real life, comorbid diseases are very common in adult patients. We review here the emerging comorbid conditions to asthma such as obesity, metabolic syndrome, diabetes mellitus type 2 (DM2), and cardiac and psychiatric diseases. Their role as risk factors for incident ...

  9. Emerging Patterns in MOOCs: Learners, Course Designs and Directions

    Science.gov (United States)

    Macleod, Hamish; Haywood, Jeff; Woodgate, Amy; Alkhatnai, Mubarak

    2015-01-01

    Engagement with Massive Open Online Courses (MOOCs) at the University of Edinburgh has emerged from its strategic priorities to explore and innovate in the area of online and technologically supported approaches to teaching and learning. This paper provides an account of analysis aimed at understanding who Edinburgh MOOC learners are, who elects…

  10. Pattern and outcome of postneonatal pediatric emergencies in ...

    African Journals Online (AJOL)

    2014-11-02

    Nov 2, 2014 ... outcome of the disease in children seen in the emergency room of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Materials and .... Most traumatic injuries are however managed in a separate ... using appropriate statistical tests like the Chi‑square to test ..... Healthcare Cost and Utilization Project.

  11. Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

    Science.gov (United States)

    Upadhyay, Ravi Kant

    2015-01-01

    Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future. PMID:25949827

  12. Emerging patterns for engineered nanomaterials in the environment: a review of fate and toxicity studies

    Science.gov (United States)

    Garner, Kendra L.; Keller, Arturo A.

    2014-08-01

    A comprehensive assessment of the environmental risks posed by engineered nanomaterials (ENMs) entering the environment is necessary, due in part to the recent predictions of ENM release quantities and because ENMs have been identified in waste leachate. The technical complexity of measuring ENM fate and transport processes in all environments necessitates identifying trends in ENM processes. Emerging information on the environmental fate and toxicity of many ENMs was collected to provide a better understanding of their environmental implications. Little research has been conducted on the fate of ENMs in the atmosphere; however, most studies indicate that ENMs will in general have limited transport in the atmosphere due to rapid settling. Studies of ENM fate in realistic aquatic media indicates that in general, ENMs are more stable in freshwater and stormwater than in seawater or groundwater, suggesting that transport may be higher in freshwater than in seawater. ENMs in saline waters generally sediment out over the course of hours to days, leading to likely accumulation in sediments. Dissolution is significant for specific ENMs (e.g., Ag, ZnO, copper ENMs, nano zero-valent iron), which can result in their transformation from nanoparticles to ions, but the metal ions pose their own toxicity concerns. In soil, the fate of ENMs is strongly dependent on the size of the ENM aggregates, groundwater chemistry, as well as the pore size and soil particle size. Most groundwater studies have focused on unfavorable deposition conditions, but that is unlikely to be the case in many natural groundwaters with significant ionic strength due to hardness or salinity. While much still needs to be better understood, emerging patterns with regards to ENM fate, transport, and exposure combined with emerging information on toxicity indicate that risk is low for most ENMs, though current exposure estimates compared with current data on toxicity indicates that at current production and

  13. Risk perception, experience, and objective risk: a cross-national study with European emergency survivors.

    Science.gov (United States)

    Knuth, Daniela; Kehl, Doris; Hulse, Lynn; Schmidt, Silke

    2014-07-01

    Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.

  14. Is a sustainable consumption pattern gradually emerging in Germany?

    DEFF Research Database (Denmark)

    Thøgersen, John

    This paper analyses the possible spreading of environmentally friendly behaviours to more and more areas of the consumption pattern as well as possible conditions for such a tendency. The conditions in focus are individuals' possession of certain attitudes or values and the degree to which product...

  15. Dietary Patterns and Pancreatic Cancer Risk: A Meta-Analysis

    Science.gov (United States)

    Lu, Pei-Ying; Shu, Long; Shen, Shan-Shan; Chen, Xu-Jiao; Zhang, Xiao-Yan

    2017-01-01

    A number of studies have examined the associations between dietary patterns and pancreatic cancer risk, but the findings have been inconclusive. Herein, we conducted this meta-analysis to assess the associations between dietary patterns and the risk of pancreatic cancer. MEDLINE (provided by the National Library of Medicine) and EBSCO (Elton B. Stephens Company) databases were searched for relevant articles published up to May 2016 that identified common dietary patterns. Thirty-two studies met the inclusion criteria and were finally included in this meta-analysis. A reduced risk of pancreatic cancer was shown for the highest compared with the lowest categories of healthy patterns (odds ratio, OR = 0.86; 95% confidence interval, CI: 0.77–0.95; p = 0.004) and light–moderate drinking patterns (OR = 0.90; 95% CI: 0.83–0.98; p = 0.02). There was evidence of an increased risk for pancreatic cancer in the highest compared with the lowest categories of western-type pattern (OR = 1.24; 95% CI: 1.06–1.45; p = 0.008) and heavy drinking pattern (OR = 1.29; 95% CI: 1.10–1.48; p = 0.002). The results of this meta-analysis demonstrate that healthy and light–moderate drinking patterns may decrease the risk of pancreatic cancer, whereas western-type and heavy drinking patterns may increase the risk of pancreatic cancer. Additional prospective studies are needed to confirm these findings. PMID:28067765

  16. Reversal in China’s Mineral Risk Prospecting Investment Pattern

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    <正>The total size of China’s central and provincial level geological prospecting funds has reached 39.9 billion yuan,which effectively propelled social capital to make investment in mineral resources risk prospecting through cooperation,and reversed the previous pattern that China’s mining risk prospecting totally relied on investment by the state government.

  17. Pattern of paediatric emergencies and outcome as seen in a teritary ...

    African Journals Online (AJOL)

    Background: The pattern of diseases in many resource-poor countries has changed in ... there has been increasing incidences of non-communicable diseases. ... of paediatric diseases and outcome as seen in a children emergency unit.

  18. Injury patterns in polytraumatized children and consequences for the emergency room management

    DEFF Research Database (Denmark)

    Zwingmann, J; Schmal, H; Mehlhorn, A

    2010-01-01

    INTRODUCTION: The effective initial treatment in the emergency room of polytraumatized children requires a sound knowledge of com- mon injury patterns, incidence, mortality, and consequences. The needed initial radiological imaging remains controversial and should be adapted to the expected injury...

  19. Is a sustainable consumption pattern gradually emerging in Germany?

    DEFF Research Database (Denmark)

    Thøgersen, John

    or behavioural categories share the same environmentally relevant characteristics. As regards the spreading issue, the cross-sectional and the time-series evidence from this study point in opposite directions. There are no clear signs of environment-friendly behaviour spreading to more areas of the consumption......This paper analyses the possible spreading of environmentally friendly behaviours to more and more areas of the consumption pattern as well as possible conditions for such a tendency. The conditions in focus are individuals' possession of certain attitudes or values and the degree to which product...... that environment-friendly behaviour must have spread between different areas of the consumption pattern when these conditions were present. The conditions identified to influence consistency - and, hence, spread or spillover of a propensity to shop in an environment-friendly way - are perceived environmental...

  20. From patterns to emerging processes in mechanistic urban ecology.

    Science.gov (United States)

    Shochat, Eyal; Warren, Paige S; Faeth, Stanley H; McIntyre, Nancy E; Hope, Diane

    2006-04-01

    Rapid urbanization has become an area of crucial concern in conservation owing to the radical changes in habitat structure and loss of species engendered by urban and suburban development. Here, we draw on recent mechanistic ecological studies to argue that, in addition to altered habitat structure, three major processes contribute to the patterns of reduced species diversity and elevated abundance of many species in urban environments. These activities, in turn, lead to changes in animal behavior, morphology and genetics, as well as in selection pressures on animals and plants. Thus, the key to understanding urban patterns is to balance studying processes at the individual level with an integrated examination of environmental forces at the ecosystem scale.

  1. Epigenetics and the environment: emerging patterns and implications.

    Science.gov (United States)

    Feil, Robert; Fraga, Mario F

    2012-01-04

    Epigenetic phenomena in animals and plants are mediated by DNA methylation and stable chromatin modifications. There has been considerable interest in whether environmental factors modulate the establishment and maintenance of epigenetic modifications, and could thereby influence gene expression and phenotype. Chemical pollutants, dietary components, temperature changes and other external stresses can indeed have long-lasting effects on development, metabolism and health, sometimes even in subsequent generations. Although the underlying mechanisms remain largely unknown, particularly in humans, mechanistic insights are emerging from experimental model systems. These have implications for structuring future research and understanding disease and development.

  2. Sustainable risk management of emerging contaminants in municipal wastewaters.

    Science.gov (United States)

    Martin, O V; Voulvoulis, N

    2009-10-13

    The presence of emerging contaminants in municipal wastewaters, particularly endocrine-disrupting compounds such as oestrogenic substances, has been the focus of much public concern and scientific attention in recent years. Due to the scientific uncertainty still surrounding their effects, the Precautionary Principle could be invoked for the interim management of potential risks. Therefore, precautionary prevention risk-management measures could be employed to reduce human exposure to the compounds of concern. Steroid oestrogens are generally recognized as the most significant oestrogenically active substances in domestic sewage effluent. As a result, the UK Environment Agency has championed a 'Demonstration Programme' to investigate the potential for removal of steroid oestrogens and alkylphenol ethoxylates during sewage treatment. Ecological and human health risks are interdependent, and ecological injuries may result in increased human exposures to contaminants or other stressors. In this context of limiting exposure to potential contaminants, examining the relative contribution of various compounds and pathways should be taken into account when identifying effective risk-management measures. In addition, the explicit use of ecological objectives within the scope of the implementation of the EU Water Framework Directive poses new challenges and necessitates the development of ecosystem-based decision tools. This paper addresses some of these issues and proposes a species sensitivity distribution approach to support the decision-making process related to the need and implications of sewage treatment work upgrade as risk-management measures to the presence of oestrogenic compounds in sewage effluent.

  3. Emergency caesarean section in low risk nulliparous women

    DEFF Research Database (Denmark)

    Haerskjold, Ann; Hegaard, H K; Kjaergaard, H

    2012-01-01

    the association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1......The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas...... and identifies maternal and fetal risk factors associated with ECS. We included 2,748 low-risk women and 8.7% had ECS. Failure-to-progress (FTP) accounted for 68.3% of the ECS and 30.4% were performed due to suspected fetal distress (SFD). Multivariate logistic regression analyses were done to estimate...

  4. Optimal network solution for proactive risk assessment and emergency response

    Science.gov (United States)

    Cai, Tianxing

    Coupled with the continuous development in the field industrial operation management, the requirement for operation optimization in large scale manufacturing network has provoked more interest in the research field of engineering. Compared with the traditional way to take the remedial measure after the occurrence of the emergency event or abnormal situation, the current operation control calls for more proactive risk assessment to set up early warning system and comprehensive emergency response planning. Among all the industries, chemical industry and energy industry have higher opportunity to face with the abnormal and emergency situations due to their own industry characterization. Therefore the purpose of the study is to develop methodologies to give aid in emergency response planning and proactive risk assessment in the above two industries. The efficacy of the developed methodologies is demonstrated via two industrial real problems. The first case is to handle energy network dispatch optimization under emergency of local energy shortage under extreme conditions such as earthquake, tsunami, and hurricane, which may cause local areas to suffer from delayed rescues, widespread power outages, tremendous economic losses, and even public safety threats. In such urgent events of local energy shortage, agile energy dispatching through an effective energy transportation network, targeting the minimum energy recovery time, should be a top priority. The second case is a scheduling methodology to coordinate multiple chemical plants' start-ups in order to minimize regional air quality impacts under extreme meteorological conditions. The objective is to reschedule multi-plant start-up sequence to achieve the minimum sum of delay time compared to the expected start-up time of each plant. All these approaches can provide quantitative decision support for multiple stake holders, including government and environment agencies, chemical industry, energy industry and local

  5. The Emerging Role of Governance, Risk Management and Compliance (GRC

    Directory of Open Access Journals (Sweden)

    Nahum Goldmann

    2012-04-01

    Full Text Available In the emerging ‘post High-tech’ economic paradigm, eFinance, as well as Governance, Risk Management and Compliance (GRC are often seen as the strategic engines of industrial and commercial growth, innovation and social renewal. Moreover, in the current financial environment, the attention of investors and stakeholders focuses on the corporate ability to maintain a strong capital position that protects it from financial crises. All these factors imply the critical importance of new innovation players, such as central banks, government regulatory bodies and investment funds, which in the past were not necessarily seen as primary industry innovation engines.

  6. Modelling the emergence of spatial patterns of economic activity

    CERN Document Server

    Yang, Jung-Hun; Frenken, Koen

    2012-01-01

    Understanding how spatial configurations of economic activity emerge is important when formulating spatial planning and economic policy. A simple model was proposed by Simon, who assumed that firms grow at a rate proportional to their size, and that new divisions of firms with certain probabilities relocate to other firms or to new centres of economic activity. Simon's model produces realistic results in the sense that the sizes of economic centres follow a Zipf distribution, which is also observed in reality. It lacks realism in the sense that mechanisms such as cluster formation, congestion (defined as an overly high density of the same activities) and dependence on the spatial distribution of external parties (clients, labour markets) are ignored. The present paper proposed an extension of the Simon model that includes both centripetal and centrifugal forces. Centripetal forces are included in the sense that firm divisions are more likely to settle in locations that offer a higher accessibility to other fi...

  7. The emergence of complex patterns in online human communication

    CERN Document Server

    Mathiesen, Joachim; Jensen, Mogens H

    2012-01-01

    Social media have become essential conduits in the worldwide exchange of ideas, opinions and consumer marketing. Complex networks are important tools for analyzing the information flow in many aspects of nature and human society. Here, we introduce a method based on networks and social media to gauge how ideas, opinions and new trends impact society. We show that correlations between different international brands, nouns or US major cities follow a universal scale free distribution. The correlations indicate a self-organizing dynamics in large social organizations where the exchange of information between individuals is highly volatile. Our method provides new fundamental insight on the propagation of opinions and the emergence of trends in online communities.

  8. Children’s development through emergent patterns of resistance

    DEFF Research Database (Denmark)

    Hviid, Pernille; Villadsen, Jakob Waag

    resist the engagements of children? How does the introduction of global learning efforts and goals affect the child, not just as a young learner but as a developing person? Our empirical work focuses on interaction between Danish preschool children and their pedagogues. We will investigate......From an existential perspective development is not something occurring bypassing the developing child. Children engage with the world and through this ongoing engagement priorities emerge. Hence, the child’s engagement in and with the world points back to the child, to what the child is and what...... this child is not yet, but might become. Danish pedagogical practice has had a long tradition of being sensitive to the engagements of children, but this tradition has recently been challenged by the introduction of standardized evidence based teaching practice. What happens when the pedagogical practice...

  9. The waterpipe: an emerging global risk for cancer.

    Science.gov (United States)

    Maziak, Wasim

    2013-02-01

    Tobacco smoking continues to be the leading preventable cause of morbidity and mortality worldwide. Each year more than 5 million smokers die prematurely because of their habit wreaking havoc on the welfare of families and communities worldwide. While cigarettes remain the main tobacco killer worldwide, for many youth tobacco use and addiction is maintained by means other than cigarettes. In particular, over the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become increasingly popular among youth in the Middle East, and is rapidly spreading globally. Available evidence suggests that waterpipe smoking is associated with many of the known risks of tobacco smoking, particularly cancer. Despite these worrisome signs, policies and interventions to address this emerging public health problem have been lagging behind. In this short review I discuss briefly the evidence generated mostly in the past decade about the global spread of waterpipe smoking and its cancer risk potential. Copyright © 2012. Published by Elsevier Ltd.

  10. Patterns of Romantic Involvement among Emerging Adults: Psychosocial Correlates and Precursors

    Science.gov (United States)

    Shulman, Shmuel; Scharf, Miri; Livne, Yaara; Barr, Tamuz

    2013-01-01

    The present study examined patterns of romantic involvement in 100 Israeli emerging adults (54 males) who were followed from age 22 to 29 years. Analyses of interviews at age 29 yielded four distinctive relational patterns that are associated with different levels of concurrent wellbeing: Intimately committed, Intimate, Non- intimately committed,…

  11. Breaking Patterns of Environmentally Influenced Disease for Health Risk Reduction: Immune Perspectives

    Science.gov (United States)

    Dietert, Rodney R.; DeWitt, Jamie C.; Germolec, Dori R.; Zelikoff, Judith T.

    2010-01-01

    Background Diseases rarely, if ever, occur in isolation. Instead, most represent part of a more complex web or “pattern” of conditions that are connected via underlying biological mechanisms and processes, emerge across a lifetime, and have been identified with the aid of large medical databases. Objective We have described how an understanding of patterns of disease may be used to develop new strategies for reducing the prevalence and risk of major immune-based illnesses and diseases influenced by environmental stimuli. Findings Examples of recently defined patterns of diseases that begin in childhood include not only metabolic syndrome, with its characteristics of inflammatory dysregulation, but also allergic, autoimmune, recurrent infection, and other inflammatory patterns of disease. The recent identification of major immune-based disease patterns beginning in childhood suggests that the immune system may play an even more important role in determining health status and health care needs across a lifetime than was previously understood. Conclusions Focusing on patterns of disease, as opposed to individual conditions, offers two important venues for environmental health risk reduction. First, prevention of developmental immunotoxicity and pediatric immune dysfunction can be used to act against multiple diseases. Second, pattern-based treatment of entryway diseases can be tailored with the aim of disrupting the entire disease pattern and reducing the risk of later-life illnesses connected to underlying immune dysfunction. Disease-pattern–based evaluation, prevention, and treatment will require a change from the current approach for both immune safety testing and pediatric disease management. PMID:20483701

  12. Temporal patterns of emergency calls of a metropolitan city in China

    Science.gov (United States)

    Wang, Wenjun; Yuan, Ning; Pan, Lin; Jiao, Pengfei; Dai, Weidi; Xue, Guixiang; Liu, Dong

    2015-10-01

    Quantitative understanding of human communication behavior, one of the fundamental human activities, is of great value in many practical problems, ranging from urban planning to emergency management. Most of the recent studies have focused on human communication under normal situations. Here, we study the temporal patterns of emergency calls, which is a special kind of human communication activity under emergency circumstances, by analyzing a dataset of emergency call records that collected from a metropolitan city in China during a five year period. We find that most individuals rarely make emergency calls. The distribution of inter-call durations decays as double power law along with an exponential tail. We also discover that, comparing with the normal communication activities, the activity of calling the emergency number shows more significant characteristics of burstiness and memory. We further demonstrate that the behavior of calling the emergency number when people encounter extreme events could be explained by an event-driven memory process.

  13. Savannah River Reactor Operation: Indices of risk for emergency planning

    Energy Technology Data Exchange (ETDEWEB)

    O' Kula, K.R.; East, J.M.

    1990-10-01

    Periodically it is necessary to re-examine the implications of new source terms for neighboring offsite populations as Probabilistic Risk Assessment (PRA) and Severe Accident studies mature, and lead to a better understanding of the progression of hypothetical core melt accidents in the Savannah River Site (SRS) reactors. In this application multiple-system failure, low-frequency events, and consequently higher radiological source terms than from normal operation or design basis accidents (DBAs) are considered. Measures of consequence such as constant dose vs distance, boundary doses, and health effects to close-in populations are usually examined in this context. A set of source terms developed for the Safety Information Document (SID) for support of the Reactor Operation Environmental Impact Statement (EIS) forms the basis for the revised risk evaluation discussed herein. The intent of this review is not to completely substantiate the sufficiency of the current Emergency Planning Zone (EPZ). However, the two principal measures (200-rem red-bone marrow dose vs distance and 300-rem thyroid dose vs distance) for setting an EPZ are considered. Additional dose-at-distance calculations and consideration of DBA doses would be needed to complete a re-evaluation of the current EPZ. These subject areas are not addressed in the current document. Also, this report evaluates the sensitivity of individual risk estimates to the extent of offsite evacuation assumed from a K reactor severe accident and compares these risks to the Draft DOE Safety Guidelines. 14 refs., 8 figs., 4 tabs.

  14. Pattern of drug overdose and chemical poisoning among patients attending an emergency department, western Saudi Arabia.

    Science.gov (United States)

    Bakhaidar, Mohamad; Jan, Saber; Farahat, Fayssal; Attar, Ahmad; Alsaywid, Basim; Abuznadah, Wesam

    2015-02-01

    Poisoning is a medical emergency that represent a major health problem all over the world. Studies on drug overdose and chemical poisoning are very limited in Saudi Arabia (SA). We aimed to describe the current pattern and assess risk factors of drug overdose and chemical poisoning in King Khalid National Guard hospital, Jeddah, SA. Medical records of patients attended emergency department in King Khalid National Guard hospital during the period from January 2008 to December 2012 due to drug overdose and chemical poisoning were reviewed. A total of 129 cases were included in the study. The majority of the population was Saudi (97.7 %), and almost half of them were females (54.3 %). Children under 12 years were the most affected age group (44.2 %). Drug overdose was the most common cause of poisoning (92.2 %). Analgesics and non-steroidal anti-inflammatory drugs represented the highest percentage of used medications (20.4 %). The most commonly reported symptoms were symptoms of the central nervous system (57.4 %) followed by GIT symptoms (41.9 %). Intentional poisoning was reported in 34 cases (26.4 %). Female patients were significantly more likely to attempt suicide than male patients (OR = 7.22, 95 % CI = 1.70, 30.62). Children continue to be at high risk for medication and chemical poisoning. Accessibility to medications at homes encountered for most of poisoning cases among children. Implementing methods to raise public awareness and minimize children access to medications would significantly contribute to reducing burden of this problem on the community.

  15. Emerging Comorbidities in Adult Asthma: Risks, Clinical Associations, and Mechanisms.

    Science.gov (United States)

    Kankaanranta, Hannu; Kauppi, Paula; Tuomisto, Leena E; Ilmarinen, Pinja

    2016-01-01

    Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Most studies with asthma have been performed in patients being otherwise healthy. However, in real life, comorbid diseases are very common in adult patients. We review here the emerging comorbid conditions to asthma such as obesity, metabolic syndrome, diabetes mellitus type 2 (DM2), and cardiac and psychiatric diseases. Their role as risk factors for incident asthma and whether they affect clinical asthma are evaluated. Obesity, independently or as a part of metabolic syndrome, DM2, and depression are risk factors for incident asthma. In contrast, the effects of comorbidities on clinical asthma are less well-known and mostly studies are lacking. Cross-sectional studies in obese asthmatics suggest that they may have less well controlled asthma and worse lung function. However, no long-term clinical follow-up studies with these comorbidities and asthma were identified. These emerging comorbidities often occur in the same multimorbid adult patient and may have in common metabolic pathways and inflammatory or other alterations such as early life exposures, systemic inflammation, inflammasome, adipokines, hyperglycemia, hyperinsulinemia, lung mechanics, mitochondrial dysfunction, disturbed nitric oxide metabolism, and leukotrienes.

  16. Emerging Comorbidities in Adult Asthma: Risks, Clinical Associations, and Mechanisms

    Directory of Open Access Journals (Sweden)

    Hannu Kankaanranta

    2016-01-01

    Full Text Available Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Most studies with asthma have been performed in patients being otherwise healthy. However, in real life, comorbid diseases are very common in adult patients. We review here the emerging comorbid conditions to asthma such as obesity, metabolic syndrome, diabetes mellitus type 2 (DM2, and cardiac and psychiatric diseases. Their role as risk factors for incident asthma and whether they affect clinical asthma are evaluated. Obesity, independently or as a part of metabolic syndrome, DM2, and depression are risk factors for incident asthma. In contrast, the effects of comorbidities on clinical asthma are less well-known and mostly studies are lacking. Cross-sectional studies in obese asthmatics suggest that they may have less well controlled asthma and worse lung function. However, no long-term clinical follow-up studies with these comorbidities and asthma were identified. These emerging comorbidities often occur in the same multimorbid adult patient and may have in common metabolic pathways and inflammatory or other alterations such as early life exposures, systemic inflammation, inflammasome, adipokines, hyperglycemia, hyperinsulinemia, lung mechanics, mitochondrial dysfunction, disturbed nitric oxide metabolism, and leukotrienes.

  17. Mining Emerging Sequential Patterns for Activity Recognition in Body Sensor Networks

    DEFF Research Database (Denmark)

    Gu, Tao; Wang, Liang; Chen, Hanhua

    2010-01-01

    Body Sensor Networks oer many applications in healthcare, well-being and entertainment. One of the emerging applications is recognizing activities of daily living. In this paper, we introduce a novel knowledge pattern named Emerging Sequential Pattern (ESP)|a sequential pattern that discovers...... signicant class dierences|to recognize both simple (i.e., sequential) and complex (i.e., interleaved and concurrent) activities. Based on ESPs, we build our complex activity models directly upon the sequential model to recognize both activity types. We conduct comprehensive empirical studies to evaluate...

  18. Alcohol Use as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis

    Directory of Open Access Journals (Sweden)

    Namkee G. Choi, PhD

    2015-12-01

    Full Text Available Introduction: Late middle-aged and older adults’ share of emergency department (ED visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Methods: Data came from the 2013 National Health Interview Survey’s Sample Adult file (n=15,713. Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/ moderate drinkers, and current heavy drinkers, chronic health and mental health status, and past-year ED visits as indicators. Results: LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/ mental health problems; Class 2 (21%; low-risk group consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Conclusion: Alcohol nonuse/use (and quantity of use and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex

  19. Longitudinal cerebral blood flow and amyloid deposition: an emerging pattern?

    Science.gov (United States)

    Sojkova, Jitka; Beason-Held, Lori; Zhou, Yun; An, Yang; Kraut, Michael A; Ye, Weigo; Ferrucci, Luigi; Mathis, Chester A; Klunk, William E; Wong, Dean F; Resnick, Susan M

    2008-01-01

    Although cerebral amyloid deposition may precede cognitive impairment by decades, the relationship between amyloid deposition and longitudinal change in neuronal function has not been studied. The aim of this paper is to determine whether nondemented individuals with high and low amyloid burden show different patterns of longitudinal regional cerebral blood flow (rCBF) changes in the years preceding measurement of amyloid deposition. Methods Twenty-eight nondemented participants (mean (SD) age at [11C] PIB 82.5(4.8) yrs; 6 mildly impaired) from the Baltimore Longitudinal Study of Aging underwent yearly resting-state [15O]H2O PET scans for up to 8 years. [11C]PIB images of amyloid deposition were acquired on average 10.8(0.8) years after the first CBF scan. [11C]PIB distribution volume ratios (DVR) of regions of interest were estimated by fitting a reference tissue model to the measured time activity curves. Based on mean cortical DVR, participants were divided into high and low [11C]PIB retention groups. Differences in longitudinal rCBF changes between high and low [11C]PIB groups were investigated by voxel-based analysis. Results Longitudinal rCBF changes differed significantly between high (n=10) and low (n=18) [11C]PIB groups (p<=0.001). Greater longitudinal decreases in rCBF in the high [11C]PIB group were seen in right anterior/mid cingulate, right supramarginal gyrus, left thalamus and midbrain bilaterally relative to the low group. Greater increases in rCBF over time in the high [11C]PIB group were found in left medial and inferior frontal gyri, right precuneus, left inferior parietal lobule, and the left postcentral gyrus. Conclusion In this group of nondemented older adults, those with high [11C]PIB show greater longitudinal declines in rCBF in certain areas, representing regions with greater decrements in neuronal function. Greater longitudinal increases in rCBF are also observed in those with higher amyloid load and may represent an attempt to preserve

  20. Occupational emerging risks affecting international virtual project Team Results

    Directory of Open Access Journals (Sweden)

    Dumitraşcu-Băldău Iulia

    2017-01-01

    Full Text Available The expansion of internet access, high-speed connection services, collaborative work platforms and tools, allowed employees to interact virtually offering companies the possibility to develop projects around the world, reducing operational costs and gain competitive advantage. Realizing the advantages and disadvantages of developing a project team in an international virtual work environment, requires adopting specific strategies to construct an effective team and ensure the project success. One of the most important disadvantages that we identified is that the new work environment brings new risks for both team members and managers. So, it becomes mandatory to identify and analyze the occupational emerging risks and their impact on the productivity of virtual team members, in order to prevent them efficiently and to ensure the safety and health of employees in a virtual working environment. This paper aims to highlight the necessity for project managers and organizations, to include in their specific project strategies, an efficient occupational risks management in the virtual workplace, to obtain a continuously improved virtual working environment, so to achieve a high performance from virtual employees.

  1. Spontaneously Emerging Patterns in Human Visual Cortex Reflect Responses to Naturalistic Sensory Stimuli.

    Science.gov (United States)

    Wilf, Meytal; Strappini, Francesca; Golan, Tal; Hahamy, Avital; Harel, Michal; Malach, Rafael

    2017-01-01

    In the absence of stimulus or task, the cortex spontaneously generates rich and consistent functional connectivity patterns (termed resting state networks) which are evident even within individual cortical areas. We and others have previously hypothesized that habitual cortical network activations during daily life contribute to the shaping of these connectivity patterns. Here we tested this hypothesis by comparing, using blood oxygen level-dependent-functional magnetic resonance imaging, the connectivity patterns that spontaneously emerge during rest in retinotopic visual areas to the patterns generated by naturalistic visual stimuli (repeated movie segments). These were then compared with connectivity patterns produced by more standard retinotopic mapping stimuli (polar and eccentricity mapping). Our results reveal that the movie-driven patterns were significantly more similar to the spontaneously emerging patterns, compared with the connectivity patterns of either eccentricity or polar mapping stimuli. Intentional visual imagery of naturalistic stimuli was unlikely to underlie these results, since they were duplicated when participants were engaged in an auditory task. Our results suggest that the connectivity patterns that appear during rest better reflect naturalistic activations rather than controlled, artificially designed stimuli. The results are compatible with the hypothesis that the spontaneous connectivity patterns in human retinotopic areas reflect the statistics of cortical coactivations during natural vision. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Patterns of cooperation during collective emergencies in the help-or-escape social dilemma

    CERN Document Server

    Moussaid, Mehdi

    2016-01-01

    Although cooperation is central to the organisation of many social systems, relatively little is known about cooperation in situations of collective emergency. When groups of people flee from a danger such as a burning building or a terrorist attack, the collective benefit of cooperation is important, but the cost of helping is high and the temptation to defect is strong. To explore the degree of cooperation in emergencies, we develop a new social game, the help-or-escape social dilemma. Under time and monetary pressure, players decide how much risk they are willing to take in order to help others. Results indicated that players took as much risk to help others during emergencies as they did under normal conditions. In both conditions, most players applied an egalitarian heuristic and helped others until their chance of success equalled that of the group. This strategy is less efficient during emergencies, however, because the increased time pressure results in fewer people helped. Furthermore, emergencies te...

  3. Mining disease risk patterns from nationwide clinical databases for the assessment of early rheumatoid arthritis risk.

    Science.gov (United States)

    Chin, Chu Yu; Weng, Meng Yu; Lin, Tzu Chieh; Cheng, Shyr Yuan; Yang, Yea Huei Kao; Tseng, Vincent S

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that can cause painful swelling in the joint lining, morning stiffness, and joint deformation/destruction. These symptoms decrease both quality of life and life expectancy. However, if RA can be diagnosed in the early stages, it can be controlled with pharmacotherapy. Although many studies have examined the possibility of early assessment and diagnosis, few have considered the relationship between significant risk factors and the early assessment of RA. In this paper, we present a novel framework for early RA assessment that utilizes data preprocessing, risk pattern mining, validation, and analysis. Under our proposed framework, two risk patterns can be discovered. Type I refers to well-known risk patterns that have been identified by existing studies, whereas Type II denotes unknown relationship risk patterns that have rarely or never been reported in the literature. These Type II patterns are very valuable in supporting novel hypotheses in clinical trials of RA, and constitute the main contribution of this work. To ensure the robustness of our experimental evaluation, we use a nationwide clinical database containing information on 1,314 RA-diagnosed patients over a 12-year follow-up period (1997-2008) and 965,279 non-RA patients. Our proposed framework is employed on this large-scale population-based dataset, and is shown to effectively discover rich RA risk patterns. These patterns may assist physicians in patient assessment, and enhance opportunities for early detection of RA. The proposed framework is broadly applicable to the mining of risk patterns for major disease assessments. This enables the identification of early risk patterns that are significantly associated with a target disease.

  4. Emergent care patterns in patients with spina bifida: a case-control study.

    Science.gov (United States)

    Wang, Hsin-Hsiao S; Wiener, John S; Ross, Sherry S; Routh, Jonathan C

    2015-01-01

    Individuals with spina bifida are typically followed closely as outpatients by multidisciplinary teams. However, emergent care of these patients is not well defined. We describe patterns of emergent care in patients with spina bifida and healthy controls. We reviewed Nationwide Emergency Department Sample data from 2006 to 2010. Subjects without spina bifida (controls) were selected from the sample using stratified random sampling and matched to each case by age, gender and treatment year at a 1:4 ratio. Missing emergency department charges were estimated by multiple imputation. Statistical analyses were performed to compare patterns of care among emergency department visits and charges. A total of 226,709 patients with spina bifida and 888,774 controls were identified. Mean age was 28.2 years, with 34.6% of patients being younger than 21. Patients with spina bifida were more likely than controls to have public insurance (63.7% vs 35.4%, p spina bifida seen emergently (OR 8.7, p spina bifida cases vs controls ($2,102 vs $1,650, p spina bifida presenting emergently are more likely to have urological or neurosurgical problems, to undergo urological or neurosurgical procedures, to be admitted from the emergency department and to incur higher associated charges. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Indicators of emerging hazards and risks to food safety.

    Science.gov (United States)

    Kleter, Gijs A; Marvin, Hans J P

    2009-05-01

    There is a widely felt need to develop methods for the early identification of emerging hazards to food safety with the aim of preventing these hazards from becoming real risks and causing incidents. This paper reviews various activities and previous reports that describe methods to select indicators that can be used for the purpose of early identification of hazards. These indicators have been divided over three different environments, including (i) the environment surrounding food production, (ii) the food production chain from farm to fork, and (iii) consumers. Changes in these indicators are signals that may require follow-up action. Besides indicators that are linked to specific kinds of hazards, the indicators used for vulnerability assessment can help identifying weak spots in the food production system that are sensitive to a broader range of hazards. Based on the various indicators for emerging hazards that have thus been identified in literature, a set of generic indicators is provided that can be useful for the early identification of hazards.

  6. Role of childhood food patterns on adult cardiovascular disease risk.

    Science.gov (United States)

    Kaikkonen, Jari E; Mikkilä, Vera; Raitakari, Olli T

    2014-10-01

    Accumulating evidence indicates that childhood nutrition plays a role in the adulthood cardiovascular health. A lifelong tracking of dietary habits, following a long-term exposure to unhealthy dietary patterns or independent effects, is a potential effect-mediating mechanism. Dietary patterns have been studied by data-driven and hypothesis-based approaches. Typically, either data-driven healthy or prudent childhood dietary patterns have been characterized and found to be associated with lower adulthood cardiovascular disease (CVD) risk in the published cohort studies. With regard to the individual food groups or food quality indices, intakes particularly of vegetables and fruits (or fiber indicating plant food intake) and polyunsaturated fatty acids have shown protective effects. The evidence which could confirm the long-term healthiness of a hypothesis-based Mediterranean diet is limited, requiring further investigation. Overall, the recent literature strengthens the view that a healthy childhood diet is associated with lowered adulthood CVD risk.

  7. Do incest, depression, parental drinking, serious romantic relationships, and living with parents influence patterns of substance use during emerging adulthood?

    Science.gov (United States)

    Snyder, Susan M; Rubenstein, Casey

    2014-01-01

    This study examined how incest, depression, parental drinking, relationship status, and living with parents affect patterns of substance use among emerging adults, 18 to 25 years old. The study sample included (n = 11,546) individuals who participated in Waves I, II, and III of the National Longitudinal Study of Adolescent Health (Add Health). The study used separate latent class analysis for males and females to determine how patterns of substance use clustered together. The study identified the following three classes of substance use: heavy, moderate, and normative substance use patterns. Multinomial logistic regression indicated that, for females only, incest histories also nearly doubled the risk of heavy-use class membership. In addition, experiencing depression, being single, and not living with parents serve as risk factors for males and females in the heavy-use group. Conversely, being Black, Hispanic, or living with parents lowered the likelihood of being in the group with the most substance use behaviors (i.e., heavy use). Findings highlight the need for interventions that target depression and female survivors of incest among emerging adults.

  8. Effective identification and management of emerging food risks: Results of an international Delphi survey

    NARCIS (Netherlands)

    Wentholt, M.T.A.; Fischer, A.R.H.; Rowe, G.; Marvin, H.J.P.; Frewer, L.J.

    2010-01-01

    Early identification of emerging food risks will protect human and animal health, the environment and economy. A two-round Delphi survey identified international experts’ views regarding knowledge gaps associated with the identification and mitigation of emerging food risks, and barriers to emerging

  9. Emerging risk factors and markers of chronic kidney disease progression.

    Science.gov (United States)

    Kronenberg, Florian

    2009-12-01

    Chronic kidney disease (CKD) is a common condition with an increasing prevalence. A number of comorbidities are associated with CKD and prognosis is poor, with many patients experiencing disease progression. Recognizing the factors associated with CKD progression enables high-risk patients to be identified and given more intensive treatment if necessary. The identification of new predictive markers might improve our understanding of the pathogenesis and progression of CKD. This Review discusses a number of emerging factors and markers for which epidemiological evidence from prospective studies indicates an association with progression of CKD. The following factors and markers are discussed: asymmetric dimethylarginine, factors involved in calcium-phosphate metabolism, adrenomedullin, A-type natriuretic peptide, N-terminal pro-brain natriuretic peptide, liver-type fatty acid binding protein, kidney injury molecule 1, neutrophil gelatinase-associated lipocalin, apolipoprotein A-IV, adiponectin and some recently identified genetic polymorphisms. Additional epidemiological and experimental data are required before these markers can be broadly used for the prediction of CKD progression and before the risk factors can be considered as potential drug targets in clinical interventional trials.

  10. Review of risk from potential emerging contaminants in UK groundwater.

    Science.gov (United States)

    Stuart, Marianne; Lapworth, Dan; Crane, Emily; Hart, Alwyn

    2012-02-01

    This paper provides a review of the types of emerging organic groundwater contaminants (EGCs) which are beginning to be found in the UK. EGCs are compounds being found in groundwater that were previously not detectable or known to be significant and can come from agricultural, urban and rural point sources. EGCs include nanomaterials, pesticides, pharmaceuticals, industrial compounds, personal care products, fragrances, water treatment by-products, flame retardants and surfactants, as well as caffeine and nicotine. Many are relatively small polar molecules which may not be effectively removed by drinking water treatment. Data from the UK Environment Agency's groundwater screening programme for organic pollutants found within the 30 most frequently detected compounds a number of EGCs such as pesticide metabolites, caffeine and DEET. Specific determinands frequently detected include pesticides metabolites, pharmaceuticals including carbamazepine and triclosan, nicotine, food additives and alkyl phosphates. This paper discusses the routes by which these compounds enter groundwater, their toxicity and potential risks to drinking water and the environment. It identifies challenges that need to be met to minimise risk to drinking water and ecosystems. Copyright © 2012. Published by Elsevier B.V.

  11. Minimum patterns of initial assistance given on the toxicological emergency to approach a poisoned child

    Directory of Open Access Journals (Sweden)

    Erika Okuda Tavares

    2012-04-01

    Full Text Available The present study aimed at presenting the minimum patterns of initial assistance to be given to poisoned children in an emergency room of a University Hospital. The construction of the minimum patterns the module IV Initial Assistance to the Poisoned Patient, from the Course of Toxicology promoted by the National Agency of Sanitary Surveillance (ANVISA, documents and technician-scientific literature about the theme, and the authors' experience in a center of toxicological information were used as a guideline. The minimum pattern comprised the structure and the assistance process. One of the limitations found here was the inexistence of consistent references regarding the initial assistance to the poisoned; however it is believed that the established patterns in this study can contribute for the initial assistance to poisoned and their families in emergency room units.

  12. Mapping spatial patterns of people's risk perception of landslides

    Science.gov (United States)

    Kofler, Christian; Pedoth, Lydia; Elzbieta Stawinoga, Agnieszka; Schneiderbauer, Stefan

    2016-04-01

    The resilience of communities against natural hazards is largely influenced by how the individuals perceive risk. A good understanding of people's risk perception, awareness and hazard knowledge is crucial for developing and improving risk management and communication strategies between authorities and the affected population. A lot of research has been done in investigating the social aspects of risks to natural hazards by means of interviews or questionnaires. However, there is still a lack of research in the investigation of the influence of the spatial distance to a hazard event on peoples risk perception. While the spatial dimension of a natural hazard event is always assessed in works with a natural science approach, it is often neglected in works on social aspects of natural hazards. In the present study, we aimed to overcome these gaps by combining methods from different disciplines and assessing and mapping the spatial pattern of risk perception through multivariate statistical approaches based on empirical data from questionnaires. We will present results from a case study carried out in Badia, located in the Province of South Tyrol- Italy, where in December 2012 a landslide destroyed four residential buildings and led to the evacuation of 36 people. By means of questionnaires distributed to all adults living in the case study area we assessed people's risk perception and asked respondents to allocate their place of residence on a map of the case study area subdivided in 7 zones. Based on the data of the questionnaire results we developed a risk perception factor in order to express various assessed aspects linked to risk perception with one metric. We analyzed and mapped this factor according to the different zones reflecting the spatial distance to the event. Furthermore, a cluster analysis identified various risk behavior profiles within the population. We also investigated the spatial patterns of these risk profiles. We revealed that the residential

  13. I Want Your Sext: Sexting and Sexual Risk in Emerging Adult Minority Men.

    Science.gov (United States)

    Davis, Mikaela Jessica; Powell, Adeya; Gordon, Derrick; Kershaw, Trace

    2016-04-01

    Sexting, sending, or receiving sexually suggestive or explicit messages/photos/videos, have not been studied extensively. The aims of this study is to understand factors associated with sexting among minority (e.g., African- American, Hispanic) emerging adult males and the association between sexting and sexual risk. We recruited 119 emerging adult heterosexual males and assessed sexting and sexual risk behaviors. Fifty-four percent of participants sent a sext, and 70% received a sext. Participants were more likely to sext with casual partners than with steady partners. Multiple regression analyses showed that participants who sent sexts to steady partners had significantly more unprotected vaginal intercourse and oral sex. Participants who sent sexts to casual partners had significantly more partners, and participants who received sexts from casual partners had significantly more unprotected oral sex and sex while on substances. We found that sexting is a frequent and reciprocal behavior among emerging adults, and there were different patterns of significance for sexts with casual and steady partners.

  14. The Success Of Stock Selection Strategies In Emerging Markets: Is It Risk Or Behavioral Bias?

    NARCIS (Netherlands)

    J. van der Hart; G.J. de Zwart (Gerben); D.J.C. van Dijk (Dick)

    2005-01-01

    textabstractWe examine competing explanations, based on risk and behavioral models, for the profitability of stock selection strategies in emerging markets. We document that both emerging market risk and global risk factors cannot account for the significant excess returns of selection strategies ba

  15. A Risk Metric Assessment of Scenario-Based Market Risk Measures for Volatility and Risk Estimation: Evidence from Emerging Markets

    Directory of Open Access Journals (Sweden)

    Sitima Innocent

    2015-03-01

    Full Text Available The study evaluated the sensitivity of the Value- at- Risk (VaR and Expected Shortfalls (ES with respect to portfolio allocation in emerging markets with an index portfolio of a developed market. This study utilised different models for VaR and ES techniques using various scenario-based models such as Covariance Methods, Historical Simulation and the GARCH (1, 1 for the predictive ability of these models in both relatively stable market conditions and extreme market conditions. The results showed that Expected Shortfall has less risk tolerance than VaR based on the same scenario-based market risk measures

  16. Evaluation of Cases with Rabies Risk Presenting to Emergency Department

    Directory of Open Access Journals (Sweden)

    Fevzi Yilmaz

    2013-10-01

    Full Text Available Aim: All around the world 10-12 million people/year receive rabies prophylaxis. Rabies is an acute fatal central nervous system viral enfection. The virus can infect all warm-blooded animals and almost in all cases the enfection results with fatal encephalitis. The aim of this study is to determine the demographic characteristics of cases with rabies risk exposures and behind this to emphasise the significance of cooperation between the institutions to perform effective and accurate treatment. Material and Method: This study was performed with retrospective analysis of 1429 cases who attended to Emergency Department of Diyarbakir Goverment Hospital between January 2007-2010 for animal bites and exposures with the risk of rabies. Statistical analysis of data was performed SPSS V16 pocket programme. Data were defined as frequency and %. For statistical analysis Chi-Square and Fischer exact test was used. A value of P<0.05 was accepted statistically significant. Results: A total of 1055 (73.8% were male, 374 (26.2% were female and the mean age was 21.75 ± 16.9 (6 months-87 years. The major group in children was 6-11 years old and 651 (% 45.5 of the cases attended to hospital were under 18 years old. The vast majority (39.3% in adults were between 19-49 years. In our study 808 (56.5% of the cases  were bitten, 597 (41.8% of the cases  were scrabbled by the animal and 24 (1.7%of them  had indirect contact with the animal Both of them were taken into prophylactic vaccination programme (p<0.05. The vast majority of animal bites were dog (67%  and cat (28%. 3 doses of Human diploid cell vaccine-HDCV were administered to 1001 (70% of the patients and 5 doses to 428 (30% of patients. Human rabies immune globulin-HRIG were administered to 475 (33,3% of the patients in addition to vaccine. Discussion:  In our region rabies risk exposure is an important public health problem. Public oriented education should be given about attending to health care

  17. Domain Walls in Non-Equilibrium Systems and the Emergence of Persistent Patterns

    CERN Document Server

    Hagberg, A

    1993-01-01

    Abstract: Domain walls in equilibrium phase transitions propagate in a preferred direction so as to minimize the free energy of the system. As a result, initial spatio-temporal patterns ultimately decay toward uniform states. The absence of a variational principle far from equilibrium allows the coexistence of domain walls propagating in any direction. As a consequence, *persistent* patterns may emerge. We study this mechanism of pattern formation using a non-variational extension of Landau's model for second order phase transitions. PACS numbers: 05.70.Fh, 42.65.Pc, 47.20.Ky, 82.20Mj

  18. Changes in latitude, changes in attitude - emerging biogeographic patterns of invasion in the Northeast Pacific

    Science.gov (United States)

    Biogeographic patterns of invasion of near-coastal and estuarine species in the Northeastern Pacific (NEP) are beginning to emerge based on surveys by U.S. EPA’s Environmental Monitoring and Assessment Program (EMAP) and the EPA/USGS synthesis of native and nonindigenous species ...

  19. epSICAR: An Emerging Patterns based Approach to Sequential, Interleaved and Concurrent Activity Recognition

    DEFF Research Database (Denmark)

    Gu, Tao; Wu, Zhanqing; Tao, Xianping;

    2009-01-01

    upon the training dataset for complex activities, we build our activity models by mining a set of Emerging Patterns from the sequential activity trace only and apply our models in recognizing sequential, interleaved and concurrent activities. We conduct our empirical studies in a real smart home...

  20. A Risk Radar driven by Internet of intelligences serving for emergency management in community.

    Science.gov (United States)

    Huang, Chongfu; Wu, Tong; Renn, Ortwin

    2016-07-01

    Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar.

  1. Emergency department crowding and risk of preventable medical errors.

    Science.gov (United States)

    Epstein, Stephen K; Huckins, David S; Liu, Shan W; Pallin, Daniel J; Sullivan, Ashley F; Lipton, Robert I; Camargo, Carlos A

    2012-04-01

    The objective of the study is to determine the association between emergency department (ED) crowding and preventable medical errors (PME). This was a retrospective cohort study of 533 ED patients enrolled in the National ED Safety Study (NEDSS) in four Massachusetts EDs. Individual patients' average exposure to ED crowding during their ED visit was compared with the occurrence of a PME (yes/no) for the three diagnostic categories in NEDSS: acute myocardial infarction, asthma exacerbation, and dislocation requiring procedural sedation. To accommodate site-to-site differences in available administrative data, ED crowding was measured using one of three previously validated crowding metrics (ED Work Index, ED Workscore, and ED Occupancy). At each site, the continuous measure was placed into site-specific quartiles, and these quartiles then were combined across sites. We found that 46 (8.6%; 95% confidence interval, 6.4-11.3%) of the 533 patients experienced a PME. For those seen during higher levels of ED crowding (quartile 4 vs. quartile 1), the occurrence of PMEs was more than twofold higher, both on unadjusted analysis and adjusting for two potential confounders (diagnosis, site). The association appeared non-linear, with most PMEs occurring at the highest crowding level. We identified a direct association between high levels of ED crowding and risk of preventable medical errors. Further study is needed to determine the generalizability of these results. Should such research confirm our findings, we would suggest that mitigating ED crowding may reduce the occurrence of preventable medical errors.

  2. Nanopesticides and nanofertilizers: emerging contaminants or opportunities for risk mitigation?

    Directory of Open Access Journals (Sweden)

    Melanie eKah

    2015-11-01

    Full Text Available Research into nanotechnology applications for use in agriculture has become increasingly popular over the past decade, with a particular interest in developing novel nanoagrochemicals in the form of so-called nanopesticides and nanofertilizers. In view of the extensive body of scientific literature available on the topic, many authors have foreseen a revolution in current agricultural practices.This perspective integrates scientific, regulatory, public and commercial viewpoints, and aims at critically evaluating progress made over the last decade. A number of key (and sometimes controversial questions are addressed with the aim of identifying the products that will soon emerge on the market and analyzing how they can fit into current regulatory and commercial frameworks. Issues related to the differences in definitions and perceptions within different sectors are discussed, as well as our current ability to assess new risks and benefits relative to conventional products. Many nanoagrochemicals resemble products used currently, which raises the question whether the effect of formulation has been sufficiently taken into account when evaluating agrochemicals. This analysis identifies directions for future research and regulatory needs in order to encourage intelligent design and promote the development of more sustainable agrochemicals.

  3. Nanopesticides and Nanofertilizers: Emerging Contaminants or Opportunities for Risk Mitigation?

    Science.gov (United States)

    Kah, Melanie

    2015-01-01

    Research into nanotechnology applications for use in agriculture has become increasingly popular over the past decade, with a particular interest in developing novel nanoagrochemicals in the form of so-called “nanopesticides” and “nanofertilizers.” In view of the extensive body of scientific literature available on the topic, many authors have foreseen a revolution in current agricultural practices. This perspective integrates scientific, regulatory, public and commercial viewpoints, and aims at critically evaluating progress made over the last decade. A number of key (and sometimes controversial) questions are addressed with the aim of identifying the products that will soon emerge on the market and analyzing how they can fit into current regulatory and commercial frameworks. Issues related to the differences in definitions and perceptions within different sectors are discussed, as well as our current ability to assess new risks and benefits relative to conventional products. Many nanoagrochemicals resemble products used currently, which raises the question whether the effect of formulation has been sufficiently taken into account when evaluating agrochemicals. This analysis identifies directions for future research and regulatory needs in order to encourage intelligent design and promote the development of more sustainable agrochemicals. PMID:26636068

  4. CLARIPED: a new tool for risk classification in pediatric emergencies.

    Science.gov (United States)

    Magalhães-Barbosa, Maria Clara de; Prata-Barbosa, Arnaldo; Alves da Cunha, Antonio José Ledo; Lopes, Cláudia de Souza

    2016-09-01

    To present a new pediatric risk classification tool, CLARIPED, and describe its development steps. Development steps: (i) first round of discussion among experts, first prototype; (ii) pre-test of reliability, 36 hypothetical cases; (iii) second round of discussion to perform adjustments; (iv) team training; (v) pre-test with patients in real time; (vi) third round of discussion to perform new adjustments; (vii) final pre-test of validity (20% of medical treatments in five days). CLARIPED features five urgency categories: Red (Emergency), Orange (very urgent), Yellow (urgent), Green (little urgent) and Blue (not urgent). The first classification step includes the measurement of four vital signs (Vipe score); the second step consists in the urgency discrimination assessment. Each step results in assigning a color, selecting the most urgent one for the final classification. Each color corresponds to a maximum waiting time for medical care and referral to the most appropriate physical area for the patient's clinical condition. The interobserver agreement was substantial (kappa=0.79) and the final pre-test, with 82 medical treatments, showed good correlation between the proportion of patients in each urgency category and the number of used resources (pPediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Nanopesticides and Nanofertilizers: Emerging Contaminants or Opportunities for Risk Mitigation?

    Science.gov (United States)

    Kah, Melanie

    2015-01-01

    Research into nanotechnology applications for use in agriculture has become increasingly popular over the past decade, with a particular interest in developing novel nanoagrochemicals in the form of so-called "nanopesticides" and "nanofertilizers." In view of the extensive body of scientific literature available on the topic, many authors have foreseen a revolution in current agricultural practices. This perspective integrates scientific, regulatory, public and commercial viewpoints, and aims at critically evaluating progress made over the last decade. A number of key (and sometimes controversial) questions are addressed with the aim of identifying the products that will soon emerge on the market and analyzing how they can fit into current regulatory and commercial frameworks. Issues related to the differences in definitions and perceptions within different sectors are discussed, as well as our current ability to assess new risks and benefits relative to conventional products. Many nanoagrochemicals resemble products used currently, which raises the question whether the effect of formulation has been sufficiently taken into account when evaluating agrochemicals. This analysis identifies directions for future research and regulatory needs in order to encourage intelligent design and promote the development of more sustainable agrochemicals.

  6. Mediterranean dietary pattern and risk of breast cancer.

    Directory of Open Access Journals (Sweden)

    Elisabeth Couto

    Full Text Available BACKGROUND: A Mediterranean diet has a recognized beneficial effect on health and longevity, with a protective influence on several cancers. However, its association with breast cancer risk remains unclear. OBJECTIVE: We aimed to investigate whether adherence to a Mediterranean dietary pattern influences breast cancer risk. DESIGN: The Swedish Women's Lifestyle and Health cohort study includes 49,258 women aged 30 to 49 years at recruitment in 1991-1992. Consumption of foods and beverages was measured at enrollment using a food frequency questionnaire. A Mediterranean diet score was constructed based on the consumption of alcohol, vegetables, fruits, legumes, cereals, fish, the ratio of unsaturated to saturated fat, and dairy and meat products. Relative risks (RR for breast cancer and specific tumor characteristics (invasiveness, histological type, estrogen/progesterone receptor status, malignancy grade and stage associated with this score were estimated using Cox regression controlling for potential confounders. RESULTS: 1,278 incident breast cancers were diagnosed. Adherence to a Mediterranean dietary pattern was not statistically significantly associated with reduced risk of breast cancer overall, or with specific breast tumor characteristics. A RR (95% confidence interval for breast cancer associated with a two-point increment in the Mediterranean diet score was 1.08 (1.00-1.15 in all women, and 1.10 (1.01-1.21 and 1.02 (0.91-1.15 in premenopausal and postmenopausal women, respectively. When alcohol was excluded from the Mediterranean diet score, results became not statistically significant. CONCLUSIONS: Adherence to a Mediterranean dietary pattern did not decrease breast cancer risk in this cohort of relatively young women.

  7. Risk analysis and emergency management of ammonia installations

    NARCIS (Netherlands)

    Ham, J.M.; Gansevoort, J.

    1992-01-01

    The use of Quantitative Risk Assessment has been increasing for evaluating the risk of handling hazardous materials and land-use planning. This article reports on several studies carried out on the risk of handling, storage and transport of ammonia.

  8. Risk analysis and emergency management of ammonia installations

    NARCIS (Netherlands)

    Ham, J.M.; Gansevoort, J.

    1992-01-01

    The use of Quantitative Risk Assessment has been increasing for evaluating the risk of handling hazardous materials and land-use planning. This article reports on several studies carried out on the risk of handling, storage and transport of ammonia.

  9. Risks from Worldwide Terrorism: Mortality and Morbidity Patterns and Trends

    Energy Technology Data Exchange (ETDEWEB)

    Bogen, K T; Jones, E D

    2005-01-25

    Worldwide data on terrorist incidents between 1968 and 2004 gathered by the RAND corporation and the Oklahoma City National Memorial Institute for the Prevention of Terrorism (MIPT) were assessed for patterns and trends in morbidity/mortality. The data involve a total of 19,828 events, 7,401 ''adverse'' events (each causing {ge}1 victim), 91,346 cases of casualty (either injury or death) and 25,408 deaths. Analyses revealed a number of interesting patterns and apparently significant trends. Most terror-related adverse events, casualties and deaths involved bombs and guns. Weapon-specific patterns and terror-related risk levels in Israel (ISR) have differed markedly from those of all other regions combined (AOR). ISR had a fatal fraction of casualties about half that of AOR, but has experienced relatively constant lifetime terror-related casualty risks on the order of 0.5%--a level 2 to 3 orders of magnitude more than those experienced in AOR, which have increased {approx}100-fold over the same period. Individual event fatality has increased steadily, the median increasing from 14 to 50%. Lorenz curves obtained indicate substantial dispersion among victim/event rates: about half of all victims were caused by the top 2% (10%) of harm-ranked events in OAR (ISR). Extreme values of victim/event rates were found to be well modeled by classic or generalized Pareto distributions, indicating that these rates have been as predictable as similarly extreme phenomena such as rainfall, sea levels, earthquakes, etc. This observation suggests that these extreme-value patterns may be used to improve strategies to prevent and manage risks associated with terror-related consequences.

  10. Sources of uncertainty about daughters' breast cancer risk that emerge during genetic counseling consultations.

    Science.gov (United States)

    Bylund, Carma L; Fisher, Carla L; Brashers, Dale; Edgerson, Shawna; Glogowski, Emily A; Boyar, Sherry R; Kemel, Yelena; Spencer, Sara; Kissane, David

    2012-04-01

    Uncertainty is central to the experience of genetic decision making and counseling about cancer risk. Women seeking genetic counseling about their breast cancer risk may experience a great deal of uncertainty about issues related to their daughters. We used a theory of Communication and Uncertainty Management to guide analysis of sources of uncertainty about daughters that emerged during 16 video-recorded and transcribed conversations between mothers at risk for a BRCA 1/2 mutation and their genetic healthcare practitioners. An interpretive design and constant comparative method revealed three dominant patterns or themes representing sources of uncertainty mothers have relating to their daughters: disease risk, future cancer screening, and communication of related information to daughters. Both practitioners and mothers discussed these aspects of uncertainty. The findings identify the significant role uncertainty and familial concerns play in mothers' genetic testing decision making process. To assist genetic practitioners, we highlight daughter-related concerns that mothers are uncertain about and which are vital to their genetic counseling needs.

  11. A FTA-based method for risk decision-making in emergency response

    DEFF Research Database (Denmark)

    Liu, Yang; Li, Hongyan

    2014-01-01

    Decision-making problems in emergency response are usually risky and uncertain due to the limited decision data and possible evolvement of emergency scenarios. This paper focuses on a risk decisionmaking problem in emergency response with several distinct characteristics including dynamic...

  12. Multimarker Strategy for Short-Term Risk Assessment in Patients With Dyspnea in the Emergency Department The MARKED (Multi mARKer Emergency Dyspnea)-Risk Score

    NARCIS (Netherlands)

    Eurlings, Luc W.; Sanders-van Wijk, Sandra; van Kimmenade, Roland; Osinski, Aart; van Helmond, Lidwien; Vallinga, Maud; Crijns, Harry J.; van Dieijen-Visser, Marja P.; Brunner-La Rocca, Hans-Peter; Pinto, Yigal M.

    2012-01-01

    Objectives The study aim was to determine the prognostic value of a multimarker strategy for risk-assessment in patients presenting to the emergency department (ED) with dyspnea. Background Combining biomarkers with different pathophysiological backgrounds may improve risk stratification in dyspneic

  13. Consistent patterns of vehicle collision risk for six mammal species.

    Science.gov (United States)

    Visintin, Casey; van der Ree, Rodney; McCarthy, Michael A

    2017-10-01

    The occurrence and rate of wildlife-vehicle collisions are related to both anthropocentric and environmental variables, however, few studies compare collision risks for multiple species within a model framework that is adaptable and transferable. Our research compares collision risk for multiple species across a large geographic area using a conceptually simple risk framework. We used six species of native terrestrial mammal often involved with wildlife-vehicle collisions in south-east Australia. We related collisions reported to a wildlife organisation to the co-occurrence of each species and a threatening process (presence and movement of road vehicles). For each species, we constructed statistical models from wildlife atlas data to predict occurrence across geographic space. Traffic volume and speed on road segments (also modelled) characterised the magnitude of threatening processes. The species occurrence models made plausible spatial predictions. Each model reduced the unexplained variation in patterns and distributions of species between 29.5% (black wallaby) and 34.3% (koala). The collision models reduced the unexplained variation in collision event data between 7.4% (koala) and 19.4% (common ringtail possum) with predictor variables correlating similarly with collision risk across species. Road authorities and environmental managers need simple and flexible tools to inform projects. Our model framework is useful for directing mitigation efforts (e.g. on road effects or species presence), predicting risk across differing spatial and temporal scales and target species, inferring patterns of threat, and identifying areas warranting additional data collection, analysis, and study. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Early signals for emerging food safety risks: From past cases to future identification

    NARCIS (Netherlands)

    Brug, F,J, van de; Luijckx, N.B.L.; Cnossen, H.J.; Houben, G.F.

    2014-01-01

    During the last decades multiple unexpected and wide spread food safety incidents have occurred. The aim of this study is to learn from the past by studying the early emergence of historic food safety risks and apply these lessons for future early identification of emerging food safety risks. Inform

  15. 12 CFR 370.8 - Systemic risk emergency special assessment to recover loss.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Systemic risk emergency special assessment to recover loss. 370.8 Section 370.8 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.8 Systemic risk emergency...

  16. Early signals for emerging food safety risks: From past cases to future identification

    NARCIS (Netherlands)

    Brug, F,J, van de; Luijckx, N.B.L.; Cnossen, H.J.; Houben, G.F.

    2014-01-01

    During the last decades multiple unexpected and wide spread food safety incidents have occurred. The aim of this study is to learn from the past by studying the early emergence of historic food safety risks and apply these lessons for future early identification of emerging food safety risks.

  17. Expert forecast on emerging psychosocial risks related to occupational safety and health

    NARCIS (Netherlands)

    Milczarek, M.; Brun, E.; Houtman, I.; Goudswaard, A.; Evers, M.; Bovenkamp, M. van de; Roskams, N.; Op de Beeck, R.; Pahkin, K.; Berthet, M.; Morvan, E.; Kuhn, K.; Kaluza, K.; Hupke, M.; Hauke, A.; Reinert, D.; Widerszal-Bazyl, M.; Perez, J.; Oncins de Frutos, M.

    2007-01-01

    This report is in cooperation with TNO Work and Employment and the European Agency for Safety and Health at Work. The expert forecast on emerging psychosocial risks was carried out by means of the Delphi method. The main emerging psychosocial risks revealed were related to new forms of employment

  18. Assessing risk based on uncertain avalanche activity patterns

    Science.gov (United States)

    Zeidler, Antonia; Fromm, Reinhard

    2015-04-01

    Avalanches may affect critical infrastructure and may cause great economic losses. The planning horizon of infrastructures, e.g. hydropower generation facilities, reaches well into the future. Based on the results of previous studies on the effect of changing meteorological parameters (precipitation, temperature) and the effect on avalanche activity we assume that there will be a change of the risk pattern in future. The decision makers need to understand what the future might bring to best formulate their mitigation strategies. Therefore, we explore a commercial risk software to calculate risk for the coming years that might help in decision processes. The software @risk, is known to many larger companies, and therefore we explore its capabilities to include avalanche risk simulations in order to guarantee a comparability of different risks. In a first step, we develop a model for a hydropower generation facility that reflects the problem of changing avalanche activity patterns in future by selecting relevant input parameters and assigning likely probability distributions. The uncertain input variables include the probability of avalanches affecting an object, the vulnerability of an object, the expected costs for repairing the object and the expected cost due to interruption. The crux is to find the distribution that best represents the input variables under changing meteorological conditions. Our focus is on including the uncertain probability of avalanches based on the analysis of past avalanche data and expert knowledge. In order to explore different likely outcomes we base the analysis on three different climate scenarios (likely, worst case, baseline). For some variables, it is possible to fit a distribution to historical data, whereas in cases where the past dataset is insufficient or not available the software allows to select from over 30 different distribution types. The Monte Carlo simulation uses the probability distribution of uncertain variables

  19. Alcohol drinking pattern and risk of alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Askgaard, Gro; Grønbæk, Morten; Kjær, Mette Skalshøi

    2015-01-01

    BACKGROUND & AIMS: Alcohol is the main contributing factor of alcoholic cirrhosis, but less is known about the significance of drinking pattern. METHODS: We investigated the risk of alcoholic cirrhosis among 55,917 participants (aged 50-64 years) in the Danish Cancer, Diet, and Health study (1993......-2011). Baseline information on alcohol intake, drinking pattern, and confounders was obtained from a questionnaire. Follow-up information came from national registers. We calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type. RESULTS......: We observed 257 and 85 incident cases of alcoholic cirrhosis among men and women, respectively, none among lifetime abstainers. In men, HR for alcoholic cirrhosis among daily drinkers was 3.65 (95% CI: 2.39; 5.55) compared to drinking 2-4 days/week. Alcohol amount in recent age periods (40-49 and 50...

  20. Risk of colorectal cancer among automotive pattern and model makers.

    Science.gov (United States)

    Tilley, B C; Johnson, C C; Schultz, L R; Buffler, P A; Joseph, C L

    1990-06-01

    Twofold to threefold increases in risk for colorectal cancer associated with pattern and model making in the automobile industry have been suggested by several reports. This paper reports the investigation of a cohort of 7545 General Motors pattern and model makers originally defined for the purpose of cancer screening. All-cause mortality for this cohort was lower than that of the US population (standardized mortality ratio [SMR] = 0.7; 95% confidence limits 0.6, 0.8). There were 22 colon cancer deaths v 10.9 expected, resulting in a significantly elevated SMR of 2.0 (95% confidence limits of 1.3, 3.0), consistent with previous studies. The colon cancer SMR for nonparticipants in the screening programs was 4.0 (95% confidence limits of 2.2, 6.7), emphasizing the importance of complete follow-up for all members of a defined cohort.

  1. Perinatal Depression and Patterns of Attachment: A Critical Risk Factor?

    Directory of Open Access Journals (Sweden)

    Valentina Meuti

    2015-01-01

    Full Text Available Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS and the Experience in Close Relationship (ECR. A clinical group of subjects with perinatal depression (PND, 89 subjects was selected and compared with a control group (C, regarding psychopathological variables and attachment patterns. Results. The ECR showed a prevalence of “Fearful-Avoidant” attachment style in PND group (29.2% versus 1.1%, p<0.001; additionally, the EPDS average score increases with the increasing of ECR dimensions (Avoidance and Anxiety. Conclusion. The severity of depression increases proportionally to attachment disorganization; therefore, we consider attachment as both an important risk factor as well as a focus for early psychotherapeutic intervention.

  2. Frequent visitors to psychiatric emergency services: staff attitudes and temporal patterns.

    Science.gov (United States)

    Arfken, Cynthia; Zeman, Lori Lackman; Yeager, Lindsay; Mischel, Edward; Amirsadri, Alireza

    2002-11-01

    Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.

  3. Nutrients, emerging pollutants and pesticides in a tropical urban reservoir: Spatial distributions and risk assessment.

    Science.gov (United States)

    López-Doval, Julio C; Montagner, Cassiana C; de Alburquerque, Anjaína Fernandes; Moschini-Carlos, Viviane; Umbuzeiro, Gisela; Pompêo, Marcelo

    2017-01-01

    Reservoirs located in urban areas suffer specific pressures related to human activities. Their monitoring, management, and protection requirements differ from reservoirs situated in non-urbanized areas. The objectives of this study were: (a) to determine the concentrations of select pesticides and emerging pollutants (EPs) present in an urban reservoir; (b) to describe their possible spatial distributions; and (c) to quantify the risks for aquatic life and safeguard drinking water supplies. For this purpose, the Guarapiranga reservoir was studied as an example of a multi-stressed urban reservoir in a tropical region. A total of 31 organic compounds (including pesticides, illicit drugs, pharmaceuticals, and endocrine disruptors) were analyzed twice over a period of one year, together with classical indicators of water quality. The physical and chemical data were treated using principal component analysis (PCA) to identify possible temporal or spatial patterns. Risk assessment was performed for biota and drinking water use, comparing maximum environmental concentrations (MECs) with the predicted no-effect concentrations (PNECs) or drinking water quality criteria (DWC), respectively. The results demonstrated the presence of pesticides and EPs, as well as pollution by high levels of nutrients and Chlorophyll a (Chl. a), during the study period. The nutrients and Trophic State Index (TSI) showed gradients in the reservoir and regional distributions, while the pesticides and EPs only clearly showed this pattern in the dry season. The concentrations and distributions of the pesticides and EPs therefore showed seasonality. These findings suggested that the two groups of pollutants (EPs+pesticides and nutrients) possessed different sources and behavior and were not always correlated in the reservoir studied. In the studied period, no risk was observed in raw water for drinking water use, but carbendazim, imidacloprid, and BPA showed risks for the biota in the reservoir

  4. Dietary patterns as risk factors of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Elwira Przybylik-Mazurek

    2012-01-01

    Full Text Available Nutritional factors are known to be important in the development of different metabolic diseases. The history of nodular or diffuse goiter is closely related to risk of thyroid carcinoma. On account of the function of the thyroid gland, many studies focus on iodine intake.The aim of the study was to assess whether dietary patterns could be risk factors of differentiated thyroid carcinoma.Material/Methods:The case-control study was based on a questionnaire, which included information about dietary patterns and was carried out on 284 patients comprising 30 males (mean age 58.4±13.7 years, and 254 females (mean age 52.1±13.8 years, as well as 345 randomly selected controls: 58 males (mean age 60.2±12 years and 287 females (mean age 53.4±14.3 years randomly selected from the Population Register and adjusted by age and gender to the group of TC. The main groups of nutritional products, i.e. starchy foods, meat, dairy products, vegetables, fruits, and beverages, were analyzed.Results:Consumption of vegetables, fruits, saltwater fish and cottage cheese was significantly lower in patients with differentiated thyroid carcinoma than in controls, quite the contrary to starchy foods, especially white bread.Conclusions:Dietary patterns appear to modify the risk of thyroid carcinoma. A diet rich in vegetables and fruit, as well as saltwater fish (a source of iodine and low-fat meat, could be an important protective factor.

  5. Human values and the emergence of a sustainable consumption pattern: A panel study

    DEFF Research Database (Denmark)

    Thøgersen, John; Ølander, Carl Folke

    2002-01-01

    In this study, data from a random sample of Danish consumers are used to test the hypothesis that the emergence of a sustainable consumption pattern is influenced by individual value priorities. By the use of a cross-lagged panel design and structural equation modelling it is possible to draw fir...... firmer conclusions about the direction of causality than has been possible in previous research. Udgivelsesdato: OCT...

  6. Refining adverse drug reaction signals by incorporating interaction variables identified using emergent pattern mining

    OpenAIRE

    Reps, Jenna M.; Aickelin, Uwe; Hubbard, Richard B.

    2016-01-01

    Purpose: To develop a framework for identifying and incorporating candidate confounding interaction terms into a regularised cox regression analysis to refine adverse drug reaction signals obtained via longitudinal observational data. Methods: We considered six drug families that are commonly associated with myocardial infarction in observational healthcare data, but where the causal relationship ground truth is known (adverse drug reaction or not). We applied emergent pattern mining to fi...

  7. Prevalence and risk factor analysis of resistant Escherichia coli urinary tract infections in the emergency department.

    Directory of Open Access Journals (Sweden)

    Bailey AM

    2013-06-01

    Full Text Available Background: Escherichia coli (E. coli is a frequent uropathogen in urinary tract infections (UTI. Widespread resistance to sulfamethoxazole-trimethoprim (SMX-TMP and increasing resistance to fluoroquinolones amongst these isolates has been recognized. There are limited data demonstrating risk factors for resistance to both SMX-TMP and fluoroquinolones.Objectives: This study was conducted to assess for the prevalence of community resistance amongst E. coli isolates to SMX-TMP and levofloxacin in ambulatory patients discharged from the emergency department (ED.Methods: Adults presenting for evaluation and discharged from the ED with a diagnosis of an E. coli UTI were retrospectively reviewed. Utilizing demographic and clinical data the prevalence of E. coli resistance and risk factors associated with SMX-TMP- and fluoroquinolone-resistant infection were determined. Results: Among the 222 patients, the mean rates of E. coli susceptibility to levofloxacin and SMX-TMP were 82.4% and 72.5%, respectively. Significant risk factors for resistance to SMX-TMP included prior antibiotic use (p=0.04 and prior diagnosis of UTI (p= 0.01. Significant risk factors for resistance to levofloxacin included: male gender, age, presence of hypertension, diabetes, chronic respiratory disease, nursing home resident, previous antibiotic use, previous diagnosis of UTI, existence of renal or genitourinary abnormalities, and prior surgical procedures (p <0.05 for all comparisons. The number of hospital days prior to initial ED evaluation (p<0.001 was determined to be a predictive factor in hospital and ED readmission. Conclusions: These results suggest that conventional approaches to monitoring for patterns of susceptibility may be inadequate. It is imperative that practitioners develop novel approaches to identifying patients with risk factors for resistance. Identification of risk factors from this evaluation should prompt providers to scrutinize the use of these agents in

  8. Patterns of parasite transmission in polar seas: Daily rhythms of cercarial emergence from intertidal snails

    Science.gov (United States)

    Prokofiev, Vladimir V.; Galaktionov, Kirill V.; Levakin, Ivan A.

    2016-07-01

    Trematodes are common parasites in intertidal ecosystems. Cercariae, their dispersive larvae, ensure transmission of infection from the first intermediate molluscan host to the second intermediate (invertebrates and fishes) or the final (fishes, marine birds and mammals) host. Trematode transmission in polar seas, while interesting in many respects, is poorly studied. This study aimed to elucidate the patterns of cercarial emergence from intertidal snails at the White Sea and Barents Sea. The study, involving cercariae of 12 species, has provided the most extensive material obtained so far in high latitude seas (66-69° N). The experiments were conducted in situ. Multichannel singular spectral analysis (MSSA) used for processing primary data made it possible to estimate the relative contribution of different oscillations into the analysed time series and to separate the daily component from the other oscillatory components and the noise. Cercarial emergence had pronounced daily rhythms, which did not depend on the daily tidal schedule but were regulated by thermo- and photoperiod. Daily emergence maximums coincided with periods favourable for infecting the second intermediate hosts. Cercarial daily emergence rhythms differed in species using the same molluscan hosts which can be explained by cercarial host searching behaviour. Daily cercarial output (DCO) correlated negatively with larval volume and positively with that of the molluscan host except in cercariae using ambuscade behaviour. In the Barents Sea cercariae emerged from their molluscan hosts at lower temperatures than in the warmer White Sea but the daily emergence period was prolonged. Thus, DCO of related species were similar in these two seas and comparable with DCO values reported for boreal seas. Local temperature adaptations in cercarial emergence suggests that in case of Arctic climate warming trematode transmission in coastal ecosystems is likely to be intensified not because of the increased

  9. Beyond age at first sex: patterns of emerging sexual behavior in adolescence and young adulthood.

    Science.gov (United States)

    Haydon, Abigail A; Herring, Amy H; Prinstein, Mitchell J; Halpern, Carolyn Tucker

    2012-05-01

    Although the emergence of sexual expression during adolescence and early adulthood is nearly universal, little is known about patterns of initiation. We used latent class analysis to group 12,194 respondents from waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) into one of five classes based on variety, timing, spacing, and sequencing of oral-genital, anal, and vaginal sex. Multinomial logistic regression models, stratified by biological sex, examined associations between sociodemographic characteristics and class membership. Approximately half of respondents followed a pattern characterized predominately by initiation of vaginal sex first, average age of initiation of approximately 16 years, and spacing of >1 year between initiation of the first and second behaviors; almost one-third initiated sexual activity slightly later but reported first experiences of oral-genital and vaginal sex within the same year. Classes characterized by postponement of sexual activity, initiation of only one type of behavior, or adolescent initiation of anal sex were substantially less common. Compared with white respondents, black respondents were more likely to appear in classes characterized by initiation of vaginal sex first. Respondents from lower socioeconomic backgrounds were more likely to be in classes distinguished by early/atypical patterns of initiation. A small number of typical and atypical patterns capture the emergence of sexual behavior during adolescence, but these patterns reveal complex associations among different elements of emerging sexuality that should be considered in future research. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. On the Determinants of Equity International Risk Premium: Are Emerging Zones Different?

    OpenAIRE

    Khaled Guesmi; Ilyes Abid; Mohamed Hedi Arouri; Frédéric Teulon

    2013-01-01

    This article contributes to the financial literature by investigating the formation of the international stock risk premium in emerging market zones. Our results from the estimation of a dynamic augmented capital asset pricing model show that the currency risk premium is the most important component of the total premium followed by the global market premium. As for the regional risk, our findings show that it is significantly priced for all studied emerging regions but its contribution to the...

  11. Changing risk of environmental Campylobacter exposure with emerging poultry production systems in Ethiopia.

    Science.gov (United States)

    Brena, M C; Mekonnen, Y; Bettridge, J M; Williams, N J; Wigley, P; Sisay Tessema, T; Christley, R M

    2016-02-01

    Campylobacter is a leading cause of diarrhoea, and its presence in chickens is a significant risk for zoonotic infection. Poultry production is becoming increasingly intensive in Ethiopia and is incorporating more high-producing breeds into traditionally managed smallholdings, especially in peri-urban areas. This cross-sectional study sampled 219 household environments in one peri-urban and two rural areas of Ethiopia, and an additional 20 semi-intensive farms in the peri-urban district. Campylobacter was detected by polymerase chain reaction (PCR)-specific assays in 44 samples; 16 of which could be identified as C. jejuni. Flocks in the peri-urban area were at significantly greater odds of detection, including those which only kept indigenous birds under a scavenging system. It was also noted that scavenging flocks of exotic high-production birds (Rhode Island Red) were at slightly greater risk, perhaps as exotic birds are under more stress when kept under traditional management systems. We suggest that changes to the system of chicken production may alter the ecology and epidemiology of Campylobacter in the environment, chickens and people, which may drive emergence of new epidemiological patterns of disease. Further research is needed to determine the extent to which the current management intensification and the distribution programmes of exotic and/or improved indigenous birds may alter Campylobacter epidemiology, ecology and public health risk, before their widespread adoption.

  12. Mining Emerging Patterns for Recognizing Activities of Multiple Users in Pervasive Computing

    DEFF Research Database (Denmark)

    Gu, Tao; Wu, Zhanqing; Wang, Liang

    2009-01-01

    sensor readings in a home environment, and propose a novel pattern mining approach to recognize both single-user and multi-user activities in a unified solution. We exploit Emerging Pattern – a type of knowledge pattern that describes significant changes between classes of data – for constructing our......Understanding and recognizing human activities from sensor readings is an important task in pervasive computing. Existing work on activity recognition mainly focuses on recognizing activities for a single user in a smart home environment. However, in real life, there are often multiple inhabitants...... live in such an environment. Recognizing activities of not only a single user, but also multiple users is essential to the development of practical context-aware applications in pervasive computing. In this paper, we investigate the fundamental problem of recognizing activities for multiple users from...

  13. Typologies and precursors of career adaptability patterns among emerging adults: a seven-year longitudinal study.

    Science.gov (United States)

    Shulman, Shmuel; Vasalampi, Kati; Barr, Tamuz; Livne, Yaara; Nurmi, Jari-Erik; Pratt, Michael W

    2014-12-01

    The present study examined career adaptability in 100 Israeli emerging adults who were followed from ages 22 to 29. Participants were given an in depth interview and were asked to talk about their current work, difficulties they might have had in the past and how they coped with them. In addition they were asked to elaborate on the extent to which their job fits their interests and is meaningful to them. Analyses of interviews yielded three distinctive career adaptability patterns that were associated with different levels of concurrent wellbeing: Integrated, Compromised, and Vague. A lower level of identified motivation measured seven years earlier predicted membership in the Compromised pattern. A higher level of extrinsic motivation combined with decreased parental support predicted membership in the Vague pattern. Findings are discussed within the framework of the occupational adaptations and compromises that young people must make when approaching the age of 30.

  14. Vegetarian Dietary Patterns and the Risk of Colorectal Cancers

    Science.gov (United States)

    Orlich, Michael J.; Singh, Pramil N.; Sabaté, Joan; Fan, Jing; Sveen, Lars; Bennett, Hannelore; Knutsen, Synnove F.; Beeson, W. Lawrence; Jaceldo-Siegl, Karen; Butler, Terry L.; Herring, R. Patti; Fraser, Gary E.

    2015-01-01

    IMPORTANCE Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established. OBJECTIVE To evaluate the association between vegetarian dietary patterns and incident colorectal cancers. DESIGN, SETTING, AND PARTICIPANTS The Adventist Health Study 2 (AHS-2) is a large, prospective, North American cohort trial including 96 354 Seventh-Day Adventist men and women recruited between January 1, 2002, and December 31, 2007. Follow-up varied by state and was indicated by the cancer registry linkage dates. Of these participants, an analytic sample of 77 659 remained after exclusions. Analysis was conducted using Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. The analysis was conducted between June 1, 2014, and October 20, 2014. EXPOSURES Diet was assessed at baseline by a validated quantitative food frequency questionnaire and categorized into 4 vegetarian dietary patterns (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a nonvegetarian dietary pattern. MAIN OUTCOMES AND MEASURES The relationship between dietary patterns and incident cancers of the colon and rectum; colorectal cancer cases were identified primarily by state cancer registry linkages. RESULTS During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64–0.95) for all colorectal cancers, 0.81 (95%CI, 0.65–1.00) for colon cancer, and 0.71 (95% CI, 0.47–1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was 0.84 (95% CI, 0.59–1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65–1.02); in pescovegetarians, 0.57 (95% CI, 0.40–0.82); and in semivegetarians, 0.92 (95% CI, 0.62–1.37) compared with

  15. Vegetarian dietary patterns and the risk of colorectal cancers.

    Science.gov (United States)

    Orlich, Michael J; Singh, Pramil N; Sabaté, Joan; Fan, Jing; Sveen, Lars; Bennett, Hannelore; Knutsen, Synnove F; Beeson, W Lawrence; Jaceldo-Siegl, Karen; Butler, Terry L; Herring, R Patti; Fraser, Gary E

    2015-05-01

    Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established. To evaluate the association between vegetarian dietary patterns and incident colorectal cancers. The Adventist Health Study 2 (AHS-2) is a large, prospective, North American cohort trial including 96,354 Seventh-Day Adventist men and women recruited between January 1, 2002, and December 31, 2007. Follow-up varied by state and was indicated by the cancer registry linkage dates. Of these participants, an analytic sample of 77,659 remained after exclusions. Analysis was conducted using Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. The analysis was conducted between June 1, 2014, and October 20, 2014. Diet was assessed at baseline by a validated quantitative food frequency questionnaire and categorized into 4 vegetarian dietary patterns (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a nonvegetarian dietary pattern. The relationship between dietary patterns and incident cancers of the colon and rectum; colorectal cancer cases were identified primarily by state cancer registry linkages. During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64-0.95) for all colorectal cancers, 0.81 (95% CI, 0.65-1.00) for colon cancer, and 0.71 (95% CI, 0.47-1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was 0.84 (95% CI, 0.59-1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65-1.02); in pescovegetarians, 0.57 (95% CI, 0.40-0.82); and in semivegetarians, 0.92 (95% CI, 0.62-1.37) compared with nonvegetarians. Effect estimates were similar for men and women and for black and nonblack individuals. Vegetarian diets are

  16. Patterns of multisite pain and associations with risk factors

    Science.gov (United States)

    Coggon, David; Ntani, Georgia; Palmer, Keith T.; Felli, Vanda E.; Harari, Raul; Barrero, Lope H.; Felknor, Sarah A.; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R.; Sadeghian, Farideh; Masood Kadir, M.; Warnakulasuriya, Sudath S.P.; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R.; Harcombe, Helen; Cox, Ken; Marziale, Maria H.; Sarquis, Leila M.; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V.; Quintana, Leonardo A.; Rojas, Marianela; Salazar Vega, Eduardo J.; Harris, E. Clare; Serra, Consol; Martinez, J. Miguel; Delclos, George; Benavides, Fernando G.; Carugno, Michele; Ferrario, Marco M.; Pesatori, Angela C.; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Sirk, Tuuli; Sadeghian, Ali; Peiris-John, Roshini J.; Sathiakumar, Nalini; Wickremasinghe, A. Rajitha; Yoshimura, Noriko; Kelsall, Helen L.; Hoe, Victor C.W; Urquhart, Donna M.; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew

    2013-01-01

    To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20–59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6–10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1–3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites. PMID:23727463

  17. Emerging viral threats in Gabon: health capacities and response to the risk of emerging zoonotic diseases in Central Africa.

    Science.gov (United States)

    Bourgarel, M; Wauquier, N; Gonzalez, J-P

    2010-01-01

    Emerging infectious diseases (EID) are currently the major threat to public health worldwide and most EID events have involved zoonotic infectious agents. Central Africa in general and Gabon in particular are privileged areas for the emergence of zoonotic EIDs. Indeed, human incursions in Gabonese forests for exploitation purposes lead to intensified contacts between humans and wildlife thus generating an increased risk of emergence of zoonotic diseases. In Gabon, 51 endemic or potential endemic viral infectious diseases have been reported. Among them, 22 are of zoonotic origin and involve 12 families of viruses. The most notorious are dengue, yellow fever, ebola, marburg, Rift Valley fever and chikungunya viruses. Potential EID due to wildlife in Gabon are thereby plentiful and need to be inventoried. The Gabonese Public Health system covers geographically most of the country allowing a good access to sanitary information and efficient monitoring of emerging diseases. However, access to treatment and prevention is better in urban areas where medical structures are more developed and financial means are concentrated even though the population is equally distributed between urban and rural areas. In spite of this, Gabon could be a good field for investigating the emergence or re-emergence of zoonotic EID. Indeed Gabonese health research structures such as CIRMF, advantageously located, offer high quality researchers and facilities that study pathogens and wildlife ecology, aiming toward a better understanding of the contact and transmission mechanisms of new pathogens from wildlife to human, the emergence of zoonotic EID and the breaking of species barriers by pathogens.

  18. 3 CFR - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Science.gov (United States)

    2010-01-01

    ... to the Risk of Nuclear Proliferation Created by the Accumulation of Weapons-Useable Fissile Material... of June 18, 2009 Continuation of the National Emergency With Respect to the Risk of Nuclear... risk of nuclear proliferation created by the accumulation of weapons-usable fissile material in...

  19. Physicians' and nurses' perceptions of patient safety risks in the emergency department.

    Science.gov (United States)

    Källberg, Ann-Sofie; Ehrenberg, Anna; Florin, Jan; Östergren, Jan; Göransson, Katarina E

    2017-02-28

    The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.

  20. Vegetarian dietary patterns and the risk of breast cancer in a low-risk population.

    Science.gov (United States)

    Penniecook-Sawyers, Jason A; Jaceldo-Siegl, Karen; Fan, Jing; Beeson, Larry; Knutsen, Synnove; Herring, Patti; Fraser, Gary E

    2016-05-28

    Among cancers in American women, breast cancer (BC) has the second highest incidence and mortality. The association of BC with diet has been inconsistent. Studies that evaluate associations with dietary patterns are less common and reflect an individual's whole diet. We associated dietary patterns with the risk of BC in American women of the Adventist Health Study-2 (AHS-2), a prospective cohort of 96 001 subjects recruited between 2002 and 2007. Answers to a previously validated FFQ were used to classify subjects to vegan, lacto-ovo-vegetarian, pesco-vegetarian, semi-vegetarian and non-vegetarian dietary patterns. Incident BC were identified by matching AHS-2 subjects to data from forty-eight state cancer registries. Statistical analyses used proportional hazard regression analyses with covariates that were chosen a priori. From 50 404 female participants (26 193 vegetarians), we identified 892 incident BC cases, with 478 cases among vegetarians. As compared with non-vegetarians, all vegetarians combined did not have a significantly lower risk (hazard ratio (HR) 0·97; CI 0·84, 1·11; P=0·64). However, vegans showed consistently lower (but non-significant) point estimates when compared with non-vegetarians (all cases: HR 0·78; CI 0·58, 1·05; P=0·09). In summary, participants in this cohort who follow a vegetarian dietary pattern did not experience a lower risk of BC as compared with non-vegetarians, although lower risk in vegans is possible. These findings add to the very limited literature associating vegetarian diets with BC risk and can assist nutritionists when evaluating the impact of these diets. The findings will also motivate further evaluation of vegan diets and their special characteristics.

  1. Emerging Patterns Of Bangsa Malaysia In Anthony Burgess’ Time For A Tiger

    Directory of Open Access Journals (Sweden)

    Farahanna Abd Razak

    2016-01-01

    Full Text Available Time for a Tiger (1956, a novel by Anthony Burgess, is believed to have been overlooked in the Malaysian literary context. Existing scholarship has maintained that the central themes of Time for a Tiger are colliding cultures, clashes of religion and racial conflicts but, in spite of these themes, this paper attempts to argue that there are in fact emerging patterns of Bangsa Malaysia in Time for a Tiger, which in turn reflect the elements of unity among the rich mixture of multi-ethnic characters. Bangsa Malaysia is not only the first of the nine challenges listed in Vision 2020 as conceptualised by Dr. Mahathir Mohamad (1991, but also marks the first time the Malaysian government is officially putting forward a clear vision in building a nation, launched to create a oneness atmosphere among the ethnic groups, in hopes it will reduce, if not erase, the tension among them. This study reveals that there are indeed emerging patterns of Bangsa Malaysia depicted through a mixture of characters from various ethnicities, namely the Malays, the Chinese and the Indians, through the implementation of government policies, education, a change of mindset and personal judgement, patriotism and the unifying role of the monarchy. Additionally, the patterns do support the earlier stage of the formation of Bangsa Malaysia, namely tolerance. Keywords: Bangsa Malaysia, Anthony Burgess, Time for a Tiger, Malayans, tolerance, unity

  2. Health Emergency and Disaster Risk Management (Health-EDRM): Developing the Research Field within the Sendai Framework Paradigm

    National Research Council Canada - National Science Library

    Sharon Tsoon Ting Lo; Emily Ying Yang Chan; Gloria Kwong Wai Chan; Virginia Murray; Jonathan Abrahams; Ali Ardalan; Ryoma Kayano; Johnny Chung Wai Yau

    2017-01-01

    .... Health Emergency and Disaster Risk Management (Health-EDRM) has emerged as an umbrella field that encompasses emergency and disaster medicine, DRR, humanitarian response, community health resilience, and health systems resilience...

  3. Risk identification in food safety: Strategy and outcomes of the EFSA emerging risks exchange network (EREN), 2010-2014

    DEFF Research Database (Denmark)

    Costa, M. C.; Goumperis, T.; Andersson, W.

    2017-01-01

    of illegal activity, new consumer consumption trends, biotoxins, new technologies and processes, allergens, animal health, environmental pollution, new analytical methods, new food packaging technology and unknown hazards were on the agenda. Based on the available evidence, EREN recommended whether an issue...... emerging issues that were presented and assessed using a standard template developed by the Emerging Risks unit of EFSA (EMRISK). Out of these signals, 39 originated from EFSA, 24 from MSs. The issues discussed were mainly microbiological and chemical hazards, but also food safety issues as result...... should be considered emerging or not, and if it merited further consideration, such as generating data on the issue, starting a full risk assessment and/or consultation of other bodies. According to the emerging risks identification process set in place at EFSA, the issues discussed and found...

  4. A Western Dietary Pattern Increases Prostate Cancer Risk: A Systematic Review and Meta-Analysis

    OpenAIRE

    Roberto Fabiani; Liliana Minelli; Gaia Bertarelli; Silvia Bacci

    2016-01-01

    Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC) risk. While the associations between PC risk with the glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by “a posteriori” methods. A literature search was carried out (PubMed, Web of Science) to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns wer...

  5. Tactical emergency medical support: physician involvement and injury patterns in tactical teams.

    Science.gov (United States)

    Gildea, Jon R; Janssen, Alan R

    2008-11-01

    Medical support provided by physicians in police tactical teams has been firmly embraced by the medical community. Our study revisited the 1995 study inquiring into injury patterns in police tactical teams. A national survey was completed by 209 members of tactical teams throughout the country over a 6-week period. An electronic survey was submitted to the National Tactical Officers Association, the International Tactical Emergency Medical Support Association, and state tactical associations. Teams reporting physician utilization were 47% of the whole (69% were presentpolice tactical teams and a need for extensive involvement in all aspects of team health, with special attention to daily health and physical fitness.

  6. Survey on methodologies in the risk assessment of chemical exposures in emergency response situations in Europe

    DEFF Research Database (Denmark)

    Heinälä, Milla; Gundert-Remy, Ursula; Wood, Maureen Heraty

    2013-01-01

    A scientifically sound assessment of the risk to human health resulting from acute chemical releases is the cornerstone for chemical incident prevention, preparedness and response. Although the general methodology to identify acute toxicity of chemicals has not substantially changed in the last....../corrosive chemicals will remain serious risks also in future the development of plausible scenarios for potential emerging risks is also needed. This includes risks from new mixtures and chemicals (e.g. nanoparticles)....

  7. Emergent archetype patterns of coupled hydrologic and biogeochemical responses in catchments

    Science.gov (United States)

    Musolff, A.; Fleckenstein, J. H.; Rao, P. S. C.; Jawitz, J. W.

    2017-05-01

    Relationships between in-stream dissolved solute concentrations (C) and discharge (Q) are useful indicators of catchment-scale processes. We combine a synthesis of observational records with a parsimonious stochastic modeling approach to test how C-Q relationships arise from spatial heterogeneity in catchment solute sources coupled with different timescales of reactions. Our model indicates that the dominant driver of emergent archetypical dilution, enrichment, and constant C-Q patterns was structured heterogeneity of solute sources implemented as correlation of source concentration to travel time. Regardless of the C-Q pattern, with weak correlation between solute-source concentration and travel time, we consistently find lower variability in C than in Q, such that the predominant solute export regime is chemostatic. Consequently, the variance in exported loads is determined primarily by variance of Q. Efforts to improve stream water quality and ecological integrity in intensely managed catchments should lead away from landscape homogenization by introducing structured source heterogeneity.

  8. Patterns of salivary cortisol levels can manifest work stress in emergency care providers.

    Science.gov (United States)

    Nakajima, Yasushi; Takahashi, Takayuki; Shetty, Vivek; Yamaguchi, Masaki

    2012-05-01

    To develop objective assessments of work fatigue, we investigated the patterns of changes in salivary cortisol levels in emergency care providers working extended work shifts. Fourteen subjects, comprising seven physicians and seven physician assistants, provided unstimulated saliva samples at regular intervals over the course of a 24-h work shift and over their subsequent free day. There was a significant time effect, with early morning cortisol levels being significantly attenuated following the work shift. Native diurnal variations varied by gender, with the female subjects manifesting greater cortisol levels. Physicians also had higher cortisol profiles even though their wake-rest cycles were similar to those of the physician assistants. Our results suggest that temporal changes, as well as diurnal similarities, in the salivary cortisol patterns can reflect work-related stress and recovery. In particular, early morning cortisol levels may manifest individual reactivity to work stressors as well as sleep deprivation.

  9. Risk Assessment for Emergency Planning Related to Nuclear Weapons Accidents

    Science.gov (United States)

    1985-09-25

    agencies for handling emergencies (e.g., police , ambulance , medical, hospital, and fire-fighting organ zations should be specified). The facility...emerganey aczions, Including protective mesures . 1. Request for any needed on-site support by off-site organizations. a. Prognosis for worsening cr...decontamination. f. Providing ambulance servlce. S. Providing medical treatment services. 2. Each organization should establish a radiation protection program

  10. Sleep patterns and the risk for ADHD: a review

    Directory of Open Access Journals (Sweden)

    Cassoff J

    2012-05-01

    Full Text Available Jamie Cassoff,1,2 Sabrina T Wiebe,1,2 Reut Gruber1,21Attention, Behavior and Sleep Lab, Douglas Mental Health University Institute, Montréal, Quebec, Canada; 2McGill University, Montréal, Quebec, CanadaAbstract: Attention-deficit/hyperactivity disorder (ADHD is often associated with comorbid sleep disturbances. Sleep disturbances may be a risk factor for development of the disorder, a symptom of the disorder, or a comorbid condition affected by a similar psychopathology. Various studies have examined the impact of sleep deprivation on the presence/exacerbation of ADHD symptomology, as well as longitudinal and concurrent associations between different sleep disturbances and ADHD, yet the notion of sleep disturbances as a predecessor to ADHD remains unclear. As such, this review examines the evidence for sleep disturbances as a risk factor for the development of ADHD, as well as the mechanisms underlying the association between sleep patterns and ADHD. Additionally, clinical implications regarding the comorbid nature of sleep disturbances and ADHD will be considered.Keywords: sleep disturbances, ADHD, development

  11. International legal framework for geoengineering: Managing the risks of an emerging technology

    NARCIS (Netherlands)

    Du, Haomiao

    2016-01-01

    The present book “International Legal Framework for Geoengineering – Managing the Risks of an Emerging Technology” is about international law and an emerging technology called geoengineering, which refers to the large-scale manipulation of the planetary environment for counteracting anthropogenic gl

  12. International legal framework for geoengineering: Managing the risks of an emerging technology

    NARCIS (Netherlands)

    Du, Haomiao

    2016-01-01

    The present book “International Legal Framework for Geoengineering – Managing the Risks of an Emerging Technology” is about international law and an emerging technology called geoengineering, which refers to the large-scale manipulation of the planetary environment for counteracting anthropogenic

  13. Emergence of localized patterns in globally coupled networks of relaxation oscillators with heterogeneous connectivity

    Science.gov (United States)

    Leiser, Randolph J.; Rotstein, Horacio G.

    2017-08-01

    Oscillations in far-from-equilibrium systems (e.g., chemical, biochemical, biological) are generated by the nonlinear interplay of positive and negative feedback effects operating at different time scales. Relaxation oscillations emerge when the time scales between the activators and the inhibitors are well separated. In addition to the large-amplitude oscillations (LAOs) or relaxation type, these systems exhibit small-amplitude oscillations (SAOs) as well as abrupt transitions between them (canard phenomenon). Localized cluster patterns in networks of relaxation oscillators consist of one cluster oscillating in the LAO regime or exhibiting mixed-mode oscillations (LAOs interspersed with SAOs), while the other oscillates in the SAO regime. Because the individual oscillators are monostable, localized patterns are a network phenomenon that involves the interplay of the connectivity and the intrinsic dynamic properties of the individual nodes. Motivated by experimental and theoretical results on the Belousov-Zhabotinsky reaction, we investigate the mechanisms underlying the generation of localized patterns in globally coupled networks of piecewise-linear relaxation oscillators where the global feedback term affects the rate of change of the activator (fast variable) and depends on the weighted sum of the inhibitor (slow variable) at any given time. We also investigate whether these patterns are affected by the presence of a diffusive type of coupling whose synchronizing effects compete with the symmetry-breaking global feedback effects.

  14. The emergence of urban land use patterns driven by dispersion and aggregation mechanisms.

    Directory of Open Access Journals (Sweden)

    James Decraene

    Full Text Available We employ a cellular-automata to reconstruct the land use patterns of cities that we characterize by two measures of spatial heterogeneity: (a a variant of spatial entropy, which measures the spread of residential, business, and industrial activity sectors, and (b an index of dissimilarity, which quantifies the degree of spatial mixing of these land use activity parcels. A minimalist and bottom-up approach is adopted that utilizes a limited set of three parameters which represent the forces which determine the extent to which each of these sectors spatially aggregate into clusters. The dispersion degrees of the land uses are governed by a fixed pre-specified power-law distribution based on empirical observations in other cities. Our method is then used to reconstruct land use patterns for the city state of Singapore and a selection of North American cities. We demonstrate the emergence of land use patterns that exhibit comparable visual features to the actual city maps defining our case studies whilst sharing similar spatial characteristics. Our work provides a complementary approach to other measures of urban spatial structure that differentiate cities by their land use patterns resulting from bottom-up dispersion and aggregation processes.

  15. Emergence of postural patterns as a function of vision and translation frequency

    Science.gov (United States)

    Buchanan, J. J.; Horak, F. B.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Emergence of postural patterns as a function of vision and translation frequency. We examined the frequency characteristics of human postural coordination and the role of visual information in this coordination. Eight healthy adults maintained balance in stance during sinusoidal support surface translations (12 cm peak to peak) in the anterior-posterior direction at six different frequencies. Changes in kinematic and dynamic measures revealed that both sensory and biomechanical constraints limit postural coordination patterns as a function of translation frequency. At slow frequencies (0.1 and 0.25 Hz), subjects ride the platform (with the eyes open or closed). For fast frequencies (1.0 and 1.25 Hz) with the eyes open, subjects fix their head and upper trunk in space. With the eyes closed, large-amplitude, slow-sway motion of the head and trunk occurred for fast frequencies above 0.5 Hz. Visual information stabilized posture by reducing the variability of the head's position in space and the position of the center of mass (CoM) within the support surface defined by the feet for all but the slowest translation frequencies. When subjects rode the platform, there was little oscillatory joint motion, with muscle activity limited mostly to the ankles. To support the head fixed in space and slow-sway postural patterns, subjects produced stable interjoint hip and ankle joint coordination patterns. This increase in joint motion of the lower body dissipated the energy input by fast translation frequencies and facilitated the control of upper body motion. CoM amplitude decreased with increasing translation frequency, whereas the center of pressure amplitude increased with increasing translation frequency. Our results suggest that visual information was important to maintaining a fixed position of the head and trunk in space, whereas proprioceptive information was sufficient to produce stable coordinative patterns between the support surface and legs. The CNS organizes

  16. Emerging contaminants: presentations at the 2009 Toxicology and Risk Assessment Conference.

    Science.gov (United States)

    Murnyak, George; Vandenberg, John; Yaroschak, Paul J; Williams, Larry; Prabhakaran, Krishnan; Hinz, John

    2011-07-15

    A session entitled "Emerging Contaminants" was held in April 2009 in Cincinnati, OH at the 2009 Toxicology and Risk Assessment Conference. The purpose of the session was to share information on both programmatic and technical aspects associated with emerging contaminants. Emerging contaminants are chemicals or materials that are characterized by a perceived or real threat to human health or environment, a lack of published health standards or an evolving standard. A contaminant may also be "emerging" because of the discovery of a new source, a new pathway to humans, or a new detection method or technology. The session included five speakers representing the Department of Defense (DoD), the Environmental Protection Agency (EPA), and each of the military services. The DoD created the Emerging Contaminant Directorate to proactively address environmental, health, and safety concerns associated with emerging contaminants. This session described the scan-watch-action list process, impact assessment methodology, and integrated risk management concept that DoD has implemented to manage emerging contaminants. EPA presented emerging trends in health risk assessment. Researchers made technical presentations on the status of some emerging contaminates in the assessment process (i.e. manganese, RDX, and naphthalene).

  17. Financial stress in emerging markets: Patterns, real effects, and cross-country spillovers

    Directory of Open Access Journals (Sweden)

    Mikhail Stolbov

    2016-06-01

    Full Text Available We extend the conventional approach to the construction of financial stress indices (FSI for emerging economies proposed by Balakrishnan et al. (2011. Based on the principal component analysis, our index accounts for developments in the residential real estate market, adopts distinctive indicators for the banking sector and sovereign debt risks, covering the period from February 2008 to September 2015 for 14 emerging economies. The FSIs accurately capture the periods of impaired financial intermediation. The hierarchical cluster analysis identifies five country groups, revealing similarities in the national structures of financial stress. We find an adverse impact of financial stress on economic activity in 9 countries. A Bayesian VAR model is also specified to test for cross-country spillovers of financial stress.

  18. Risk assessment and emerging chemicals hazards in foods

    Directory of Open Access Journals (Sweden)

    Umberto Moscato

    2007-03-01

    Full Text Available The main beliefs relating to the risk assessment of chemicals in foods, new chemicals in raw material as well as in food processing are briefly presented. Evaluation reviews of representative chemicals found in traditional and novel foods are given. Old and new processes or newly recognized compounds, that require careful assessment in terms of their potential human health impact, are discussed. As example of processing-related contaminants, a risk assessment for acrylamide, is described, providing two different approaches in food safety assessment and the management of carcinogenic contaminants.

  19. Emerging frontier technologies for food safety analysis and risk assessment

    Institute of Scientific and Technical Information of China (English)

    DONG Yi-yang; LIU Jia-hui; WANG Sai; CHEN Qi-long; GUO Tian-yang; ZHANG Li-ya; JIN Yong; SU Hai-jia; TAN Tian-wei

    2015-01-01

    Access to security and safe food is a basic human necessity and essential for a sustainable world. To perform hi-end food safety analysis and risk assessment with state of the art technologies is of utmost importance thereof. With applications as exempliifed by microlfuidic immunoassay, aptasensor, direct analysis in real time, high resolution mass spectrometry, benchmark dose and chemical speciifc adjustment factor, this review presents frontier food safety analysis and risk assess-ment technologies, from which both food quality and public health wil beneift undoubtedly in a foreseeable future.

  20. Agile supply chain capabilities: emerging patterns as a determinant of competitive objectives

    Science.gov (United States)

    Yusuf, Yahaya Y.; Adeleye, E. O.; Sivayoganathan, K.

    2001-10-01

    Turbulent change caused by factors such as changing customer and technological requirements threatens manufacturers through lower product life cycles, profits and bleak survival prospects. Therefore, several companies are stressing flexibility and agility in order to respond, real time, to the unique needs of customers and markets. However, the resource competencies required are often difficult to mobilise and retain by single companies. It is therefore imperative for companies to co-operate and leverage complementary competencies. To this end, legally separate and spatially distributed companies are becoming integrated through Internet-based technologies. The paper reviews emerging patterns in supply chain integration. It also explores the relationship between the emerging patterns and attainment of competitive objectives. The results reported in the paper are based on data from a survey by questionnaire. The survey involved 600 companies in the UK, as part of a larger study of agile manufacturing. The study was driven by a conceptual model, which relates supply chain practices to competitive objectives. The analysis involves the use of factor analysis to reduce research variables to a few principal components. Subsequently, multiple regression was conducted to study the relationship amongst the reduced variables. The results validate the proposed conceptual model and lend credence to current thinking that supply chain integration is a vital tool for competitive advantage.

  1. Optimal search patterns in honeybee orientation flights are robust against emerging infectious diseases

    Science.gov (United States)

    Wolf, Stephan; Nicholls, Elizabeth; Reynolds, Andrew M.; Wells, Patricia; Lim, Ka S.; Paxton, Robert J.; Osborne, Juliet L.

    2016-01-01

    Lévy flights are scale-free (fractal) search patterns found in a wide range of animals. They can be an advantageous strategy promoting high encounter rates with rare cues that may indicate prey items, mating partners or navigational landmarks. The robustness of this behavioural strategy to ubiquitous threats to animal performance, such as pathogens, remains poorly understood. Using honeybees radar-tracked during their orientation flights in a novel landscape, we assess for the first time how two emerging infectious diseases (Nosema sp. and the Varroa-associated Deformed wing virus (DWV)) affect bees’ behavioural performance and search strategy. Nosema infection, unlike DWV, affected the spatial scale of orientation flights, causing significantly shorter and more compact flights. However, in stark contrast to disease-dependent temporal fractals, we find the same prevalence of optimal Lévy flight characteristics (μ ≈ 2) in both healthy and infected bees. We discuss the ecological and evolutionary implications of these surprising insights, arguing that Lévy search patterns are an emergent property of fundamental characteristics of neuronal and sensory components of the decision-making process, making them robust against diverse physiological effects of pathogen infection and possibly other stressors. PMID:27615605

  2. Emergence of long-range correlations and bursty activity patterns in online communication.

    Science.gov (United States)

    Panzarasa, Pietro; Bonaventura, Moreno

    2015-12-01

    Research has suggested that the activity occurring in a variety of social, economic, and technological systems exhibits long-range fluctuations in time. Pronounced levels of rapidly occurring events are typically observed over short periods of time, followed by long periods of inactivity. Relatively few studies, however, have shed light on the degree to which inhomogeneous temporal processes can be detected at, and emerge from, different levels of analysis. Here we investigate patterns of human activity within an online forum in which communication can be assessed at three intertwined levels: the micro level of the individual users; the meso level of discussion groups and continuous sessions; and the macro level of the whole system. To uncover the relation between different levels, we conduct a number of numerical simulations of a zero-crossing model in which users' behavior is constrained by progressively richer and more realistic rules of social interaction. Results indicate that, when users are solipsistic, their bursty behavior is not sufficient for generating heavy-tailed interevent time distributions at a higher level. However, when users are socially interdependent, the power spectra and interevent time distributions of the simulated and real forums are remarkably similar at all levels of analysis. Social interaction is responsible for the aggregation of multiple bursty activities at the micro level into an emergent bursty activity pattern at a higher level. We discuss the implications of the findings for an emergentist account of burstiness in complex systems.

  3. Emergence of long-range correlations and bursty activity patterns in online communication

    Science.gov (United States)

    Panzarasa, Pietro; Bonaventura, Moreno

    2015-12-01

    Research has suggested that the activity occurring in a variety of social, economic, and technological systems exhibits long-range fluctuations in time. Pronounced levels of rapidly occurring events are typically observed over short periods of time, followed by long periods of inactivity. Relatively few studies, however, have shed light on the degree to which inhomogeneous temporal processes can be detected at, and emerge from, different levels of analysis. Here we investigate patterns of human activity within an online forum in which communication can be assessed at three intertwined levels: the micro level of the individual users; the meso level of discussion groups and continuous sessions; and the macro level of the whole system. To uncover the relation between different levels, we conduct a number of numerical simulations of a zero-crossing model in which users' behavior is constrained by progressively richer and more realistic rules of social interaction. Results indicate that, when users are solipsistic, their bursty behavior is not sufficient for generating heavy-tailed interevent time distributions at a higher level. However, when users are socially interdependent, the power spectra and interevent time distributions of the simulated and real forums are remarkably similar at all levels of analysis. Social interaction is responsible for the aggregation of multiple bursty activities at the micro level into an emergent bursty activity pattern at a higher level. We discuss the implications of the findings for an emergentist account of burstiness in complex systems.

  4. The cyanobacteria toxins, microcystins – emerging risks to human health

    Science.gov (United States)

    Dialysis patients appear to be at increased risk for exposure to cyanobacteria toxins; episodes of microcystin (MCYST) exposure via dialysate during 1996 and 2001 have been previously reported. During 2001, as many as 44 renal insufficiency patients were exposed to contaminated d...

  5. [Principle for strategic decision based on population health risk in emergence environmental cadmium pollution control].

    Science.gov (United States)

    Shang, Qi

    2012-05-01

    The principles for strategic decision in emergence environmental pollution control was summarized based on population health risk and features of emergence events of environmental cadmium pollution. Main task and strategies for the events control was suggested in emergency treatment and post-event for water and soil cadmium pollution respectively. The work, monitoring method, key problems for both environment cadmium pollution and human health risk, and main content of health education for cadmium exposure people was proposed in follow-up action, at meanwhile, achievements of study on human health effects caused by environmental cadmium pollution was introduced briefly over recent years.

  6. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section.

    Science.gov (United States)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola; Kristensen, Kim; Secher, Niels Jørgen

    2017-01-01

    Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal respiratory morbidity, the risk of childhood asthma following emergency caesarean section remained unchanged. Emergency caesarean section was not associated with childhood asthma. none. not relevant.

  7. Venoms of Micrurus coral snakes: Evolutionary trends in compositional patterns emerging from proteomic analyses.

    Science.gov (United States)

    Lomonte, Bruno; Rey-Suárez, Paola; Fernández, Julián; Sasa, Mahmood; Pla, Davinia; Vargas, Nancy; Bénard-Valle, Melisa; Sanz, Libia; Corrêa-Netto, Carlos; Núñez, Vitelbina; Alape-Girón, Alberto; Alagón, Alejandro; Gutiérrez, José María; Calvete, Juan J

    2016-11-01

    The application of proteomic tools to the study of snake venoms has led to an impressive growth in the knowledge about their composition (venomics), immunogenicity (antivenomics), and toxicity (toxicovenomics). About one-third of all venomic studies have focused on elapid species, especially those of the Old World. The New World elapids, represented by coral snakes, have been less studied. In recent years, however, a number of venomic studies on Micrurus species from North, Central, and South America have been conducted. An overview of these studies is presented, highlighting the emergence of some patterns and trends concerning their compositional, functional, and immunological characteristics. Results gathered to date, encompassing 18 out of the approximately 85 species of Micrurus, reveal a dichotomy of venom phenotypes regarding the relative abundance of the omnipresent phospholipases A2 (PLA2) and 'three-finger' toxins (3FTx): a group of species express a PLA2-predominant venom composition, while others display a 3FTx-predominant compositional pattern. These two divergent toxin expression phenotypes appear to be related to phylogenetic positions and geographical distributions along a North-South axis in the Americas, but further studies encompassing a higher number of species are needed to assess these hypotheses. The two contrasting phenotypes also show correlations with some toxic functionalities, complexity in the diversity of proteoforms, and immunological cross-recognition patterns. The biological significance for the emergence of a dichotomy of venom compositions within Micrurus, in some cases observed even among sympatric species that inhabit relatively small geographic areas, represents a puzzling and challenging area of research which warrants further studies.

  8. In-Training Practice Patterns of Combined Emergency Medicine/Internal Medicine Residents, 2003-2007

    Directory of Open Access Journals (Sweden)

    Todd A Templeman

    2011-05-01

    Full Text Available Introduction: This study seeks to evaluate the practice patterns of current combined emergency medicine/internal medicine (EM/IM residents during their training and compare them to the typical practice patterns of EM/IM graduates. We further seek to characterize how these current residents perceive the EM/IM physician’s niche. Methods: This is a multi-institution, cross-sectional, survey-based cohort study. Between June 2008 and July 2008, all 112 residents of the 11 EM/IM programs listed by the Accreditation Council for Graduate Medical Education were contacted and asked to complete a survey concerning plans for certification, fellowship, and practice setting. Results: The adjusted response rate was 71%. All respondents anticipated certifying in both specialties, with 47% intending to pursue fellowships. Most residents (97% allotted time to both EM and IM, with a median time of 70% and 30%, respectively. Concerning academic medicine, 81% indicated intent to practice academic medicine, and 96% planned to allocate at least 10% of their future time to a university/academic setting. In evaluating satisfaction, 94% were (1 satisfied with their residency choice, (2 believed that a combined residency will advance their career, and (3 would repeat a combined residency if given the opportunity. Conclusion: Current EM/IM residents were very content with their training and the overwhelming majority of residents plan to devote time to the practice of academic medicine. Relative to the practice patterns previously observed in EM/IM graduates, the current residents are more inclined toward pursuing fellowships and practicing both specialties. [West J Emerg Med. 2011;12(4:530–536.

  9. Microbiological Zoonotic Emerging Risks, Transmitted Between Livestock Animals and Humans (2007-2015).

    Science.gov (United States)

    Filippitzi, M E; Goumperis, T; Robinson, T; Saegerman, C

    2017-08-01

    As part of the Emerging Risk Identification (ERI) activities of the European Food Safety Authority (EFSA), a literature search was conducted to identify the microbiological agents transmitted between livestock animals and humans that have been suggested as having emerged between 2007 and 2015 in peer-reviewed scientific literature published during the same period (2007-2015). According to the criteria set, the search identified seven such zoonotic agents, namely West Nile Fever virus, Rift Valley Fever virus, Crimean-Congo Haemorrhagic Fever virus, Influenza A H1N1 virus, Coxiella burnetii, Streptococcus suis and livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398. An explanation of the agents' consideration as emerging risks is provided. The experience gained from these emergences has shown that the detection of and response to such risks can be achieved faster and more successfully within a multidisciplinary, collaborative context at the field, local, national and international levels. © 2016 Blackwell Verlag GmbH.

  10. Health Risk Information Engagement and Amplification on Social Media: News about an Emerging Pandemic on Facebook

    Science.gov (United States)

    Strekalova, Yulia A.

    2017-01-01

    Emerging pandemics call for unique health communication and education strategies in which public health agencies need to satisfy the public's information needs about possible risks while preventing risk exaggeration and dramatization. As a route to providing a framework for understanding public information behaviors in response to an emerging…

  11. Outbreaks of emerging infectious diseases: Risk perception and behaviour of the general public

    NARCIS (Netherlands)

    M. Bults (Marloes)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on risk perception and behaviour of the public during the outbreaks of emerging infectious diseases. It consists of studies on Influenza A (H1N1), Q fever and Lyme disease. These studies were conducted among both the general public and specific risk

  12. Determinants of sovereign risk premia for European emerging markets

    Directory of Open Access Journals (Sweden)

    Mirna Dumičić

    2011-09-01

    Full Text Available This paper analyses the determinants of the changes in sovereign bond spreads in emerging European markets before and during the recent global financial crisis. In particular, these determinants are associated with changes in market sentiment and in domestic macroeconomic fundamentals. The model was estimated on panel data for eight central and eastern European countries between Q1:2000 and Q2:2010, using least squares and controlling for serial correlation. The results show that the dynamics of spreads can be explained by both market sentiment indicators and macroeconomic fundamentals. In particular, the external imbalances did not exert any discernible effect on spreads prior to the crisis, but became increasingly signifi cant as the crisis broke out.

  13. Individual Movement Strategies Revealed through Novel Clustering of Emergent Movement Patterns

    Science.gov (United States)

    Valle, Denis; Cvetojevic, Sreten; Robertson, Ellen P.; Reichert, Brian E.; Hochmair, Hartwig H.; Fletcher, Robert J.

    2017-03-01

    Understanding movement is critical in several disciplines but analysis methods often neglect key information by adopting each location as sampling unit, rather than each individual. We introduce a novel statistical method that, by focusing on individuals, enables better identification of temporal dynamics of connectivity, traits of individuals that explain emergent movement patterns, and sites that play a critical role in connecting subpopulations. We apply this method to two examples that span movement networks that vary considerably in size and questions: movements of an endangered raptor, the snail kite (Rostrhamus sociabilis plumbeus), and human movement in Florida inferred from Twitter. For snail kites, our method reveals substantial differences in movement strategies for different bird cohorts and temporal changes in connectivity driven by the invasion of an exotic food resource, illustrating the challenge of identifying critical connectivity sites for conservation in the presence of global change. For human movement, our method is able to reliably determine the origin of Florida visitors and identify distinct movement patterns within Florida for visitors from different places, providing near real-time information on the spatial and temporal patterns of tourists. These results emphasize the need to integrate individual variation to generate new insights when modeling movement data.

  14. Emergence and stability of interlimb coordination patterns in children with developmental coordination disorder.

    Science.gov (United States)

    de Castro Ferracioli, Marcela; Hiraga, Cynthia Yukiko; Pellegrini, Ana Maria

    2014-02-01

    The purpose of this study was to investigate the emergence and stability of coordination patterns in children with developmental coordination disorder (DCD) when performing a rhythmic interlimb coordination task on rigid (floor) and elastic (mini-trampoline) surfaces. Twelve typically developing (TD) children and 12 children with DCD were required to clap while jumping under different conditions: in a chosen pattern - Free; when the feet touched the surface - Clapping-surface; when the body reached the maximum jumping height - Clapping-jump; and when the feet touched the surface and the body reached the maximum jumping height - Clapping-both. The results showed that the coordination pattern of children with DCD was more variable in the Free, Clapping-surface, and Clapping-jumping conditions and more variable on the mini-trampoline than on the floor under the Free condition when compared with the TD children. Clapping-jumping was more difficult to perform than Clapping-surface for both groups. These findings suggest that the children with DCD were less capable of rhythmically coordinating the jumping-clapping task because they used a type of exploratory strategy regarding the physical properties of the surfaces, whereas the TD children used a type of adaptive strategy displaying behavior that was more consistent across the tasks/environmental demands.

  15. RISK EVALUATION ON RAILWAY PUBLIC EMERGENCIES DURING 2008 BEIJING OLYMPIC GAMES

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Risk evaluation is fundamental to eliminate and prenent any kind of public emergencies ,while that for railway public emergencies is the foundation to guarantee railway sicurity.With the researches on the flow and methods of risk evaluation and the evaltation on railway public evtergencies during 2008 Beijing Olympic Games,the article puts forward measures and suggestions for risk control,providing reference for decision making by government departments,the Organizing Committee of Beijing Olympic Games,and the Security Coorduating Tean of Beijing Olympics as well as jproviding basis for solutions by the Security Control Center of Beijing Olympics and the relevant dipartments of railway sector.

  16. Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial.

    Science.gov (United States)

    Arendts, Glenn; Love, Jennefer; Nagree, Yusuf; Bruce, David; Hare, Malcolm; Dey, Ian

    2017-08-01

    To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. Prospective trial with sequential introduction of screening and interventional processes. Two tertiary referral hospitals in Australia. Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905). Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention and management of delirium during the subsequent admission MEASUREMENTS: Delirium diagnosis at hospital discharge, proportion discharged to new assisted living arrangements, in-hospital complications (use of sedation, falls, aspiration pneumonia, death), hospital length of stay. Participants with a positive risk screen were significantly more likely (relative risk = 6.0, 95% confidence interval = 4.9-7.3) to develop delirium, and the proportion of at-risk participants with a positive screen was constant across three study phases. Delirium detection rate in participants undergoing the final intervention (Phase 3) was 12.1% (a 2% absolute and 17% relative increase from the baseline rate) but this was not statistically significant (P = .29), and a similar relative increase was seen over time in participants not receiving the intervention CONCLUSION: A risk screening and warning or action card intervention in the ED did not significantly improve rates of delirium detection or other important outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  17. Spatial implications of covariate adjustment on patterns of risk

    DEFF Research Database (Denmark)

    Sabel, Clive Eric; Wilson, Jeff Gaines; Kingham, Simon

    2007-01-01

    Epidemiological studies that examine the relationship between environmental exposures and health often address other determinants of health that may influence the relationship being studied by adjusting for these factors as covariates. While disease surveillance methods routinely control for cova......Epidemiological studies that examine the relationship between environmental exposures and health often address other determinants of health that may influence the relationship being studied by adjusting for these factors as covariates. While disease surveillance methods routinely control......), then for a deprivation index, and finally for both PM10 and deprivation. Spatial patterns of risk, disease clusters and cold and hot spots were generated using a spatial scan statistic and a Getis-Ord Gi* statistic. In all disease groups tested (except the control disease), adjustment for chronic PM10 exposure...... area to a mixed residential/industrial area, possibly introducing new environmental exposures. Researchers should be aware of the potential spatial effects inherent in adjusting for covariates when considering study design and interpreting results. © 2007 Elsevier Ltd. All rights reserved....

  18. Emergence and transitions of dynamic patterns of thickness oscillation of the plasmodium of the true slime mold Physarum polycephalum

    Science.gov (United States)

    Takagi, Seiji; Ueda, Tetsuo

    2008-03-01

    The emergence and transitions of various spatiotemporal patterns of thickness oscillation were studied in the freshly isolated protoplasm of the Physarum plasmodium. New patterns, such as standing waves, and chaotic and rotating spirals, developed successively before the well-documented synchronous pattern appeared. There was also a spontaneous opposite transition from synchrony to chaotic and rotating spirals. Rotating spiral waves were observed in the large migrating plasmodium, where the vein structures were being destroyed. Thus, the Physarum plasmodium exhibits versatile patterns, which are generally expected in coupled oscillator systems. This paper discusses the physiological roles of spatiotemporal patterns, comparing them with other biological systems.

  19. Developmental origins of adult phonology: the interplay between phonetic emergents and the evolutionary adaptations of sound patterns.

    Science.gov (United States)

    Lindblom, B

    2000-01-01

    In this paper fragments of a theory of emergent phonology are presented. Phonological patterns are seen as products of cultural evolution adapted to universal biological constraints on listening, speaking and learning. It is proposed that children develop adult phonology thanks to the interaction of the emergent patterning of phonetic content and the adaptive organization of sound structure. Emergence - here used in the technical sense of qualitatively new development - is illustrated with examples from the study of perception, motor mechanisms and memory encoding. In this framework, there is no split between 'behavioral phonetics' and 'abstract phonology'. Phonology differs qualitatively from phonetics in that it represents a new, more complex and higher level of organization of speech behavior. Accordingly, the phonology that the child ends up with as an adult is neither abstract nor independent of use. It represents an emergent patterning of phonetic content.

  20. Country Risk Volatility Spillovers of Emerging Oil Economies: An Application to Russia and Kazakhstan

    Science.gov (United States)

    Sun, Xiaolei; He, Wan; Li, Jianping

    The emerging oil economies (EOEs) of geographical proximity, are usually impacted by some common risk factors which may make the interaction of their country risk closely related. This paper focuses on the interaction of country risk between EOEs by investigating the volatility spillovers of country risk. Taking Russia and Kazakhstan for example, a multivariate conditional volatility model is used to capture the dynamic spillovers of country risk. Empirical results show that there are significant bidirectional spillover effects with the asymmetrical volatility between Russia and Kazakhstan.

  1. Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Kelly, Jaimon T; Palmer, Suetonia C; Wai, Shu Ning; Ruospo, Marinella; Carrero, Juan-Jesus; Campbell, Katrina L; Strippoli, Giovanni F M

    2017-02-07

    Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited. This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD. A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40). Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease. Copyright © 2017 by the American Society of Nephrology.

  2. Emerging Politics of Authorship: Recovering Collectivity, Negotiating the Risk

    Directory of Open Access Journals (Sweden)

    Andrea Pisac

    2011-12-01

    Full Text Available This article examines authorship as a socially embedded process by challenging Western notions of the autonomous creative genius. It considers social interactions between various agents in the field of literary production which in turn recovers the collective nature of modern authorship. Far from leaving it unexamined, it further contextualises authorial collectivity and its role in the emerging model of authorship. Questions and arguments raised in this article are informed by the ethnographic data collected during my doctoral research focusing on the reception of post-1990s ex-Yugoslav literature on the UK book market. Such ethnographic approach to literary translations – i.e. the micro-level analysis of social interactions that ‘create’ literature – demonstrated how the author is ‘created’ in the communication of two literary systems through linguistic translation as well as re-translations of symbolic and social capitals. My research was concerned with analysing the ‘backstage’ of the publishing industry – informal networks and international literary geopolitics – which all contributed to debunking the myth of the autonomous creative genius. However, instead of retracing my steps, this article outlines new avenues and questions that such analysis has opened up. One such question is how new technologies are (reconstructing and (repositioning the role of the author.

  3. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol

    Directory of Open Access Journals (Sweden)

    Gagliardi Stefano

    2005-05-01

    Full Text Available Abstract Background Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. Design All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium. Our exposures are the following: ASA, Pain (SVS; VAS, Blood gas analysis (pH; Hb; pO2; pCO2, Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates, Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma

  4. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol.

    Science.gov (United States)

    Agnoletti, Vanni; Ansaloni, Luca; Catena, Fausto; Chattat, Rabbih; De Cataldis, Angelo; Di Nino, Gianfranco; Franceschi, Claudio; Gagliardi, Stefano; Melotti, Rita Maria; Potalivo, Antonella; Taffurelli, Mario

    2005-05-28

    Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state) is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium) and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium). Our exposures are the following: ASA, Pain (SVS; VAS), Blood gas analysis (pH; Hb; pO2; pCO2), Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates), Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma Scale (GCS), Cognitive state (SPMSQ

  5. Confounding by Dietary Patterns of the Inverse Association Between Alcohol Consumption and Type 2 Diabetes Risk

    National Research Council Canada - National Science Library

    Imamura, Fumiaki; Lichtenstein, Alice H; Dallal, Gerard E; Meigs, James B; Jacques, Paul F

    2009-01-01

    .... To examine confounding by dietary pattern as well as standard risk factors and selected nutrients, the authors modeled the longitudinal association between alcohol consumption and 7-year risk of type...

  6. Emergent Patterns of Forest Biomass Production from Across and within a Micro-Network

    Science.gov (United States)

    Pederson, N.; Martin Benito, D.; Bishop, D. A.; Dawson, A.; Dietze, M.; Druckenbrod, D.; Dye, A.; Gonzalez, A. C.; Hessl, A. E.; Martin Fernandez, J.; McLachlan, J. S.; Paciorek, C. J.; Poulter, B.; Williams, J. W.

    2014-12-01

    Many factors drive short- and long-term trends in forest biomass production. Replication at multiple scales, from within individual trees up to continental scales, is necessary to determine factors of growth and at what scale they are most important. Here we report on patterns of biomass production from within and across a micro-network of three forests in the northeastern US. Each forest has different histories and species composition, but each is within a similar climatological setting, which gives insight on important factors of short- and long-term patterns of forest production. One emergent pattern is that two forests are showing a large uptick in production over the last decade. Coincident to this uptick, late-season biomass production is showing a significant increase, even among 150-200+ year old trees. The third forest experienced a severe ice storm in the early-Aughts that paused a three-decade trend of increasing production. In the least diverse forest, the most dominant species drives most of the annual to decadal trend in production. In the most diverse forest, no one species appears to be driving landscape-level production, yet the emergent pattern of production reflects not only drought and pluvial events, but the impact of invasive species and the ice storm. Variation in annual biomass production for most species is strongly related to annual variations in soil moisture. Interestingly at the species level, coherency of growth among yellow birch is lower in the oldest forest in which is it is common versus the youngest forest. Differences in coherency suggest different drivers operating at different scales. Growth of red maple is also driven by moisture, but competition appears to be driving a long-term decline of individuals below the canopy. The decline begins soon after a severe defoliation event. In this same forest, however, significant wetting and warming over the last two decades appears to have reduced some of the climatic constraints on red

  7. Identifying the benefits and risks of emerging treatments for idiopathic pulmonary fibrosis: a qualitative study.

    Science.gov (United States)

    Bridges, John F P; Paly, Victoria Federico; Barker, Elizabeth; Kervitsky, Dolly

    2015-02-01

    Idiopathic pulmonary fibrosis (IPF) is a rare, progressive, and fatal disease, with very few therapeutic options. Given a paucity of qualitative research to the perspective of patients and other stakeholders in IPF, we sought to identify issues associated with the benefits and risks of emerging treatments and other issues relevant to design of a survey for assessing patient preferences for IPF treatments. Semi-structured key informant interviews were conducted, predominately via telephone, with a range of stakeholder perspectives identified through partnership with a national advocacy organization using a combination of purposive and snowball sampling. Stakeholders were asked guiding questions related to emerging trends impacting IPF patients, likely benefits and risks of emerging treatments, and the outcomes most relevant to patients. Detailed and de-identified field notes were analyzed using interpretive phenomenological analysis (IPA), and a taxonomy of key themes was developed. A total of 20 interviews (participation rate 63%) were conducted with patients/advocates/caregivers (n = 7), providers/researchers (n = 8), and experts associated with policy/industry (n = 5). All interviewees expressed great hope with regards to emerging treatments. Three super-ordinate themes emerged: impact of emerging therapies (spanning the benefits, risks, and unintended consequences of emerging therapies); documenting the patient experience (spanning measuring patient-reported outcomes and quality of life and understanding the burden of disease); and coping with disease progression (including symptom mitigation, lung transplantation, and end-of-life considerations). In identifying issues associated with emerging IPF treatments, we demonstrate the value of qualitative research in understanding the views of diverse stakeholders and in providing a basis for future survey research. As such, qualitative methods should play an important role in understanding the benefits and

  8. On the emergence of syntactic structures: quantifying and modelling duality of patterning

    CERN Document Server

    Loreto, Vittorio; Servedio, Vito D P; Tria, Francesca

    2016-01-01

    The complex organization of syntax in hierarchical structures is one of the core design features of human language. Duality of patterning refers for instance to the organization of the meaningful elements in a language at two distinct levels: a combinatorial level where meaningless forms are combined into meaningful forms and a compositional level where meaningful forms are composed into larger lexical units. The question remains wide open regarding how such a structure could have emerged. Furthermore a clear mathematical framework to quantify this phenomenon is still lacking. The aim of this paper is that of addressing these two aspects in a self-consistent way. First, we introduce suitable measures to quantify the level of combinatoriality and compositionality in a language, and present a framework to estimate these observables in human natural languages. Second, we show that the theoretical predictions of a multi-agents modeling scheme, namely the Blending Game, are in surprisingly good agreement with empi...

  9. Emergent cellular self-organization and mechanosensation initiate follicle pattern in the avian skin.

    Science.gov (United States)

    Shyer, Amy E; Rodrigues, Alan R; Schroeder, Grant G; Kassianidou, Elena; Kumar, Sanjay; Harland, Richard M

    2017-08-25

    The spacing of hair in mammals and feathers in birds is one of the most apparent morphological features of the skin. This pattern arises when uniform fields of progenitor cells diversify their molecular fate while adopting higher-order structure. Using the nascent skin of the developing chicken embryo as a model system, we find that morphological and molecular symmetries are simultaneously broken by an emergent process of cellular self-organization. The key initiators of heterogeneity are dermal progenitors, which spontaneously aggregate through contractility-driven cellular pulling. Concurrently, this dermal cell aggregation triggers the mechanosensitive activation of β-catenin in adjacent epidermal cells, initiating the follicle gene expression program. Taken together, this mechanism provides a means of integrating mechanical and molecular perspectives of organ formation. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  10. Risk analysis of emergent water pollution accidents based on a Bayesian Network.

    Science.gov (United States)

    Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie

    2016-01-01

    To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents.

  11. Food and dietary pattern-based recommendations: an emerging approach to clinical practice guidelines for nutrition therapy in diabetes.

    Science.gov (United States)

    Sievenpiper, John L; Dworatzek, Paula D N

    2013-02-01

    Clinical practice guidelines (CPGs) for the nutritional management of diabetes mellitus have evolved considerably over the last 25 years. As major diabetes associations have focussed on the individualization of nutrition therapy, there has been a move toward a broader more flexible macronutrient distribution that emphasizes macronutrient quality over quantity. There is now a call for the integration of food- and dietary pattern-based approaches into diabetes association CPGs. The main argument has been that an approach that focuses on nutrients alone misses important nutrient interactions oversimplifying the complexity of foods and dietary patterns, both of which have been shown to have a stronger influence on disease risk than nutrients alone. Although cancer and heart associations have begun to integrate this approach into their dietary guidelines, diabetes associations have not yet adopted this approach. We provide a rationale for the adoption of this approach for The Canadian Diabetes Association (CDA) 2013 CPGs for nutrition therapy. The systematic review for the development of these guidelines revealed emerging evidence to support the use of vegetarian, Mediterranean, and Dietary Approaches to Stop Hypertension (DASH) dietary patterns as well as specific foods such as dietary pulses and nuts in people with diabetes. Popular and conventional weight loss diets were also found to have similar advantages in people with diabetes, although poor dietary adherence remains an issue with these diets. The CDA 2013 CPGs will support an even greater individualization of nutrition therapy for people with diabetes and appeal to a broader range of practice styles of health professionals. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Patient characteristics and patterns of intoxication: one-time and repeated use of emergency ambulance services.

    Science.gov (United States)

    Holzer, Barbara M; Minder, Christoph E; Rosset, Nina; Schaetti, Gabriela; Battegay, Edouard; Mueller, Stefan; Zimmerli, Lukas

    2013-05-01

    The aim of this study was to investigate the utilization of ambulance services that resulted from alcohol and drug intoxication over a period of 1 year in a metropolitan area, with an emphasis on characteristic differences between patients with one-time versus repeated use. All ambulance-service report forms filed in 2010 were systematically screened for utilizations in which alcohol intoxication or intoxication resulting from consumption of illicit or legal drugs other than alcohol was the chief complaint (N = 2,341 patients; 65% male). Repeat users differed from persons with one-time use in their characteristics and patterns of intoxication. On average, patients with repeated ambulance use were almost 8 years older and had a different pattern of ambulance use over the course of the week with no clear peak on any specific day. The mean number of ambulance services in patients with repeated use was 2.8 (SD = 1.517) in the 1-year study period. Repeat users were less likely to be injured than patients with one-time ambulance-service use and more often showed aggression or uncooperative behavior toward paramedics. All cases of death associated with intoxication involved patients with one-time ambulance use. The ambulance-service users' generally slight impairment of consciousness and the high proportion of intoxicated patients without any injuries raise the question of how many of these patients could be adequately cared for in a sobering center. Sobering centers might relieve hospital emergency departments of patients not requiring acute emergency care and, in addition, could provide intervention services to prevent relapses.

  14. High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities; Hochrisikoanlagen. Notfallschutz bei Kernkraft-, Chemie- und Sondermuellanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Kloepfer, Michael (ed.) [Humboldt-Universitaet, Berlin (Germany)

    2012-07-01

    The book on emergency management in high-risk facilities covers the following topics: Change in the nuclear policy, risk management of high-risk facilities as a constitutional problem - emergency management in nuclear facilities, operational mechanisms of risk control in nuclear facilities, regulatory surveillance responsibilities for nuclear facilities, operational mechanism of the risk control in chemical plants, regulatory surveillance responsibilities for chemical facilities, operational mechanisms of the risk control in hazardous waste facilities, regulatory surveillance responsibilities for hazardous waste facilities, civil law consequences in case of accidents in high-risk facilities, criminal prosecution in case of accidents in high-risk facilities, safety margins as site risk for emission protection facilities, national emergency management - strategic emergency management structures, warning and self-protection of the public in case of CBRN hazards including aspects of the psych-social emergency management.

  15. Emergent global patterns of ecosystem structure and function from a mechanistic general ecosystem model.

    Science.gov (United States)

    Harfoot, Michael B J; Newbold, Tim; Tittensor, Derek P; Emmott, Stephen; Hutton, Jon; Lyutsarev, Vassily; Smith, Matthew J; Scharlemann, Jörn P W; Purves, Drew W

    2014-04-01

    Anthropogenic activities are causing widespread degradation of ecosystems worldwide, threatening the ecosystem services upon which all human life depends. Improved understanding of this degradation is urgently needed to improve avoidance and mitigation measures. One tool to assist these efforts is predictive models of ecosystem structure and function that are mechanistic: based on fundamental ecological principles. Here we present the first mechanistic General Ecosystem Model (GEM) of ecosystem structure and function that is both global and applies in all terrestrial and marine environments. Functional forms and parameter values were derived from the theoretical and empirical literature where possible. Simulations of the fate of all organisms with body masses between 10 µg and 150,000 kg (a range of 14 orders of magnitude) across the globe led to emergent properties at individual (e.g., growth rate), community (e.g., biomass turnover rates), ecosystem (e.g., trophic pyramids), and macroecological scales (e.g., global patterns of trophic structure) that are in general agreement with current data and theory. These properties emerged from our encoding of the biology of, and interactions among, individual organisms without any direct constraints on the properties themselves. Our results indicate that ecologists have gathered sufficient information to begin to build realistic, global, and mechanistic models of ecosystems, capable of predicting a diverse range of ecosystem properties and their response to human pressures.

  16. Emergent global patterns of ecosystem structure and function from a mechanistic general ecosystem model.

    Directory of Open Access Journals (Sweden)

    Michael B J Harfoot

    2014-04-01

    Full Text Available Anthropogenic activities are causing widespread degradation of ecosystems worldwide, threatening the ecosystem services upon which all human life depends. Improved understanding of this degradation is urgently needed to improve avoidance and mitigation measures. One tool to assist these efforts is predictive models of ecosystem structure and function that are mechanistic: based on fundamental ecological principles. Here we present the first mechanistic General Ecosystem Model (GEM of ecosystem structure and function that is both global and applies in all terrestrial and marine environments. Functional forms and parameter values were derived from the theoretical and empirical literature where possible. Simulations of the fate of all organisms with body masses between 10 µg and 150,000 kg (a range of 14 orders of magnitude across the globe led to emergent properties at individual (e.g., growth rate, community (e.g., biomass turnover rates, ecosystem (e.g., trophic pyramids, and macroecological scales (e.g., global patterns of trophic structure that are in general agreement with current data and theory. These properties emerged from our encoding of the biology of, and interactions among, individual organisms without any direct constraints on the properties themselves. Our results indicate that ecologists have gathered sufficient information to begin to build realistic, global, and mechanistic models of ecosystems, capable of predicting a diverse range of ecosystem properties and their response to human pressures.

  17. Determining optimum flash patterns for emergency service vehicles: an experimental investigation using high definition film.

    Science.gov (United States)

    Turner, Sally; Wylde, Julie; Langham, Martin; Morrow, Andrew

    2014-09-01

    An investigation of how emergency vehicle lighting (EVL) can be improved is reported with reference to an analysis of police vehicle road traffic accidents (Study 1). In Study 2, 37 regular drivers were shown film clips of a marked police vehicle, in which flash rate (1 Hz, 4 Hz) and pattern (single, triple pulse) were varied on the blue Light Emitting Diode (LED) roofbar. Results indicate a 4 Hz flash rate conveys greater urgency than a 1 Hz rate, while a 1 Hz, single flash combination was ranked the least urgent of all combinations. Participants claimed they would leave significantly more space before pulling out in front of an approaching police car (gap acceptance) in the 4 Hz single pulse condition in comparison to other EVL combinations. The preliminary implications for which flash characteristics could prove most optimal for emergency service use are discussed with regard to effects on driver perception and expected driving behaviour.

  18. Identification of the Risk Related to a Process on Hospital Emergency Service: a Case Study

    CERN Document Server

    Santos, Carlos; Ferreira, Carla; Tribolet, José

    2011-01-01

    This paper, framed in a vast investigation, describes the application of techniques and methodologies in Organizational Engineering connected to the associated risk to the processes developed in an Emergency Service of an important Portuguese Hospital. The transactions performed in an emergency service and the consequent risk identification (negative behaviour associated to those transactions) is done based on static and dynamic models, developed during the business modelling. Any non-trivial system is better portrayed trough a small number of reasonably independent models. From this point of view it is important to look at the systems from a "micro" perspective, which allows us to analyse the system at the transaction level. All processes have some associated risk (inherent risk). Its identification will be decisive for future analysis and for the consequent decision over the need, or not, to study internal control mechanisms. This decision will depend on the risk level that the organization considers accept...

  19. Dietary Patterns Are Associated with Predicted Cardiovascular Disease Risk in an Urban Mexican Adult Population.

    Science.gov (United States)

    Denova-Gutiérrez, Edgar; Tucker, Katherine L; Flores, Mario; Barquera, Simón; Salmerón, Jorge

    2016-01-01

    Dietary patterns may predict cardiovascular disease (CVD) risk more accurately than does consumption of specific nutrients or foods. We evaluated the association between Mexican adults' dietary patterns and development of a >10% risk of 10-y CVD (using the Framingham risk score) over 7 y of follow-up. This prospective cohort study included 1196 men and women aged 20-80 y with a 10-y predicted risk risk of elevated 10-y CVD (RR: 2.98; 95% CI: 1.46, 6.10; P-trend = 0.020) than did those in the lowest quintile. Finally, the meat/fish dietary pattern was not significantly associated with 10-y CVD. Our data suggest that the prudent pattern is associated with a reduced risk of 10-y CVD, whereas the refined-foods pattern may increase 10-y CVD in Mexican adults. © 2016 American Society for Nutrition.

  20. Teammate familiarity and risk of injury in emergency medical services.

    Science.gov (United States)

    Patterson, P Daniel; Weaver, Matthew D; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Vena, John E; Hughes, Ashley M; Salas, Eduardo; Yealy, Donald M

    2016-04-01

    We investigated the association between teammate familiarity and workplace injury in the emergency medical services (EMS) setting. From January 2011 to November 2013, we abstracted a mean of 29 months of shift records and Occupational Safety Health Administration injury logs from 14 EMS organisations with 37 total bases located in four US Census regions. Total teammate familiarity was calculated for each dyad as the total number of times a clinician dyad worked together over the study period. We used negative binomial regression to examine differences in injury incidence rate ratios (IRRs) by familiarity. We analysed 715 826 shift records, representing 4197 EMS clinicians and 60 701 unique dyads. We determined the mean shifts per dyad was (5.9, SD 19.7), and quartiles of familiarity were 1 shift worked together over the study period, 2-3 shifts, 4-9 shifts and ≥10 shifts worked together. More than half of all dyads worked one shift together (53.9%, n=32 739), 24.8% of dyads 2-3 shifts, 11.8% worked 4-9 shifts and 9.6% worked ≥10 shifts. The overall incidence rate of injury across all organisations was 17.5 per 100 full-time equivalent (FTE), range 4.7-85.6 per 100 FTE. The raw injury rate was 33.5 per 100 FTEs for dyads with one shift of total familiarity, 14.2 for 2-3 shifts, 8.3 for 4-9 shifts and 0.3 for ≥10 shifts. Negative binomial regression confirmed that dyads with ≥10 shifts had the lowest incidence of injury (IRR 0.03; 95% CI 0.02 to 0.04). Familiarity between teammates varies in the EMS setting, and less familiarity is associated with greater incidence of workplace injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Emerging technologies in educational institutions: assets and potential risks

    Directory of Open Access Journals (Sweden)

    François Victor Tochon

    2012-12-01

    Full Text Available This article is a review of some aspects of research on electronic portfolios with a critical analysis of the pros and cons of the invasive use of new technologies for education. Besides the creation and conceptual composition of educative portfolios that help teachers grow professionnally, this instrument implies a formatting around artifacts posited as proofs of competence, which support an uncritical realist ontology that has its limitations. Thus networked learning and personal learning environments stimulate reflective teacher learning, but possibly lead portfolio users to confuse the indicator of performance with the actual competence. Portfolio creation takes much time on other activities that could be most beneficial (and could be complementary, such as shared reflection on personal belief systems. Universalist stands and standardisation seem to take the fore while educative humane value go back stage. The new wave of distance learning creates new risks in terms of depth and quality as well as health, related to the daily use of pulsed microwaves and radio frequencies. It is suggested that a mode of control independent from the financial milieux that capitalize on these innovations should be created.

  2. An emergency department intervention to protect an overlooked group of children at risk of significant harm.

    LENUS (Irish Health Repository)

    Kaye, P

    2012-02-01

    BACKGROUND: Parental psychiatric disorder, especially depression, personality disorder and deliberate self-harm, is known to put children at greater risk of mental illness, neglect or physical, emotional and sexual abuse. Without a reliable procedure to identify children of parents presenting with these mental health problems, children at high risk of significant harm can be easily overlooked. Although deliberate self-harm constitutes a significant proportion of emergency presentations, there are no guidelines which address the emergency physician\\'s role in identifying and assessing risk to children of these patients. METHODS: A robust system was jointly developed with the local social services child protection team to identify and risk-stratify children of parents with mental illness. This allows us to intervene when we identify children at immediate risk of harm and to ensure that social services are aware of potential risk to all children in this group. The referral process was audited repeatedly to refine the agreed protocol. RESULTS: The proportion of patients asked by the emergency department personnel about dependent children increased and the quality of information received by the social services child protection team improved. CONCLUSIONS: All emergency departments should acknowledge the inadequacy of information available to them regarding patients\\' children and consider a policy of referral to social services for all children of parents with mental health presentations. This process can only be developed through close liaison within the multidisciplinary child protection team.

  3. Assessing risks for a pre-emergent pathogen: virginiamycin use and the emergence of streptogramin resistance in Enterococcus faecium.

    Science.gov (United States)

    Smith, D L; Johnson, J A; Harris, A D; Furuno, J P; Perencevich, E N; Morris, J G

    2003-04-01

    Vancomycin-resistant enterococci (VRE) are an important cause of hospital-acquired infections and an emerging infectious disease. VRE infections were resistant to standard antibiotics until quinupristin/dalfopristin (QD), a streptogramin antibiotic, was approved in 1999 for the treatment of vancomycin-resistant Enterococcus faecium infections in people. After that decision, the practice of using virginiamycin in agriculture for animal growth promotion came under intense scrutiny. Virginiamycin, another streptogramin, threatens the efficacy of QD in medicine because streptogramin resistance in enterococci associated with food animals may be transferred to E faecium in hospitalised patients. Policy makers face an unavoidable conundrum when assessing risks for pre-emergent pathogens; good policies that prevent or delay adverse outcomes may leave little evidence that they had an effect. To provide a sound basis for policy, we have reviewed the epidemiology of E faecium and streptogramin resistance and present qualitative results from mathematical models. These models are based on simple assumptions consistent with evidence, and they establish reasonable expectations about the population-genetic and population-dynamic processes underlying the emergence of streptogramin-resistant E faecium (SREF). Using the model, we have identified critical aspects of SREF emergence. We conclude that the emergence of SREF is likely to be the result of an interaction between QD use in medicine and the long-term use of virginiamycin for animal growth promotion. Virginiamycin use has created a credible threat to the efficacy of QD by increasing the mobility and frequency of high-level resistance genes. The potential effects are greatest for intermediate rates of human-to-human transmission (R0 approximately equal 1).

  4. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

    Directory of Open Access Journals (Sweden)

    José Luiz Rodrigues Leles

    2010-02-01

    Full Text Available BACKGROUND: Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. OBJECTIVE: The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. MATERIAL AND METHODS: A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. RESULTS: The main causes of trauma were traffic accidents (45.7% and physical assaults (24.3%, and differences in etiological factors were identified according to gender (p<0.001. The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01, physical assaults (p<0.001, falls (p<0.001 and sport injuries (p<0.01. In the multinomial logistic regression analysis (R² = 0.233; p<0.05, age was associated with injury in traffic accidents and falls (p<0.01, sports-related accidents were associated with males (p<0.05, and alcohol consumption with assaults and traffic accidents (p<0.001. Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. CONCLUSIONS: The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.

  5. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola;

    2017-01-01

    INTRODUCTION: Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. METHODS......: The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. RESULTS......: In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery...

  6. Optimization on Emergency Resources Transportation Network Based on Bayes Risk Function: A Case Study

    Directory of Open Access Journals (Sweden)

    Changfeng Zhu

    2016-01-01

    Full Text Available In order to coordinate the complex relationship between supplies distribution and path selection, some influential factors must be taken into account such as the insufficient remaining capacity of the road and uncertainty of travel time during supplies distribution and transportation. After the structure of emergency logistics network is analyzed, the travel time Bayes risk function of path and the total loss Bayes risk function of the disaster area are proposed. With the emergency supplies total transportation unit loss as the goal, an emergency logistics network optimization model under crowded conditions is established by the Bayes decision theory and solved by the improved ant colony algorithm. Then, a case of the model is validated to prove that the emergency logistics network optimization model is effective in congested conditions.

  7. Health professionals' migration in emerging market economies: patterns, causes and possible solutions.

    Science.gov (United States)

    Nair, Manisha; Webster, Premila

    2013-03-01

    About a third of the countries affected by shortage of human resources for health are the emerging market economies (EMEs). The greatest shortage in absolute terms was found to be in India and Indonesia leading to health system crisis. This review identifies the patterns of migration of health workers, causes and possible solutions in these EMEs. A qualitative synthesis approach based on the 'critical review' and 'realist review' approaches to the literature review was used. The patterns of migration of health professionals' in the EMEs have led to two types of discrepancies between health needs and healthcare workers: (i) within country (rural-urban, public-private or government healthcare sector-private sector) and (ii) across countries (south to north). Factors that influence migration include lack of employment opportunities, appropriate work environment and wages in EMEs, growing demand in high-income countries due to demographic transition, favourable country policies for financial remittances by migrant workers and medical education system of EMEs. A range of successful national and international initiatives to address health workforce migration were identified. Measures to control migration should be country specific and designed in accordance with the push and pull factors existing in the EMEs.

  8. Incorporating emergency evacuation planning, through human reliability analysis, in the risk management of industrial installation

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Isaac J.A. Luquetti; Carvalho, Paulo V.R.; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)], Email: luquetti@ien.gov.br

    2009-07-01

    An industrial installation presents many risks in the form of the process hazards, such as fire, explosion, gas and radiation release. In these situations, workers may need to evacuate from the work environment as soon as possible. In this case, the emergency evacuation planning is a key element that involves an iterative process to identify the best evacuation routes and to estimate the time required to evacuate the area at risk. The mean aspects for a successful emergency evacuation are influenced by the type of human error and the severity of the initiator event. The aim of this paper is to present a methodological framework for the identification of the performance shaping factors and prediction of human error probabilities of the responsible by the emergency evacuation of the workers in an industrial installation, providing a proactive approach for the allocation of the human factors in the risk assessment of the industrial installation. (author)

  9. Branching patterns emerge in a mathematical model of the dynamics of lung development.

    Science.gov (United States)

    Guo, Yina; Chen, Ting-Hsuan; Zeng, Xingjuan; Warburton, David; Boström, Kristina I; Ho, Chih-Ming; Zhao, Xin; Garfinkel, Alan

    2014-01-15

    Recent experimental work has described an elegant pattern of branching in the development of the lung. Multiple forms of branching have been identified, including side branching and tip bifurcation. A particularly interesting feature is the phenomenon of 'orthogonal rotation of the branching plane'. The lung must fill 3D space with the essentially 2D phenomenon of branching. It accomplishes this by rotating the branching plane by 90° with each generation. The mechanisms underlying this rotation are not understood. In general, the programmes that underlie branching have been hypothetically attributed to genetic 'subroutines' under the control of a 'global master routine' to invoke particular subroutines at the proper time and location, but the mechanisms of these routines are not known. Here, we demonstrate that fundamental mechanisms, the reaction and diffusion of biochemical morphogens, can create these patterns. We used a partial differential equation model that postulates three morphogens, which we identify with specific molecules in lung development. We found that cascades of branching events, including side branching, tip splitting and orthogonal rotation of the branching plane, all emerge immediately from the model, without further assumptions. In addition, we found that one branching mode can be easily switched to another, by increasing or decreasing the values of key parameters. This shows how a 'global master routine' could work by the alteration of a single parameter. Being able to simulate cascades of branching events is necessary to understand the critical features of branching, such as orthogonal rotation of the branching plane between successive generations, and branching mode switch during lung development. Thus, our model provides a paradigm for how genes could possibly act to produce these spatial structures. Our low-dimensional model gives a qualitative understanding of how generic physiological mechanisms can produce branching phenomena, and how

  10. Identification and Risk-Stratification of Problem Alcohol Drinkers with Minor Trauma in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Stewart, Scott H. MD

    2010-05-01

    Full Text Available BACKGROUND: Brief alcohol intervention may improve outcomes for injury patients with hazardous drinking but is less effective with increased severity of alcohol involvement. This study evaluated a brief method for detecting problem drinking in minor trauma patients and differentiating hazardous drinkers from those with more severe alcohol problems.METHODS: Subjects included 60 minor trauma patients in an academic urban emergency department (ED who had consumed any amount of alcohol in the prior month. Screening and risk stratification involved the use of a heavy-drinking-day screening item and the Rapid Alcohol Problems Screen (RAPS. We compared the heavy-drinking-day item to past-month alcohol use, as obtained by validated self-reporting methods, and measured the percentage of carbohydrate-deficient transferrin (%CDT to assess the accuracy of self-reporting. The Alcohol Dependence Scale (ADS was administered to gauge the severity of alcohol involvement and compared to the RAPS.RESULTS: Eighty percent of the subjects endorsed at least one heavy drinking day in the past year, and all patients who exceeded recommended weekly drinking limits endorsed at least one heavy drinking day. Among those with at least one heavy drinking day, 58% had a positive RAPS result. Persons with no heavy drinking days (n=12 had a median ADS of 0.5 (range 0 to 3. RAPS-negative persons with heavy drinking days (n=20 had a median ADS of 2 (range 0 to 8. RAPS-positive persons with heavy drinking days (n=28 had a median ADS of 8 (range 1 to 43.CONCLUSION: A heavy-drinking-day item is useful for detecting hazardous drinking patterns, and the RAPS is useful for differentiating more problematic drinkers who may benefit from referral from those more likely to respond to a brief intervention. This represents a time-sensitive approach for risk-stratifying non-abstinent injury patients prior to ED discharge. [West J Emerg Med. 2010 May;11(2:133-7.

  11. Trade Openness and Bank Risk-Taking Behavior: Evidence from Emerging Economies

    Directory of Open Access Journals (Sweden)

    Badar Nadeem Ashraf

    2017-07-01

    Full Text Available In this paper, we examine the impact of trade openness on bank risk-taking behavior. Using a panel dataset of 291 banks from 37 emerging countries over the period from 1998 to 2012, we find that higher trade openness decreases bank risk-taking. The results are robust when we use alternative bank risk-taking proxies and alternative estimation methods. We argue that trade openness provides diversification opportunities to banks in lending activities, which decrease overall bank risk. Further to this end, we observe that higher trade openness helps domestic banks to smooth out income volatility and decreases the impact of a financial crisis on banks.

  12. Risk model for suspected acute coronary syndrome is of limited value in an emergency department

    DEFF Research Database (Denmark)

    Mogensen, Christian Backer; Christiansen, Maja; Jørgensen, Jess Bjerre

    2015-01-01

    INTRODUCTION: Among patients with acute chest pain, acute coronary syndrome (ACS) is seen only in a minority of the patients, which raises the question, whether it is possible to separate a group with a high risk of ACS for admission to a cardiac care unit (CCU) from those with a low risk who would...... be treated at an emergency department (ED). The aim of this study was to describe a risk stratification model for a Danish context. METHODS: This was a historic prospective cohort study of patients with suspicion of ACS. The patient was defined as a low-risk patient and admitted to the ED if: 1...

  13. Estimating the country risk premium in emerging markets: the case of the Republic of Macedonia

    Directory of Open Access Journals (Sweden)

    Aleksandar Naumoski

    2012-12-01

    Full Text Available Estimation of the cost of capital is difficult in developed markets and even more difficult in emerging markets. Investments in the emerging markets are more risky than in the developed markets but return is also higher. The key question here is whether the return on investments in emerging markets should be rewarded by compensation in excess of that provided by an equivalent investment in a developed market. Contemporary literature provides alternative ways for calculating the cost of capital invested in emerging markets. In general, it can be concluded that it is widely accepted that country risk matters when investing in emerging markets and it is a key component in the estimation of the cost of capital for those investments. Country risk is non-diversifiable, which will be argued in this paper first, after which an alternative approach will be provided for quantification of country risk in the risk premium measure, which is integral component in the models for estimating the cost of capital.

  14. Probabilistic risk assessment of emerging materials: case study of titanium dioxide nanoparticles.

    Science.gov (United States)

    Tsang, Michael P; Hristozov, Danail; Zabeo, Alex; Koivisto, Antti Joonas; Jensen, Alexander Christian Østerskov; Jensen, Keld Alstrup; Pang, Chengfang; Marcomini, Antonio; Sonnemann, Guido

    2017-05-01

    The development and use of emerging technologies such as nanomaterials can provide both benefits and risks to society. Emerging materials may promise to bring many technological advantages but may not be well characterized in terms of their production volumes, magnitude of emissions, behaviour in the environment and effects on living organisms. This uncertainty can present challenges to scientists developing these materials and persons responsible for defining and measuring their adverse impacts. Human health risk assessment is a method of identifying the intrinsic hazard of and quantifying the dose-response relationship and exposure to a chemical, to finally determine the estimation of risk. Commonly applied deterministic approaches may not sufficiently estimate and communicate the likelihood of risks from emerging technologies whose uncertainty is large. Probabilistic approaches allow for parameters in the risk assessment process to be defined by distributions instead of single deterministic values whose uncertainty could undermine the value of the assessment. A probabilistic approach was applied to the dose-response and exposure assessment of a case study involving the production of nanoparticles of titanium dioxide in seven different exposure scenarios. Only one exposure scenario showed a statistically significant level of risk. In the latter case, this involved dumping high volumes of nano-TiO2 powders into an open vessel with no personal protection equipment. The probabilistic approach not only provided the likelihood of but also the major contributing factors to the estimated risk (e.g. emission potential).

  15. Unemployment and depression among emerging adults in 12 states, Behavioral Risk Factor Surveillance System, 2010.

    Science.gov (United States)

    McGee, Robin E; Thompson, Nancy J

    2015-03-19

    The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults. Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Responses to the Patient Health Questionnaire-8 provided data about the prevalence of depression. Bivariate relationships were assessed using χ(2) tests, and multivariable adjusted odds ratios were calculated with logistic regressions. Sociodemographic variables were sex, race/ethnicity, marital status, and education. In addition, logistic regression models adjusted for health insurance status, disability, smoking, and body mass index. The analyses were completed using SAS 9.3 survey procedures to account for the complex sampling design. Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults. The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health-focused interventions.

  16. 75 FR 34919 - Continuation of the National Emergency With Respect To the Risk of Nuclear Proliferation Created...

    Science.gov (United States)

    2010-06-18

    ... Notice of June 17, 2010--Continuation of the National Emergency With Respect To the Risk of Nuclear..., 2010 Continuation of the National Emergency With Respect To the Risk of Nuclear Proliferation Created... risk of nuclear proliferation created by the accumulation of weapons- usable fissile material in...

  17. Dietary pattern classifications with nutrient intake and health-risk factors in Korean men.

    Science.gov (United States)

    Lee, Ji Eun; Kim, Jung-Hyun; Son, Say Jin; Ahn, Younjhin; Lee, Juyoung; Park, Chan; Lee, Lilha; Erickson, Kent L; Jung, In-Kyung

    2011-01-01

    This study was performed to identify dietary patterns in Korean men and to determine the associations among dietary patterns, nutrient intake, and health-risk factors. Using baseline data from the Korean Health and Genome Study, dietary patterns were identified using factor analysis of data from a validated food-frequency questionnaire, and associations between these dietary patterns and health-risk factors were analyzed. Three dietary patterns were identified: 1) the "animal-food" pattern (greater intake of meats, fish, and dairy products), 2) the "rice-vegetable" pattern (greater intake of rice, tofu, kimchi, soybean paste, vegetables, and seaweed), and 3) the "noodle-bread" pattern (greater intake of instant noodles, Chinese noodles, and bread). The animal-food pattern (preferred by younger people with higher income and education levels) had a positive correlation with obesity and hypercholesterolemia, whereas the rice-vegetable pattern (preferred by older people with lower income and educational levels) was positively associated with hypertension. The noodle-bread pattern (also preferred by younger people with higher income and education levels) had a positive association with abdominal obesity and hypercholesterolemia. This study identifies three unique dietary patterns in Korean men, which are independently associated with certain health-risk factors. The rice-vegetable dietary pattern, modified for a low sodium intake, might be a healthy dietary pattern for Korean men. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

    DEFF Research Database (Denmark)

    Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

    2017-01-01

    , distribution of their age, sex, hospital diagnoses, comorbidity, and 1-day and 30-day mortality were assessed by calendar year. Poisson regression with robust variance estimation was used to estimate both age-and sex-adjusted relative risk of death and prevalence ratios for Charlson Comorbidity Index (CCI......) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48.......39). The 1-day and 30 day mortality decreased from 2.40% to 1.21% and from 5.01% to 4.36%, respectively, from 2007 to 2014, corresponding to age-adjusted and sex-adjusted relative risk of 0.43 (95% CI 0.37 to 0.50) and 0.72 (95% CI 0.66 to 0.79), respectively. CONCLUSION: During the 8-year period...

  19. Risk-Averse Evolutionary Game Model of Aviation Joint Emergency Response

    Directory of Open Access Journals (Sweden)

    Wei Pan

    2016-01-01

    Full Text Available We study effects of risk-averse attitude of both participators in aviation joint emergency response on the coevolution of cooperation mechanisms and individual preferences between airport and nonprofit organization. First, based on the current aviation joint emergency mechanism in China, we put forward two mechanisms to select the joint nonprofit organization, including reputation cooperation and bidding competition. Meanwhile, we consider two preferences including altruism and selfishness. Then we build replicator dynamics equations using the theory of conditional value-at-risk (CVaR taking risk aversion attitude into account. Finally, we introduce the factor of government and give all participators some suggestions. We show that the risk-averse attitude of the other game participator affects the one participator’s decision and the effects subject to some parameters.

  20. Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses

    Science.gov (United States)

    Segura, Carlota; Duch, Jordi; Perelló, Josep

    2016-01-01

    Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go “up” or “down” in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops. PMID:27532219

  1. Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses.

    Science.gov (United States)

    Gutiérrez-Roig, Mario; Segura, Carlota; Duch, Jordi; Perelló, Josep

    2016-01-01

    Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go "up" or "down" in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops.

  2. Analysis of work zone rear-end crash risk for different vehicle-following patterns.

    Science.gov (United States)

    Weng, Jinxian; Meng, Qiang; Yan, Xuedong

    2014-11-01

    This study evaluates rear-end crash risk associated with work zone operations for four different vehicle-following patterns: car-car, car-truck, truck-car and truck-truck. The deceleration rate to avoid the crash (DRAC) is adopted to measure work zone rear-end crash risk. Results show that the car-truck following pattern has the largest rear-end crash risk, followed by truck-truck, truck-car and car-car patterns. This implies that it is more likely for a car which is following a truck to be involved in a rear-end crash accident. The statistical test results further confirm that rear-end crash risk is statistically different between any two of the four patterns. We therefore develop a rear-end crash risk model for each vehicle-following pattern in order to examine the relationship between rear-end crash risk and its influencing factors, including lane position, the heavy vehicle percentage, lane traffic flow and work intensity which can be characterized by the number of lane reductions, the number of workers and the amount of equipment at the work zone site. The model results show that, for each pattern, there will be a greater rear-end crash risk in the following situations: (i) heavy work intensity; (ii) the lane adjacent to work zone; (iii) a higher proportion of heavy vehicles and (iv) greater traffic flow. However, the effects of these factors on rear-end crash risk are found to vary according to the vehicle-following patterns. Compared with the car-car pattern, lane position has less effect on rear-end crash risk in the car-truck pattern. The effect of work intensity on rear-end crash risk is also reduced in the truck-car pattern. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Risk classification in an emergency room: agreement level between a Brazilian institutional and the Manchester Protocol

    OpenAIRE

    de Souza, Cristiane Chaves; Toledo,Alexandre Duarte; Tadeu,Luiza Ferreira Ribeiro; Chianca,Tânia Couto Machado

    2011-01-01

    The aim of this study was to assess the level of agreement between an institutional protocol and the Manchester protocol for the risk assessment of patients attended in an emergency room of a public hospital in Belo Horizonte - MG - Brazil. This is a descriptive and comparative study, in which 382 patients' reports were evaluated and the risk was classified, using the institutional protocol and the Manchester protocol. Rates were calculated through weighted and unweighted kappa, in order to d...

  4. Risk and Ambiguity in Information Seeking: Eye Gaze Patterns Reveal Contextual Behavior in Dealing with Uncertainty.

    Science.gov (United States)

    Wittek, Peter; Liu, Ying-Hsang; Darányi, Sándor; Gedeon, Tom; Lim, Ik Soo

    2016-01-01

    Information foraging connects optimal foraging theory in ecology with how humans search for information. The theory suggests that, following an information scent, the information seeker must optimize the tradeoff between exploration by repeated steps in the search space vs. exploitation, using the resources encountered. We conjecture that this tradeoff characterizes how a user deals with uncertainty and its two aspects, risk and ambiguity in economic theory. Risk is related to the perceived quality of the actually visited patch of information, and can be reduced by exploiting and understanding the patch to a better extent. Ambiguity, on the other hand, is the opportunity cost of having higher quality patches elsewhere in the search space. The aforementioned tradeoff depends on many attributes, including traits of the user: at the two extreme ends of the spectrum, analytic and wholistic searchers employ entirely different strategies. The former type focuses on exploitation first, interspersed with bouts of exploration, whereas the latter type prefers to explore the search space first and consume later. Our findings from an eye-tracking study of experts' interactions with novel search interfaces in the biomedical domain suggest that user traits of cognitive styles and perceived search task difficulty are significantly correlated with eye gaze and search behavior. We also demonstrate that perceived risk shifts the balance between exploration and exploitation in either type of users, tilting it against vs. in favor of ambiguity minimization. Since the pattern of behavior in information foraging is quintessentially sequential, risk and ambiguity minimization cannot happen simultaneously, leading to a fundamental limit on how good such a tradeoff can be. This in turn connects information seeking with the emergent field of quantum decision theory.

  5. Risk and Ambiguity in Information Seeking: Eye Gaze Patterns Reveal Contextual Behaviour in Dealing with Uncertainty

    Directory of Open Access Journals (Sweden)

    Peter Wittek

    2016-11-01

    Full Text Available Information foraging connects optimal foraging theory in ecology withhow humans search for information. The theory suggests that, followingan information scent, the information seeker must optimize the tradeoffbetween exploration by repeated steps in the search space vs.exploitation, using the resources encountered. We conjecture that thistradeoff characterizes how a user deals with uncertainty and its twoaspects, risk and ambiguity in economic theory. Risk is related to theperceived quality of the actually visited patch of information, and canbe reduced by exploiting and understanding the patch to a better extent.Ambiguity, on the other hand, is the opportunity cost of having higherquality patches elsewhere in the search space. The aforementionedtradeoff depends on many attributes, including traits of the user: atthe two extreme ends of the spectrum, analytic and wholistic searchersemploy entirely different strategies. The former type focuses onexploitation first, interspersed with bouts of exploration, whereas thelatter type prefers to explore the search space first and consume later.Our findings from an eye-tracking study of experts' interactions withnovel search interfaces in the biomedical domain suggest that usertraits of cognitive styles and perceived search task difficultyare significantly correlated with eye gaze and search behaviour. Wealso demonstrate that perceived risk shifts the balance betweenexploration and exploitation in either type of users, tilting it againstvs. in favour of ambiguity minimization. Since the pattern of behaviourin information foraging is quintessentially sequential, risk andambiguity minimization cannot happen simultaneously, leading to afundamental limit on how good such a tradeoff can be. This in turnconnects information seeking with the emergent field of quantum decisiontheory.

  6. Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid.

    Science.gov (United States)

    Pajewski, Nicholas M; Okunseri, Christopher

    2014-01-01

    To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition (NTDC) visits to the emergency department (ED). This is a retrospective, observational study of claims for NTDC visits to the ED and dental service encounters from the Wisconsin Medicaid Evaluation and Decision Support database (2001-2009). We used competing risk models to predict probabilities of returning to the ED versus obtaining follow-up care from a dentist. We observed a 43 percent increase in the rate of NTDC visits to the ED, with most of this increase occurring from 2001 to 2005. Within 30 days of an NTDC visit to the ED, ∼29.6 percent of enrollees will first visit a dentist office, while ∼9.9 percent will return to the ED. Young to middle-aged adults (18 to dental providers were more likely to return to the ED following a NTDC visit. Among the enrollees that first visited a dental office following an ED visit, 37.6 percent had an extraction performed at this visit. Almost one in five adult Medicaid enrollees will subsequently return to the ED following a previous NTDC visit. The provision of definitive care for these individuals appears to primarily consist of extractions. © 2012 American Association of Public Health Dentistry.

  7. Risk Perception of an Emergent Technology: The Case of Hydrogen Energy

    Directory of Open Access Journals (Sweden)

    Rob Flynn

    2006-01-01

    Full Text Available Although hydrogen has been used in industry for many years as a chemical commodity, its use as a fuel or energy carrier is relatively new and expert knowledge about its associated risks is neither complete nor consensual. Public awareness of hydrogen energy and attitudes towards a future hydrogen economy are yet to be systematically investigated. This paper opens by discussing alternative conceptualisations of risk, then focuses on issues surrounding the use of emerging technologies based on hydrogen energy. It summarises expert assessments of risks associated with hydrogen. It goes on to review debates about public perceptions of risk, and in doing so makes comparisons with public perceptions of other emergent technologies—Carbon Capture and Storage (CCS, Genetically Modified Organisms and Food (GM and Nanotechnology (NT—for which there is considerable scientific uncertainty and relatively little public awareness. The paper finally examines arguments about public engagement and "upstream" consultation in the development of new technologies. It is argued that scientific and technological uncertainties are perceived in varying ways and different stakeholders and different publics focus on different aspects or types of risk. Attempting to move public consultation further "upstream" may not avoid this, because the framing of risks and benefits is necessarily embedded in a cultural and ideological context, and is subject to change as experience of the emergent technology unfolds. URN: urn:nbn:de:0114-fqs0601194

  8. Pediatric Emergency Department Return: A Literature Review of Risk Factors and Interventions.

    Science.gov (United States)

    Tran, Quincy Khoi; Bayram, Jamil D; Boonyasai, Romsai T; Case, Meredith A; Connor, Christine; Doggett, David; Fawole, Oluwakemi A; Ijagbemi, O Mayowa; Levin, Scott; Wu, Albert W; Pham, Julius Cuong

    2016-08-01

    Children discharged from emergency departments (EDs) are often at risk for ED return. The objective was to identify risk factors and interventions to mitigate or prevent ED return among this patient population. Structured literature review of PubMed and clinicaltrials.gov was conducted to identify relevant studies. Inclusion criteria were studies evaluating ED returns by identifying risk factors and interventions in the pediatric population. Emergency department return was defined as returning to the ED within 1 year after initial visit. Abstract and full text articles were reviewed, and data were abstracted by 2 independent authors. A total of 963 articles were screened and yielded 42 potential relevant articles involving pediatric population. After full text review, a total of 12 articles were included in the final analysis (6 on risk factors and 6 on interventions). Risk factors for pediatric ED return included behavioral/psychiatric problems, younger age, acuity of illness, medical history of asthma, and social factors. Interventions included computer-generated instructions, postdischarge telephone coaching, ED-made appointments, case management, and home environment intervention. Emergency department-made appointments and postdischarge telephone coaching plus monetary incentive improved outpatient follow-up rate but not ED return. Home environment assessment coupled with case management reduced ED returns specifically among asthma patients. Several patient and visit characteristics can help predict children at risk for ED return. Although some interventions are successful at improving postdischarge follow-up, most did not reduce ED returns.

  9. Risk-communication capability for public health emergencies varies by community diversity

    Directory of Open Access Journals (Sweden)

    Viswanath Kasisomayajula

    2008-03-01

    Full Text Available Abstract Background Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02. With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.

  10. Incommensurate Environmental Risks and the Regulator’s Dilemma in the Governance of Emergency Situation

    Directory of Open Access Journals (Sweden)

    Vesela Radovic

    2016-12-01

    Full Text Available In the 21st century humans face with the great risk how to protect themselves from disasters of different kinds. Emergencies happened in many countries and caused a great suffering of humans. The main question of stakeholders is: ‘’how to protect human health and environment in an adequate way’’. Emergency management is an issue which is included in numerous education institutions all over the globe and the action of various national and international organizations. Therefore it is interesting that in the process of fostering emergency management many countries neglect the need of creating more effective tools for response, preparedness and recovery in environmental emergencies. The paper is based on analyzes of Serbian approach in the governance of emergency situation followed by incommensurate environmental risks. Serbia had to accept International environmental emergency help after the floods in 2014. The Joint United Nations Environment Programme (UNEP / Office for the Coordination of Humanitarian Affairs (OCHA Environment Unit (JEU helped Serbia to mitigate consequences of horrified environmental emergency in “Stolice” mine near city Krupanj. This assistance was needed because Serbia did not have enough capacity to struggle with the consequences of breaking the dam and contamination of soil and rivers. This study shows that a similar disaster in the future could be solved only by strengthening multilateral response of different actors at local and national level. After all, Serbia is at the beginning of the path, and need to highlight strategic challenges in the governance of emergency situation followed by environmental emergencies. Only with full implementation of positive practice of the international community Serbia could avoid long term impact on life support functions, nature and humans.

  11. Risk factors of the rebleeding according to the patterns of nonvariceal upper gastrointestinal bleeding.

    Science.gov (United States)

    Nam, Ji Hyung; Jeon, Tae Joo; Cho, Jae Hee; Kim, Jae Hak

    2017-07-01

    Despite of successful endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding (NGIB), rebleeding rate has not decreased. The aim of this study was to identify risk factors for rebleeding after endoscopic hemostasis in patients with NGIB according to bleeding patterns. A retrospective analysis was performed on the consecutive patients with NGIB in whom successful primary endoscopic hemostasis had been achieved at three university hospitals in Korea. All patients underwent endoscopic treatment with hemoclips, epinephrine injection, argon-plasma coagulation, or its combinations within 12 h. A total of 198 patients were studied. The male-to-female ratio was 3:1. Mean age was 60.7±14.9 years. Rebleeding occurred in 41 cases (20.7%). Median day of rebleeding after endoscopic therapy was 2.0 days. Overall mortality rate was 5.1%. Risk factors for rebleeding were inpatients [odds ratio (OR) 2.61, 95% confidence interval (CI): 1.05-6.46, p=0.038) and Forrest Ib (OR=2.73, 95% CI: 1.15-6.47, p=0.023) by multivariate regression analysis. Despite of successful emergent endoscopic therapy for NGIB, rebleeding occurred in 17.7% within a week. Endoscopic treatments should be more carefully performed for patients in hospitalization or patients with active oozing.

  12. Nutrient patterns and risk of cataract: a case-control study

    Directory of Open Access Journals (Sweden)

    Fatemeh Sedaghat

    2017-04-01

    Full Text Available AIM: To assess the relation between nutrient patterns and cataract risk. METHODS: This is a hospital-based case-control study with 97 cataract patients and 198 matched controls. Dietary consumption was collected through a valid food frequency questionnaire (FFQ. Nutrient patterns were detected by applying factor analysis. Unconditional logistic regression models were used to estimate odds ratio (ORs and 95%CIs. RESULTS: We extracted 5 main nutrient patterns. Factor 1 included niacin, thiamin, carbohydrates, protein, zinc, vitamin B6 and sodium (sodium pattern. Factor 2 was characterized by oleic acid, monounsaturated fats, polyunsaturated fats, linoleic acid, trans fatty acid, linolenic acid, vitamin E and saturated fats (fatty acid pattern. The third factor represented high intake of vitamin B12, vitamin D, cholesterol and calcium (mixed pattern. The 4th pattern was high in intake of beta and alpha carotene, vitamin A and vitamin C (antioxidant pattern. Finally, the 5th pattern loaded heavily on docosahexaenoic acid (DHA and eicosapentaenoic acid (EPA (omega-3 pattern. In crude and multivariate analysis, the sodium pattern was associated with increased risk of cataract (OR=1.97, 95%CI: 1.09-3.96. The fatty acid pattern elevated the risk of cataract (OR=1.94, 95%CI: 1.1-3.86. Antioxidant pattern was associated with a significant 79% reduced risk (2nd category compared with the 1st. Omega-3 pattern was significantly negatively associated with risk of cataract (P=0.04. CONCLUSION: These findings imply that nutrient patterns reflecting a combined consumption of nutrients might be important in the etiology of cataract. Additional studies with more efficient designs are warranted to confirm our findings.

  13. Nano-ethics as NEST-ethics: Patterns of Moral Argumentation About New and Emerging Science and Technology

    OpenAIRE

    2007-01-01

    There might not be a specific nano-ethics, but there definitely is an ethics of new & emerging science and technology (NEST), with characteristic tropes and patterns of moral argumentation. Ethical discussion in and around nanoscience and technology reflects such NEST-ethics. We offer an inventory of the arguments, and show patterns in their evolution, in arenas full of proponents and opponents. We also show that there are some nano-specific issues: in how size matters, and when agency is del...

  14. Farmers risk perception and risk management strategies in an emerging mussel aquaculture industry in Denmark

    DEFF Research Database (Denmark)

    Ahsan, Dewan; Roth, Eva

    2010-01-01

    The aim of this exploratory study is to provide empirical insight into how the mussel farmers perceive and manage risks. The results show that future price and demand of mussel are the high ranked perceived risk. Bad weather, oxygen depletion, harmful algal blooms, E-coli, change in governmental...... regulation and public view towards mussel culture are also considered important risk factors in mussel farming. On the other hand, produced at lowest possible cost, cooperative marketing, good relation with government, prioritize liquidity, adopt new technology and experience sharing are perceived most...... important risk management strategies. When developing and changing policies for farmers’ reliability and for the long-term sustainability of mussel aquaculture, policy-makers should consider those risks and risk management strategies which have been emphasized by the farmers....

  15. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola

    2017-01-01

    ) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal...

  16. Food safety ontology and text mining strategies as a tool in (re)emerging risk identification

    NARCIS (Netherlands)

    Brug, F. van de

    2009-01-01

    Industry and government are held responsible for the safety of food and feed products. Therefore actual and relevant information concerning emerging safety risks is crucial. But how is it possible to filter relevant information from the fast growing volumes of information produced by science and the

  17. Suicide Risk Assessment in Australian Emergency Departments: Assessing Clinicians’ Disposition Decisions

    Directory of Open Access Journals (Sweden)

    T. J. Weiland

    2014-01-01

    Full Text Available Objective. To determine (1 the uniformity of disposition decisions made by clinicians working in Australian emergency departments (EDs using vignettes describing patients presenting with deliberate self-harm or suicide risk; (2 factors associated with these decisions; (3 factors associated with confidence in these decisions. Methodology. We validated and distributed by email an online survey tool to Australian emergency clinicians via their colleges. Participants were presented with five vignettes and asked to rate the level of risk and protective factors for suicide, the patient’s disposition (admit/discharge/review, factors influencing this decision, their confidence in the decision, and factors that would have improved their confidence. Results. Percentages of participants choosing the modal disposition decision for each scenario ranged from 58.6% (136/232 to 92.4% (220/238, demonstrating uniformity in clinicians’ disposition decisions. Predictors of disposition were consistently level of risk factors perceived and, infrequently, clinician factors including age and years experience. Confidence in disposition decisions was high across scenarios. Clinicians reported patient, clinician, contextual and decision support factors relevant to an Australian emergency context affected their disposition decisions and confidence in decisions. Conclusion. Emergency clinicians are uniform and confident in their disposition decisions for patient vignettes where there is risk of suicide or self harm.

  18. Support for Emergency Department Screening for Intimate Partner Violence Depends on Perceived Risk

    Science.gov (United States)

    Witting, Michael D.; Furuno, Jon P.; Hirshon, Jon Mark; Krugman, Scott D.; Perisse, Andre R. S.; Limcangco, Rhona

    2006-01-01

    Emergency department (ED) screening for intimate partner violence (IPV) faces logistic difficulties and has uncertain efficacy. We surveyed 146 ED visitors and 108 ED care providers to compare their support for ED IPV screening in three hypothetical scenarios of varying IPV risk. Visitor support for screening was 5 times higher for the high-risk…

  19. Food safety ontology and text mining strategies as a tool in (re)emerging risk identification

    NARCIS (Netherlands)

    Brug, F. van de

    2009-01-01

    Industry and government are held responsible for the safety of food and feed products. Therefore actual and relevant information concerning emerging safety risks is crucial. But how is it possible to filter relevant information from the fast growing volumes of information produced by science and the

  20. Outbreaks of emerging infectious diseases: Risk perception and behaviour of the general public

    NARCIS (Netherlands)

    M. Bults (Marloes)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on risk perception and behaviour of the public during the outbreaks of emerging infectious diseases. It consists of studies on Influenza A (H1N1), Q fever and Lyme disease. These studies were conducted among both the general public and specific

  1. BIOTOXIN-INDUCED NEUROTOXICITY: AN EMERGING RISK FOR HUMAN HEALTH AND ECOLOGY.

    Science.gov (United States)

    The increasing incidence of human illness associated with exposure to biotoxins from harmful algal blooms (HABs) in aquatic environments, and fungi and bacteria on land, may indicate an emerging human-health risk. HABs are reported to be increasing worldwide in frequency, duratio...

  2. Species undersampling in tropical bat surveys: effects on emerging biodiversity patterns.

    Science.gov (United States)

    Meyer, Christoph F J; Aguiar, Ludmilla M S; Aguirre, Luis F; Baumgarten, Julio; Clarke, Frank M; Cosson, Jean-François; Estrada Villegas, Sergio; Fahr, Jakob; Faria, Deborah; Furey, Neil; Henry, Mickaël; Jenkins, Richard K B; Kunz, Thomas H; Cristina MacSwiney González, M; Moya, Isabel; Pons, Jean-Marc; Racey, Paul A; Rex, Katja; Sampaio, Erica M; Stoner, Kathryn E; Voigt, Christian C; von Staden, Dietrich; Weise, Christa D; Kalko, Elisabeth K V

    2015-01-01

    Undersampling is commonplace in biodiversity surveys of species-rich tropical assemblages in which rare taxa abound, with possible repercussions for our ability to implement surveys and monitoring programmes in a cost-effective way. We investigated the consequences of information loss due to species undersampling (missing subsets of species from the full species pool) in tropical bat surveys for the emerging patterns of species richness (SR) and compositional variation across sites. For 27 bat assemblage data sets from across the tropics, we used correlations between original data sets and subsets with different numbers of species deleted either at random, or according to their rarity in the assemblage, to assess to what extent patterns in SR and composition in data subsets are congruent with those in the initial data set. We then examined to what degree high sample representativeness (r ≥ 0·8) was influenced by biogeographic region, sampling method, sampling effort or structural assemblage characteristics. For SR, correlations between random subsets and original data sets were strong (r ≥ 0·8) with moderate (ca. 20%) species loss. Bias associated with information loss was greater for species composition; on average ca. 90% of species in random subsets had to be retained to adequately capture among-site variation. For nonrandom subsets, removing only the rarest species (on average c. 10% of the full data set) yielded strong correlations (r > 0·95) for both SR and composition. Eliminating greater proportions of rare species resulted in weaker correlations and large variation in the magnitude of observed correlations among data sets. Species subsets that comprised ca. 85% of the original set can be considered reliable surrogates, capable of adequately revealing patterns of SR and temporal or spatial turnover in many tropical bat assemblages. Our analyses thus demonstrate the potential as well as limitations for reducing survey effort and streamlining

  3. Causal relationships vs. emergent patterns in the global controls of fire frequency

    Directory of Open Access Journals (Sweden)

    I. Bistinas

    2014-03-01

    Full Text Available Global controls on month-by-month fractional burnt area (2000–2005 were investigated by fitting a generalized linear model to Global Fire Emissions Database data with 11 predictor variables representing vegetation, climate, land use and potential ignition sources. Burnt area is shown to increase with annual net primary production (NPP, number of dry days, maximum temperature, grazing-land area, grass/shrub cover and diurnal temperature range, and to decrease with soil moisture, cropland area and population density. Lightning showed an apparent (weak negative influence, but this disappeared when pure seasonal-cycle effects were taken into account. The model predicts observed geographic and seasonal patterns, and the emergent relationships seen when burnt area is plotted against each variable separately. Unimodal relationships to mean annual temperature and precipitation, population density and gross domestic product (GDP are reproduced too, and thus shown to be secondary consequences of correlations among different controls (e.g. high NPP with high precipitation; low NPP with low population density and GDP. These findings have major implications for the design of global fire models, as several assumptions in current models – most notably, the widely assumed dependence of fire frequency on ignition rates – are evidently incorrect.

  4. Bacteriological profile and antibiotic susceptibility patterns in neonatal septicemia in view of emerging drug resistance

    Directory of Open Access Journals (Sweden)

    Maimoona Mustafa

    2014-02-01

    Full Text Available The objective of this study was to isolate pathogenic bacteria in neo-natal septicaemia cases, and to know their antibiograms. Under aseptic precautions, blood was drawn from 140 neonates with sus-pected septicaemia and inoculated in brain heart infusion (BHI broth. Isolates obtained were identified as per standard protocol and antibi-otic susceptibility was done by Kirby Bauer disc diffusion method (as per CLSI guidelines. A total number of 62 (44.2% patients had positive blood cultures. The most common pathogens isolated were Klebsiella pneumoniae (n=22, 35% followed by Staphylococcus aureus (n=15, 24.1%, Escherichia coli (n=14, 22.5%, CONS (n=7, 11.2% and Pseudomonas aeruginosa (n=4, 6.4%. The Gram nega-tive organisms showed high resistance to commonly used antibiotics and were highly sensitive to Meropenem. The Gram positive bacteria showed high resistance to Ampicillin, Erythromycin and Amoxycillin; but they were highly susceptible to Linizolid and Vancomycin. As the Gram negative organisms were the most common isolates in neona-tal septicemia, their resistance pattern should be considered essen-tial for deciding the empirical treatment. Prompt treatment of neonatal sepsis with judicious use of appropriate antibiotics can minimize the morbidity and mortality, besides reducing the emergence of multi-drug resistant organisms in intensive care units (ICUs.

  5. Dietary pattern and risk of hodgkin lymphoma in a population-based case-control study.

    Science.gov (United States)

    Epstein, Mara M; Chang, Ellen T; Zhang, Yawei; Fung, Teresa T; Batista, Julie L; Ambinder, Richard F; Zheng, Tongzhang; Mueller, Nancy E; Birmann, Brenda M

    2015-09-01

    Classic Hodgkin lymphoma (cHL) has few known modifiable risk factors, and the relationship between diet and cHL risk is unclear. We performed the first investigation of an association between dietary pattern and cHL risk in 435 cHL cases and 563 population-based controls from Massachusetts and Connecticut (1997-2000) who completed baseline diet questionnaires. We identified 4 major dietary patterns ("vegetable," "high meat," "fruit/low-fat dairy," "desserts/sweets") using principal components analysis. We computed multivariable odds ratios and 95% confidence intervals for associations of dietary pattern score (quartiles) with younger-adult (age dietary patterns were not clearly associated with cHL. We report the first evidence for a role of dietary pattern in cHL etiology. Diets featuring high intake of meat or desserts and sweets may increase cHL risk.

  6. Farmers risk perception and risk management strategies in an emerging mussel aquaculture industry in Denmark

    DEFF Research Database (Denmark)

    Ahsan, Dewan; Roth, Eva

    2010-01-01

    The aim of this exploratory study is to provide empirical insight into how the mussel farmers perceive and manage risks. The results show that future price and demand of mussel are the high ranked perceived risk. Bad weather, oxygen depletion, harmful algal blooms, E-coli, change in governmental ...

  7. Developing a precise questionnaire to elucidate risk factors and injury pattern in RTA victims

    Directory of Open Access Journals (Sweden)

    RK Singh

    2013-12-01

    Full Text Available Introduction: Road traffic injuries are a growing public health issue. Despite good numbers of traffic legislations/ law/bye-laws/ regulations/ policies at the national/ state level and various safety measures to prevent road accidents/ mishaps, awareness remains comparatively low in India. Till date no questionnaire has been suitably developed, standardized and positivised for determining association of causality with injury pattern and severity score. Objective: To design and develop a précised survey questionnaire determining association of causality with injury pattern along with severity score in RTA victims.  Methodology: Till date no such study has been ventured which has observed the inter relationship of these factors resulting in a specific injury. Designed questionnaire was based on literature review, and updated several times to ensure the precision and agreement with the help of institutional trauma expert team. As a pilot study, 30 RTA victims admitted in trauma centre of KG Medical University were enrolled and designed questionnaire was tested for easiness and doubts. The results were thoroughly analyzed for item difficulty, precision and internal consistency. Results: A significant agreement of question pertaining to speed (k=0.99, CI=0.95, visibility (k=0.87, alcohol (k=0.65 in the questionnaire. Questions related to environment, driver, vehicle and road factors show a significant consistency (p>0.05 as cause of accidents. Test of agreements done by Kappa showed in variables having value more than 0.60 except few variables. Discussion: The designed questionnaire is precise, reasonably reliable in perfect agreement. This questionnaire should emerge a useful tool in determining the association of risk factors with injury pattern and severity. 

  8. Development and implementation of a system for the early identification of emerging risks in food and feed

    National Research Council Canada - National Science Library

    2010-01-01

    ...). Through the identification of drivers of emerging risks, EFSA also intends to anticipate future risks derived from changes in current food/feed production practices or factors impinging on food/feed...

  9. GROWTH AND MOTOR DEVELOPMENT IN FETUSES OF WOMEN WITH TYPE-1 DIABETES .2. EMERGENCE OF SPECIFIC MOVEMENT PATTERNS

    NARCIS (Netherlands)

    MULDER, EJH; VISSER, GHA

    1991-01-01

    In 20 women with type-1 diabetes, the emergence of fetal movement patterns was studied using real-time ultrasound. One-hour recordings were made once a week between the 7th and 17th week of gestation. Data were compared to those obtained in uncomplicated pregnancy. The diabetic women were being trea

  10. Nano-ethics as NEST-ethics: Patterns of Moral Argumentation About New and Emerging Science and Technology

    NARCIS (Netherlands)

    Swierstra, Tjalling; Rip, Arie

    2007-01-01

    There might not be a specific nano-ethics, but there definitely is an ethics of new & emerging science and technology (NEST), with characteristic tropes and patterns of moral argumentation. Ethical discussion in and around nanoscience and technology reflects such NEST-ethics. We offer an inventory o

  11. Emerging Occupational Patterns in Australia in the Era of Globalisation and Rapid Technological Change: Implications for Education and Training.

    Science.gov (United States)

    Maglen, Leo; Shah, Chandra

    The effects of globalization and rapid technological change on emerging occupational patterns in Australia need to be understood in order to understand their implications for the effects on education and vocational training. Building on the classification scheme introduced by Robert Reich in his 1992 book, the Work of Nations, Australian…

  12. GROWTH AND MOTOR DEVELOPMENT IN FETUSES OF WOMEN WITH TYPE-1 DIABETES .2. EMERGENCE OF SPECIFIC MOVEMENT PATTERNS

    NARCIS (Netherlands)

    MULDER, EJH; VISSER, GHA

    1991-01-01

    In 20 women with type-1 diabetes, the emergence of fetal movement patterns was studied using real-time ultrasound. One-hour recordings were made once a week between the 7th and 17th week of gestation. Data were compared to those obtained in uncomplicated pregnancy. The diabetic women were being trea

  13. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    Science.gov (United States)

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  14. Dietary patterns and home food availability during emerging adulthood: do they differ by living situation?

    Science.gov (United States)

    Nelson Laska, Melissa; Larson, Nicole I; Neumark-Sztainer, Dianne; Story, Mary

    2010-02-01

    The objective of the present work was to cross-sectionally examine and compare dietary behaviours and home food environments by young adults' living situation. Using data from Project EAT (Eating Among Teens)-II, a large diverse youth cohort originally sampled in Minnesota, linear regression was used to examine self-reported meal frequency, dietary intake and home food availability outcomes by living situation (i.e. living with parents, renting an apartment/house or living on a college campus). Young adults (n 1687), mean age 20.5 years. Results suggested that young adults living with their parents or in rented apartments/houses had less frequent meals, poorer dietary intake and less healthy home food availability compared with those living on campus. These findings were evident even after controlling for sociodemographic factors (e.g. race/ethnicity, socio-economic status), particularly among females. Although few emerging adults consume diets that are consistent with national recommendations, those living with parents and in rented apartments/houses may represent particularly at-risk groups. These differences in dietary factors across living situations appear to exist beyond the sociodemographic differences in these populations. Effective nutrition and healthy eating promotion strategies are needed for young adults.

  15. Predation risk and elk-aspen foraging patterns

    Science.gov (United States)

    Clifford A. White; Michael C. Feller

    2001-01-01

    Elk-aspen foraging patterns may be influenced by cover type, distance from roads or trails, the type of user on road or trail (park visitor, human hunter, or predator), and two general states of aspen condition (open-grown or thicket). Pellet group and browse utilization transects in the Canadian Rockies showed that elk were attracted to roads used by park visitors and...

  16. PATTERNS OF RISK IN THE RETAIL BUSINESS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Adina CATANA

    2010-12-01

    Full Text Available The risk issue has become lately one of the most important themes in economic life. The risk is an important component of all management activities, whether it is a simple or more complex activity. There is a common opinion of those who study economics that the business risk is a natural thing, and it is irreplaceable in the business world. Risk disappearance creates confusion, inefficiency and generates the unnatural behaviour of the economic agents. Developing a business involves making decisions about the future. Information available to managers in making decisions is never perfect and complete. Considered one of the most dynamic economic sectors, trade is a deep restructuring process. The rapid rate of development in the economic activity has resulted in changes in trade activity, mainly in the retail sector, the new store formats of thousands of square feet generates a lot of turnover. The risks that appear in this sector, represented by large retail stores, are multiple: increased competition, technological development requiring replacement of hold capacity, insufficient information on the external elements of the enterprise, uncertain economic context, state intervention in the economy, environmental impact.

  17. Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

    Science.gov (United States)

    Evans, J. D.; Hao, W.; Chettri, S. R.

    2014-12-01

    Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

  18. Rethinking risk assessment for emerging technology first-in-human trials.

    Science.gov (United States)

    Genske, Anna; Engel-Glatter, Sabrina

    2016-03-01

    Recent progress in synthetic biology (SynBio) has enabled the development of novel therapeutic opportunities for the treatment of human disease. In the near future, first-in-human trials (FIH) will be indicated. FIH trials mark a key milestone in the translation of medical SynBio applications into clinical practice. Fostered by uncertainty of possible adverse events for trial participants, a variety of ethical concerns emerge with regards to SynBio FIH trials, including 'risk' minimization. These concerns are associated with any FIH trial, however, due to the novelty of the approach, they become more pronounced for medical applications of emerging technologies (emTech) like SynBio. To minimize potential harm for trial participants, scholars, guidelines, regulations and policy makers alike suggest using 'risk assessment' as evaluation tool for such trials. Conversely, in the context of emTech FIH trials, we believe it to be at least questionable to contextualize uncertainty of potential adverse events as 'risk' and apply traditional risk assessment methods. Hence, this issue needs to be discussed to enable alterations of the evaluation process before the translational phase of SynBio applications begins. In this paper, we will take the opportunity to start the debate and highlight how a misunderstanding of the concept of risk, and the possibilities and limitations of risk assessment, respectively, might impair decision-making by the relevant regulatory authorities and research ethics committees, and discuss possible solutions to tackle the issue.

  19. Dietary patterns and the risk of rhinitis in primary school children: a prospective cohort study

    Science.gov (United States)

    Liu, Xudong; Wong, Claudie Chiu-Yi; Yu, Ignatius T. S.; Zhang, Zilong; Tan, Lixing; Lau, Arthur P. S.; Lee, Albert; Yeoh, Eng Kiong; Lao, Xiang Qian

    2017-01-01

    This study was to investigate the association between dietary patterns and rhinitis in primary school children. 1,599 students without rhinitis at baseline survey were selected from a primary school children cohort. Information on food consumption, respiratory symptoms, and confounders was collected using questionnaires. Dietary patterns were defined using principal component analysis. Logistic regression was performed to calculate odds ratio (OR) with 95% confidence intervals (95% CI). The incidence of rhinitis during 12 months follow-up was 21.2%. Three patterns were extracted and labeled as pattern I, II and III. Dietary pattern II which had higher factor loadings of legumes, butter, nuts and potatoes was associated with an increased risk of rhinitis (OR: 1.34, 95% CI: 1.01–1.87) when the highest tertile of pattern score was compared to the lowest tertile, after adjusted for confounders. Besides, every 1-unit increase of score of pattern II was also associated with an increased risk of rhinitis (OR: 1.19, 95% CI: 1.05–1.35). Neither pattern I nor Pattern III was observed to be associated with risk of rhinitis. A diet with higher levels of consumption of legumes, butter, nuts and potatoes may increase the risk of allergic rhinitis in primary school children. PMID:28294150

  20. A dietary pattern associated with LINE-1 methylation alters the risk of developing cervical intraepithelial neoplasia.

    Science.gov (United States)

    Piyathilake, Chandrika J; Badiga, Suguna; Kabagambe, Edmond K; Azuero, Andres; Alvarez, Ronald D; Johanning, Gary L; Partridge, Edward E

    2012-03-01

    There is a paucity of research examining the relationships between dietary patterns and risk of developing precancerous lesions as well as biomarkers associated with such dietary patterns. The purpose of the current study was to identify dietary patterns that are associated with higher grades of cervical intraepithelial neoplasia (CIN 2+) and to determine whether these dietary patterns are associated with the degree of DNA methylation in the long interspersed nucleotide elements (L1s) of peripheral blood mononuclear cells (PBMCs), a biomarker associated with risk of developing CIN 2+. Study population consisted of 319 child-bearing age women. Dietary patterns were derived by factor analysis. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models were used to evaluate the associations between dietary patterns and CIN 2+. Similar models were used to evaluate the associations between dietary patterns and degree of PBMC L1 methylation in women free of CIN 2+. Women with the unhealthiest dietary pattern were 3.5 times more likely to be diagnosed with CIN 2+ than women with the healthiest dietary pattern [OR = 3.5; 95% confidence interval (CI), 1.2-10.1; P = 0.02]. Women at risk for developing CIN 2+ with the healthiest dietary pattern were 3.3 times more likely to have higher PBMC L1 methylation than women with the unhealthiest dietary pattern (OR = 3.3; 95% CI, 1.0-10.6; P = 0.04). Our findings suggest that human papilloma virus associated risk of developing CIN 2+ may be reduced by improving dietary patterns. The degree of PBMC L1 methylation may serve as a biomarker for monitoring the effectiveness of dietary modifications needed for reducing the risk of CIN 2+.

  1. Workshop "Emerging risks and early warning systems" : deelproject 1.2 : miniconferentie over roegtijdig signalering en waarschuwingssystemen

    NARCIS (Netherlands)

    Koenderink, N.J.J.P.; Kreft, F.

    2007-01-01

    This report is the result of the workshop “Emerging risks and early warning system” held in Wageningen, the Netherlands on October the 19th 2006. The workshop is part of the project “Emerging risks in Dutch food chains”. The purpose of this project is to develop a procedure to identify potential ris

  2. From Spatial Data to Synchronised Actions: the Network-centric Organisation of spatial decision support for risk and emergency management

    NARCIS (Netherlands)

    Neuvel, J.M.M.; Scholten, H.J.; Brink, van den A.

    2012-01-01

    A considerable amount of the required information in risk and emergency management is geographical, but this information does not always reach the right actors at the right time, so how can geographical information be organised in such a way that it supports risk and emergency management more

  3. Workshop "Emerging risks and early warning systems" : deelproject 1.2 : miniconferentie over roegtijdig signalering en waarschuwingssystemen

    NARCIS (Netherlands)

    Koenderink, N.J.J.P.; Kreft, F.

    2007-01-01

    This report is the result of the workshop “Emerging risks and early warning system” held in Wageningen, the Netherlands on October the 19th 2006. The workshop is part of the project “Emerging risks in Dutch food chains”. The purpose of this project is to develop a procedure to identify potential

  4. From Spatial Data to Synchronised Actions: the Network-centric Organisation of spatial decision support for risk and emergency management

    NARCIS (Netherlands)

    Neuvel, J.M.M.; Scholten, H.J.; Brink, van den A.

    2012-01-01

    A considerable amount of the required information in risk and emergency management is geographical, but this information does not always reach the right actors at the right time, so how can geographical information be organised in such a way that it supports risk and emergency management more effect

  5. 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

    ... [Docket No. FDA-2011-N-0002] Data and Data Needs To Advance Risk Assessment for Emerging Infectious... entitled: ``Data and Data Needs to Advance Risk Assessment for Emerging Infectious Diseases Relevant to... available basis beginning at 8 a.m. If you need special accommodations due to a disability, please...

  6. EFSA’s approach to identifying emerging risks in food and feed: taking stock and looking forward

    Directory of Open Access Journals (Sweden)

    Robinson T

    2012-10-01

    Full Text Available

    The Emerging Risks Unit has the responsibility for coordinating EFSA’s activities to establish a capacity for the identification of emerging risks. A process was trialled and further developed during a pilot period of 18 months from 2010-2012. This included the implementation of an operational procedure for emerging risks identification, the assessment of selected data sources, the testing of tools for collecting information, the consolidation of knowledge networks for sharing information and the development of a methodological framework. Specific issues were identified for follow-up activities using an expert judgment approach. These include a study on climate change and the emergence of aflatoxins in cereal crops in the European Union (EU, a European-wide survey on the consumption of energy drinks, a task force on human risk assessment of chemical mixtures, an internal task force on bee health, and a foresight study on the potential impact of omics technologies on food and feed safety risk assessment. These follow-up activities will contribute to the determination of whether the issues identified can indeed give rise to emerging risks. Overall, our experience shows that emerging risks identification requires a high level of expertise due to major data gaps and uncertainties in the evaluation process. Effective networking has proven to be essential for exchanging methods, data and evaluations of emerging risks. The system piloted has shown some potential for the identification of issues that may give rise to emerging risks. Useful knowledge has been gained in the area of gathering and filtering large amounts of information and building knowledge networks on emerging risks. Next steps include the establishment of a standing Working Group (WG on Emerging Risks, the reinforcement of the engagement with Member States and Stakeholders, the fine tuning of the revised methodological framework, and the completion of the projects on the issues

  7. A Snack Dietary Pattern Increases the Risk of Hypercholesterolemia in Northern Chinese Adults: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Lixin Na

    Full Text Available The evidence about the effect of dietary patterns on blood cholesterol from cohort studies was very scarce. The study was to identify the association of dietary patterns with lipid profile, especially cholesterol, in a cohort in north China. Using a 1-year food frequency questionnaire, we assessed the dietary intake of 4515 adults from the Harbin People's Health Study in 2008, aged 20-74 years. Principle component analysis was used to identify dietary patterns. The follow-up was completed in 2012. Fasting blood samples were collected for the determination of blood lipid concentrations. Logistic regression models were used to evaluate the association of dietary patterns with the incidence of hypercholesterolemia, hypertriglyceridemia, and low-HDL cholesterolemia. Five dietary patterns were identified ("staple food", "vegetable, fruit and milk", "potato, soybean and egg", "snack", and "meat". The relative risk (RR between the extreme tertiles of the snack dietary pattern scores was 1.72 (95% CI = 1.14, 2.59, P = 0.004 for hypercholesterolemia, 1.39 (1.13, 1.75, P = 0.036 for hypertriglyceridemia, after adjustment for age, sex, education, body mass index, smoking, alcohol consumption, energy intake, exercise and baseline lipid concentrations. There was a significant positive association between the snack dietary pattern scores and fasting serum total cholesterol (SRC (standardized regression coefficient = 0.262, P = 0.025, LDL-c (SRC = 0.324, P = 0.002 and triglycerides (SRC = 0.253, P = 0.035, after adjustment for the multiple variables above. Moreover, the adjusted RR of hypertriglyceridemia between the extreme tertiles was 0.73 (0.56, 0.94, P = 0.025 for the vegetable, fruit and milk dietary pattern, and 1.86 (1.33, 2.41, P = 0.005 for the meat dietary pattern. The snack dietary pattern was a newly emerged dietary pattern in northern Chinese adults. It appears conceivable that the risk of hypercholesterolemia can be reduced by changing the snack

  8. Instant noodle intake and dietary patterns are associated with distinct cardiometabolic risk factors in Korea

    National Research Council Canada - National Science Library

    Shin, Hyun Joon; Cho, Eunyoung; Lee, Hae-Jeung; Fung, Teresa T; Rimm, Eric; Rosner, Bernard; Manson, JoAnn E; Wheelan, Kevin; Hu, Frank B

    2014-01-01

    The consumption of instant noodles is relatively high in Asian populations. It is unclear whether a higher intake of instant noodles is associated with cardiometabolic risk independent of overall dietary patterns...

  9. Perception of the Risks of Ebola, Enterovirus-E68 and Influenza Among Emergency Department Patients

    Directory of Open Access Journals (Sweden)

    Lauren K. Whiteside

    2016-06-01

    Full Text Available Introduction: Emerging infectious diseases often create concern and fear among the public. Ebola virus disease (EVD and enterovirus (EV-68 are uncommon viral illnesses compared to influenza. The objective of this study was to determine risk for these viral diseases and then determine how public perception of influenza severity and risk of infection relate to more publicized but less common emerging infectious diseases such as EVD and EV-68 among a sample of adults seeking care at an emergency department (ED in the United States. Methods: We included consenting adults who sought care in two different urban EDs in Seattle, WA in November 2014. Excluded were those who were not fluent in English, in police custody, had decreased level of consciousness, a psychiatric emergency, or required active resuscitation. Patients were approached to participate in an anonymous survey performed on a tablet computer. Information sought included demographics, medical comorbidities, risk factors for EVD and EV-68, and perceptions of disease likelihood, severity and worry for developing EVD, EV-68 or influenza along with subjective estimates of the number of people who have died of each virus over the year in the United States. Results: A total of 262 (88.5% participation rate patients participated in the survey. Overall, participants identified that they were more likely to get influenza compared to EVD (p<0.001 or EV-68 (p<0.001, but endorsed worry and concern about getting both EVD and EV-68 despite having little or no risk for these viral diseases. Nearly two-thirds (64% of participants had at-least one risk factor for an influenza-related complication. Most participants (64% believed they could get influenza in the next 12 months. Only 52% had received a seasonal influenza vaccine. Conclusion: Perception of risk for EVD, EV-68 and influenza is discordant with actual risk as well as self-reported use of preventive care. Influenza is a serious public health

  10. A Western Dietary Pattern Increases Prostate Cancer Risk: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Roberto Fabiani

    2016-10-01

    Full Text Available Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC risk. While the associations between PC risk with the glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by “a posteriori” methods. A literature search was carried out (PubMed, Web of Science to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns were selected and the risks estimated were calculated by a random-effect model. Multivariable-adjusted odds ratios (ORs, for a first-percentile increase in dietary pattern score, were combined by a dose-response meta-analysis. Twelve observational studies were included in the meta-analysis which identified a “Healthy pattern” and a “Western pattern”. The Healthy pattern was not related to PC risk (OR = 0.96; 95% confidence interval (CI: 0.88–1.04 while the Western pattern significantly increased it (OR = 1.34; 95% CI: 1.08–1.65. In addition, the “Carbohydrate pattern”, which was analyzed in four articles, was positively associated with a higher PC risk (OR = 1.64; 95% CI: 1.35–2.00. A significant linear trend between the Western (p = 0.011 pattern, the Carbohydrate (p = 0.005 pattern, and the increment of PC risk was observed. The small number of studies included in the meta-analysis suggests that further investigation is necessary to support these findings.

  11. A Western Dietary Pattern Increases Prostate Cancer Risk: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Fabiani, Roberto; Minelli, Liliana; Bertarelli, Gaia; Bacci, Silvia

    2016-01-01

    Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC) risk. While the associations between PC risk with the glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by “a posteriori” methods. A literature search was carried out (PubMed, Web of Science) to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns were selected and the risks estimated were calculated by a random-effect model. Multivariable-adjusted odds ratios (ORs), for a first-percentile increase in dietary pattern score, were combined by a dose-response meta-analysis. Twelve observational studies were included in the meta-analysis which identified a “Healthy pattern” and a “Western pattern”. The Healthy pattern was not related to PC risk (OR = 0.96; 95% confidence interval (CI): 0.88–1.04) while the Western pattern significantly increased it (OR = 1.34; 95% CI: 1.08–1.65). In addition, the “Carbohydrate pattern”, which was analyzed in four articles, was positively associated with a higher PC risk (OR = 1.64; 95% CI: 1.35–2.00). A significant linear trend between the Western (p = 0.011) pattern, the Carbohydrate (p = 0.005) pattern, and the increment of PC risk was observed. The small number of studies included in the meta-analysis suggests that further investigation is necessary to support these findings. PMID:27754328

  12. Applying the emergency risk management process to tackle the crisis of antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Dale eDominey-Howes

    2015-09-01

    Full Text Available We advocate that antibiotic resistance be reframed as a disaster risk management problem. Antibiotic resistant infections represent a risk to life every bit as significant as other commonly occurring natural disasters (e.g. earthquakes. Despite significant efforts by global health authorities, antibiotic resistance continues to escalate. Therefore, new approaches and expertise are needed to manage the issue. In this perspective we: (1 make a novel call for the emergency management community to recognise the antibiotic resistance risk and join in addressing this problem; (2 suggest using the risk management process to help tackle antibiotic resistance; (3 show why this approach has value and why it is different to existing approaches; and (4 identify public perception of antibiotic resistance as an important issue that warrants exploration.

  13. Applying the emergency risk management process to tackle the crisis of antibiotic resistance.

    Science.gov (United States)

    Dominey-Howes, Dale; Bajorek, Beata; Michael, Carolyn A; Betteridge, Brittany; Iredell, Jonathan; Labbate, Maurizio

    2015-01-01

    We advocate that antibiotic resistance be reframed as a disaster risk management problem. Antibiotic-resistant infections represent a risk to life as significant as other commonly occurring natural disasters (e.g., earthquakes). Despite efforts by global health authorities, antibiotic resistance continues to escalate. Therefore, new approaches and expertise are needed to manage the issue. In this perspective we: (1) make a call for the emergency management community to recognize the antibiotic resistance risk and join in addressing this problem; (2) suggest using the risk management process to help tackle antibiotic resistance; (3) show why this approach has value and why it is different to existing approaches; and (4) identify public perception of antibiotic resistance as an important issue that warrants exploration.

  14. Occupational Risks of Health Professionals in Turkey as an Emerging Economy.

    Science.gov (United States)

    Ulutasdemir, Nilgun; Cirpan, Metin; Copur, Ebru Ozturk; Tanir, Ferdi

    2015-01-01

    Health services are one of the work areas that contain important risks in terms of the occupational health and safety of the laborer. Professionals in various areas of health services encounter biological, chemical, physical, ergonomic, and psychosocial risks, particularly in hospitals. This study has been performed to evaluate the impacts of the occupational risks on health of health professionals in Turkey. In Turkey, as an emerging economy, the history of studies on health professionals is not longstanding. There have been various regulations intended for the occupational health and safety of health professionals in line with the Regulation of the Provision on Patient and Staff Safety prepared in 2012. However, applications can differ from region to region, institution to institution, and person to person. We believe that this review will lead health professionals to be aware of occupational risks and contribute to planning health services for health professionals. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Fear of childbirth and emergency caesarean section in low-risk nulliparous women

    DEFF Research Database (Denmark)

    Jespersen, Cecilie; Hegaard, Hanne Kristine; Schroll, Anne-Mette

    2014-01-01

    OBJECTIVE: To assess the association between fear of childbirth (FOC) and emergency caesarean section. DESIGN: A prospective cohort study of low-risk nulliparous women at term. SETTING: Nine obstetric departments in Denmark, May 2004-July 2005. POPULATION: A total of 2598 nulliparous women...... in spontaneous labor with a single fetus in cephalic presentation at term. METHODS: Self-reported FOC was assessed at 37 weeks of gestation by the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A and at admission to the labor ward by the Delivery Fear Scale (DFS). Mode of delivery...... was recorded by the attending staff. Logistic regression analyses were used to estimate unadjusted and adjusted odds ratios (OR). MAIN OUTCOME MEASURES: Risk of emergency caesarean section in women who feared childbirth. RESULTS: FOC (W-DEQ sum score ≥ 85 and DFS sum score ≥ 70) was not associated...

  16. Ethnic differences in offence patterns and the prevalence and impact of risk factors for recidivism

    NARCIS (Netherlands)

    C. van der Put; G.J. Stams; M. Deković; M. Hoeve; P. van der Laan

    2013-01-01

    This study examined differences in offense patterns and the prevalence and importance of risk factors for recidivism between Dutch (n = 542), Moroccan (n = 292), Surinamese (n = 133), Turkish (n = 97), and Antillean youth (n = 72). Results showed differences in offense patterns, the prevalence of ri

  17. Generalizability of dietary patterns of the inverse association between alcohol consumption and type 2 diabetes risk

    Science.gov (United States)

    Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome this limitation. To examine confounding by dietary pattern as well as ...

  18. Confounding by dietary pattern of the inverse association between alcohol consumption and type 2 diabetes risk

    Science.gov (United States)

    Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome the limitation. To examine confounding by dietary pattern as well as ...

  19. Confounding by dietary patterns of the inverse association between alcohol consumption and type 2 diabetes risk

    Science.gov (United States)

    Epidemiology of dietary components and disease risk limits interpretability due to potential residual confounding by correlated dietary components. Dietary pattern analyses by factor analysis or partial least squares may overcome this limitation. To examine confounding by dietary pattern as well as ...

  20. Comparison of 3 methods for identifying dietary patterns associated with risk of disease.

    Science.gov (United States)

    DiBello, Julia R; Kraft, Peter; McGarvey, Stephen T; Goldberg, Robert; Campos, Hannia; Baylin, Ana

    2008-12-15

    Reduced rank regression and partial least-squares regression (PLS) are proposed alternatives to principal component analysis (PCA). Using all 3 methods, the authors derived dietary patterns in Costa Rican data collected on 3,574 cases and controls in 1994-2004 and related the resulting patterns to risk of first incident myocardial infarction. Four dietary patterns associated with myocardial infarction were identified. Factor 1, characterized by high intakes of lean chicken, vegetables, fruit, and polyunsaturated oil, was generated by all 3 dietary pattern methods and was associated with a significantly decreased adjusted risk of myocardial infarction (28%-46%, depending on the method used). PCA and PLS also each yielded a pattern associated with a significantly decreased risk of myocardial infarction (31% and 23%, respectively); this pattern was characterized by moderate intake of alcohol and polyunsaturated oil and low intake of high-fat dairy products. The fourth factor derived from PCA was significantly associated with a 38% increased risk of myocardial infarction and was characterized by high intakes of coffee and palm oil. Contrary to previous studies, the authors found PCA and PLS to produce more patterns associated with cardiovascular disease than reduced rank regression. The most effective method for deriving dietary patterns related to disease may vary depending on the study goals.

  1. A neuroscience perspective on sexual risk behavior in adolescence and emerging adulthood.

    Science.gov (United States)

    Victor, Elizabeth C; Hariri, Ahmad R

    2016-05-01

    Late adolescence and emerging adulthood (specifically ages 15-24) represent a period of heightened sexual risk taking resulting in the greatest annual rates of sexually transmitted infections and unplanned pregnancies in the US population. Ongoing efforts to prevent such negative consequences are likely to benefit from a deepening of our understanding of biological mechanisms through which sexual risk taking emerges and biases decision making during this critical window. Here we present a neuroscience framework from which a mechanistic examination of sexual risk taking can be advanced. Specifically, we adapt the neurodevelopmental triadic model, which outlines how motivated behavior is governed by three systems: approach, avoidance, and regulation, to sexual decision making and subsequent risk behavior. We further propose a testable hypothesis of the triadic model, wherein relatively decreased threat-related amygdala reactivity and increased reward-related ventral striatum reactivity leads to sexual risk taking, which is particularly exaggerated during adolescence and young adulthood when there is an overexpression of dopaminergic neurons coupled with immature top-down prefrontal cortex regulation. We conclude by discussing how future research based on our adapted triadic model can inform ongoing efforts to improve intervention and prevention efforts.

  2. Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review.

    Science.gov (United States)

    de la Cruz, Cara Z; Thompson, Erika L; O'Rourke, Kathleen; Nembhard, Wendy N

    2015-12-01

    Our objective was to determine the incidence and mortality rates associated with emergency peripartum hysterectomy, factors that lead to uncontrolled hemorrhage and emergency peripartum hysterectomy, and to determine the relationship between cesarean section and risk of emergency peripartum hysterectomy. Studies published between January 1, 2000 and December 31, 2012 were identified using PubMed, OVID and Web of Science databases. Studies were included if they reported incidence rates for emergency peripartum hysterectomy, factors that lead to hemorrhage and emergency peripartum hysterectomy, or the association of emergency peripartum hysterectomy with cesarean section in high-income countries. Four hundred and fifty-one studies were identified, and 52 were included. The incidence of emergency peripartum hysterectomy ranged from 0.20 to 5.09 per 1000 deliveries with a median incidence rate of 0.61 per 1000 deliveries. These rates have increased over time. Rates varied by region/country, specifically with the United States reporting higher rates than North American, Asian, Oceania, and European countries. The most common factor leading to emergency peripartum hysterectomy was placental abnormalities. Both cesarean section and prior cesarean section were strong risk factors for emergency peripartum hysterectomy with higher risks conferred for each additional cesarean section. The mean percentage of maternal deaths for EPH survivors was 3.0 %. Given the association of cesarean section with emergency peripartum hysterectomy, the increased risk of emergency peripartum hysterectomy should be factored into the decision of whether to proceed with cesarean delivery, particularly for women who desire more children.

  3. Pattern of Sexual Offences Attended at Accident and Emergency Department of HUSM from Year 2000 to 2003: A Retrospective Study.

    Science.gov (United States)

    Islam, Mohammed Nasimul; See, Khoo Lay; Ting, Lai Chin; Khan, Jesmine

    2006-01-01

    This paper investigates the pattern of sexual offence cases attended at the One Stop Crisis Center (OSCC) of the Accident and Emergency Department, Hospital Universiti Sains Malaysia (HUSM), Kelantan. A total of 439 reported sexual offence cases were examined over a period of 4 years from 2000 to 2003. Sexual offence constituted by male partner or boyfriend in 18.9%, by relatives in 27.3% and by "others" in 53.8% of cases. Only 0.7% of victims did not attempt to lodge a police report. There is a significant relationship between occupation and the risk of experiencing sexual violence. Students were mostly targeted by the perpetrator throughout the study period. Among the offences, rape cases were the highest in number, among those who attended at the OSCC, HUSM with a total of 72.7%; followed by 27.3% of incest; 26.4% of child sexual abuse; 4.8% of sodomy and lastly 1.6% of gerontophilia cases. Only 70% of the specimens obtained from sexual offences victims were sent for laboratory analysis. The result remained negative in 82.4% specimens and thus the laboratory analysis result is merely functioning as a supportive evidence for sexual offence cases attended at OSCC. The studies showed that most of the sexual assault perpetrators were known to the victims. The place of crime was also known to the perpetrators. Health sectors of various levels should be working in conjunction to promote a societal changes to improve more of the women's right and thus to reduce the violence crime.

  4. Do foreign portfolio flows increase risk in emerging stock markets? Evidence from six Latin American countries

    OpenAIRE

    Agudelo, Diego A.; Castaño, Milena M.

    2011-01-01

    Foreign portfolio flows have been blamed for causing instability in emerging markets, especially during financial crises. This study measured the effect of foreign capital flows on volatility and exposure to world market risk in the six largest Latin American stock markets: Argentina, Brazil, Colombia, Chile, Mexico and Peru, for around 10 years including the 2008 World financial crisis. This will test whether these flows cause instability for those markets and increase their exposure to inte...

  5. Economic growth, urbanization, globalization, and the risks of emerging infectious diseases in China: A review.

    Science.gov (United States)

    Wu, Tong; Perrings, Charles; Kinzig, Ann; Collins, James P; Minteer, Ben A; Daszak, Peter

    2017-02-01

    Three interrelated world trends may be exacerbating emerging zoonotic risks: income growth, urbanization, and globalization. Income growth is associated with rising animal protein consumption in developing countries, which increases the conversion of wild lands to livestock production, and hence the probability of zoonotic emergence. Urbanization implies the greater concentration and connectedness of people, which increases the speed at which new infections are spread. Globalization-the closer integration of the world economy-has facilitated pathogen spread among countries through the growth of trade and travel. High-risk areas for the emergence and spread of infectious disease are where these three trends intersect with predisposing socioecological conditions including the presence of wild disease reservoirs, agricultural practices that increase contact between wildlife and livestock, and cultural practices that increase contact between humans, wildlife, and livestock. Such an intersection occurs in China, which has been a "cradle" of zoonoses from the Black Death to avian influenza and SARS. Disease management in China is thus critical to the mitigation of global zoonotic risks.

  6. Gene polymorphisms in association with emerging cardiovascular risk markers in adult women

    Directory of Open Access Journals (Sweden)

    Dowling Nicole F

    2010-01-01

    Full Text Available Abstract Background Evidence on the associations of emerging cardiovascular disease risk factors/markers with genes may help identify intermediate pathways of disease susceptibility in the general population. This population-based study is aimed to determine the presence of associations between a wide array of genetic variants and emerging cardiovascular risk markers among adult US women. Methods The current analysis was performed among the National Health and Nutrition Examination Survey (NHANES III phase 2 samples of adult women aged 17 years and older (sample size n = 3409. Fourteen candidate genes within ADRB2, ADRB3, CAT, CRP, F2, F5, FGB, ITGB3, MTHFR, NOS3, PON1, PPARG, TLR4, and TNF were examined for associations with emerging cardiovascular risk markers such as serum C-reactive protein, homocysteine, uric acid, and plasma fibrinogen. Linear regression models were performed using SAS-callable SUDAAN 9.0. The covariates included age, race/ethnicity, education, menopausal status, female hormone use, aspirin use, and lifestyle factors. Results In covariate-adjusted models, serum C-reactive protein concentrations were significantly (P value controlling for false-discovery rate ≤ 0.05 associated with polymorphisms in CRP (rs3093058, rs1205, MTHFR (rs1801131, and ADRB3 (rs4994. Serum homocysteine levels were significantly associated with MTHFR (rs1801133. Conclusion The significant associations between certain gene variants with concentration variations in serum C-reactive protein and homocysteine among adult women need to be confirmed in further genetic association studies.

  7. Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention

    OpenAIRE

    Pamela J Schreiner

    2016-01-01

    Animals interact with humans in multiple ways, including as therapy and service animals, commercially as livestock, as wildlife, and in zoos. But the most common interaction is as companion animals in our homes, with an estimated 180 million cats and dogs living in US households. While pet ownership has been reported to have many health benefits, the findings are inconsistent. Cardiovascular risk factors such as lipids, glucose, obesity, and heart rate variability have improved, worsened, or ...

  8. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : The TRAILS study

    NARCIS (Netherlands)

    de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

    2016-01-01

    Background. Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. Purpose. To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescent

  9. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : The TRAILS study

    NARCIS (Netherlands)

    de Winter, Andrea F.; Visser, Leenke; Verhulst, Frank C.; Vollebergh, Wilma A M|info:eu-repo/dai/nl/090632893; Reijneveld, Sijmen A.

    2016-01-01

    BackgroundMost studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PurposeTo examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. M

  10. Identifying Learning Patterns of Children at Risk for Specific Reading Disability

    Science.gov (United States)

    Barbot, Baptiste; Krivulskaya, Suzanna; Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

    2016-01-01

    Differences in learning patterns of vocabulary acquisition in children at risk (+SRD) and not at risk (-SRD) for Specific Reading Disability (SRD) were examined using a microdevelopmental paradigm applied to the multi-trial Foreign Language Learning Task (FLLT; Baddeley et al., 1995). The FLLT was administered to 905 children from rural…

  11. Latent Patterns of Risk Behavior in Urban African-American Middle School Students in Baltimore City

    Science.gov (United States)

    Hedden, Sarra L.; Whitaker, Damiya E.; von Thomsen, Sarah; Severtson, S. Geoffrey; Latimer, William W.

    2011-01-01

    Students who engage in high-risk behaviors, including early initiation of sexual intercourse, alcohol use, marijuana use, tobacco use, and externalizing behavior are vulnerable to a broad range of adverse outcomes as adults. Latent class analysis was used to determine whether varying patterns of risk behavior existed for 212 urban African-American…

  12. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : The TRAILS study

    NARCIS (Netherlands)

    de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

    2016-01-01

    BACKGROUND: Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PURPOSE: To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescent

  13. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : The TRAILS study

    NARCIS (Netherlands)

    de Winter, Andrea F.; Visser, Leenke; Verhulst, Frank C.; Vollebergh, Wilma A M; Reijneveld, Sijmen A.

    2016-01-01

    BackgroundMost studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PurposeTo examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. M

  14. Amphibian responses to wildfire in the western united states: Emerging patterns from short-term studies

    Science.gov (United States)

    Hossack, B.R.; Pilliod, D.S.

    2011-01-01

    The increased frequency and severity of large wildfires in the western United States is an important ecological and management issue with direct relevance to amphibian conservation. Although the knowledge of fire effects on amphibians in the region is still limited relative to most other vertebrate species, we reviewed the current literature to determine if there are evident patterns that might be informative for conservation or management strategies. Of the seven studies that compared pre- and post-wildfire data on a variety of metrics, ranging from amphibian occupancy to body condition, two reported positive responses and five detected negative responses by at least one species. Another seven studies used a retrospective approach to compare effects of wildfire on populations: two studies reported positive effects, three reported negative effects from wildfire, and two reported no effects. All four studies that included plethodontid salamanders reported negative effects on populations or individuals; these effects were greater in forests where fire had been suppressed and in areas that burned with high severity. Species that breed in streams are also vulnerable to post-wildfire changes in habitat, especially in the Southwest. Wildfire is also important for maintaining suitable habitat for diverse amphibian communities, although those results may not be evident immediately after an area burns. We expect that wildfire will extirpate few healthy amphibian populations, but it is still unclear how populations will respond to wildfire in the context of land management (including pre- and post-fire timber harvest) and fragmentation. Wildfire may also increase the risk of decline or extirpation for small, isolated, or stressed (e.g., from drought or disease) populations. Improved understanding of how these effects vary according to changes in fire frequency and severity are critical to form more effective conservation strategies for amphibians in the western United States.

  15. Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department

    Directory of Open Access Journals (Sweden)

    Thana Khawcharoenporn

    2013-01-01

    Full Text Available Background. Selection of empiric antibiotics for urinary tract infections (UTIs has become more challenging because of the increasing rates of multidrug-resistant Enterobacteriaceae (MDRE infections. Methods. This retrospective study was conducted to determine antibiotic resistance patterns, risk factors, and appropriate empiric antibiotic selection for MDRE UTIs. Adult patients seen in the Emergency Department (ED with Enterobacteriaceae UTIs during 2008-2009 were identified from review of microbiology records. MDRE were defined as organisms resistant to at least 3 categories of antibiotics. Results. There were 431 eligible patients; 83 (19% had MDRE UTIs. Resistance rates for individual antibiotics among MDRE UTIs were significantly greater than non-MDRE UTIs: levofloxacin, 72% versus 14%; TMP-SMX, 77% versus 12%; amoxicillin-clavulanate, 35% versus 4%; nitrofurantoin, 21% versus 12%, and ceftriaxone, 20% versus 0%. All Enterobacteriaceae isolates were susceptible to ertapenem (MIC ≤ 2 mg/L. Independent risk factors for MDRE UTI were prior fluoroquinolone use within 3 months (adjusted odds ratio (aOR 3.64; , healthcare-associated risks (aOR 2.32; , and obstructive uropathy (aOR 2.22; . Conclusion. Our study suggests that once-daily intravenous or intramuscular ertapenem may be appropriate for outpatient treatment of ED patients with MDRE UTI.

  16. Sleep patterns and the risk for ADHD: a review

    OpenAIRE

    Cassoff J; Wiebe ST; Gruber R.

    2012-01-01

    Jamie Cassoff,1,2 Sabrina T Wiebe,1,2 Reut Gruber1,21Attention, Behavior and Sleep Lab, Douglas Mental Health University Institute, Montréal, Quebec, Canada; 2McGill University, Montréal, Quebec, CanadaAbstract: Attention-deficit/hyperactivity disorder (ADHD) is often associated with comorbid sleep disturbances. Sleep disturbances may be a risk factor for development of the disorder, a symptom of the disorder, or a comorbid condition affected by a similar psychopathology...

  17. The Emerging Epidemic of Cardiovascular Risk Factors and Atherosclerotic Disease in Developing Countries.

    Science.gov (United States)

    Teo, Koon K; Dokainish, Hisham

    2017-03-01

    Cardiovascular disease (CVD) and its risk factors, which are major health burdens in high-income countries, are a growing problem in developing or lower-income countries, where the vast majority of CVD now occurs. Two case-control studies, INTERHEART and INTERSTROKE, which included a majority of patients from developing countries, were seminal in identifying common risk factors explaining the vast majority of risk for acute myocardial infarction and stroke, respectively. The population-based Prospective Urban and Rural Epidemiological (PURE) study, which included > 150,000 participants, also with a majority from developing countries, found that although high-income countries were at highest cardiovascular (CV) risk, they had the lowest incidence of CVD and associated case-fatality rates, whereas patients in low-income countries had the lowest CV risk and yet the highest CVD and case-fatality rates. The PURE study also demonstrated relatively low rates of CV medicine use in high- and middle-income countries, but even lower rates in low-income countries, where these medicines were often either unavailable or unaffordable. The PURE study also demonstrated that control of CV risk factors and adherence to lifestyle modifications, although suboptimal globally, were poorest in low-income countries. Taken together, these data identify common CV risk factors requiring targeted, systematic, sustained, and effective interventions in developing countries to mitigate the emerging epidemic of CVD in these regions of the world.

  18. Inheritance pattern of familial hypercholesterolemia and markers of cardiovascular risk.

    Science.gov (United States)

    Kusters, D Meeike; Avis, Hans J; Braamskamp, Marjet J; Huijgen, Roeland; Wijburg, Frits A; Kastelein, John J; Wiegman, Albert; Hutten, Barbara A

    2013-09-01

    Studies in children and adults have resulted in conflicting evidence in the quest for the answer to the hypothesis that offspring from hypercholesterolemic mothers might have an increased cardiovascular risk. Previous studies might have suffered from limitations such as cohort size and clinical sampling bias. We therefore explored this hypothesis in large cohorts of both subjects with familial hypercholesterolemia (FH) and unaffected siblings in a wide age range. In three cohorts (cohort 1: n = 1,988, aged 0-18 years; cohort 2: n = 300, 8-30 years; cohort 3: n = 369, 18-60 years), we measured lipid and lipoproteins as well as carotid intima-media thickness (c-IMT) in offspring from FH mothers versus FH fathers. For LDL cholesterol, triglycerides (TGs), and c-IMT, we performed a pooled analysis. No significant differences could be observed in c-IMT, lipid, or lipoprotein levels from offspring of FH mothers versus FH fathers. Pooled analyses showed no significant differences for either LDL cholesterol [mean difference 0.02 (-0.06,0.11) mmol/l, P = 0.60], TGs [mean difference 0.07 (0.00,0.14) mmol/l, P = 0.08], or c-IMT [mean difference -0.00 (-0.01,0.01) mm, P = 0.86]. Our data do not support the hypothesis that cardiovascular risk markers are different between offspring from FH mothers and FH fathers.

  19. Risk-health behavior Patterns in Germany. Results from the GEDA 2009 survey

    OpenAIRE

    von der Lippe, Elena; Müters, Stephan; Kamtsiuris, Panagiotis

    2013-01-01

    Objective: Lifestyle-related risks are known to have a strong impact on health. Health outcomes also depend on many other factors, such as environmental pollution and the use of public health services, but another very important factor is lifestyle. In our study we investigate people's health-risk behavior and distinguish between possible behavior patterns in the German population. For our study we make a selection of four human behavior risks and take into account the daily consumption of...

  20. Dietary patterns and risk of hip fractures in postmenopausal women and men over 50 years

    Science.gov (United States)

    Fung, Teresa T.; Feskanich, Diane

    2016-01-01

    Purpose We examined the association between predominant dietary patterns and risk of hip fractures in postmenopausal women and men over 50 years. Methods We used data from 74,540 women in the Nurses’ Health Study followed between 1980 and 2010, and 35,451 men from the Health Professionals Follow-up Study followed between 1986 and 2012 for this analysis. Health and lifestyle information was assessed every two years. Diet was assessed approximately every four years with a food frequency questionnaire. Two major dietary patterns were previously derived using principal component analysis. The Prudent pattern is characterized by higher intakes of fruits, vegetables, whole grains, and poultry, and the Western pattern is characterized by higher intakes of red and processed meats, sweets, and refined grains. We computed relative risks (RR) for hip fracture by dietary pattern scores using Cox proportional hazards models, adjusting for potential confounders. Results During follow-up, there were 1891 hip fractures in women and 596 in men. No association was observed between the Prudent or Western pattern and risk of hip fractures in either men or women. We also did not find an association among lean (BMI=25) individuals or among those with higher or lower levels of physical activity. Conclusion Neither the Prudent nor the Western dietary pattern was associated with risk of hip fractures in postmenopausal women or men over 50 years of age. PMID:25731807

  1. Changing trends of cardiovascular risk factors among Indians: a review of emerging risks

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2014-12-01

    Full Text Available The global burden of disease due to cardiovascular diseases (CVDs is escalating, and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition. Contributory causes include: growing population with demographic shifts and altered age profile, socio-economic factors, lifestyle changes due to urbanization. Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity. Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics, along with all form of tobacco use. The pace of health transition, however, varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives, enable nutrition-based preventive strategies to protect and promote cardiovascular health.

  2. Changing trends of cardiovascular risk factors among Indians:a review of emerging risks

    Institute of Scientific and Technical Information of China (English)

    Arun; Kumar

    2014-01-01

    The global burden of disease due to cardiovascular diseases(CVDs) is escalating,and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition.Contributory causes include:growing population with demographic shifts and altered age profile,socio-economic factors,lifestyle changes due to urbanization.Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity.Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics,along with all form of tobacco use.The pace of health transition,however,varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs.A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial,primary and secondary prevention.Populations as well as individuals at risk must be protected through initiatives,enable nutritionbased preventive strategies to protect and promote cardiovascular health.

  3. Changing trends of cardiovascular risk factors among Indians:a review of emerging risks

    Institute of Scientific and Technical Information of China (English)

    Arun Kumar

    2014-01-01

    The global burden of disease due to cardiovascular diseases (CVDs) is escalating, and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition. Contributory causes include: growing population with demographic shifts and altered age profile, socio-economic factors, lifestyle changes due to urbanization. Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity. Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics, along with all form of tobacco use. The pace of health transition, however, varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives, enable nutrition-based preventive strategies to protect and promote cardiovascular health.

  4. 77 FR 37261 - Continuation of the National Emergency With Respect to the Risk of Nuclear Proliferation Created...

    Science.gov (United States)

    2012-06-21

    ... posed by the risk of nuclear proliferation created by the accumulation of a large volume of weapons... respect to the risk of nuclear proliferation created by the accumulation of weapons- usable fissile... Documents#0;#0; ] Notice of June 18, 2012 Continuation of the National Emergency With Respect to the Risk...

  5. Zooplankton of the lagoons of the Laccadives: diel patterns and emergence

    Digital Repository Service at National Institute of Oceanography (India)

    Madhupratap, M.; Achuthankutty, C.T.; Nair, S.R.S.

    , were responsible for this. Unsealed traps were found subject to contamination and hence less reliable in estimating densities of emerging fauna compared with sealed traps. Direct sampling of the substratum during daytime showed that the actual densities...

  6. Health risk assessment of cadmium pollution emergency for urban populations in Foshan City, China.

    Science.gov (United States)

    Dou, Ming; Zhao, Peipei; Wang, Yanyan; Li, Guiqiu

    2017-03-01

    With rapid socioeconomic development, water pollution emergency has become increasingly common and could potentially harm the environment and human health, especially heavy metal pollution. In this paper, we investigate the Cd pollution emergency that occurred in the Pearl River network, China, in 2005, and we build a migration and transformation model for heavy metals to simulate the spatiotemporal distribution of Cd concentrations under various scenarios of Cd pollution emergency in Foshan City. Moreover, human health hazard and carcinogenic risk for local residents of Foshan City were evaluated. The primary conclusions were as follows: (1) the number of carcinogen-affected people per year under scenario 1 reached 254.41 when the frequency was 0.1 year/time; specifically, the number of people with cancer per year in the area of the Datang, Lubao, and Nanbian waterworks was 189.36 accounting for 74% of the total number per year; (2) at the frequency of 5 years/time, the Lubao waterwork is the only one in extremely high- or high-risk grade, while besides it, the risk grade in the Datang, Nanbian, Xinan, Shitang, and Jianlibao waterworks is in the extremely high or high grade when the frequency is 0.1 year/time; (3) when Cd pollution accidents with the same level occurs again, Cd concentration decreases to a low level in the water only if the migration distance of Cd is at least 40-50 km. Based on the health risk assessment of Cd pollution, this study gives the recommendation that the distance should keep above 50 km in tidal river network of the Pearl River Delta between those factories existing the possibility of heavy metal pollution and the drinking water source. Only then can the public protect themselves from hazardous effects of higher levels of heavy metal.

  7. Disparate patterns of prenatal care utilization stratified by medical and psychosocial risk.

    Science.gov (United States)

    Krans, Elizabeth E; Davis, Matthew M; Palladino, Christie L

    2013-05-01

    To evaluate patterns of prenatal care utilization stratified by medical and psychosocial risk. A retrospective cohort of 786 pregnant women who subsequently delivered live births from 1999 to 2003 at the University of Michigan were classified into high medical, high psychosocial, high medical and high psychosocial (dual high risk) and low-risk pregnancies. Chi-square and logistic regression analyses assessed the association between risk and prenatal care utilization using the Kotelchuck Index. Of 786 pregnancies, 202 (25.7%) were high medical risk, 178 (22.7%) were high psychosocial risk, 227 (28.9%) were dual high risk and 179 (22.8%) were low-risk. Over 31% of dual high risk and 25% of high medical risk pregnancies received "adequate plus" prenatal care versus 10% of high psychosocial risk pregnancies. In multivariate analyses, adjusted for risk, race and insurance, high psychosocial risk pregnancies (OR = 1.69; 95% CI 1.06-2.72) were significantly more likely to receive inadequate prenatal care than care of greater intensity. Many high psychosocial risk pregnancies do not receive adequate prenatal care.

  8. Preservation of a traditional Korean dietary pattern and emergence of a fruit and dairy dietary pattern among adults in South Korea: secular transitions in dietary patterns of a prospective study from 1998 to 2010.

    Science.gov (United States)

    Lim, Hyunjung; Kim, Sang Yeun; Wang, Youfa; Lee, Sun Ju; Oh, Kyungwon; Sohn, Chun Young; Moon, Young Myoung; Jee, Sun Ha

    2014-09-01

    Transitions in nutrition patterns tend to emerge through industrialization and economic development. We hypothesized that the dietary patterns among South Korean adults who were 20 years or older have changed significantly from 1998 to 2010. Herein, a repeated cross-sectional analysis of data was followed for 140601 adults. We noted changes in consumption, after adjusting for age, sex, body mass index, and exercise, and tested the trends across the study period. Factor and cluster analyses were used to derive dietary patterns. A decrease in traditional Korean food consumption, including cereals, vegetables (252-176 g), and Kimchi (127-82 g), occurred, whereas fruit (172-252 g), egg, and fried food intakes increased (P dietary patterns: "Korean" diet (rice, vegetables, and Kimchi), "Western" diet (soda, eggs, and oil), and "New" diet (low sugar and high fruit and dairy product intakes). Compared to 1998, approximately 40% of participants still followed a Korean diet in 2010. Interestingly, the popularity of the Western diet fell by approximately 20%, whereas the new diet pattern increased 2-fold over the study period. Overall, these data show secular trends in dietary patterns that included a preservation of the traditional Korean diet and the emergence of a new diet pattern, and it demonstrated a unique transition in food and nutrient intakes in Korea.

  9. Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Ruth Chan

    2015-08-01

    Full Text Available Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged > 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I and the Mediterranean Diet Score (MDS was assessed. Factor analysis identified three a posteriori dietary patterns, namely “vegetables-fruits”, “snacks-drinks-milk products”, and “meat-fish”. Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1% incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex- and age-adjusted model (odds ratio (OR (95% confidence interval (CI: 0.59 (0.42–0.85, p = 0.004. The association attenuated in the multivariate adjusted model (0.69 (0.47–1.02, p = 0.056. No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.

  10. The Cognitive Underpinnings of Emerging Mathematical Skills: Executive Functioning, Patterns, Numeracy, and Arithmetic

    Science.gov (United States)

    Lee, Kerry; Ng, Swee Fong; Pe, Madeline Lee; Ang, Su Yin; Hasshim, Muhammad Nabil Azhar Mohd; Bull, Rebecca

    2012-01-01

    Background: Exposure to mathematical pattern tasks is often deemed important for developing children's algebraic thinking skills. Yet, there is a dearth of evidence on the cognitive underpinnings of pattern tasks and how early competencies on these tasks are related to later development. Aims: We examined the domain-specific and domain-general…

  11. A scenario-based modeling approach for emergency evacuation management and risk analysis under multiple uncertainties.

    Science.gov (United States)

    Lv, Y; Huang, G H; Guo, L; Li, Y P; Dai, C; Wang, X W; Sun, W

    2013-02-15

    Nuclear emergency evacuation is important to prevent radioactive harms by hazardous materials and to limit the accidents' consequences; however, uncertainties are involved in the components and processes of such a management system. In the study, an interval-parameter joint-probabilistic integer programming (IJIP) method is developed for emergency evacuation management under uncertainties. Optimization techniques of interval-parameter programming (IPP) and joint-probabilistic constrained (JPC) programming are incorporated into an integer linear programming framework, so that the approach can deal with uncertainties expressed as joint probability and interval values. The IJIP method can schedule the optimal routes to guarantee the maximum population evacuated away from the effected zone during a finite time. Furthermore, it can also facilitate post optimization analysis to enhance robustness in controlling system violation risk imposed on the joint-probabilistic constraints. The developed method has been applied to a case study of nuclear emergency management; meanwhile, a number of scenarios under different system conditions have been analyzed. It is indicated that the solutions are useful for evacuation management practices. The result of the IJIP method can not only help to raise the capability of disaster responses in a systematic manner, but also provide an insight into complex relationships among evacuation planning, resources utilizations, policy requirements and system risks.

  12. Light mediated emergence of surface patterns in azopolymers at low temperatures

    CERN Document Server

    Teboul, V; Tajalli, P; Ahmadi-Kandjani, S; Tajalli, H; Zielinska, S; Ortyl, E

    2015-01-01

    Polymer thin films doped with azobenzene molecules do have the ability to organize themselves in spontaneous surface relief gratings (SRG) under irradiation with a single polarized beam. To shed some light in this still unexplained phenomenon, we use a new method that permits us to access experimentally the very first steps of the pattern formation process. Decreasing the temperature, we slow down the formation and organization of patterns, due to the large increase of the viscosity and relaxation time of the azopolymer. As a result decreasing the temperature allows us to access and study much shorter time scales,in the physical mechanisms underlying the pattern formation, than previously reported. We find that the patterns organize themselves in sub-structures which size increase with the temperature, following the diffusion coefficient evolution of the material. That result suggests that the pattern formation and organization is mainly governed by diffusive processes, in agreement with some theories of the ...

  13. An estrogen-associated dietary pattern and breast cancer risk in the Swedish Mammography Cohort.

    Science.gov (United States)

    Harris, Holly R; Bergkvist, Leif; Wolk, Alicja

    2015-11-01

    High endogenous hormone levels have been associated with breast cancer and dietary factors have the potential to influence breast cancer risk through effects on hormone levels. Dietary patterns derived from reduced rank regression provide a way to identify food groups correlated with hormones and subsequently examine food patterns that may be associated with breast cancer risk. We investigated whether a dietary pattern previously correlated with estradiol and estrone sulfate was associated with breast cancer in the prospective Swedish Mammography Cohort. Among 37,004 primarily postmenopausal women diet was assessed with a food frequency questionnaire. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs). During 15 years of follow-up 1,603 cases of breast cancer were identified. A higher estrogen dietary pattern score was associated with an increased risk of breast cancer. Women in the highest quartile of estrogen pattern score had a 29% (95% CI = 1.08-1.55) increased risk of breast cancer compared to women in the lowest quartile (p(trend) = 0.006). When the association was examined by estrogen-receptor status, it was only significant for those with estrogen-receptor-positive tumors; however, in the competing risk analysis there were no significant differences in the effect estimates by receptor subtype (p(heterogeneity) = 0.65). Our findings suggest that a dietary pattern associated with higher estrogen levels may increase breast cancer risk. However, whether the influence of this dietary pattern is through a direct effect on estrogen levels deserves further study.

  14. "Doing Difference" and Fast Food Consumption: Patterns Among a Sample of White and African American Emerging Adults.

    Science.gov (United States)

    Wade, Jeannette M

    2017-06-22

    Previous research has demonstrated that frequent consumption of fast food is linked to obesity and that trends in both are disparate across race and sex categories. Contextualizing race- and sex-related factors that structure fast food consumption in emerging adulthood is a much-needed contribution to social research. Specifically, this study uses the "doing difference" framework, to examine the frequency of fast food consumption in a sample of White and African American (18-25 years old). According to the framework, social inequalities are reproduced through dramaturgical performances of race, class, and gender. Results of this suggest that feminine gender orientation and education serve as protective factors, while African American race and male sex serve as risk factors. African American women emerged as especially high risk given their higher prevalence of traditionally masculine traits.

  15. Perceived discrimination, ruminative subtypes, and risk for depressive symptoms in emerging adulthood.

    Science.gov (United States)

    Miranda, Regina; Polanco-Roman, Lillian; Tsypes, Aliona; Valderrama, Jorge

    2013-10-01

    Perceived discrimination has been found to increase risk for depression in emerging adulthood, but explanatory cognitive mechanisms have not been well studied. We examined whether the brooding and reflective subtypes of rumination would mediate the relation between perceived discrimination and depressive symptoms among racial/ethnic minority, versus White, emerging adults, and whether a strong ethnic identity would buffer against this effect. Emerging adults (N = 709; 70% female; 68% racial/ethnic minority), ages 18-25, completed measures of perceived discrimination, rumination, depressive symptoms, and ethnic identity. Perceived discrimination was positively associated with depressive symptoms among racial/ethnic minority and White participants. Brooding--but not reflection--mediated this relation only among racial/ethnic minorities. Ethnic identity, though negatively associated with depressive symptoms, did not buffer against the mediating effect of brooding on the discrimination-depression relation. Interventions for depression among racial/ethnic minority emerging adults should address maladaptive cognitive responses, such as brooding, associated with perceived discrimination.

  16. Effect of biodiversity changes in disease risk: exploring disease emergence in a plant-virus system.

    Directory of Open Access Journals (Sweden)

    Israel Pagán

    Full Text Available The effect of biodiversity on the ability of parasites to infect their host and cause disease (i.e. disease risk is a major question in pathology, which is central to understand the emergence of infectious diseases, and to develop strategies for their management. Two hypotheses, which can be considered as extremes of a continuum, relate biodiversity to disease risk: One states that biodiversity is positively correlated with disease risk (Amplification Effect, and the second predicts a negative correlation between biodiversity and disease risk (Dilution Effect. Which of them applies better to different host-parasite systems is still a source of debate, due to limited experimental or empirical data. This is especially the case for viral diseases of plants. To address this subject, we have monitored for three years the prevalence of several viruses, and virus-associated symptoms, in populations of wild pepper (chiltepin under different levels of human management. For each population, we also measured the habitat species diversity, host plant genetic diversity and host plant density. Results indicate that disease and infection risk increased with the level of human management, which was associated with decreased species diversity and host genetic diversity, and with increased host plant density. Importantly, species diversity of the habitat was the primary predictor of disease risk for wild chiltepin populations. This changed in managed populations where host genetic diversity was the primary predictor. Host density was generally a poorer predictor of disease and infection risk. These results support the dilution effect hypothesis, and underline the relevance of different ecological factors in determining disease/infection risk in host plant populations under different levels of anthropic influence. These results are relevant for managing plant diseases and for establishing conservation policies for endangered plant species.

  17. Effect of biodiversity changes in disease risk: exploring disease emergence in a plant-virus system.

    Science.gov (United States)

    Pagán, Israel; González-Jara, Pablo; Moreno-Letelier, Alejandra; Rodelo-Urrego, Manuel; Fraile, Aurora; Piñero, Daniel; García-Arenal, Fernando

    2012-01-01

    The effect of biodiversity on the ability of parasites to infect their host and cause disease (i.e. disease risk) is a major question in pathology, which is central to understand the emergence of infectious diseases, and to develop strategies for their management. Two hypotheses, which can be considered as extremes of a continuum, relate biodiversity to disease risk: One states that biodiversity is positively correlated with disease risk (Amplification Effect), and the second predicts a negative correlation between biodiversity and disease risk (Dilution Effect). Which of them applies better to different host-parasite systems is still a source of debate, due to limited experimental or empirical data. This is especially the case for viral diseases of plants. To address this subject, we have monitored for three years the prevalence of several viruses, and virus-associated symptoms, in populations of wild pepper (chiltepin) under different levels of human management. For each population, we also measured the habitat species diversity, host plant genetic diversity and host plant density. Results indicate that disease and infection risk increased with the level of human management, which was associated with decreased species diversity and host genetic diversity, and with increased host plant density. Importantly, species diversity of the habitat was the primary predictor of disease risk for wild chiltepin populations. This changed in managed populations where host genetic diversity was the primary predictor. Host density was generally a poorer predictor of disease and infection risk. These results support the dilution effect hypothesis, and underline the relevance of different ecological factors in determining disease/infection risk in host plant populations under different levels of anthropic influence. These results are relevant for managing plant diseases and for establishing conservation policies for endangered plant species.

  18. Role of disease risk scores in comparative effectiveness research with emerging therapies

    Science.gov (United States)

    Glynn, Robert J; Gagne, Joshua J; Schneeweiss, Sebastian

    2012-01-01

    Background Usefulness of propensity scores and regression models to balance potential confounders at treatment initiation may be limited for newly introduced therapies with evolving use patterns. Objectives To consider settings in which the disease risk score has theoretical advantages as a balancing score in comparative effectiveness research, because of stability of disease risk and the availability of ample historical data on outcomes in people treated before introduction of the new therapy. Methods We review the indications for and balancing properties of disease risk scores in the setting of evolving therapies, and discuss alternative approaches for estimation. We illustrate development of a disease risk score in the context of the introduction of atorvastatin and the use of high-dose statin therapy beginning in 1997, based on data from 5,668 older survivors of myocardial infarction who filled a statin prescription within 30 days after discharge from 1995 until 2004. Theoretical considerations suggested development of a disease risk score among non-users of atorvastatin and high-dose statins during the period 1995–1997. Results Observed risk of events increased from 11% to 35% across quintiles of the disease risk score which had a C-statistic of 0.71. The score allowed control of many potential confounders even during early follow-up with few study endpoints. Conclusions Balancing on a disease risk score offers an attractive alternative to a propensity score in some settings such as newly marketed drugs and provides an important axis for evaluation of potential effect modification. Joint consideration of propensity and disease risk scores may be valuable. PMID:22552989

  19. Probabilistic risk assessment support of emergency preparedness at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    O`Kula, K.R.; Baker, W.H.; Simpkins, A.A.; Taylor, R.P. [Westinghouse Savannah River Co., Aiken, SC (United States); Wagner, K.C.; Amos, C.N. [Science Applications International Corp., Albuquerque, NM (United States)

    1992-12-31

    Integration of the Probabilistic Risk Assessment (PRA) for K Reactor operation into related technical areas at the Savannah River Site (SRS) includes coordination with several onsite organizations responsible for maintaining and upgrading emergency preparedness capabilities. Major functional categories of the PRA application are scenario development and source term algorithm enhancement. Insights and technologies from the SRS PRA have facilitated development of: (1) credible timelines for scenarios; (2) algorithms tied to plant instrumentation to provide best-estimate source terms for dose projection; and (3) expert-system logic models to implement informed counter-measures to assure onsite and offsite safety following accidental releases. The latter methodology, in particular, is readily transferable to other reactor and non-reactor facilities at SRS and represents a distinct advance relative to emergency preparedness capabilities elsewhere in the DOE complex.

  20. Probabilistic risk assessment support of emergency preparedness at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    O' Kula, K.R.; Baker, W.H.; Simpkins, A.A.; Taylor, R.P. (Westinghouse Savannah River Co., Aiken, SC (United States)); Wagner, K.C.; Amos, C.N. (Science Applications International Corp., Albuquerque, NM (United States))

    1992-01-01

    Integration of the Probabilistic Risk Assessment (PRA) for K Reactor operation into related technical areas at the Savannah River Site (SRS) includes coordination with several onsite organizations responsible for maintaining and upgrading emergency preparedness capabilities. Major functional categories of the PRA application are scenario development and source term algorithm enhancement. Insights and technologies from the SRS PRA have facilitated development of: (1) credible timelines for scenarios; (2) algorithms tied to plant instrumentation to provide best-estimate source terms for dose projection; and (3) expert-system logic models to implement informed counter-measures to assure onsite and offsite safety following accidental releases. The latter methodology, in particular, is readily transferable to other reactor and non-reactor facilities at SRS and represents a distinct advance relative to emergency preparedness capabilities elsewhere in the DOE complex.

  1. Risk Assessment Methodology for Water utilities (RAM-W) : the foundation for emergency response planning.

    Energy Technology Data Exchange (ETDEWEB)

    Danneels, Jeffrey John

    2005-03-01

    Concerns about acts of terrorism against critical infrastructures have been on the rise for several years. Critical infrastructures are those physical structures and information systems (including cyber) essential to the minimum operations of the economy and government. The President's Commission on Critical Infrastructure Protection (PCCIP) probed the security of the nation's critical infrastructures. The PCCIP determined the water infrastructure is highly vulnerable to a range of potential attacks. In October 1997, the PCCIP proposed a public/private partnership between the federal government and private industry to improve the protection of the nation's critical infrastructures. In early 2000, the EPA partnered with the Awwa Research Foundation (AwwaRF) and Sandia National Laboratories to create the Risk Assessment Methodology for Water Utilities (RAM-W{trademark}). Soon thereafter, they initiated an effort to create a template and minimum requirements for water utility Emergency Response Plans (ERP). All public water utilities in the US serving populations greater than 3,300 are required to undertaken both a vulnerability assessment and the development of an emergency response plan. This paper explains the initial steps of RAM-W{trademark} and then demonstrates how the security risk assessment is fundamental to the ERP. During the development of RAM-W{trademark}, Sandia performed several security risk assessments at large metropolitan water utilities. As part of the scope of that effort, ERPs at each utility were reviewed to determine how well they addressed significant vulnerabilities uncovered during the risk assessment. The ERP will contain responses to other events as well (e.g. natural disasters) but should address all major findings in the security risk assessment.

  2. Research on Risks Recognition and Management of Contractor on the Design Construction Pattern of Contract

    Institute of Scientific and Technical Information of China (English)

    杨鹏飞

    2013-01-01

    By combining with the implementation in expressway of traffic branch’s test point of design construction pattern of contract,the paper illustrates the risks from the bidding,the design of the construction graphic,the process dynamic design and construction process,the recognition of the unpredictable risks,the risk recognition,the evaluation,the prevention and the control of the risk management,so as to seek for the method which can be favorable for improving the design construction contract.

  3. OCCUPATIONAL RISK SITUATION OF HEALTH STAFF THAT IS WORKING AT THE EMERGENCY HEALTH STATIONS

    Directory of Open Access Journals (Sweden)

    Sevinc Kant Sokel

    2015-12-01

    Full Text Available In order to determine the risks of occupational hazards in Emergency Medical Care Staff, a research has been planned. The universe of the descriptive research consists of Ambulance Chief Physician staff. The speed of the application is 79.84% (210/263. The questionnaire which consists of questions about sociodemographic attributes, occupational hazard and protective application has been applied face to face between the dates 01-31 January in 2014. The analysis of the data is made on the SPSS 19,0 program. Specifications have been evaluated by percentage and occupational hazards have been evaluated by chi-square test. In the statistical analysises was utilized 0.05 threshold limit value as significance level. 55.7% of participants are men, 63.8% of participants are married, 52.4 % of participants are emergency medical technician and 59,0% of them are working in A2 station and 5.2% of them are working in operation center. The youngest group paramedics (25,1+/-4,5 years are ATTs (25,4+/-4,7 years. The participants occupational hazards has been observed for the last one year and having occupational accidents risk is 9,0%, 44.3% in musculoskeletal discomfort, 22.9% of the risk of contact with blood and body fluids were determined. 11.0 % of traffic accident in the ambulance is 15.7% psychological self as often / very often stated that you feel bad . When we examine the factors that affect the participants occupational risk, the incidence of work-related accidents in the under-30 group was higher ( p = 0.044 . Physicians and other health care professional or work-related illness in more risky (p = 0.009. Review status of musculoskeletal disorders were more frequent in women (p < 0.001. Paramedic ( 18.2 % and drivers ( 16.3 % in the ambulance traffic accident was determined to be at risk for. As determined above in emergency health station staff for the prevention of occupational risks and factors that affect the work to be done. [J Contemp Med 2015; 5

  4. The influence of work patterns on indicators of cardiometabolic risk in female hospital employees.

    Science.gov (United States)

    Kirk, Megan; VanDenKerkhof, Elizabeth; Janssen, Ian; Tranmer, Joan

    2015-05-01

    This study explored the associations between work patterns and indicators of cardiometabolic risk in female hospital employees. Aspects of work environments potentially influence the health of employees; however, we have a poor understanding of how different hospital work patterns contribute to cardiovascular risk in female employees. We conducted a cross-sectional study of 466 female employees from 2 hospitals in Ontario. Data were collected through self-report, physical examination, and use of hospital administrative work data. In the adjusted analyses, full-time work status, extended shift length, and working 35 or more paid overtime hours per year were significantly associated with metabolic syndrome. Different work patterns increase cardiometabolic risk in female employees, suggesting a need to better monitor the health of the workforce and implement healthy workplace policy.

  5. Emergent group level navigation: an agent-based evaluation of movement patterns in a folivorous primate.

    Science.gov (United States)

    Bonnell, Tyler R; Campennì, Marco; Chapman, Colin A; Gogarten, Jan F; Reyna-Hurtado, Rafael A; Teichroeb, Julie A; Wasserman, Michael D; Sengupta, Raja

    2013-01-01

    The foraging activity of many organisms reveal strategic movement patterns, showing efficient use of spatially distributed resources. The underlying mechanisms behind these movement patterns, such as the use of spatial memory, are topics of considerable debate. To augment existing evidence of spatial memory use in primates, we generated movement patterns from simulated primate agents with simple sensory and behavioral capabilities. We developed agents representing various hypotheses of memory use, and compared the movement patterns of simulated groups to those of an observed group of red colobus monkeys (Procolobus rufomitratus), testing for: the effects of memory type (Euclidian or landmark based), amount of memory retention, and the effects of social rules in making foraging choices at the scale of the group (independent or leader led). Our results indicate that red colobus movement patterns fit best with simulated groups that have landmark based memory and a follow the leader foraging strategy. Comparisons between simulated agents revealed that social rules had the greatest impact on a group's step length, whereas the type of memory had the highest impact on a group's path tortuosity and cohesion. Using simulation studies as experimental trials to test theories of spatial memory use allows the development of insight into the behavioral mechanisms behind animal movement, developing case-specific results, as well as general results informing how changes to perception and behavior influence movement patterns.

  6. Emergent group level navigation: an agent-based evaluation of movement patterns in a folivorous primate.

    Directory of Open Access Journals (Sweden)

    Tyler R Bonnell

    Full Text Available The foraging activity of many organisms reveal strategic movement patterns, showing efficient use of spatially distributed resources. The underlying mechanisms behind these movement patterns, such as the use of spatial memory, are topics of considerable debate. To augment existing evidence of spatial memory use in primates, we generated movement patterns from simulated primate agents with simple sensory and behavioral capabilities. We developed agents representing various hypotheses of memory use, and compared the movement patterns of simulated groups to those of an observed group of red colobus monkeys (Procolobus rufomitratus, testing for: the effects of memory type (Euclidian or landmark based, amount of memory retention, and the effects of social rules in making foraging choices at the scale of the group (independent or leader led. Our results indicate that red colobus movement patterns fit best with simulated groups that have landmark based memory and a follow the leader foraging strategy. Comparisons between simulated agents revealed that social rules had the greatest impact on a group's step length, whereas the type of memory had the highest impact on a group's path tortuosity and cohesion. Using simulation studies as experimental trials to test theories of spatial memory use allows the development of insight into the behavioral mechanisms behind animal movement, developing case-specific results, as well as general results informing how changes to perception and behavior influence movement patterns.

  7. Source apportionment and risk assessment of emerging contaminants: an approach of pharmaco-signature in water systems.

    Directory of Open Access Journals (Sweden)

    Jheng-Jie Jiang

    Full Text Available This paper presents a methodology based on multivariate data analysis for characterizing potential source contributions of emerging contaminants (ECs detected in 26 river water samples across multi-scape regions during dry and wet seasons. Based on this methodology, we unveil an approach toward potential source contributions of ECs, a concept we refer to as the "Pharmaco-signature." Exploratory analysis of data points has been carried out by unsupervised pattern recognition (hierarchical cluster analysis, HCA and receptor model (principal component analysis-multiple linear regression, PCA-MLR in an attempt to demonstrate significant source contributions of ECs in different land-use zone. Robust cluster solutions grouped the database according to different EC profiles. PCA-MLR identified that 58.9% of the mean summed ECs were contributed by domestic impact, 9.7% by antibiotics application, and 31.4% by drug abuse. Diclofenac, ibuprofen, codeine, ampicillin, tetracycline, and erythromycin-H2O have significant pollution risk quotients (RQ>1, indicating potentially high risk to aquatic organisms in Taiwan.

  8. Source apportionment and risk assessment of emerging contaminants: an approach of pharmaco-signature in water systems.

    Science.gov (United States)

    Jiang, Jheng-Jie; Jiang, Jheng Jie; Lee, Chon-Lin; Lee, Chon Lin; Fang, Meng-Der; Fang, Meng Der; Boyd, Kenneth G; Gibb, Stuart W

    2015-01-01

    This paper presents a methodology based on multivariate data analysis for characterizing potential source contributions of emerging contaminants (ECs) detected in 26 river water samples across multi-scape regions during dry and wet seasons. Based on this methodology, we unveil an approach toward potential source contributions of ECs, a concept we refer to as the "Pharmaco-signature." Exploratory analysis of data points has been carried out by unsupervised pattern recognition (hierarchical cluster analysis, HCA) and receptor model (principal component analysis-multiple linear regression, PCA-MLR) in an attempt to demonstrate significant source contributions of ECs in different land-use zone. Robust cluster solutions grouped the database according to different EC profiles. PCA-MLR identified that 58.9% of the mean summed ECs were contributed by domestic impact, 9.7% by antibiotics application, and 31.4% by drug abuse. Diclofenac, ibuprofen, codeine, ampicillin, tetracycline, and erythromycin-H2O have significant pollution risk quotients (RQ>1), indicating potentially high risk to aquatic organisms in Taiwan.

  9. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study

    NARCIS (Netherlands)

    R.G. Nijman (Ruud); Y. Vergouwe (Yvonne); M.J. Thompson (Matthew); M.V. Veen (Mirjam Van); A.H.J. van Meurs (Alfred); J. van der Lei (Johan); E.W. Steyerberg (Ewout); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

    2013-01-01

    textabstractObjective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Design: Prospective observational diagnostic study. Setting: Three paediatric em

  10. Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient

    Directory of Open Access Journals (Sweden)

    Surekha S Patil

    2010-01-01

    Full Text Available A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial, a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.

  11. Differential Dynamic Evolutionary Model of Emergency Financial Service Supply Chain in Natural Disaster Risk Management

    Directory of Open Access Journals (Sweden)

    Shujian Ma

    2016-01-01

    Full Text Available A government-market-public partnership (GMPP could be a feasible arrangement for providing insurance coverage for natural disaster. Firstly, we put forward GMPP management mode. Secondly, the emergency financial service supply chain for natural disaster risk is built from the view of supply chain. Finally, the objective of this paper is to obtain insights into the cooperative and competitive relationship in GMPP system. We establish the cooperative and competitive differential dynamic evolutionary models and prove the existence of equilibrium solutions in order to solve the coordination problems. In conclusion, the equilibrium solutions can be achieved among the insurers, the operating governments, and the public.

  12. A Healthy Dietary Pattern Reduces Lung Cancer Risk: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yanlai Sun

    2016-03-01

    Full Text Available Background: Diet and nutrients play an important role in cancer development and progress; a healthy dietary pattern has been found to be associated with several types of cancer. However, the association between a healthy eating pattern and lung cancer risk is still unclear. Objective: Therefore, we conducted a systematic review with meta-analysis to evaluate whether a healthy eating pattern might reduce lung cancer risk. Methods: We identified relevant studies from the PubMed and Embase databases up to October 2015, and the relative risks were extracted and combined by the fixed-effects model when no substantial heterogeneity was observed; otherwise, the random-effects model was employed. Subgroup and publication bias analyses were also performed. Results: Finally, eight observational studies were included in the meta-analysis. The pooled relative risk of lung cancer for the highest vs. lowest category of healthy dietary pattern was 0.81 (95% confidence interval, CI: 0.75–0.86, and no significant heterogeneity was detected. The relative risks (RRs for non-smokers, former smokers and current smokers were 0.89 (95% CI: 0.63–1.27, 0.74 (95% CI: 0.62–0.89 and 0.86 (95% CI: 0.79–0.93, respectively. The results remained stable in subgroup analyses by other confounders and sensitivity analysis. Conclusions: The results of our meta-analysis suggest that a healthy dietary pattern is associated with a lower lung cancer risk, and they provide more beneficial evidence for changing the diet pattern in the general population.

  13. MAOA gene hypomethylation in panic disorder-reversibility of an epigenetic risk pattern by psychotherapy.

    Science.gov (United States)

    Ziegler, C; Richter, J; Mahr, M; Gajewska, A; Schiele, M A; Gehrmann, A; Schmidt, B; Lesch, K-P; Lang, T; Helbig-Lang, S; Pauli, P; Kircher, T; Reif, A; Rief, W; Vossbeck-Elsebusch, A N; Arolt, V; Wittchen, H-U; Hamm, A O; Deckert, J; Domschke, K

    2016-04-05

    Epigenetic signatures such as methylation of the monoamine oxidase A (MAOA) gene have been found to be altered in panic disorder (PD). Hypothesizing temporal plasticity of epigenetic processes as a mechanism of successful fear extinction, the present psychotherapy-epigenetic study for we believe the first time investigated MAOA methylation changes during the course of exposure-based cognitive behavioral therapy (CBT) in PD. MAOA methylation was compared between N=28 female Caucasian PD patients (discovery sample) and N=28 age- and sex-matched healthy controls via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells. MAOA methylation was furthermore analyzed at baseline (T0) and after a 6-week CBT (T1) in the discovery sample parallelized by a waiting time in healthy controls, as well as in an independent sample of female PD patients (N=20). Patients exhibited lower MAOA methylation than healthy controls (P<0.001), and baseline PD severity correlated negatively with MAOA methylation (P=0.01). In the discovery sample, MAOA methylation increased up to the level of healthy controls along with CBT response (number of panic attacks; T0-T1: +3.37±2.17%), while non-responders further decreased in methylation (-2.00±1.28%; P=0.001). In the replication sample, increases in MAOA methylation correlated with agoraphobic symptom reduction after CBT (P=0.02-0.03). The present results support previous evidence for MAOA hypomethylation as a PD risk marker and suggest reversibility of MAOA hypomethylation as a potential epigenetic correlate of response to CBT. The emerging notion of epigenetic signatures as a mechanism of action of psychotherapeutic interventions may promote epigenetic patterns as biomarkers of lasting extinction effects.

  14. MAOA gene hypomethylation in panic disorder—reversibility of an epigenetic risk pattern by psychotherapy

    Science.gov (United States)

    Ziegler, C; Richter, J; Mahr, M; Gajewska, A; Schiele, M A; Gehrmann, A; Schmidt, B; Lesch, K-P; Lang, T; Helbig-Lang, S; Pauli, P; Kircher, T; Reif, A; Rief, W; Vossbeck-Elsebusch, A N; Arolt, V; Wittchen, H-U; Hamm, A O; Deckert, J; Domschke, K

    2016-01-01

    Epigenetic signatures such as methylation of the monoamine oxidase A (MAOA) gene have been found to be altered in panic disorder (PD). Hypothesizing temporal plasticity of epigenetic processes as a mechanism of successful fear extinction, the present psychotherapy-epigenetic study for we believe the first time investigated MAOA methylation changes during the course of exposure-based cognitive behavioral therapy (CBT) in PD. MAOA methylation was compared between N=28 female Caucasian PD patients (discovery sample) and N=28 age- and sex-matched healthy controls via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells. MAOA methylation was furthermore analyzed at baseline (T0) and after a 6-week CBT (T1) in the discovery sample parallelized by a waiting time in healthy controls, as well as in an independent sample of female PD patients (N=20). Patients exhibited lower MAOA methylation than healthy controls (P<0.001), and baseline PD severity correlated negatively with MAOA methylation (P=0.01). In the discovery sample, MAOA methylation increased up to the level of healthy controls along with CBT response (number of panic attacks; T0–T1: +3.37±2.17%), while non-responders further decreased in methylation (−2.00±1.28% P=0.001). In the replication sample, increases in MAOA methylation correlated with agoraphobic symptom reduction after CBT (P=0.02–0.03). The present results support previous evidence for MAOA hypomethylation as a PD risk marker and suggest reversibility of MAOA hypomethylation as a potential epigenetic correlate of response to CBT. The emerging notion of epigenetic signatures as a mechanism of action of psychotherapeutic interventions may promote epigenetic patterns as biomarkers of lasting extinction effects. PMID:27045843

  15. Dietary Patterns, Alcohol Consumption and Risk of Coronary Heart Disease in Adults: A Meta-Analysis.

    Science.gov (United States)

    Zhang, Xiao-Yan; Shu, Long; Si, Cai-Juan; Yu, Xiao-Long; Liao, Dan; Gao, Wei; Zhang, Lun; Zheng, Pei-Fen

    2015-08-07

    Previous studies reported the potential associations between dietary patterns and the risk of coronary heart disease (CHD) in adulthood, however a consistent perspective has not been established to date. Herein, we carried out this meta-analysis to evaluate the associations between dietary patterns and the risk of CHD. MEDLINE and EBSCO were searched for relevant articles published up to April 2015. A total of 35 articles (reporting 37 original studies) met the inclusion criteria and were included in the present meta-analysis. The decreased risk of CHD was shown for the highest compared with the lowest categories of healthy/prudent dietary patterns (odds ratio (OR) = 0.67; 95% confidence interval (CI): 0.60, 0.75; p consumption (OR = 0.68; 95% CI: 0.59, 0.78; p patterns (OR = 1.45; 95% CI: 1.05, 2.01; p = 0.02). The results of this meta-analysis indicate that different dietary patterns may be associated with the risk of CHD.

  16. Screening for violence risk factors identifies young adults at risk for return emergency department visit for injury.

    Science.gov (United States)

    Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

    2014-08-01

    Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18-24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3-5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return visits for injuries were significantly

  17. Screening for Violence Risk Factors Identifies Young Adults at Risk for Return Emergency Department Visit for Injury

    Directory of Open Access Journals (Sweden)

    Abigail Hankin

    2014-08-01

    Full Text Available Introduction: Homicide is the second leading cause of death among youth aged 15–24. Prior crosssectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. Methods: This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18–24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3–5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a aggression, b perceived likelihood of violence, c recent violent behavior, d peer behavior, e community exposure to violence, and f positive future outlook. At 12 months following the initial ED visit, the participants’ medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chisquare and logistic regression analyses. Results: Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants’ average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first

  18. Stroke prevention and cognitive reserve: emerging approaches to modifying risk and delaying onset of dementia

    Directory of Open Access Journals (Sweden)

    Kevin eWillis

    2013-03-01

    Full Text Available Demographic changes and improvements in health care are projected to result in dramatic increases in the prevalence of dementia. Alzheimer’s disease is widely considered to be the primary cause of dementia - a disease for which there is currently no cure nor effective treatment, and for which it is thought that little can be done to mitigate risk. However, an increasing understanding of the role and extent of vascular contributions to the development of dementia, and appreciation of the interactions between stroke and Alzheimer’s disease, suggest that targeting vascular risk factors may be very beneficial in reducing the impact of dementia. We also describe how active stimulation of the brain throughout the life course builds cognitive reserve that can offset or compensate for cognitive decline in later life. Finally, we discuss the implications of these emerging approaches for dementia prevention and advocate for the urgent implementation of more extensive public health strategies to improve vascular health.

  19. Laboratory risk indicators for acute necrotizing fasciitis in the emergency setting

    Directory of Open Access Journals (Sweden)

    Syed Shayan Ali

    2016-03-01

    Full Text Available Necrotizing fasciitis is a rare bacterial skin condition which forms a major diagnostic challenge and is associated with poor prognosis unless promptly treated. Initial clinical presentation is often misleading with characteristic features developing only late in the course of the disease. In this review, we discuss the applicability and usefulness of laboratory risk indicator for necrotizing fasciitis score in facilitating rapid diagnosis of necrotizing fasciitis in emergency department by differentiating it from other skin infections like cellulitis and abscesses. A high index of suspicion resulting from the laboratory risk indicator for necrotizing fasciitis score can facilitate early diagnosis enabling prompt antibiotic administration and timely referral to surgery for wound debridement, ultimately reducing both the morbidity and mortality.

  20. On the benefits of multi-attribute risk analysis in nuclear emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Haemaelaeinen, R.P.; Lindstedt, M. [Helsinki Univ. of Technology (Finland). Systems Analysis Lab.; Sinkko, K. [The Radiation and Nuclear Safety Authority, Helsinki (Finland)

    1999-12-01

    The radiation protection authorities have seen a need to apply multi-attribute risk analysis in the nuclear emergency management and planning processes to deal with the conflicting objectives, different parties involved and uncertainties. This type of an approach is expected to help in at least the following three areas; to ensure that all the relevant attributes are considered in the decision making, to enhance communication between concerned parties including the population, and to provide a method for including risk analysis explicitly in the process. A MAUT analysis was used to select a strategy for protecting the population after a simulated nuclear accident. A value-focused approach and the use of a neutral facilitator were seen as very useful.

  1. Improper Consumption of Alcohol in Spanish Teenagers: Emergent Trends and Perceptions of Risk

    Directory of Open Access Journals (Sweden)

    María de la Villa Moral Jiménez

    2011-01-01

    Full Text Available In the Mediterranean culture the young consumption of alcohol represents a practice associated with a recreative culture tied to processes of group interaction and identity. Our aim is to offer a descriptive and differential analysis for levels of age and ingestion realized of the trends of consumption of alcohol, as well as the perceptions of risk and motivations of consumption in a group of 845 Spanish teenagers of the Principado de Asturias. The emergent trends are confirmed on habits of consumption of alcohol and the representative bosses of use/abuse of the style of juvenile leisure, as well as motivations and differential perceptions of risk by virtue of the mentality of the user. There are advanced market lines of prevention based on psychosocial interventions and socio community

  2. Laboratory risk indicators for acute necrotizing fasciitis in the emergency setting

    Institute of Scientific and Technical Information of China (English)

    Syed Shayan Ali; Fatimah Lateef

    2016-01-01

    Necrotizing fasciitis is a rare bacterial skin condition which forms a major diagnostic challenge and is associated with poor prognosis unless promptly treated. Initial clinical presentation is often misleading with characteristic features developing only late in the course of the disease. In this review, we discuss the applicability and usefulness of laboratory risk indicator for necrotizing fasciitis score in facilitating rapid diagnosis of necrotizing fasciitis in emergency department by differentiating it from other skin in-fections like cellulitis and abscesses. A high index of suspicion resulting from the lab-oratory risk indicator for necrotizing fasciitis score can facilitate early diagnosis enabling prompt antibiotic administration and timely referral to surgery for wound debridement, ultimately reducing both the morbidity and mortality.

  3. Osteoporosis among Fallers without Concomitant Fracture Identified in an Emergency Department: Frequencies and Risk Factors

    DEFF Research Database (Denmark)

    Glintborg, Bente; Hesse, Ulrik; Houe, Thomas

    2011-01-01

    aged 50-80 years sustaining a low-energy fall without fracture were identified from an ED (n = 199). Patients answered a questionnaire on risk factors and underwent osteodensitometry. Data was compared to a group of patients routinely referred to osteodensitometry from general practice (n = 201......We aimed to determine whether the Emergency Department (ED) is a suitable entrance point for osteoporosis screening among fallers without concomitant fracture compared to referral from general practice. Furthermore, to identify factors associated with osteoporosis among fallers. Methods. Patients......). Results. Among the 199 included fallers, 41 (21%) had osteoporosis. Among these, 35 (85%) reported either previous fracture or reduced body height (>3¿cm). These two risk factors were more frequent among fallers with osteoporosis compared to fallers with normal bone mineral density or osteopenia (previous...

  4. Potential links between the emerging risk factors for food allergy and vitamin D status.

    Science.gov (United States)

    Vuillermin, P J; Ponsonby, A-L; Kemp, A S; Allen, K J

    2013-06-01

    A variety of hypotheses have been proposed to explain the recently described increase in food allergy among children living in developed countries. In this study, we summarize the emerging risk factors for IgE-mediated food allergy in early life, and then review the evidence for and against an association between low vitamin status (VDS) and food allergy. We consider whether each of the epidemiological variables that have been associated with food allergy may also be associated with VDS; and argue that future studies must adequately account for the potential relationships between risk factors for food allergy and VDS, and must also discriminate between vitamin D derived by sun exposure, diet and oral supplementation. © 2012 John Wiley & Sons Ltd.

  5. Partial Least Square Discriminant Analysis Discovered a Dietary Pattern Inversely Associated with Nasopharyngeal Carcinoma Risk.

    Science.gov (United States)

    Lo, Yen-Li; Pan, Wen-Harn; Hsu, Wan-Lun; Chien, Yin-Chu; Chen, Jen-Yang; Hsu, Mow-Ming; Lou, Pei-Jen; Chen, I-How; Hildesheim, Allan; Chen, Chien-Jen

    2016-01-01

    Evidence on the association between dietary component, dietary pattern and nasopharyngeal carcinoma (NPC) is scarce. A major challenge is the high degree of correlation among dietary constituents. We aimed to identify dietary pattern associated with NPC and to illustrate the dose-response relationship between the identified dietary pattern scores and the risk of NPC. Taking advantage of a matched NPC case-control study, data from a total of 319 incident cases and 319 matched controls were analyzed. Dietary pattern was derived employing partial least square discriminant analysis (PLS-DA) performed on energy-adjusted food frequencies derived from a 66-item food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with multiple conditional logistic regression models, linking pattern scores and NPC risk. A high score of the PLS-DA derived pattern was characterized by high intakes of fruits, milk, fresh fish, vegetables, tea, and eggs ordered by loading values. We observed that one unit increase in the scores was associated with a significantly lower risk of NPC (ORadj = 0.73, 95% CI = 0.60-0.88) after controlling for potential confounders. Similar results were observed among Epstein-Barr virus seropositive subjects. An NPC protective diet is indicated with more phytonutrient-rich plant foods (fruits, vegetables), milk, other protein-rich foods (in particular fresh fish and eggs), and tea. This information may be used to design potential dietary regimen for NPC prevention.

  6. A perspective on vegetarian dietary patterns and risk of metabolic syndrome.

    Science.gov (United States)

    Sabaté, Joan; Wien, Michelle

    2015-04-01

    The vegetarian dietary pattern is traditionally a plant-based diet that includes fruits, vegetables, cereals, legumes, nuts, vegetable oils, soya, and possibly dairy products and/or eggs. Vegetarians and other populations who follow a plant-based dietary pattern enjoy longevity. Specifically, vegetarian dietary patterns have been associated with a lower risk for developing IHD, type 2 diabetes, hypertension, specific cancers, lower all-cause mortality and reduction in cause-specific mortality. The prevalence of the metabolic syndrome (MetS) in the USA is approximately 20 % and is currently increasing in developing countries in line with the obesity epidemic. The health care costs associated with the MetS are on a magnitude of 1.6 overall compared with healthy individuals, which makes it an important public health problem. Current evidence from several cross-sectional and case-control studies shows an association between consumption of a vegetarian dietary pattern and a reduced prevalence or risk of developing the MetS. There is a need for further research to be conducted, particularly prospective cohort studies to evaluate the effect of vegetarian dietary patterns on reducing the incidence of the MetS and, clinical trials should be designed to explore vegetarian dietary patterns for the reversal of the MetS in high-risk populations. This research could contribute to reduce the societal and economic burdens associated with the disorder.

  7. Comparison Of Patterns Of Convergence Among “Emerging Markets” Of Central Europe, Eastern Europe And Central Asia

    Directory of Open Access Journals (Sweden)

    POZNAŃSKA JOANNA

    2015-03-01

    Full Text Available Based on analysis of economic growth indicators for 1989-2014, this article distinguishes the “emerging markets” of Central and Eastern Europe (with Russia included, from the other economies that fall in the broad ‘emerging markets’ category. Following the post–1989 reforms, the countries of the region share many of the same typical institutional features as other “emerging economies”, but not necessarily the associated economic outcomes. What characterizes “emerging economies” is that they grow fast enough to systematically close the distance dividing them from the advanced economies, creating convergence. Departing from this pattern, Central and Eastern Europe (and Russia have so far fallen short in terms of the growth rates, and the region as a whole has not made much progress in catching up. By more than doubling its national product Poland is the only notable exception in the region, although Slovenia may fit in the same category. At the other extreme, some of the economies actually lost two decades in terms of reducing the gaps, and some even fell further behind (e.g., Serbia, Ukraine. These findings have potentially serious implications for economic theory in general and for the presumption that globalization processes act as a unifying developmental force.

  8. Emerging risk of infestation and contamination of dried fruits by mites in the Czech Republic.

    Science.gov (United States)

    Hubert, Jan; Erban, Tomas; Nesvorna, Marta; Stejskal, Vaclav

    2011-09-01

    The introduction of live insects into human food is rare in developed countries. However, we report, for the first time, an emerging risk that exists from dried fruit in Central Europe. Recently, massive and frequent infestation of dried fruit imported from the Mediterranean region by the mite, Carpoglpyhus lactis L. (Acarina: Carpoglyphidae), has been found. In 180 samples taken from supermarkets, 13% were contaminated; the contamination levels ranged from 0 to 660 mites per g of dried fruit. The contamination was found in dried apricots, figs, plums and raisins. To estimate the risks and food preferences of C. lactis, its growth rate was examined under laboratory conditions. Starting with a hypothetical population of 10 mites per g of dried fruit, the risk level of 1000 mites per g of dried fruit is reached at 42 days for dried figs, 49 days for dried pineapple and 63 days for dried apricots, dates and plums at 25 °C and 85% relative humidity. We found that mites are able to enter every dried fruit packing material tested, including polypropylene and aluminum foils. This indicates that mites can move from package to package in supermarkets. Mites are known as allergen producers and vectors of mycotoxin-producing fungi. These findings indicate that an increased risk of C. lactis contamination exists in dried fruit. © 2011 Taylor & Francis

  9. Current and emerging strategies in the management of venous thromboembolism: benefit-risk assessment of dabigatran.

    Science.gov (United States)

    Fanola, Christina L

    2015-01-01

    Venous thromboembolism (VTE) is a disease state that carries significant morbidity and mortality, and is a known cause of preventable death in hospitalized and orthopedic surgical patients. There are many identifiable risk factors for VTE, yet up to half of VTE incident cases have no identifiable risk factor and carry a high likelihood of recurrence, which may warrant extended therapy. For many years, parenteral unfractionated heparin, low-molecular weight heparin, fondaparinux, and oral vitamin K antagonists (VKAs) have been the standard of care in VTE management. However, limitations in current drug therapy options have led to suboptimal treatment, so there has been a need for rapid-onset, fixed-dosing novel oral anticoagulants in both VTE treatment and prophylaxis. Oral VKAs have historically been challenging to use in clinical practice, with their narrow therapeutic range, unpredictable dose responsiveness, and many drug-drug and drug-food interactions. As such, there has also been a need for novel anticoagulant therapies with fewer limitations, which has recently been met. Dabigatran etexilate is a fixed-dose oral direct thrombin inhibitor available for use in acute and extended treatment of VTE, as well as prophylaxis in high-risk orthopedic surgical patients. In this review, the risks and overall benefits of dabigatran in VTE management are addressed, with special emphasis on clinical trial data and their application to general clinical practice and special patient populations. Current and emerging therapies in the management of VTE and monitoring of dabigatran anticoagulant-effect reversal are also discussed.

  10. ALDH1 and podoplanin expression patterns predict the risk of malignant transformation in oral leukoplakia

    Science.gov (United States)

    Habiba, Umma; Hida, Kyoko; Kitamura, Tetsuya; Matsuda, Aya Yanagawa; Higashino, Fumihiro; Ito, Yoichi M.; Ohiro, Yoichi; Totsuka, Yasunori; Shindoh, Masanobu

    2017-01-01

    Oral leukoplakia (OL) is a clinically diagnosed preneoplastic lesion of the oral cavity with an increased oral cancer risk. However, the risk of malignant transformation is still difficult to assess. The objective of the present study was to examine the expression patterns of aldehyde dehydrogenase 1 (ALDH1) and podoplanin in OL, and to determine their roles in predicting oral cancer development. In the present study, the expression patterns of ALDH1 and podoplanin were determined in samples from 79 patients with OL. The association between protein expression and clinicopathological parameters, including oral cancer-free survival, was analyzed during a mean follow-up period of 3.4 years. Expression of ALDH1 and podoplanin was observed in 61 and 67% patients, respectively. Kaplan-Meier analysis demonstrated that the expression of the proteins was correlated with the risk of progression to oral cancer. Multivariate analysis revealed that expression of ALDH1 and podoplanin was associated with 3.02- and 2.62-fold increased risk of malignant transformation, respectively. The malignant transformation risk of OL was considerably higher in cases with expression of both proteins. Point-prevalence analysis revealed that 66% of patients with co-expression of ALDH1 and podoplanin developed oral cancer. Taken together, our data indicate that ALDH1 and podoplanin expression patterns in OL are associated with oral cancer development, suggesting that ALDH1 and podoplanin may be useful biomarkers to identify OL patients with a substantially high oral cancer risk. PMID:28123562

  11. ALDH1 and podoplanin expression patterns predict the risk of malignant transformation in oral leukoplakia.

    Science.gov (United States)

    Habiba, Umma; Hida, Kyoko; Kitamura, Tetsuya; Matsuda, Aya Yanagawa; Higashino, Fumihiro; Ito, Yoichi M; Ohiro, Yoichi; Totsuka, Yasunori; Shindoh, Masanobu

    2017-01-01

    Oral leukoplakia (OL) is a clinically diagnosed preneoplastic lesion of the oral cavity with an increased oral cancer risk. However, the risk of malignant transformation is still difficult to assess. The objective of the present study was to examine the expression patterns of aldehyde dehydrogenase 1 (ALDH1) and podoplanin in OL, and to determine their roles in predicting oral cancer development. In the present study, the expression patterns of ALDH1 and podoplanin were determined in samples from 79 patients with OL. The association between protein expression and clinicopathological parameters, including oral cancer-free survival, was analyzed during a mean follow-up period of 3.4 years. Expression of ALDH1 and podoplanin was observed in 61 and 67% patients, respectively. Kaplan-Meier analysis demonstrated that the expression of the proteins was correlated with the risk of progression to oral cancer. Multivariate analysis revealed that expression of ALDH1 and podoplanin was associated with 3.02- and 2.62-fold increased risk of malignant transformation, respectively. The malignant transformation risk of OL was considerably higher in cases with expression of both proteins. Point-prevalence analysis revealed that 66% of patients with co-expression of ALDH1 and podoplanin developed oral cancer. Taken together, our data indicate that ALDH1 and podoplanin expression patterns in OL are associated with oral cancer development, suggesting that ALDH1 and podoplanin may be useful biomarkers to identify OL patients with a substantially high oral cancer risk.

  12. Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways

    Directory of Open Access Journals (Sweden)

    Robert W. Derlet

    2014-03-01

    Full Text Available We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG, and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP. As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP’s medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety. [West J Emerg Med. 2014;15(2:137–141.

  13. Calcium Disorders in the Emergency Department: Independent Risk Factors for Mortality.

    Directory of Open Access Journals (Sweden)

    Thomas C Sauter

    Full Text Available Calcium disorders are common in both intensive care units and in patients with chronic kidney disease and are associated with increased morbidity and mortality. It is unknown whether calcium abnormalities in unselected emergency department admissions have an impact on in-hospital mortality.This cross-sectional analysis included all admissions to the Emergency Department at the Inselspital Bern, Switzerland from 2010 to 2011. For hyper- and hypocalcaemic patients with a Mann-Whitney U-test, the differences between subgroups divided by age, length of hospital stay, creatinine, sodium, chloride, phosphate, potassium and magnesium were compared. Associations between calcium disorders and 28-day in-hospital mortality were assessed using the Cox proportional hazard regression model.8,270 patients with calcium measurements were included in our study. Overall 264 (3.2% patients died. 150 patients (6.13% with hypocalcaemia and 7 patients with hypercalcaemia (6.19% died, in contrast to 104 normocalcaemic patients (1.82%. In univariate analysis, calcium serum levels were associated with sex, mortality and pre-existing diuretic therapy (all p<0.05. In multivariate Cox regression analysis, hypocalcaemia and hypercalcaemia were independent risk factors for mortality (HR 2.00 and HR 1.88, respectively; both p<0.01.Both hypocalcaemia and hypercalcaemia are associated with increased 28-day in-hospital mortality in unselected emergency department admissions.

  14. Patterns of participation: a framework for understanding the role of the teacher for emerging classroom practices

    DEFF Research Database (Denmark)

    Larsen, Dorthe M.; Østergaard, Camilla H.; Skott, Jeppe

    Research on teachers’ knowledge and beliefs has grown big in recent years. The larger parts of these fields are built on acquisitionist interpretations of human functioning. We explore the potentials of a participationist framework for understanding the role of the teacher for emerging classroom ...... potential and sheds light on the dynamic relationships between the teacher’s engagement in the practices of the mathematics classroom and other, personally significant, past and present ones.......Research on teachers’ knowledge and beliefs has grown big in recent years. The larger parts of these fields are built on acquisitionist interpretations of human functioning. We explore the potentials of a participationist framework for understanding the role of the teacher for emerging classroom...

  15. How Do Emerging Technologies Conquer the World? An Exploration of Patterns of Diffusion and Network Formation

    CERN Document Server

    Leydesdorff, Loet

    2010-01-01

    Grasping the fruits of "emerging technologies" is an objective of many government priority programs in a knowledge-based and globalizing economy. We use the publication records (in the Science Citation Index) of two emerging technologies to study the mechanisms of diffusion in the case of two innovation trajectories: small interference RNA (siRNA) and nano-crystalline solar cells (NCSC). Methods for analyzing and visualizing geographical and cognitive diffusion are specified as indicators of different dynamics. Geographical diffusion is illustrated with overlays to Google Maps; cognitive diffusion is mapped using an overlay to a map based on the ISI Subject Categories. The evolving geographical networks show both preferential attachment and small-world characteristics. The strength of preferential attachment decreases over time, while the network evolves into an oligopolistic control structure with small-world characteristics. The transferability of the research technology in cognitive terms--that is, the tra...

  16. Nonvariceal upper gastrointestinal tract bleeding - risk factors and the value of emergency endoscopy.

    Science.gov (United States)

    Wierzchowski, Pawel; Dabrowiecki, Stanislaw; Szczesny, Wojciech; Szmytkowski, Jakub

    2013-10-31

    Upper gastrointestinal tract bleeding (UGIB) remains a valid issue of modern medicine. The mortality and recurrence rates remain high and have not decreased as expected over the past decades. to assess the treatment outcomes of nonvariceal UGIB depending on the timing of endoscopy (urgent vs. elective) and to perform an analysis of risk factors for death in patients with nonvariceal UGIB. Comparative evaluation of treatment outcomes in two groups of patients. Group A consisted of patients undergoing elective endoscopy (n = 187). Group B consisted of patients undergoing emergency endoscopy (n = 295). Moreover, the influence of selected factors on the risk of death and bleeding recurrence was analyzed in the combined population of the two groups. This was done by constructing a logistic regression model and testing dependence hypotheses. In group A the mortality rate was 9.1%, and the recurrence rate was 18.2%. In group B the values were 6.8% and 12.2%, respectively. No statistically significant difference was found (p = NS). In group B the number of surgical interventions, blood transfusions and intensive care admissions was significantly lower (p bleeding from a malignant lesion, recurrent bleeding and the need for surgery (p < 0.05). The use of emergency endoscopy improves the treatment outcomes in patients with UGIB, although no statistically significant decrease in the mortality and recurrence rates could be observed.

  17. [Challenges in the assessment and managment of health risks associated with emerging water micropollutants].

    Science.gov (United States)

    Levi, Yves

    2009-06-01

    Analytical laboratories can now identify and quantify an impressive number of "new" pollutants present at very low concentrations in water. Nanotechnology products are a new cause for concern. " Emerging " pollutants are defined as substances that were not previously sought or detected (plasticizers, drugs, chlorination byproducts, persistant organic pollutants, ...) and that are now being identified in many continental water resources. The biological actions of these substances, alone and in combination with other more " classical "pollutants, include such effects as endocrine disruption. Contaminants may be present in surface and groundwater resources, may be generated during treatment, and are found in drinking water distribution networks. In industrialized countries, the main source of emerging pollutants for humans is not water, but rather food, cosmetics and air. Urgent measures are needed to protect biodiversity and human health, including quantitative risk assessment, toxicologic studies of xenobiotic mixtures and chronic effects, strategies to protect water resources, technological advances in wastewater treatment, reliable potable water production, and new inert materials for transport and storage. Good sanitation and safe tap water are major contributors to human health and well-being Major efforts and investments are needed, based on rigorous, objective assessments of risks for the environment and public health.

  18. The Impact of Infant Well-Child Care Compliance and Social Risks on Emergency Department Utilization.

    Science.gov (United States)

    Lawson, Nikki R; Klein, Melissa D; Ollberding, Nicholas J; Wurster Ovalle, Victoria; Beck, Andrew F

    2017-09-01

    Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84.4% publicly insured. A total of 72.6% visited the ED by 2 years of life. Sixty percent received ≥5 well-child visits by 14 months; 25.9% reported ≥1 social risk. There were no statistically significant associations between number of completed well-child visits, or reported social risks, and ED utilization. Renewed focus on preventive care delivery and content and its effect on ED utilization, and other patient outcomes, is warranted.

  19. Emergent team roles in organizational meetings: Identifying communication patterns via cluster analysis.

    OpenAIRE

    Lehmann-Willenbrock, N.K.; Beck, S.J.; Kauffeld, S.

    2016-01-01

    Previous team role taxonomies have largely relied on self-report data, focused on functional roles, and described individual predispositions or personality traits. Instead, this study takes a communicative approach and proposes that team roles are produced, shaped, and sustained in communicative behaviors. To identify team roles communicatively, 59 regular organizational meetings were videotaped and analyzed. Cluster analysis revealed five emergent roles: the solution seeker, the problem anal...

  20. Diversity in Pathways to Parenthood: Patterns, Implications, and Emerging Research Directions

    Science.gov (United States)

    Smock, Pamela J.; Greenland, Fiona Rose

    2010-01-01

    This review examines and synthesizes recent research on pathways to parenthood. We begin by providing basic information about patterns, differentials, and trends and discussing adoption and new reproductive technologies. We next turn to several areas of inquiry that became particularly prominent in the last decade: the continued "decoupling" of…

  1. Zika--an emerging infectious disease. The risk assessment from Polish perspective.

    Science.gov (United States)

    Gańczak, Maria

    2016-01-01

    In the last years, attention has been paid to Zika virus (ZIKV) infection, the emerging vector-borne disease. It is responsible for major outbreaks in Africa, Asia and, more recently, in previously infection-naïve territories of the Pacific area, South America and Caribbean. The etiology, epidemiology, transmission, and clinical manifestations of ZIKV disease are discussed, along with the diagnostic possibilities in the aim to assessing the risk of its introduction to Poland. ZIKV is spread by Aedes mosquitoes which are not found throughout Poland. The prevention strategies adopted by national public health authorities should be based on a surveillance of imported cases and on increasing awareness among healthcare professionals and travelers. Due to a large number of asymptomatic ZIKV infections and limitations in the availability of diagnostic tests, monitoring based on laboratory results is likely to be unreliable in Poland. There are no requirements to report ZIKV infections to the European Centre for Disease Prevention and Control. Nevertheless, the global epidemic continues to spread, and despite travels of Poles to countries in which Aedes mosquitoes are active, Polish sportsmen will be travelling to Brazil in August 2016 to participate in the Olympic Games, the will also be true of the many fans who will follow them; therefore imported cases of ZIKV infection are possible. As the awareness of the infection risk will increase among medical staff and travelers, the number of suspected cases of travel-related ZIKV infections may rise in Poland. Medical staff should be informed where and how to report such cases. Thorough surveillance, adequate assessment of possible threats, action plans, rapid and effective intervention development, spread of up to date information of ZIKV, as well as other emerging or re-emerging infectious pathogens can play a key role in guaranteeing population health.

  2. Patterns of health-related quality of life and patterns associated with health risks among Rhode Island adults

    Directory of Open Access Journals (Sweden)

    Hesser Jana

    2008-07-01

    Full Text Available Abstract Background Health-related quality of life (HRQOL has become an important consideration in assessing the impact of chronic disease on individuals as well as in populations. HRQOL is often assessed using multiple indicators. The authors sought to determine if multiple indicators of HRQOL could be used to characterize patterns of HRQOL in a population, and if so, to examine the association between such patterns and demographic, health risk and health condition covariates. Methods Data from Rhode Island's 2004 Behavioral Risk Factor Surveillance System (BRFSS were used for this analysis. The BRFSS is a population-based random-digit-dialed telephone survey of adults ages 18 and older. In 2004 RI's BRFSS interviewed 3,999 respondents. A latent class regression (LCR model, using 9 BRFSS HRQOL indicators, was used to determine latent classes of HRQOL for RI adults and to model the relationship between latent class membership and covariates. Results RI adults were categorized into four latent classes of HRQOL. Class 1 (76% was characterized by good physical and mental HRQOL; Class 2 (9% was characterized as having physically related poor HRQOL; Class 3 (11% was characterized as having mentally related poor HRQOL; and Class 4 (4% as having both physically and mentally related poor HRQOL. Class 2 was associated with older age, being female, unable to work, disabled, or unemployed, no participation in leisure time physical activity, or with having asthma or diabetes. Class 3 was associated with being female, current smoking, or having asthma or disability. Class 4 was associated with almost all the same predictors of Classes 2 and 3, i.e. older age, being female, unable to work, disabled, or unemployed, no participation in leisure time physical activity, current smoking, with having asthma or diabetes, or with low income. Conclusion Using a LCR model, the authors found 4 distinct patterns of HRQOL among RI adults. The largest class was associated

  3. Agent-Based Simulation of School Choice in Bandung, Indonesia: The Emergence of Enrolment Pattern Trough Individual Preferences

    Directory of Open Access Journals (Sweden)

    Dhanan Sarwo Utomo

    2012-01-01

    Full Text Available This study is motivated by the reality that school choice programs that is currently implemented in Bandung that, always resulting student deficit (lack of student in some schools. In this study, a mechanism that can describe how the enrollment pattern in a school choice program emerge as a result of individual preferences of the prospective students, is constructed. Using computer simulation, virtual experiments are conducted. In these experiments, the enrollment patterns and the number of student deficit that were resulted by various school choice program configurations are analyzed. Based on the experiment results, modification of the current program that can minimize the number of student deficit can be purposed.Keywords: agent-based simulation, school choice, computer simulation

  4. The Leviathan model: Absolute dominance, generalised distrust and other patterns emerging from combining vanity with opinion propagation

    CERN Document Server

    Deffuant, Guillaume; Huet, Sylvie

    2012-01-01

    We propose an opinion dynamics model that combines processes of vanity and opinion propagation. The interactions take place between randomly chosen pairs. During an interaction, the agents propagate their opinions about themselves and about other people they know. Moreover, each individual is subject to vanity: if her interlocutor seems to value her highly, then she increases her opinion about this interlocutor. On the contrary she tends to decrease her opinion about those who seem to undervalue her. The combination of these dynamics with the hypothesis that the opinion propagation is more efficient when coming from highly valued individuals, leads to different patterns when varying the parameters. In one of the patterns, absolute dominance of one agent alternates with a state of generalised distrust, where all agents have a very low opinion of all the others (including themselves). We provide some explanations of the mechanisms behind these emergent behaviors and finally propose a discussion about their inte...

  5. Risk assessment of the emergency processes: Healthcare failure mode and effect analysis

    Science.gov (United States)

    Taleghani, Yasamin Molavi; Rezaei, Fatemeh; Sheikhbardsiri, Hojat

    2016-01-01

    BACKGROUND: Ensuring about the patient’s safety is the first vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. METHODS: In this study, in combination (qualitative action research and quantitative cross-sectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the “nursing errors in clinical management model (NECM)”, the classification of the effective causes of error from “Eindhoven model” and determination of the strategies to improve from the “theory of solving problem by an inventive method” were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. RESULTS: In 5 selected processes by “voting method using rating”, 23 steps, 61 sub-processes and 217 potential failure modes were identified by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy. CONCLUSION: “Revision and re-engineering of processes”, “continuous monitoring of the works”, “preparation and revision of operating procedures and policies”, “developing the criteria for evaluating the performance of the personnel”, “designing a suitable educational content for needs of employee”,

  6. A dietary pattern rich in lignans, quercetin and resveratrol decreases the risk of oesophageal cancer.

    Science.gov (United States)

    Lin, Yulan; Yngve, Agneta; Lagergren, Jesper; Lu, Yunxia

    2014-12-28

    Dietary lignans, quercetin and resveratrol have oestrogenic properties, and animal studies suggest that they synergistically decrease cancer risk. A protective effect of lignans on the development of oesophageal cancer in humans has recently been demonstrated, and the present study aimed to test whether these three phytochemicals synergistically decrease the risk of oesophageal cancer. Data from a Swedish nationwide population-based case-control study that recruited 181 cases of oesophageal adenocarcinoma (OAC), 158 cases of oesophageal squamous-cell carcinoma (OSCC), 255 cases of gastro-oesophageal junctional adenocarcinoma (JAC) and 806 controls were analysed. Exposure data were collected through face-to-face interviews and questionnaires. The intake of lignans, quercetin and resveratrol was assessed using a sixty-three-item FFQ. Reduced-rank regression was used to assess a dietary pattern, and a simplified dietary pattern score was categorised into quintiles on the basis of the distribution among the control subjects. Unconditional multivariable logistic regression provided OR with 95% CI, adjusted for all the potential risk factors. A dietary pattern rich in lignans, quercetin and resveratrol was mainly characterised by a high intake of tea, wine, lettuce, mixed vegetables, tomatoes, and whole-grain bread and a low intake of milk. There were dose-dependent associations between simplified dietary pattern scores and all types of oesophageal cancer (all P for trend dietary pattern characterised by the intake of lignans, quercetin and resveratrol may play a protective role in the development of oesophageal cancer in the Swedish population.

  7. Dietary patterns in transition can inform health risk, but detailed assessments are needed to guide recommendations

    Science.gov (United States)

    Most research on diet and health has historically focused on single nutrients or foods and their effect on disease outcomes. In recent years, this focus has shifted to include the total dietary pattern as a risk factor in epidemiologic studies. This change has occurred for several reasons. First, as...

  8. Patterns and Factors of High School Dropout Risks of Racial and Linguistic Groups

    Science.gov (United States)

    Kim, Sunha; Chang, Mido; Singh, Kusum; Allen, Katherine R.

    2015-01-01

    This study examined the dropout trajectories of racial and linguistic minority students and explored the effects of students' contextual factors on their high school dropout risks. Our motivation was to identify the dropout patterns of Black, Hispanic, and Hispanic English language learner (ELL) students, who have comparatively high dropout rates,…

  9. Application of a Proactive Risk Analysis to Emergency Department Sickle Cell Care

    Directory of Open Access Journals (Sweden)

    Victoria L. Thornton

    2014-07-01

    Full Text Available Introduction: Patients with sickle cell disease (SCD often seek care in emergency departments (EDs for severe pain. However, there is evidence that they experience inaccurate assessment, suboptimal care, and inadequate follow-up referrals. The aim of this project was to 1 explore the feasibility of applying a failure modes, effects and criticality analysis (FMECA in two EDs examining four processes of care (triage, analgesic management, high risk/high users, and referrals made for patients with SCD, and 2 report the failures of these care processes in each ED. Methods: A FMECA was conducted of ED SCD patient care at two hospitals. A multidisciplinary group examined each step of four processes. Providers identified failures in each step, and then characterized the frequency, impact, and safeguards, resulting in risk categorization. Results: Many “high risk” failures existed in both institutions, including a lack of recognition of high-risk or high-user patients and a lack of emphasis on psychosocial referrals. Specific to SCD analgesic management, one setting inconsistently used existing analgesic policies, while the other setting did not have such policies. Conclusion: FMECA facilitated the identification of failures of ED SCD care and has guided quality improvement activities. Interventions can focus on improvements in these specific areas targeting improvements in the delivery and organization of ED SCD care. Improvements should correspond with the forthcoming National Heart, Lung and Blood-sponsored guidelines for treatment of patients with sickle cell disease. [West J Emerg Med. 2014;15(4:446–458.

  10. Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres--a cross-sectional study.

    Science.gov (United States)

    Ellensen, Eirin N; Hunskaar, Steinar; Wisborg, Torben; Zakariassen, Erik

    2014-01-08

    The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators' self-reported use of Index as a first step towards a validation study. We registered all medical emergency calls to the EMCCs during a 72 h period in a national cross sectional study. We subsequently sent a questionnaire to all EMCC operators in Norway, asking how they use Index. A combined outcome variable "use of Index" was computed through a Likert scale, range 1-5. Regression models were used to examine factors influencing use. 2 298 contacts were included. National contact rate was 56/1,000 inhabitants per year, range between EMCCs 34 - 119. Acute contact (life-threatening situations) rate was 21/1,000 per year, range between EMCCs 5 - 31. Index criteria 6 - 'Unresolved problem' accounts for 20% of the 113 contacts, range between EMCCs 10 - 42%. The mean use of Index was 3.95 (SD 0.39), corresponding to "more than 75% of emergency calls". There were differences in use of Index on EMCC level, range 3.7 - 4.4, and a multi regression model explained 23.4% of the variation in use. Operators working rotation with ground ambulance services reported reduced use of Index compared to operators not working in rotation, while distinct EMCC focus on Index increased use of Index compared to EMCCs with no focus on Index. Use of electronic records and operators experience were the main reasons given for not using Index. There is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level.

  11. Emerging pattern of global change in the upper atmosphere and ionosphere

    Directory of Open Access Journals (Sweden)

    J. Laštovička

    2008-05-01

    Full Text Available In the upper atmosphere, greenhouse gases produce a cooling effect, instead of a warming effect. Increases in greenhouse gas concentrations are expected to induce substantial changes in the mesosphere, thermosphere, and ionosphere, including a thermal contraction of these layers. In this article we construct for the first time a pattern of the observed long-term global change in the upper atmosphere, based on trend studies of various parameters. The picture we obtain is qualitative, and contains several gaps and a few discrepancies, but the overall pattern of observed long-term changes throughout the upper atmosphere is consistent with model predictions of the effect of greenhouse gas increases. Together with the large body of lower atmospheric trend research, our synthesis indicates that anthropogenic emissions of greenhouse gases are affecting the atmosphere at nearly all altitudes between ground and space.

  12. Identifying learning patterns of children at risk for Specific Reading Disability.

    Science.gov (United States)

    Barbot, Baptiste; Krivulskaya, Suzanna; Hein, Sascha; Reich, Jodi; Thuma, Philip E; Grigorenko, Elena L

    2016-05-01

    Differences in learning patterns of vocabulary acquisition in children at risk (+SRD) and not at risk (-SRD) for Specific Reading Disability (SRD) were examined using a microdevelopmental paradigm applied to the multi-trial Foreign Language Learning Task (FLLT; Baddeley et al., 1995). The FLLT was administered to 905 children from rural Chitonga-speaking Zambia. A multi-group Latent Growth Curve Model (LGCM) was implemented to study interindividual differences in intraindividual change across trials. Results showed that the +SRD group recalled fewer words correctly in the first trial, learned at a slower rate during the subsequent trials, and demonstrated a more linear learning pattern compared to the -SRD group. This study illustrates the promise of LGCM applied to multi-trial learning tasks, by isolating three components of the learning process (initial recall, rate of learning, and functional pattern of learning). Implications of this microdevelopmental approach to SRD research in low-to-middle income countries are discussed.

  13. Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study

    DEFF Research Database (Denmark)

    Bao, Wei; Bowers, Katherine; Tobias, Deirdre K

    2014-01-01

    BACKGROUND: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown. OBJECTIVE: We aimed to prospectively examine the association of 3 prepregnancy low......-carbohydrate dietary patterns with risk of GDM. DESIGN: We included 21,411 singleton pregnancies in the Nurses' Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat......, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models. RESULTS: We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons...

  14. Dietary Patterns and Cardiovascular Disease–Related Risks in Chinese Older Adults

    Directory of Open Access Journals (Sweden)

    Jing eSun

    2013-11-01

    Full Text Available AbstractStudies of Western populations demonstrate a relationship between dietary patterns and cardiovascular-related risk factors. Simiar research regarding Chinese populations is limited. This study explored the dietary patterns of Chinese older adults and their association with cardiovascular-related risk factors, including hypertension, obesity and metabolic syndrome. Data were collected using a 34-item Chinese food frequency questionnaire from 750 randomly selected older adults aged 50–88 who participated in the study in 2012. Factor analysis revealed four dietary patterns: a ‘traditional food pattern’, consisting of vegetable, fruit, rice, pork and fish; a ‘fast and processed food pattern’ consisting of fast or processed food products, sugar and confectionery; a ‘soybean, grain and flour food pattern’; and a ‘dairy, animal liver and other animal food pattern’. These patterns explained 17.48%, 9.52%, 5.51% and 4.80% of the variances in food intake, respectively. This study suggests that specific dietary patterns are evident in Chinese older adults. Moderate intake of ‘traditional Chinese food’ is associated with decreased blood pressure and cholesterol level. A dietary pattern rich in soybeans, grains, potatoes and flour is associated with reduced metabolic factors including reduced triglycerides, fasting glucose, waist circumference, and waist–hip ratio, and a high level of dairy, animal liver and other animal intake food pattern is associated with increased level of Body Mass Index. In conclusion, this study revealed identifiable dietary patterns among Chinese older adults that are significantly related to blood pressure and metabolic biomarkers. Further study using prospective cohort or intervention study should be used to confirm the association between dietary patterns and blood pressure and metabolic factors.

  15. Question-learn-test-feedback pattern to test emerging software construction paradigms

    OpenAIRE

    Baudry, Benoit

    2010-01-01

    This habilitation introduces the question-learn-test-feedback pattern that resulted from a series of investigations in the domains of software testing and modular software construction. The contributions to these fields are of various natures, but are all fundamentally related through two major assumptions: software construction paradigms have to constantly evolve in order to deal with the increasingly complex requirements that software-intensive systems have to meet; a tester's perspective c...

  16. How fun are your meetings? How and when humor patterns emerge and impact team performance.

    OpenAIRE

    Lehmann-Willenbrock, N.K.; Allen, J A

    2014-01-01

    Research on humor in organizations has rarely considered the social context in which humor occurs. One such social setting that most of us experience on a daily basis concerns the team context. Building on recent theorizing about the humor–performance link in teams, this study seeks to increase our understanding of the function and effects of humor in team interaction settings. We examined behavioral patterns of humor and laughter in real teams by videotaping and coding humor and laughter dur...

  17. Perception of radiation dose and potential risks of computed tomography in emergency department medical personnel

    Science.gov (United States)

    Lee, Jin Hee; Kim, Kyuseok; Lee, Kyoung Ho; Kim, Kwang Pyo; Kim, Yu Jin; Park, Chanjong; Kang, Changwoo; Lee, Soo Hoon; Jeong, Jin Hee; Rhee, Joong Eui

    2015-01-01

    Objective Use of computed tomography (CT) continues to increase, but the relatively high radiation doses associated with CT have raised health concerns such as future risk of cancer. We investigated the level of awareness regarding radiation doses and possible risks associated with CT in medical personnel (MP). Methods This study was conducted from April to May 2012 and included physicians and nurses who worked in the emergency department of 17 training hospitals. The questionnaire included measurement of the effect of CT or radiography on health using a 10-point numerical rating scale, estimation of the radiation dose of one abdominal CT scan compared with one chest radiograph, and perception of the increased lifetime risk of cancer associated with CT. Results A total of 354 MP participated in this study: 142 nurses, 87 interns, 86 residents, and 39 specialists. Interns were less aware of the effects of CT or radiography on health than other physicians or nurses (mean±SD of 4.8±2.7, 5.9±2.7, 6.1±2.7, and 6.0±2.2 for interns, residents, specialists, and nurses, respectively; P<0.05). There was a significant difference in knowledge about the relative radiation dose of one abdominal CT scan compared with one chest radiograph between physicians and nurses (48.6% vs. 28.9% for physicians vs. nurses, P<0.05). MP perceived an increased risk of cancer from radiation associated with CT. Conclusion MP perceive the risk of radiation associated with CT, but their level of knowledge seems to be insufficient.

  18. Emergence of social cooperation in threshold public goods games with collective risk

    Science.gov (United States)

    Wang, Jing; Fu, Feng; Wu, Te; Wang, Long

    2009-07-01

    In real situations, people are often faced with the option of voluntary contribution to achieve a collective goal, for example, building a dam or a fence, in order to avoid an unfavorable loss. Those who do not donate, however, can free ride on others’ sacrifices. As a result, cooperation is difficult to maintain, leading to an enduring collective-risk social dilemma. To address this issue, here we propose a simple yet effective theoretical model of threshold public goods game with collective risk and focus on the effect of risk on the emergence of social cooperation. To do this, we consider the population dynamics represented by replicator equation for two simplifying scenarios, respectively: one with fair sharers, who contribute the minimum average amount versus defectors and the other with altruists contributing more than average versus defectors. For both cases, we find that the dilemma is relieved in high-risk situations where cooperation is likely to persist and dominate defection in the population. Large initial endowment to individuals also encourages the risk-averse action, which means that, as compared to poor players (with small initial endowment), wealthy individuals (with large initial endowment) are more likely to cooperate in order to protect their private accounts. In addition, we show that small donation amount and small threshold (collective target) can encourage and sustain cooperation. Furthermore, for other parameters fixed, the impacts of group size act differently on the two scenarios because of distinct mechanisms: in the former case where the cost of cooperation depends on the group size, large size of group readily results in defection, while easily maintains cooperation in the latter case where the cost of cooperation is fixed irrespective of the group size. Our theoretical results of the replicator dynamics are in excellent agreement with the individual based simulation results.

  19. Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program

    Directory of Open Access Journals (Sweden)

    Jill M. Huded

    2015-12-01

    Full Text Available Introduction: Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT, a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL model. Methods: Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT, social work or home health as determined by the GNL. Results: Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%, outpatient PT referrals (n=56, 12.2% and social work consultation (n=162, 44%. Conclusion: The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

  20. Role of India's wildlife in the emergence and re-emergence of zoonotic pathogens, risk factors and public health implications.

    Science.gov (United States)

    Singh, B B; Gajadhar, A A

    2014-10-01

    Evolving land use practices have led to an increase in interactions at the human/wildlife interface. The presence and poor knowledge of zoonotic pathogens in India's wildlife and the occurrence of enormous human populations interfacing with, and critically linked to, forest ecosystems warrant attention. Factors such as diverse migratory bird populations, climate change, expanding human population and shrinking wildlife habitats play a significant role in the emergence and re-emergence of zoonotic pathogens from India's wildlife. The introduction of a novel Kyasanur forest disease virus (family flaviviridae) into human populations in 1957 and subsequent occurrence of seasonal outbreaks illustrate the key role that India's wild animals play in the emergence and reemergence of zoonotic pathogens. Other high priority zoonotic diseases of wildlife origin which could affect both livestock and humans include influenza, Nipah, Japanese encephalitis, rabies, plague, leptospirosis, anthrax and leishmaniasis. Continuous monitoring of India's extensively diverse and dispersed wildlife is challenging, but their use as indicators should facilitate efficient and rapid disease-outbreak response across the region and occasionally the globe. Defining and prioritizing research on zoonotic pathogens in wildlife are essential, particularly in a multidisciplinary one-world one-health approach which includes human and veterinary medical studies at the wildlife-livestock-human interfaces. This review indicates that wild animals play an important role in the emergence and re-emergence of zoonotic pathogens and provides brief summaries of the zoonotic diseases that have occurred in wild animals in India.

  1. Ectomycorrhizal impacts on plant nitrogen nutrition: emerging isotopic patterns, latitudinal variation and hidden mechanisms.

    Science.gov (United States)

    Mayor, Jordan; Bahram, Mohammad; Henkel, Terry; Buegger, Franz; Pritsch, Karin; Tedersoo, Leho

    2015-01-01

    Ectomycorrhizal (EcM)-mediated nitrogen (N) acquisition is one main strategy used by terrestrial plants to facilitate growth. Measurements of natural abundance nitrogen isotope ratios (denoted as δ(15)N relative to a standard) increasingly serve as integrative proxies for mycorrhiza-mediated N acquisition due to biological fractionation processes that alter (15)N:(14)N ratios. Current understanding of these processes is based on studies from high-latitude ecosystems where plant productivity is largely limited by N availability. Much less is known about the cause and utility of ecosystem δ(15)N patterns in the tropics. Using structural equation models, model selection and isotope mass balance we assessed relationships among co-occurring soil, mycorrhizal plants and fungal N pools measured from 40 high- and 9 low-latitude ecosystems. At low latitudes (15)N-enrichment caused ecosystem components to significantly deviate from those in higher latitudes. Collectively, δ(15)N patterns suggested reduced N-dependency and unique sources of EcM (15)N-enrichment under conditions of high N availability typical of the tropics. Understanding the role of mycorrhizae in global N cycles will require reevaluation of high-latitude perspectives on fractionation sources that structure ecosystem δ(15)N patterns, as well as better integration of EcM function with biogeochemical theories pertaining to climate-nutrient cycling relationships.

  2. A GIS based urban flood risk analysis model for vulnerability assessment of critical structures during flood emergencies

    Science.gov (United States)

    Albano, R.; Sole, A.; Adamowski, J.; Mancusi, L.

    2014-04-01

    Risk analysis has become a priority for authorities and stakeholders in many European countries, with the aim of reducing flooding risk by considering the priority and benefits of possible interventions. Within this context, a flood risk analysis model was developed in this study that is based on GIS, and integrated with a model that assesses the degree of accessibility and operability of strategic emergency response structures in an urban area. The proposed model is unique in that it provides a quantitative estimation of flood risk on the basis of the operability of the strategic emergency structures in an urban area, their accessibility, and connection within the urban system of a city (i.e., connection between aid centres and buildings at risk) in the emergency phase. The results of a case study in the Puglia Region in Southern Italy are described to illustrate the practical applications of this newly proposed approach. The main advantage of the proposed approach is that it allows for the defining of a hierarchy between different infrastructures in the urban area through the identification of particular components whose operation and efficiency are critical for emergency management. This information can be used by decision makers to prioritize risk reduction interventions in flood emergencies in urban areas.

  3. Prediction of Outcome After Emergency High-Risk Intra-abdominal Surgery Using the Surgical Apgar Score

    DEFF Research Database (Denmark)

    Cihoric, Mirjana; Toft Tengberg, Line; Bay-Nielsen, Morten

    2016-01-01

    BACKGROUND: With current literature quoting mortality rates up to 45%, emergency high-risk abdominal surgery has, compared with elective surgery, a significantly greater risk of death and major complications. The Surgical Apgar Score (SAS) is predictive of outcome in elective surgery, but has never...... been validated exclusively in an emergency setting. METHODS: A consecutive prospective single-center cohort study of 355 adults undergoing emergency high-risk abdominal surgery between June 2013 and May 2014 is presented. The primary outcome measure was 30-day mortality. Secondary outcome measures were...... the incidence of both outcomes. Area under the curve was used to demonstrate the scores' discriminatory power. RESULTS: One hundred eighty-one (51.0%) patients developed minor or no complications. The overall incidence of major complications was 32.7% and the overall death rate was 16.3%. Risk of major...

  4. Patterns of participation: a framework for understanding the role of the teacher for emerging classroom practices

    DEFF Research Database (Denmark)

    Larsen, Dorthe M.; Østergaard, Camilla H.; Skott, Jeppe

    Research on teachers’ knowledge and beliefs has grown big in recent years. The larger parts of these fields are built on acquisitionist interpretations of human functioning. We explore the potentials of a participationist framework for understanding the role of the teacher for emerging classroom ...... potential and sheds light on the dynamic relationships between the teacher’s engagement in the practices of the mathematics classroom and other, personally significant, past and present ones.......Research on teachers’ knowledge and beliefs has grown big in recent years. The larger parts of these fields are built on acquisitionist interpretations of human functioning. We explore the potentials of a participationist framework for understanding the role of the teacher for emerging classroom...... practices. The framework is built on social practice theory and symbolic interactionism and adopts a processual approach to understanding the role of the teacher. We use the framework in a qualitative study of two teachers with different prior experiences. The study suggests that the framework has some...

  5. High speed rail trends, technologies and operational patterns: a comparison of established and emerging networks

    Directory of Open Access Journals (Sweden)

    Roberto PALACIN

    2014-10-01

    Full Text Available This paper is set within the framework of the RailNewcastle Summer School program 2014 run by Newcastle University (UK. It presents a short history of high speed rail describing its main design and operational characteristics. The focus of the paper is on assessing the two key distinct models emerging from this trend: the Japanese or Shinkansen model and the French or TGV model. The study then applies these two models to an emerging high speed network such as the planned corridors in California (U.S. to assess the extent of applicability and suitability of applying established high speed models to the Californian network. The results suggest that a suitable possibility would be to apply the French model for the operational aspects given the similarities in terms of geography, population distribution and distance. Implementing the lessons learned from the Japanese model in terms of construction and infrastructure design would be more suitable given the striking similarities in geological characteristics linked to the latent earthquake threat.

  6. Risk for physical restraint or seclusion in the psychiatric emergency service (PES).

    Science.gov (United States)

    Simpson, Scott A; Joesch, Jutta M; West, Imara I; Pasic, Jagoda

    2014-01-01

    We describe risk factors associated with patients experiencing physical restraint or seclusion in the psychiatric emergency service (PES). We retrospectively reviewed medical records, nursing logs and quality assurance data for all adult patient encounters in a PES over a 12-month period (June 1, 2011-May 31, 2012). Descriptors included demographic characteristics, diagnoses, laboratory values, and clinician ratings of symptom severity. χ(2) and multivariate logistic regression analyses were performed. Restraint/seclusion occurred in 14% of 5335 patient encounters. The following characteristics were associated with restraint/seclusion: arrival to the PES in restraints; referral not initiated by the patient; arrival between 1900 and 0059 hours; bipolar mania or mixed episode; and clinician rating of severe disruptiveness, psychosis or insight impairment. Severe suicidality and a depression diagnosis were associated with less risk of restraint or seclusion. Acute symptomatology and characteristics of the encounter were more likely to be associated with restraint/seclusion than patient demographics or diagnoses. These findings support recent guidelines for the treatment of agitation and can help clinicians identify patients at risk of behavioral decompensation. © 2014.

  7. Estimating the risk of re-emergence after stopping polio vaccination

    Directory of Open Access Journals (Sweden)

    Akira eSasaki

    2012-05-01

    Full Text Available Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactive polio vaccine (IPV is extensively used after the termination of live vaccination.

  8. Artificial Neural Networks and risk stratification models in Emergency Departments: The policy maker's perspective.

    Science.gov (United States)

    Casagranda, Ivo; Costantino, Giorgio; Falavigna, Greta; Furlan, Raffaello; Ippoliti, Roberto

    2016-01-01

    The primary goal of Emergency Department (ED) physicians is to discriminate between individuals at low risk, who can be safely discharged, and patients at high risk, who require prompt hospitalization. The problem of correctly classifying patients is an issue involving not only clinical but also managerial aspects, since reducing the rate of admission of patients to EDs could dramatically cut costs. Nevertheless, a trade-off might arise due to the need to find a balance between economic interests and the health conditions of patients. This work considers patients in EDs after a syncope event and presents a comparative analysis between two models: a multivariate logistic regression model, as proposed by the scientific community to stratify the expected risk of severe outcomes in the short and long run, and Artificial Neural Networks (ANNs), an innovative model. The analysis highlights differences in correct classification of severe outcomes at 10 days (98.30% vs. 94.07%) and 1 year (97.67% vs. 96.40%), pointing to the superiority of Neural Networks. According to the results, there is also a significant superiority of ANNs in terms of false negatives both at 10 days (3.70% vs. 5.93%) and at 1 year (2.33% vs. 10.07%). However, considering the false positives, the adoption of ANNs would cause an increase in hospital costs, highlighting the potential trade-off which policy makers might face.

  9. Floods and climate: emerging perspectives for flood risk assessment and management

    Directory of Open Access Journals (Sweden)

    B. Merz

    2014-02-01

    Full Text Available Flood estimation and flood management have traditionally been the domain of hydrologists, water resources engineers and statisticians, and disciplinary approaches have abound. Dominant views have been shaped; one example is the catchment perspective: floods are formed and influenced by the interaction of local, catchment-specific characteristics, such as meteorology, topography and geology. These traditional views have been beneficial, but they have a narrow framing. In this paper we contrast traditional views with broader perspectives that are emerging from an improved understanding of the climatic context of floods. We conclude: (1 extending the traditional system boundaries (local catchment, recent decades, hydrological/hydraulic processes opens up exciting possibilities for better understanding and improved tools for flood risk assessment and management. (2 Statistical approaches in flood estimation need to be complemented by the search for the causal mechanisms and dominant processes in the atmosphere, catchment and river system that leave their fingerprints on flood characteristic. (3 Natural climate variability leads to time-varying flood characteristics, and this variation may be partially quantifiable and predictable, with the perspective of a dynamic, climate informed flood risk management. (4 Efforts are needed to fully account for factors that contribute to changes in all three risk components (hazard, exposure, vulnerability, and to better understand the interactions between society and floods. (5 Given the global scale and societal importance, we call for the organization of an international multidisciplinary collaboration and data sharing initiative to understand further the links between climate and flooding and to advance flood research.

  10. Metabolic risk factors in pediatric stone formers: a report from an emerging economy.

    Science.gov (United States)

    Imran, Kiran; Zafar, Mirza Naqi; Ozair, Uzma; Khan, Sadia; Rizvi, Syed Adibul Hasan

    2016-10-15

    The goal of this study was to investigate metabolic risk factors in pediatric stone formers in an emerging economy. A prospective, data collection enrolled 250 children age family history of urolithiasis was found in 41 (16.4 %), urinary tract infection in 18 (7 %) and chronic diarrhea in 75 (30 %). Hypercalcemia was seen in 37 (14.8 %), hyperuricemia in 23 (9.2 %) and hyperphosphatemia in 6 (2.4 %). Urinary metabolic abnormalities were identified in 248 (98 %) of the cases. Hypocitraturia was found in 207 (82.8 %), hyperoxaluria in 62 (26.4 %), hyperuricosuria in 82 (32.8 %), hypercalciuria in 51 (20.4 %), hyperphosphaturia in 46 (18.4 %), hyperammonuria in 10 (4 %), hypocalciuria in 82 (32.8 %), and hypovolemia in 73 (29.2 %). Risk factors were similar between genders except higher rates of hyponatriuria, hypophosphaturia, and hypocalciuria in females. Hyperuricosuria, hyponatriuria, and hypovolemia were highest in 1-5 years (52, 49, 49 %) as compared to (18, 21, 12 %) those in 11-15 years (p < 0.001), respectively. This study shows that careful metabolic analysis can identify risk factors in 98 % of the children where appropriate metaphylaxis can be undertaken both for treatment and prevention of recurrence.

  11. Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

    Directory of Open Access Journals (Sweden)

    Evandro Fornias Sperandio

    2016-02-01

    Full Text Available Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL, as well as with cardiovascular disease (CVD risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness, the following variables retained significance (OR; 95% CI as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8, smoking (11.6; 1.56-87.5, physical inactivity (8.1; 1.43-46.4, larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71; and dyslipidemia (1.89; 1.12-1.98. Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies.

  12. Understanding Emergent Dynamics: Using a Collective Activity Coordinate of a Neural Network to Recognize Time-Varying Patterns.

    Science.gov (United States)

    Hopfield, John J

    2015-10-01

    In higher animals, complex and robust behaviors are produced by the microscopic details of large structured ensembles of neurons. I describe how the emergent computational dynamics of a biologically based neural network generates a robust natural solution to the problem of categorizing time-varying stimulus patterns such as spoken words or animal stereotypical behaviors. The recognition of these patterns is made difficult by their substantial variation in cadence and duration. The neural circuit behaviors used are similar to those associated with brain neural integrators. In the larger context described here, this kind of circuit becomes a building block of an entirely different computational algorithm for solving complex problems. While the network behavior is simulated in detail, a collective view is essential to understanding the results. A closed equation of motion for the collective variable describes an algorithm that quantitatively accounts for many aspects of the emergent network computation. The feedback connections and ongoing activity in the network shape the collective dynamics onto a reduced dimensionality manifold of activity space, which defines the algorithm and computation actually performed. The external inputs are weak and are not the dominant drivers of network activity.

  13. Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study.

    Science.gov (United States)

    de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

    2016-03-01

    Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. The risk factors and pattern of cerebral microbleeds in Parkinson's disease.

    Science.gov (United States)

    He, Dian; Liu, Chun-Feng; Chu, Lan; Li, Ya; Xu, Da-Fei; Jiao, Ling

    2017-10-01

    Cerebral microbleeds (CMBs) in Parkinson's disease (PD) have been reported recently and concerned increasingly. Our aim was to investigate the risk factors and pattern of CMBs in patients with PD, as well as the influence of risk factors on the pattern of CMBs. We retrospectively collected medical and imaging data of 247 patients who underwent brain susceptibility-weighted imaging. Logistic regression analyses were performed to determine the risk factors of CMBs. The frequency and amount of CMBs in different locations between patients with and without risk factors were analyzed. Of the 247 patients with PD, 39 (15.79%) had CMBs, 27 (69.23%) had lobar CMBs, 20 (51.28%) had deep CMBs and 17 (43.59%) had infratentorial CMBs. A history of cerebral ischemic events was independently associated with the presence of CMBs (odds ratio (OR) 4.485 [95% CI 2.150-9.356]; p = 0.000), especially with lobar and deep CMBs. Hypertension and Hoehn and Yahr score were also associated with the presence of deep CMBs. Only white matter hyperintensities were independently associated with the presence of infratentorial CMBs. Compared to patients without risk factors, the frequency of deep CMBs was greater in those with a history of cerebral ischemic events (p = 0.013), while the amount of deep CMBs was higher in those with hypertension (p = 0.035). CMBs in PD seem to present a lobe-dominant pattern. A history of cerebral ischemic events and hypertension may be two strong risk factors which preferentially influences the pattern of deep CMBs in PD.

  15. Late Language Emergence in 24-Month-Old Twins: Heritable and Increased Risk for Late Language Emergence in Twins

    Science.gov (United States)

    Rice, Mabel L.; Zubrick, Stephen R.; Taylor, Catherine L.; Gayán, Javier; Bontempo, Daniel E.

    2014-01-01

    Purpose: This study investigated the etiology of late language emergence (LLE) in 24-month-old twins, considering possible twinning, zygosity, gender, and heritability effects for vocabulary and grammar phenotypes. Method: A population-based sample of 473 twin pairs participated. Multilevel modeling estimated means and variances of vocabulary and…

  16. On the emergence of natural singularities and state transitions in living patterns

    CERN Document Server

    Dobay, Akos

    2014-01-01

    As far as human perceptions and rational thinking are concerned, contradictions constitute a non negligible part of our reality. We often refer to these phenomena, in a more informal way, as the chicken or the egg causality dilemma. However, it is not clear whether the chicken or the egg dilemma exists only within the scope of our perceptions, or contradictions have a deeper meaning towards our understanding of reality. Here we argue that if there is an element of reality such that can be adequately described in terms of the chicken or the egg dilemma, then it might lead to a spontaneous symmetry breaking by creating an alternate entity, capable of ultimately separating the chicken from the egg. We propose a formalism to describe such mechanism and discuss how it can be applied to phenomena to describe the natural emergence of singularities and state transitions in living systems.

  17. Longitudinal patterns of emerging literacy in beginning deaf and hearing readers.

    Science.gov (United States)

    Kyle, Fiona E; Harris, Margaret

    2011-01-01

    The emerging reading and spelling abilities of 24 deaf and 23 hearing beginning readers were followed over 2 years. The deaf children varied in their language backgrounds and preferred mode of communication. All children were given a range of literacy, cognitive and language-based tasks every 12 months. Deaf and hearing children made similar progress in literacy in the beginning stages of reading development and then their trajectories began to diverge. The longitudinal correlates of beginning reading in the deaf children were earlier vocabulary, letter-sound knowledge, and speechreading. Earlier phonological awareness was not a longitudinal correlate of reading ability once earlier reading levels were controlled. Only letter name knowledge was longitudinally related to spelling ability. Speechreading was also a strong longitudinal correlate of reading and spelling in the hearing children. The findings suggested that deaf and hearing children utilize slightly different reading strategies over the first 2 years of schooling.

  18. Analysis of sex-specific injury patterns and risk factors in young high-level athletes.

    Science.gov (United States)

    Frisch, A; Seil, R; Urhausen, A; Croisier, J L; Lair, M L; Theisen, D

    2009-12-01

    This study analyzed sex-specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand-Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self-administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete-hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex-related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex-specific injury patterns and risk factors could be of importance for effective injury prevention.

  19. Cricket fast bowling workload patterns as risk factors for tendon, muscle, bone and joint injuries.

    Science.gov (United States)

    Orchard, John W; Blanch, Peter; Paoloni, Justin; Kountouris, Alex; Sims, Kevin; Orchard, Jessica J; Brukner, Peter

    2015-08-01

    To assess workload-related risk factors for injuries to particular tissue types in cricket fast bowlers. 235 fast bowlers who bowled in 14600 player innings over a period of 15 years were followed in a prospective cohort risk factor study to compare overs bowled in each match (including preceding workload patterns) and injury risk in the 3-4 weeks subsequent to the match. Injuries were categorised according to the affected tissue type as either: bone stress, tendon injuries, muscle strain or joint injuries. Workload risk factors were examined using binomial logistic regression multivariate analysis, with a forward stepwise procedure requiring a significance of injuries, but high medium term (3-month workload) was protective. For bone stress injuries, high medium term workload and low career workload were risk factors. For joint injuries, high previous season and career workload were risk factors. There was little relationship between muscle injury and workload although high previous season workload was slightly protective. The level of injury risk for some tissue types varies in response to preceding fast bowling workload, with tendon injuries most affected by workload patterns. Workload planning may need to be individualised, depending on individual susceptibility to various injury types. This study supports the theory that tendons are at lowest risk with consistent workloads and susceptible to injury with sudden upgrades in workload. Gradual upgrades are recommended, particularly at the start of a bowler's career to reduce the risk of bone stress injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Assessment and risk classification protocol for patients in emergency units1

    Science.gov (United States)

    Silva, Michele de Freitas Neves; Oliveira, Gabriela Novelli; Pergola-Marconato, Aline Maino; Marconato, Rafael Silva; Bargas, Eliete Boaventura; Araujo, Izilda Esmenia Muglia

    2014-01-01

    Objective to develop, validate the contents and verify the reliability of a risk classification protocol for an Emergency Unit. Method the content validation was developed in a University Hospital in a country town located in the state of Sao Paulo and was carried out in two stages: the first with the individual assessment of specialists and the second with the meeting between the researchers and the specialists. The use of the protocol followed a specific guide. Concerning reliability, the concordance or equivalent method among observers was used. Results the protocol developed showed to have content validity and, after the suggested changes were made, there were excellent results concerning reliability. Conclusion the assistance flow chart was shown to be easy to use, and facilitate the search for the complaint in each assistance priority. PMID:26107828

  1. Passing crisis and emergency risk communications: the effects of communication channel, information type, and repetition.

    Science.gov (United States)

    Edworthy, Judy; Hellier, Elizabeth; Newbold, Lex; Titchener, Kirsteen

    2015-05-01

    Three experiments explore several factors which influence information transmission when warning messages are passed from person to person. In Experiment 1, messages were passed down chains of participants using five different modes of communication. Written communication channels resulted in more accurate message transmission than verbal. In addition, some elements of the message endured further down the chain than others. Experiment 2 largely replicated these effects and also demonstrated that simple repetition of a message eliminated differences between written and spoken communication. In a final field experiment, chains of participants passed information however they wanted to, with the proviso that half of the chains could not use telephones. Here, the lack of ability to use a telephone did not affect accuracy, but did slow down the speed of transmission from the recipient of the message to the last person in the chain. Implications of the findings for crisis and emergency risk communication are discussed.

  2. The association between food patterns and adiposity among Canadian children at risk of overweight.

    Science.gov (United States)

    Shang, Lei; O'Loughlin, Jennifer; Tremblay, Angelo; Gray-Donald, Katherine

    2014-02-01

    Identifying food patterns related to obesity can provide information for health promotion in nutrition. Food patterns and their relation with obesity among Canadian children have not been reported to date. Our aim was to identify and describe food patterns associated with obesity in children at risk of overweight. Caucasian children (n = 630) with at least 1 obese biological parent recruited into the Quebec Adiposity and Lifestyle Investigation in Youth (QUALITY) cohort were studied in cross-sectional analyses. Measures of adiposity (body mass index (BMI), waist circumference, body fat mass percentage measured by dual-energy X-ray absorptiometry), screen time, physical activity (accelerometer over 7 days), and dietary intake (three 24-h food recalls) were collected. Factor analysis was used to identify food patterns. The relationships between food patterns and overweight were investigated in logistic and multiple linear regression models. Three food patterns were retained for analysis: traditional food (red meats, main dishes-soups, high-fat dairy products, tomato products, dressings, etc.); healthy food (low-fat dairy products, whole grains, legumes-nuts-seeds, fruits, vegetables); and fast food (sugar-sweetened beverages, fried potatoes, fried chicken, hamburgers-hot dogs-pizza, salty snacks). Higher scores on the fast food pattern were associated with overweight (BMI ≥ 85th percentile), and other measures of adiposity (BMI, waist circumference, body fat mass percentage) after adjustment for age, sex, physical activity, screen time, sleep time, family income, and mother's obesity (p obesity in children.

  3. A Clinicopathologic Correlation of Mammographic Parenchymal Patterns and Associated Risk Factors for Human Mammary Carcinoma

    Science.gov (United States)

    Bland, Kirby I.; Kuhns, James G.; Buchanan, Jerry B.; Dwyer, Patricia A.; Heuser, Louis F.; O'Connor, Carol A.; Gray, Laman A.; Polk, Hiram C.

    1982-01-01

    The five-year screening experience for 10,131 asymptomatic women evaluated at the Louisville Breast Cancer Detection Demonstration Project (LBCDDP) disclosed 144 breast carcinomas in 1,209 patients (12%) aged 35 to 74 years in whom 904 biopsies and 305 aspirations were performed. This study included 44,711 high-quality xeromammograms (XM) prospectively classified by the modified Wolfe mammographic parenchymal patterns into low-risk (N1, P1) versus high-risk (P2, DY) groups, with expansion of the P2 cohort into three additional categories. Using BMDP computer-program analysis, each XM pattern was collated with 21 nonneoplastic and 18 malignant pathologic variables and commonly associated risk factors. A separate analysis of epithelial proliferative and nonproliferative fibrocystic disease of the breast (FCDB) was performed. The histopathology for each biopsy, with distinction of FCDB and neoplasms, was analyzed with regard to the statistical probability of influencing the XM pattern. An average of 1.05 biopsies per patient were performed in women with findings suggestive of carcinoma at clinical and/or XM examinations. An equal distribution of the N1, P1, and P2 DYXM patterns was observed in the 10,131 screenees. Of 8.5% of the screened population having biopsies, 623 were observed to have nonproliferative FCDB and 137, proliferative FCDB. For women 50 years of age or younger, these pathologic variables were seen more frequently in the P2 DY patterns (p < 0.001), whereas no difference in XM pattern distribution was observed for the screenee 50 years of age or older for proliferative FCDB (p = 0.65). Sixteen percent of the biopsied/aspirated lesions were carcinomas, yielding a biopsy/cancer ratio of 6.25:1. These in situ and invasive neoplasms were more commonly (p < 0.04) observed in 55% of the P2 (P2f, P2n, P2c) categories, while 64% of all cancers appeared more frequently in the P2 DY subgroup (p <0.001), compared with this pattern in the screened population. An

  4. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Groen, Aard J.; Sijde, van der Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies an

  5. The Risk of Treatment-Emergent Mania With Methylphenidate in Bipolar Disorder.

    Science.gov (United States)

    Viktorin, Alexander; Rydén, Eleonore; Thase, Michael E; Chang, Zheng; Lundholm, Cecilia; D'Onofrio, Brian M; Almqvist, Catarina; Magnusson, Patrik K E; Lichtenstein, Paul; Larsson, Henrik; Landén, Mikael

    2017-04-01

    The authors sought to determine the risk of treatment-emergent mania associated with methylphenidate, used in monotherapy or with a concomitant mood-stabilizing medication, in patients with bipolar disorder. Using linked Swedish national registries, the authors identified 2,307 adults with bipolar disorder who initiated therapy with methylphenidate between 2006 and 2014. The cohort was divided into two groups: those with and those without concomitant mood-stabilizing treatment. To adjust for individual-specific confounders, including disorder severity, genetic makeup, and early environmental factors, Cox regression analyses were used, conditioning on individual to compare the rate of mania (defined as hospitalization for mania or a new dispensation of stabilizing medication) 0-3 months and 3-6 months after medication start following nontreated periods. Patients on methylphenidate monotherapy displayed an increased rate of manic episodes within 3 months of medication initiation (hazard ratio=6.7, 95% CI=2.0-22.4), with similar results for the subsequent 3 months. By contrast, for patients taking mood stabilizers, the risk of mania was lower after starting methylphenidate (hazard ratio=0.6, 95% CI=0.4-0.9). Comparable results were observed when only hospitalizations for mania were counted. No evidence was found for a positive association between methylphenidate and treatment-emergent mania among patients with bipolar disorder who were concomitantly receiving a mood-stabilizing medication. This is clinically important given that up to 20% of people with bipolar disorder suffer from comorbid ADHD. Given the markedly increased hazard ratio of mania following methylphenidate initiation in bipolar patients not taking mood stabilizers, careful assessment to rule out bipolar disorder is indicated before initiating monotherapy with psychostimulants.

  6. The financial management of catastrophic flood risks in emerging-economy countries.

    Science.gov (United States)

    Kunreuther, Howard C; Linnerooth-Bayer, Joanne

    2003-06-01

    This article examines the potential of pre- and post-disaster instruments for funding disaster response and recovery and for creating incentives for flood loss mitigation in countries with emerging or transition economies. As a concrete case, we discuss the disaster recovery arrangements following the 1997 flood disaster in Poland. We examine the advantages and limitations of hedging instruments, which are instruments for transferring the risk to investors either through insurance or capital market-based securities. We compare these mechanisms with financing instruments whereby the government sets aside funds prior to a disaster or taps its own funding sources after the event occurs. We show how hedging instruments can be designed to create incentives for the mitigation of damage to public infrastructure using the flood proofing of a water-treatment plant on the hypothetical Topping River as an illustrative example. We conclude that hedging instruments can be an attractive alternative to financing instruments that have been traditionally used in the poorer, emerging-economy countries to fund disaster recovery. Since very poor countries are likely to have difficulty paying the price of protection prior to a disaster, we suggest that international lending institutions consider innovations for subsidizing these payments.

  7. POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

    Science.gov (United States)

    Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

    Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

  8. How agricultural management shapes soil microbial communities: patterns emerging from genetic and genomic studies

    Science.gov (United States)

    Daly, Amanda; Grandy, A. Stuart

    2016-04-01

    Agriculture is a predominant land use and thus a large influence on global carbon (C) and nitrogen (N) balances, climate, and human health. If we are to produce food, fiber, and fuel sustainably we must maximize agricultural yield while minimizing negative environmental consequences, goals towards which we have made great strides through agronomic advances. However, most agronomic strategies have been designed with a view of soil as a black box, largely ignoring the way management is mediated by soil biota. Because soil microbes play a central role in many of the processes that deliver nutrients to crops and support their health and productivity, agricultural management strategies targeted to exploit or support microbial activity should deliver additional benefits. To do this we must determine how microbial community structure and function are shaped by agricultural practices, but until recently our characterizations of soil microbial communities in agricultural soils have been largely limited to broad taxonomic classes due to methodological constraints. With advances in high-throughput genetic and genomic sequencing techniques, better taxonomic resolution now enables us to determine how agricultural management affects specific microbes and, in turn, nutrient cycling outcomes. Here we unite findings from published research that includes genetic or genomic data about microbial community structure (e.g. 454, Illumina, clone libraries, qPCR) in soils under agricultural management regimes that differ in type and extent of tillage, cropping selections and rotations, inclusion of cover crops, organic amendments, and/or synthetic fertilizer application. We delineate patterns linking agricultural management to microbial diversity, biomass, C- and N-content, and abundance of microbial taxa; furthermore, where available, we compare patterns in microbial communities to patterns in soil extracellular enzyme activities, catabolic profiles, inorganic nitrogen pools, and nitrogen

  9. Pre-college matriculation risk profiles and alcohol consumption patterns during the first semesters of college.

    Science.gov (United States)

    Stapleton, Jerod L; Turrisi, Rob; Cleveland, Michael J; Ray, Anne E; Lu, Shou-En

    2014-10-01

    Excessive alcohol consumption represents a significant concern on U.S. college campuses, and there is a need to identify students who may be at risk for engaging in risky alcohol use. The current study examined how variables measured prior to college matriculation, specifically alcohol-related decision-making variables drawn from the Theory of Reasoned Action (i.e., alcohol expectancies, attitudes, and normative beliefs), were associated with patterns of alcohol use prior to and throughout the first semesters of college. Participants were 392 undergraduate students (56% female) from a large Northeastern U.S. university. Decision-making variables were assessed prior to college matriculation, and alcohol use was measured with five assessments before and throughout freshman and sophomore semesters. Latent profile analysis was used to identify types of students with distinct patterns of decision-making variables. These decision-making profiles were subsequently linked to distinct patterns of alcohol use using latent transition analysis. Four distinct decision-making profiles were found and were labeled "Anti-Drinking," "Unfavorable," "Mixed," and "Risky." Five drinking patterns were observed and included participants who reported consistently low, moderate, or high rates of alcohol use. Two patterns described low or non-drinking at the pre-college baseline with drinking escalation during the measurement period. Students' likelihood of following the various drinking patterns varied according to their decision-making. Findings suggest the early identification of at-risk students may be improved by assessing decision-making variables in addition to alcohol use. The findings also have implications for the design of early identification assessments to identify at-risk college students and for the targeting of alcohol prevention efforts to students based on their alcohol-related attitudes and beliefs.

  10. Male pattern baldness and risk of incident skin cancer in a cohort of men.

    Science.gov (United States)

    Li, Wen-Qing; Cho, Eunyoung; Han, Jiali; Weinstock, Martin A; Qureshi, Abrar A

    2016-12-15

    We examined the association between male-pattern baldness and risk of incident skin cancer, including invasive melanoma, invasive squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) in a prospective analysis, based on 36,032 participants from the Health Professionals' Follow-up Study. In 1992, participants reported their status of male-pattern baldness at age 45 years by choosing from five crown-view pictograms based on Norwood's classification. Diagnosis of skin cancers was reported biennially and information on melanoma and SCC was pathologically confirmed. We identified 327 melanoma cases, 1324 SCC cases, and 8438 BCC cases during the follow-up. Male-pattern baldness was not significantly associated with risk of incident melanoma, but was significantly associated with increased risk of SCC and BCC. The multivariate-adjusted hazard ratio (HR) (95% confidence interval, CI) for the highest category of baldness (frontal plus severe vertex baldness) was 1.33 (1.06-1.68) for SCC (ptrend  = 0.001) and 1.23 (1.12-1.35) for BCC (ptrend  baldness. Analyses by body sites found significant associations between frontal plus moderate to severe vertex baldness and risk of melanoma (HR = 1.83, 95% CI: 1.01-3.34) and SCC (HR = 1.30, 95% CI: 1.02-1.66) at head and neck. The associations were particularly stronger for scalp melanoma (HR = 7.15, 95% CI: 1.29-39.42) and scalp SCC (HR = 7.09, 95% CI: 3.84-13.08), but not for non-scalp head and neck sites. Information on body sites was not available for BCC. In conclusion, male pattern baldness may be associated with increased risk of skin cancer, but the associations may only exist for those occurring at head and neck, particularly at scalp.

  11. Emergent Central Pattern Generator Behavior in Gap-Junction-Coupled Hodgkin-Huxley Style Neuron Model

    Directory of Open Access Journals (Sweden)

    Kyle G. Horn

    2012-01-01

    Full Text Available Most models of central pattern generators (CPGs involve two distinct nuclei mutually inhibiting one another via synapses. Here, we present a single-nucleus model of biologically realistic Hodgkin-Huxley neurons with random gap junction coupling. Despite no explicit division of neurons into two groups, we observe a spontaneous division of neurons into two distinct firing groups. In addition, we also demonstrate this phenomenon in a simplified version of the model, highlighting the importance of afterhyperpolarization currents ( to CPGs utilizing gap junction coupling. The properties of these CPGs also appear sensitive to gap junction conductance, probability of gap junction coupling between cells, topology of gap junction coupling, and, to a lesser extent, input current into our simulated nucleus.

  12. Soil nutrients affect spatial patterns of aboveground biomass and emergent tree density in southwestern Borneo.

    Science.gov (United States)

    Paoli, Gary D; Curran, Lisa M; Slik, J W F

    2008-03-01

    Studies on the relationship between soil fertility and aboveground biomass in lowland tropical forests have yielded conflicting results, reporting positive, negative and no effect of soil nutrients on aboveground biomass. Here, we quantify the impact of soil variation on the stand structure of mature Bornean forest throughout a lowland watershed (8-196 m a.s.l.) with uniform climate and heterogeneous soils. Categorical and bivariate methods were used to quantify the effects of (1) parent material differing in nutrient content (alluvium > sedimentary > granite) and (2) 27 soil parameters on tree density, size distribution, basal area and aboveground biomass. Trees > or =10 cm (diameter at breast height, dbh) were enumerated in 30 (0.16 ha) plots (sample area = 4.8 ha). Six soil samples (0-20 cm) per plot were analyzed for physiochemical properties. Aboveground biomass was estimated using allometric equations. Across all plots, stem density averaged 521 +/- 13 stems ha(-1), basal area 39.6 +/- 1.4 m(2) ha(-1) and aboveground biomass 518 +/- 28 Mg ha(-1) (mean +/- SE). Adjusted forest-wide aboveground biomass to account for apparent overestimation of large tree density (based on 69 0.3-ha transects; sample area = 20.7 ha) was 430 +/- 25 Mg ha(-1). Stand structure did not vary significantly among substrates, but it did show a clear trend toward larger stature on nutrient-rich alluvium, with a higher density and larger maximum size of emergent trees. Across all plots, surface soil phosphorus (P), potassium, magnesium and percentage sand content were significantly related to stem density and/or aboveground biomass (R (Pearson) = 0.368-0.416). In multiple linear regression, extractable P and percentage sand combined explained 31% of the aboveground biomass variance. Regression analyses on size classes showed that the abundance of emergent trees >120 cm dbh was positively related to soil P and exchangeable bases, whereas trees 60-90 cm dbh were negatively related to these

  13. Emergent patterns of population genetic structure for a coral reef community.

    Science.gov (United States)

    Selkoe, Kimberly A; Gaggiotti, Oscar E; Bowen, Brian W; Toonen, Robert J

    2014-06-01

    What shapes variation in genetic structure within a community of codistributed species is a central but difficult question for the field of population genetics. With a focus on the isolated coral reef ecosystem of the Hawaiian Archipelago, we assessed how life history traits influence population genetic structure for 35 reef animals. Despite the archipelago's stepping stone configuration, isolation by distance was the least common type of genetic structure, detected in four species. Regional structuring (i.e. division of sites into genetically and spatially distinct regions) was most common, detected in 20 species and nearly in all endemics and habitat specialists. Seven species displayed chaotic (spatially unordered) structuring, and all were nonendemic generalist species. Chaotic structure also associated with relatively high global FST. Pelagic larval duration (PLD) was not a strong predictor of variation in population structure (R2=0.22), but accounting for higher FST values of chaotic and invertebrate species, compared to regionally structured and fish species, doubled the power of PLD to explain variation in global FST (adjusted R2=0.50). Multivariate correlation of eight species traits to six genetic traits highlighted dispersal ability, taxonomy (i.e. fish vs. invertebrate) and habitat specialization as strongest influences on genetics, but otherwise left much variation in genetic traits unexplained. Considering that the study design controlled for many sampling and geographical factors, the extreme interspecific variation in spatial genetic patterns observed for Hawaìi marine species may be generated by demographic variability due to species-specific abundance and migration patterns and/or seascape and historical factors.

  14. Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions.

    Science.gov (United States)

    Haji Aghajani, Mohammad; Haddadi, Mashyaneh; Saadat, Soheil

    2017-01-01

    Globally, it is estimated that around 5.8 million people die annually as result of injuries, which causes 10% of all deaths and 16% of disability adjusted life years lost worldwide. This study aimed to determine the epidemiology of injuries in emergency departments in Iran. This cross sectional study was carried out using national injury surveillance data registry from 21 March 2009 to 20 March 2014. 7,176,344 patients with the mean age of 27.5 ± 17.8 years were registered to 657 EDs (70.6% male). Road Traffic Crash (RTC) was the most common cause of injury (31.0%) followed by hit (28.2%) and fall (10.1%). While roads were the commonest place of injuries, 34.0% of patients have been injured at home. More than 90% of injuries were unintentional. Assault and suicide attempt were causes of injury in 5.6% and 3.9% of patients, respectively. This paper addresses where prevention measures are most urgently needed and offers insights which could be useful for injury prevention programs in Iran and other developing countries.

  15. Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions

    Directory of Open Access Journals (Sweden)

    Mohammad Haji Aghajani

    2017-01-01

    Full Text Available Introduction: Globally, it is estimated that around 5.8 million people die annually as result of injuries, which causes 10% of all deaths and 16% of disability adjusted life years lost worldwide. This study aimed to determine the epidemiology of injuries in emergency departments in Iran.Method: This cross sectional study was carried out using national injury surveillance data registry from 21 March 2009 to 20 March 2014.Results: 7,176,344 patients with the mean age of 27.5 ± 17.8 years were registered to 657 EDs (70.6% male. Road Traffic Crash (RTC was the most common cause of injury (31.0% followed by hit (28.2% and fall (10.1%. While roads were the commonest place of injuries, 34.0% of patients have been injured at home. More than 90% of injuries were unintentional. Assault and suicide attempt were causes of injury in 5.6% and 3.9% of patients, respectively.Conclusion:This paper addresses where prevention measures are most urgently needed and offers insights which could be useful for injury prevention programs in Iran and other developing countries.

  16. Patterns of New Physical Problems Emerging in Long-Term Care Residents With Dementia.

    Science.gov (United States)

    Kovach, Christine R; Ellis, Julie; Evans, Crystal-Rae

    2017-04-11

    Individuals receiving skilled nursing care have multiple comorbid conditions that impact comfort and resource use. The current study describes variations in the trajectories of new physical problems emerging over 8 weeks and the predictive value for future health and behavior in a sample of 72 residents with dementia. Residents had two to 37 new physical problems occurring over 8 weeks. Sixty-five percent of the sample had five or more new problems and were identified by three unstable trajectories. Common problems, illnesses, and symptoms accounted for 28.2% of the variance in subsequent new physical problems (p < 0.001) and 25.7% of the variance in subsequent agitation (p < 0.001). This study found more new problems than earlier studies that only examined new acute illness. Findings suggest a higher intensity of need for skilled assessment and treatment than may be available in many long-term care organizations. [Journal of Gerontological Nursing, xx(x), xx-xx.]. Copyright 2017, SLACK Incorporated.

  17. Intrinsic and synaptic dynamics interact to generate emergent patterns of rhythmic bursting in thalamocortical neurons.

    Science.gov (United States)

    Sohal, Vikaas S; Pangratz-Fuehrer, Susanne; Rudolph, Uwe; Huguenard, John R

    2006-04-19

    Rhythmic inhibition entrains the firing of excitatory neurons during oscillations throughout the brain. Previous work has suggested that the strength and duration of inhibitory input determines the synchrony and period, respectively, of these oscillations. In particular, sleep spindles result from a cycle of events including rhythmic inhibition and rebound bursts in thalamocortical (TC) neurons, and slowing and strengthening this inhibitory input may transform spindles into spike-wave discharges characteristic of absence epilepsy. Here, we used dynamic clamp to inject TC neurons with spindle-like trains of IPSCs and studied how modest changes in the amplitude and/or duration of these IPSCs affected the responses of the TC neurons. Contrary to our expectations, we found that prolonging IPSCs accelerates postinhibitory rebound (PIR) in TC neurons, and that increasing either the amplitude or duration of IPSCs desynchronizes PIR activity in a population of TC cells. Tonic injection of hyperpolarizing or depolarizing current dramatically alters the timing and synchrony of PIR. These results demonstrate that rhythmic PIR activity is an emergent property of interactions between intrinsic and synaptic currents, not just a passive reflection of incoming synaptic inhibition.

  18. Contaminants of emerging concern in tributaries to the Laurentian Great Lakes: I. Patterns of occurrence

    Science.gov (United States)

    Elliott, Sarah M.; Brigham, Mark E.; Lee, Kathy E.; Banda, Jo A.; Choy, Steven J.; Gefell, Daniel J.; Minarik, Thomas A.; Moore, Jeremy N.; Jorgenson, Zachary G.

    2017-01-01

    Human activities introduce a variety of chemicals to the Laurentian Great Lakes including pesticides, pharmaceuticals, flame retardants, plasticizers, and solvents (collectively referred to as contaminants of emerging concern or CECs) potentially threatening the vitality of these valuable ecosystems. We conducted a basin-wide study to identify the presence of CECs and other chemicals of interest in 12 U.S. tributaries to the Laurentian Great Lakes during 2013 and 2014. A total of 292 surface-water and 80 sediment samples were collected and analyzed for approximately 200 chemicals. A total of 32 and 28 chemicals were detected in at least 30% of water and sediment samples, respectively. Concentrations ranged from 0.0284 (indole) to 72.2 (cholesterol) μg/L in water and 1.75 (diphenhydramine) to 20,800 μg/kg (fluoranthene) in sediment. Cluster analyses revealed chemicals that frequently co-occurred such as pharmaceuticals and flame retardants at sites receiving similar inputs such as wastewater treatment plant effluent. Comparison of environmental concentrations to water and sediment-quality benchmarks revealed that polycyclic aromatic hydrocarbon concentrations often exceeded benchmarks in both water and sediment. Additionally, bis(2-ethylhexyl) phthalate and dichlorvos concentrations exceeded water-quality benchmarks in several rivers. Results from this study can be used to understand organism exposure, prioritize river basins for future management efforts, and guide detailed assessments of factors influencing transport and fate of CECs in the Great Lakes Basin.

  19. Understanding patterns of use and scientific opportunities in the emerging global microbial commons.

    Science.gov (United States)

    Dijkshoorn, Lenie; De Vos, Paul; Dedeurwaerdere, Tom

    2010-01-01

    Rapidly growing global networking has induced and supported an increased interest in the life sciences in such general issues as health, climate change, food security and biodiversity. Therefore, the need to address and share research data and materials in a systematic way emerged almost simultaneously. This movement has been described as the so-called global research commons. Also in microbiology, where the sharing of microbiological materials is a key issue, microbial commons is attracting attention. Microbiology is currently facing great challenges with the advances of high throughput screening and next-generation whole genome sequencing. Furthermore, the exploration and use of microorganisms in agriculture and food production are increasing so as to safeguard global food and feed production. Further to several meetings on the subject, a special issue of Research in Microbiology is dedicated to Microbial Research Commons with a series of reviews elaborating its major pay-offs and needs in basic and applied microbiology. This paper gives an introduction to these articles covering a range of topics. These include the role of public culture collections and biological resource centers and legal aspects in the exchange of materials, microbial classification, an internet-based platform for data-sharing, applications in agriculture and food production, and challenges in metagenomics and extremophile research. (c) 2010 Elsevier Masson SAS. All rights reserved.

  20. Risks vs benefits of glatiramer acetate: a changing perspective as new therapies emerge for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Kenneth P Johnson

    2010-04-01

    Full Text Available Kenneth P JohnsonMaryland Center for MS, Baltimore, Maryland, USAAbstract: An understanding of the risks, benefits, and relative value of glatiramer acetate (GA in multiple sclerosis (MS has been evolving based on recently completed head-to-head studies: REGARD (REbif vs Glatiramer Acetate in Relapsing MS Disease; BEYOND (Betaseron Efficacy Yielding Outcomes of a New Dose; and BECOME (BEtaseron vs COpaxone in Multiple Sclerosis with Triple-Dose Gadolinium and 3-Tesla MRI Endpoints. Outcomes in the primary endpoints of these trials showed no significant differences between GA and high-dose beta-interferons (IFNβs. Results of the PreCISe (Early GA Treatment in Delaying Conversion to Clinically Definite Multiple Sclerosis [CDMS] in Subjects Presenting With a Clinically Isolated Syndrome [CIS] trial led to the US Food and Drug Administration approval of GA in patients with a CIS. Furthermore, the ongoing follow-up study to the original pivotal GA trial, now extending beyond 15 years, continues to support the safety of GA. Currently, GA and IFNβs are no longer the only immunomodulators available for MS. Introduction of the monoclonal antibody, natalizumab (Tysabri®; Biogen Idec, Inc., Cambridge, MA, USA provides an alternative immunomodulator for MS and has changed the therapeutic landscape dramatically. However, the rare but serious cases of progressive multifocal leukoencephalopathy that have occurred with natalizumab have raised concerns among clinicians and patients about using this agent and some of the emerging agents. The potential risks and benefits of the emerging therapies (cladribine, alemtuzumab, rituximab, fingolimod, laquinimod, teriflunomide, and dimethyl fumarate based on phase II/III trials, as well as their use for indications other than MS, will be presented. This review provides available data on GA, natalizumab, and the emerging agents to support new developments in our understanding of GA and how its long-standing role as a

  1. Current patterns of marijuana use initiation by age among US adolescents and emerging adults: implications for intervention.

    Science.gov (United States)

    Chen, Xinguang; Yu, Bin; Lasopa, Sonam O; Cottler, Linda B

    2017-05-01

    More recent data are required for effective measures to prevent marijuana use among youth in the United States. To investigate the risk of marijuana use onset by age using the most recent data from a national sample. Data for participants (n = 26,659) aged 12-21 years from the 2013 National Survey on Drug Use and Health (NSDUH) (50.4% male, 55.6% White) were analyzed. Patterns of the risk of marijuana use initiation from birth to age of 20 years by single year of age were characterized using hazards survival models. The estimated hazards of marijuana use showed unique age patterns for the overall sample and by gender and racial/ethnic groups. Up to age of 11 years, the hazards of marijuana use initiation were below 0.0500; the hazards after age of 11 years increased rapidly with two peaks at age 16 (0.1291) and 18 years (0.1496), separated by a reduction at age 17 years (0.1112). The age pattern differed significantly by gender (hazards from high to low: male, female) and race/ethnicity (hazards from high to low: multi-racial, Black, White, Hispanic, and Asian). By age of 21 years, 54.1% (56.4% for male and 51.9% for female) had initiated marijuana use with a mean onset age of 16.5 years. This study documented the risk of marijuana use initiation by age. Research findings suggest the timing of marijuana use prevention was no later than middle school. Additional attention is indicated to multi-racial/ethnic youth. Future interventions should be developed for both parents and adolescents, and delivered to the right target population at the right time.

  2. Idiopathic focal eosinophilic enteritis (IFEE, an emerging cause of abdominal pain in horses: the effect of age, time and geographical location on risk.

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    Debra C Archer

    Full Text Available BACKGROUND: Idiopathic focal eosinophilic enteritis (IFEE is an emerging cause of abdominal pain (colic in horses that frequently requires surgical intervention to prevent death. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. The aetiology of this condition and methods of possible prevention are currently unknown. The aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on risk. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective, nested case-control study was undertaken using data from 85 IFEE cases and 848 randomly selected controls admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Generalised additive models (GAMs were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of 'residual' risk over the study region. The relative risk of IFEE increased over the study period (p = 0.001 and a seasonal pattern was evident (p<0.01 with greatest risk of IFEE being identified between the months of July and November. IFEE risk decreased with increasing age (p<0.001 with younger (0-5 years old horses being at greatest risk. The mapped surface estimate exhibited significantly atypical sub-regions (p<0.001 with increased IFEE risk in horses residing in the North-West of the study region. CONCLUSIONS/SIGNIFICANCE: IFEE was found to exhibit both spatial and temporal variation in risk and is more likely to occur in younger horses. This information may help to identify horses at increased risk of IFEE, provide clues about the aetiology of this condition and to identify areas that require further research.

  3. Inheritance pattern of familial hypercholesterolemia and markers of cardiovascular risk[S

    Science.gov (United States)

    Kusters, D. Meeike; Avis, Hans J.; Braamskamp, Marjet J.; Huijgen, Roeland; Wijburg, Frits A.; Kastelein, John J.; Wiegman, Albert; Hutten, Barbara A.

    2013-01-01

    Studies in children and adults have resulted in conflicting evidence in the quest for the answer to the hypothesis that offspring from hypercholesterolemic mothers might have an increased cardiovascular risk. Previous studies might have suffered from limitations such as cohort size and clinical sampling bias. We therefore explored this hypothesis in large cohorts of both subjects with familial hypercholesterolemia (FH) and unaffected siblings in a wide age range. In three cohorts (cohort 1: n = 1,988, aged 0–18 years; cohort 2: n = 300, 8–30 years; cohort 3: n = 369, 18–60 years), we measured lipid and lipoproteins as well as carotid intima-media thickness (c-IMT) in offspring from FH mothers versus FH fathers. For LDL cholesterol, triglycerides (TGs), and c-IMT, we performed a pooled analysis. No significant differences could be observed in c-IMT, lipid, or lipoprotein levels from offspring of FH mothers versus FH fathers. Pooled analyses showed no significant differences for either LDL cholesterol [mean difference 0.02 (−0.06,0.11) mmol/l, P = 0.60], TGs [mean difference 0.07 (0.00,0.14) mmol/l, P = 0.08], or c-IMT [mean difference −0.00 (−0.01,0.01) mm, P = 0.86]. Our data do not support the hypothesis that cardiovascular risk markers are different between offspring from FH mothers and FH fathers. PMID:23833242

  4. Patterns of nonmasslike enhancement at screening breast MR imaging of high-risk premenopausal women.

    Science.gov (United States)

    Giess, Catherine S; Raza, Sughra; Birdwell, Robyn L

    2013-01-01

    Current U.S. recommendations for breast cancer screening of women with at least a 20%-25% lifetime risk of developing breast cancer include contrast material-enhanced magnetic resonance (MR) imaging of the breasts. The cancer detection rate in high-risk women undergoing screening MR imaging is approximately 10 times higher than that in normal-risk women undergoing screening mammography. Many of these high-risk women commence MR imaging screening while they are premenopausal, when the breasts are most influenced by cyclical hormonal changes. Healthy premenopausal breast tissue enhances in a cyclical and variable manner. This enhancement is described as background enhancement. Typically, enhancement of normal breast tissue occurs in a symmetric and diffuse pattern, and there is little diagnostic difficulty in classifying it as normal background parenchymal enhancement. However, sometimes the pattern is more focal, asymmetric, or regional. It may then be described as nonmasslike enhancement, an observation associated with both benign and malignant breast pathologic conditions. A review of the morphologic features and internal enhancement patterns in normal but nondiffuse background enhancement and abnormal nonmasslike enhancement in high-risk premenopausal women can help improve interpretive specificity and decrease false-positive interpretations. MR imaging pitfalls and interpretation strategies for localized background enhancement and pathologic nonmasslike enhancement in this high-risk population are highlighted. In evaluating nonmasslike enhancement, the use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon to perform careful analysis of morphologic features, along with an understanding of the role and limitations of kinetic information, will help balance early breast cancer detection against false-positive interpretation.

  5. Evaluating the components of an emergent literacy intervention for preschool children at risk for reading difficulties

    Science.gov (United States)

    Lonigan, Christopher J.; Purpura, David J.; Wilson, Shauna B.; Walker, Patricia M.; Clancy-Menchetti, Jeanine

    2013-01-01

    Many preschool children are at risk for reading problems because of inadequate emergent literacy skills. Evidence supports the effectiveness of interventions to promote these skills, but questions remain about which intervention components work and whether combining intervention components will result in larger gains. In this study, 324 preschoolers (mean age = 54.32 months, SD = 5.88) from low-income backgrounds (46% girls and 54% boys; 82% African American, 14% White, and 4% other) were randomized to combinations of meaning-focused (dialogic reading or shared reading) and code-focused (phonological awareness, letter knowledge, or both) interventions or a control group. Interventions had statistically significant positive impacts only on measures of their respective skill domains. Combinations of interventions did not enhance outcomes across domains, indicating instructional needs in all areas of weakness for young children at risk for later reading difficulties. Less time for each intervention in the combined phonological awareness and letter knowledge intervention conditions, however, did not result in reduced effects relative to nearly twice as much time for each intervention when children received either only the phonological awareness intervention or only the letter knowledge intervention. This finding suggests that a relatively compact code-focused intervention can address the needs of children with weaknesses in both domains. PMID:23073367

  6. Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Wang; Adrian Barnett; Yu-Ming Guo; Wei-Wei Yu; Xiao-Ming Shen; Shi-Lu Tong

    2014-01-01

    Background: Heatwaves have a significant impact on population health including both morbidity and mortality. In this study we examined the association between heatwaves and emergency hospital admissions (EHAs) for renal diseases in children (aged 0-14 years) in Brisbane, Australia. Methods: Daily data on EHAs for renal diseases in children and exposure to temperature and air pollution were obtained for Brisbane city from January 1, 1996 to December 31, 2005. A time-stratified case-crossover design was used to compare the risks for renal diseases between heatwave and non-heatwave periods. Results: There were 1565 EHAs for renal diseases in children during the study period. Heatwaves exhibited a signifi cant impact on EHAs for renal diseases in children after adjusting for confounding factors (odds ratio: 3.6; 95% confidence interval: 1.4-9.5). The risk estimates differed with lags and the use of different heatwave defi nitions. Conclusions: There was a significant increase in EHAs for renal diseases in children during heatwaves in Brisbane, a subtropical city where people are well accustomed to warm weather. This finding may have significant implications for pediatric renal care, particularly in subtropical and tropical regions.

  7. Is warfarin usage a risk factor for osteoporotic fractures? A cohort study in the emergency department

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    Genady Drozdinsky

    2017-04-01

    Full Text Available Background Several studies have examined the association between warfarin sodium use and risk of osteoporotic fractures with conflicting results. Our study addresses this question, for the first time regarding patients attending emergency department (ED. Aims The aim of this study was to retrospectively detect whether there is higher rate of usage of warfarin sodium in patients with osteoporotic fractures attending an ED. Methods This is a retrospective study from patients' computerized charts. All individuals >65 years old who had an osteoporotic fracture and attended an ED in a tertiary hospital were compared with a similar group of elderly individuals >65 years old without an osteoporotic fracture who attended the ED for a cause other than an osteoporotic fracture. Results This study included 328 patients who were evaluated in the years 2005–2016. Overall, 164 individuals with a typical osteoporotic fracture (hip -66 patients (40 per cent, spine- 92 patients (56 per cent, humerus -4 patients (2 per cent, radius -13 patients (8 per cent were identified and compared with a matched group of elderly individuals who were evaluated in the ED for other complaints. Warfarin sodium was used in 61 individuals (19 per cent in the entire cohort, 34 in the fracture group and 27 in the non-fracture group (p=0.324. Conclusion In elderly patients, attending an ED, warfarin sodium use does not seem to be a risk factor for an osteoporotic fracture

  8. Sedentary behaviour as an emerging risk factor for cardiometabolic diseases in children and youth.

    Science.gov (United States)

    Saunders, Travis J; Chaput, Jean-Philippe; Tremblay, Mark S

    2014-02-01

    Sedentary behaviour (e.g. TV viewing, seated video game playing, prolonged sitting) has recently emerged as a distinct risk factor for cardiometabolic diseases in children and youth. This narrative review provides an overview of recent evidence in this area and highlights research gaps. Current evidence suggests that North American children and youth spend between 40% and 60% of their waking hours engaging in sedentary pursuits. Although data are lacking concerning temporal trends of objectively measured sedentary time, self-reported sedentary behaviours have increased over the past half century, with a rapid increase since the late 1990s. Excessive sedentary behaviour has been found to have independent and deleterious associations with markers of adiposity and cardiometabolic disease risk. These associations are especially consistent for screen-based sedentary behaviours (TV viewing, computer games, etc), with more conflicting findings observed for overall sedentary time. The above associations are possibly mediated by the influence of screen-based sedentary behaviours on energy intake. Although excessive sitting has been reported to have adverse acute and chronic metabolic impacts in adults, research on children is lacking. Research is particularly needed to investigate the impact of characteristics of sedentary behaviour (i.e. type/context, sedentary bout length, breaks in sedentary time, etc), as well as interventions that examine the health and behavioural impacts of sitting per se.

  9. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities.

    Science.gov (United States)

    Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew

    2017-06-01

    Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  10. Risk perception and psychological behavior of investors in emerging market: Indonesian Stock Exchange

    Directory of Open Access Journals (Sweden)

    Yuliani

    2017-08-01

    Full Text Available Capital market functions as a mediator between parties who have excess funds that is, investors and those who need the funds that is, emitents. Decision to sell and buy shares of a financial asset is very strategic decision for investors because it is associated with the chances of return to be earned in the future. The objective of this paper is to investigate the investor’s psychology on buying and selling common stock in the stock exchange in emerging market. The specific purpose of this research is to provide the simultaneous empirical evidence about the perception of risk, psychology aspects towards the confidence and performance. The sample consists of 100 individual investors in Palembang, South Sumatera, Indonesia. The data were collected during March-May 2016 using questionnaire. Research findings show that perception of risk and psychology significantly affect confidence. Furthermore, confidence has a significantly positive impact on performance. This research has not been explained entirely towards the investor’s psychological behavior aspects, so the additional variable may be needed as the full reflection of investor’s psychology. The further research may use experimental study, starts from buying stocks, and factors that can be considered in selling stock.

  11. Emerging contaminants in the environment: Risk-based analysis for better management.

    Science.gov (United States)

    Naidu, Ravi; Arias Espana, Victor Andres; Liu, Yanju; Jit, Joytishna

    2016-07-01

    Emerging contaminants (ECs) are chemicals of a synthetic origin or deriving from a natural source that has recently been discovered and for which environmental or public health risks are yet to be established. This is due to limited available information on their interaction and toxicological impacts on receptors. Several types of ECs exist such as antibiotics, pesticides, pharmaceuticals, personal care products, effluents, certain naturally occurring contaminants and more recently nanomaterials. ECs may derive from a known source, for example released directly to the aquatic environment from direct discharges such as those from wastewater treatment plants. Although in most instances the direct source cannot be identified, ECs have been detected in virtually every country's natural environment and as a consequence they represent a global problem. There is very limited information on the fate and transport of ECs in the environment and their toxicological impact. This lack of information can be attributed to limited financial resources and the lack of analytical techniques for detecting their effects on ecosystems and human health on their own or as mixture. We do not know how ECs interact with each other or various contaminants. This paper presents an overview of existing knowledge on ECs, their fate and transport and a risk-based analysis for ECs management and complementary strategies.

  12. An Online Tool for Nurse Triage to Evaluate Risk for Acute Coronary Syndrome at Emergency Department

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    Yuwares Sittichanbuncha

    2015-01-01

    Full Text Available Background. To differentiate acute coronary syndrome (ACS from other causes in patients presenting with chest pain at the emergency department (ED is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital. Methods. We retrospectively enrolled consecutive patients who were identified as ACS at risk patients by the ED nurse triage. Patients were categorized as ACS and non-ACS group by the final diagnosis. Multivariate logistic analysis was used to predict factors associated with ACS. An online model predictive of ACS for the ED nurse triage was constructed. Results. There were 175 patients who met the study criteria. Of those, 28 patients (16.0% were diagnosed with ACS. Patients with diabetes, patients with previous history of CAD, and those who had at least one character of ACS chest pain were independently associated with having ACS by multivariate logistic regression. The adjusted odds ratios (95% confidence interval were 4.220 (1.445, 12.327, 3.333 (1.040, 10.684, and 12.539 (3.876, 40.567, respectively. Conclusions. The effectiveness of the ED nurse triage for ACS was 16%. The online tool is available for the ED triage nurse to evaluate risk of ACS in individuals.

  13. Do free-living amoebae in treated drinking water systems present an emerging health risk?

    Science.gov (United States)

    Thomas, Jacqueline M; Ashbolt, Nicholas J

    2011-02-01

    There is an expanding body of evidence that free-living amoebae (FLA) increase both the numbers and virulence of water-based, human-pathogenic, amoeba-resisting microorganisms (ARM). Legionella spp., Mycobacterium spp., and other opportunistic human pathogens are known to be both ARM and also the etiologic agents of potentially fatal human lung infections. However, comparatively little is known about the FLA that may facilitate ARM growth in drinking water. This review examines the available literature on FLA in treated drinking water systems; in total 26 studies from 18 different countries. FLA were reported to breakthrough the water treatment barrier and enter distribution systems, in addition to the expected post-treatment system ingress. Once in the distribution system there is evidence of FLA colonization and regrowth especially in reservoirs and in-premise plumbing storage tanks. At the point of use the average FLA detection rate was 45% but highly variable (n = 16, σ = 31) due to both differences in both assay methods and the type of water systems examined. This review reveals that FLA are consistently detected in treated drinking water systems around the world and present a yet unquantified emerging health risk. However, more research is urgently required before accurate risks assessments can be undertaken to assess the impacts on human health, in households and institutions, due to exposure to FLA facilitated pathogenic ARM.

  14. An online tool for nurse triage to evaluate risk for acute coronary syndrome at emergency department.

    Science.gov (United States)

    Sittichanbuncha, Yuwares; Sanpha-Asa, Patchaya; Thongkrau, Theerayut; Keeratikasikorn, Chaiyapon; Aekphachaisawat, Noppadol; Sawanyawisuth, Kittisak

    2015-01-01

    Background. To differentiate acute coronary syndrome (ACS) from other causes in patients presenting with chest pain at the emergency department (ED) is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital. Methods. We retrospectively enrolled consecutive patients who were identified as ACS at risk patients by the ED nurse triage. Patients were categorized as ACS and non-ACS group by the final diagnosis. Multivariate logistic analysis was used to predict factors associated with ACS. An online model predictive of ACS for the ED nurse triage was constructed. Results. There were 175 patients who met the study criteria. Of those, 28 patients (16.0%) were diagnosed with ACS. Patients with diabetes, patients with previous history of CAD, and those who had at least one character of ACS chest pain were independently associated with having ACS by multivariate logistic regression. The adjusted odds ratios (95% confidence interval) were 4.220 (1.445, 12.327), 3.333 (1.040, 10.684), and 12.539 (3.876, 40.567), respectively. Conclusions. The effectiveness of the ED nurse triage for ACS was 16%. The online tool is available for the ED triage nurse to evaluate risk of ACS in individuals.

  15. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities

    Directory of Open Access Journals (Sweden)

    Felicity A. Smout

    2017-06-01

    Full Text Available Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively. The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7% and soil (55.6% in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to “closing the gap” in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  16. Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals.

    Science.gov (United States)

    Dugas, Tammy R; Lomnicki, Slawomir; Cormier, Stephania A; Dellinger, Barry; Reams, Margaret

    2016-06-08

    Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant.

  17. Direct Conjugation of Emerging Contaminants in Arabidopsis: Indication for an Overlooked Risk in Plants?

    Science.gov (United States)

    Fu, Qiuguo; Zhang, Jianbo; Borchardt, Dan; Schlenk, Daniel; Gan, Jay

    2017-06-06

    Agricultural use of treated wastewater, biosolids, and animal wastes introduces a multitude of contaminants of emerging concerns (CECs) into the soil-plant system. The potential for food crops to accumulate CECs depends largely on their metabolism in plants, which at present is poorly understood. Here, we evaluated the metabolism of naproxen and ibuprofen, two of the most-used human drugs from the Profen family, in Arabidopsis thaliana cells and the Arabidopsis plant. The complementary use of high-resolution mass spectrometry and (14)C labeling allowed the characterization of both free and conjugated metabolites, as well as nonextractable residues. Naproxen and ibuprofen, in their parent form, were conjugated quickly and directly with glutamic acid and glutamine, and further with peptides, in A. thaliana cells. For example, after 120 h, the metabolites of naproxen accounted for >90% of the extractable chemical mass, while the intact parent itself was negligible. The structures of glutamate and glutamine conjugates were confirmed using synthesized standards and further verified in whole plants. Amino acid conjugates may easily deconjugate, releasing the parent molecule. This finding highlights the possibility that the bioactivity of such CECs may be effectively preserved through direct conjugation, a previously overlooked risk. Many other CECs are also carboxylic acids, such as the profens. Therefore, direct conjugation may be a common route for plant metabolism of these CECs, making it imperative to consider conjugates when assessing their risks.

  18. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department.

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    Daniel Pilsgaard Henriksen

    Full Text Available OBJECTIVE: Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal vital signs at arrival to a medical emergency department (MED. DESIGN AND SETTING: Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory rate, Glasgow Coma Scale, oxygen saturation and temperature were within the normal range at arrival. Deterioration was defined as a deviation from the defined normal range 2-24 hours after arrival. RESULTS: 4292 of the 6257 (68.6% admitted to the MED had a full set of vital signs at first presentation, 1440/4292 (33.6% had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21-90 years and 446/1440 (31.0% deteriorated within 24 hours. Independent risk factors for deterioration included age 65-84 years odds ratio (OR: 1.79 (95% confidence interval [CI]: 1.27-2.52, 85+ years OR 1.67 (95% CI: 1.10-2.55, Do-not-attempt-to-resuscitate order OR 3.76 (95% CI: 1.37-10.31 and admission from the open general ED OR 1.35 (95% CI: 1.07-1.71. Thirty-day mortality was 7.9% (95% CI: 5.5-10.7% among deteriorating patients and 1.9% (95% CI: 1.2-3.0% among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10. CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether

  19. Understanding of headache patterns modification in an emergency department during the economic crisis of Greece.

    Science.gov (United States)

    Bougea, Anastasia; Spantideas, Nicolaos; Anagnostou, Evangelos; Massou, Efthalia; Xirou, Sophia; Thomaidis, Thomas; Evdokimidis, Ioannis; Kararizou, Evangelia

    2016-08-01

    Very few neurological research is published regarding health effects of global economic crisis. Our aim was to assess the impact of economic recession on frequency and severity of headaches. We also tested if depression, anxiety and experiences associated with crisis, such as unemployment, were reflected in headaches. This is a retrospective observational study in the Emergency setting of tertiary Clinic from 1 January 2008 until 31 December 2009 and from 1 January 2010 until 31 December 2011. Demographic data were collected of 1094 consecutive adult patients with headache. Multinomial logistic regression performed to examine if hospital anxiety depression (HAD), HAD anxiety, experience of serious life events, year of survey had influence on type of headache. The total number of headache cases increased significantly from 2008 to 2011 (p  0.05), while migraines decreased. Secondary and not otherwise specified (NOS) increased significantly (p < 0.05). The most common, overtime, was Tension type headache, followed by migraines (in 2008, 2011) and NOS (2010). Chi square test showed significant correlation between type of headache and year, as well medication type and year (p < 0.05). Common analgesics, the most common medication, increased five times during survey period (77 % 2008 to 87.6 % 2011). Multivariate analysis revealed stronger association for experience serious events with NOS vs. tension type headache [odds ratio (OR) 0.13; 95 % confidence interval (CI) 0.03, 0.7]. This is the first study showing that the prolonged economic crisis affected headache frequency accompanied by a higher use of analgesics.

  20. The nature, patterns, clinical outcomes, and financial impact of intraoperative adverse events in emergency surgery.

    Science.gov (United States)

    Ramly, Elie P; Bohnen, Jordan D; Farhat, Maha R; Razmdjou, Shadi; Mavros, Michael N; Yeh, Daniel D; Lee, Jarone; Butler, Kathryn; De Moya, Marc; Velmahos, George C; Kaafarani, Haytham M A

    2016-07-01

    Little is known about intraoperative adverse events (iAEs) in emergency surgery (ES). We sought to describe iAEs in ES and to investigate their clinical and financial impact. The 2007 to 2012 administrative and American College of Surgeons-National Surgical Quality Improvement Program databases at our tertiary academic center were: (1) linked, (2) queried for all ES procedures, and then (3) screened for iAEs using the ICD-9-CM-based Patient Safety Indicator "accidental puncture/laceration". Flagged cases were systematically reviewed to: (1) confirm or exclude the occurrence of iAEs (defined as inadvertent injuries during the operation) and (2) extract additional variables such as procedure type, approach, complexity (measured by relative value units), need for adhesiolysis, and extent of repair. Univariate and multivariate analyses were performed to assess the independent impact of iAEs on 30-day morbidity, mortality, and hospital charges. Of a total of 9,288 patients, 1,284 (13.8%) patients underwent ES, of which 23 had iAEs (1.8%); 18 of 23 (78.3%) of the iAEs involved the small bowel or spleen, 10 of 23 (43.5%) required suture repair, and 8 of 23 (34.8%) required tissue or organ resection. Compared with those without iAEs, patients with iAEs were older (median age 62 vs 50; P = .04); their procedures were more complex (total relative value unit 46.7, interquartile range [27.5 to 52.6] vs 14.5 [.5 to 30.2]; P 3 hours: 52% vs 8%; P 7 days; odds ratio, 5.60 [1.54 to 20.35]; P = .01]. A trend toward increased mortality did not reach statistical significance. In ES, iAEs are independently associated with significantly higher postoperative morbidity and prolonged LOS. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Shaping the aging brain: Role of auditory input patterns in the emergence of auditory cortical impairments

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    Brishna Soraya Kamal

    2013-09-01

    Full Text Available Age-related impairments in the primary auditory cortex (A1 include poor tuning selectivity, neural desynchronization and degraded responses to low-probability sounds. These changes have been largely attributed to reduced inhibition in the aged brain, and are thought to contribute to substantial hearing impairment in both humans and animals. Since many of these changes can be partially reversed with auditory training, it has been speculated that they might not be purely degenerative, but might rather represent negative plastic adjustments to noisy or distorted auditory signals reaching the brain. To test this hypothesis, we examined the impact of exposing young adult rats to 8 weeks of low-grade broadband noise on several aspects of A1 function and structure. We then characterized the same A1 elements in aging rats for comparison. We found that the impact of noise exposure on A1 tuning selectivity, temporal processing of auditory signal and responses to oddball tones was almost indistinguishable from the effect of natural aging. Moreover, noise exposure resulted in a reduction in the population of parvalbumin inhibitory interneurons and cortical myelin as previously documented in the aged group. Most of these changes reversed after returning the rats to a quiet environment. These results support the hypothesis that age-related changes in A1 have a strong activity-dependent component and indicate that the presence or absence of clear auditory input patterns might be a key factor in sustaining adult A1 function.

  2. Emerging Risks Due to New Injecting Patterns in Hungary During Austerity Times.

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    Tarján, Anna; Dudás, Mária; Gyarmathy, V Anna; Rusvai, Erzsébet; Tresó, Bálint; Csohán, Ágnes

    2015-01-01

    As a consequence of the massive restructuring of drug availability, heroin injection in Hungary was largely replaced by the injecting of new psychoactive substances (NPS) starting in 2010. In the following years in our sero-prevalence studies we documented higher levels of injecting paraphernalia sharing, daily injection-times, syringe reuse, and HCV prevalence among stimulant injectors, especially among NPS injectors. Despite the increasing demand, in 2012 the number of syringes distributed dropped by 35% due to austerity measures. Effects of drug market changes and the economic recession may have future epidemiological consequences. Study limitations are noted and future needed research is suggested.

  3. Risk of hospitalisation after early-revisit in the emergency department.

    Science.gov (United States)

    Cozzi, Giorgio; Ghirardo, Sergio; Fiorese, Ilaria; Proietti, Ilaria; Monasta, Lorenzo; Minute, Marta; Barbi, Egidio; Calligaris, Lorenzo

    2017-09-01

    Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease. Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy. We selected all patients who were revisited within 72 h from the initial visit (study cohort), while all other patients accessed in the same period were considered the control cohort. The two cohorts were compared for age, gender, triage category, hospitalisation rate, diagnosis at admission and hospital length of stay. In the study period, we reviewed 10 750 visits, of which 430 (4%) were unplanned revisits for the same chief complaint within 72 h from the initial visit. Hospitalisation rate of early-revisited patients was significantly higher compared to control patients (8.4 vs. 2.9%). Hospitalisation rate increases in parallel with the number of revisits, but in many cases, it was not directly related to a worst triage category, neither to a longer hospital length of stay. Early revisited patients in the ED had a significantly higher risk of hospitalisation, but this risk was only partially related to their clinical conditions. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  4. Two Chaotic Patterns of Dynamic Risk Definition for Solving Hazardous Materials Routing Problem

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    Abbas Mahmoudabadi

    2015-01-01

    Full Text Available In the case of determining routes for hazardous material transportation, risk is considered as a main attribute. Transport risk, which is usually combined with other attributes such as cost or travel time, plays a significant role in determining paths for hazardous materials transportation. Since, risk is chaotically affected by road incidents, decision makers are dealing with selecting a method for defining chaotic risk factors in hazmat transportation. In this paper, transport risk has been defined as a chaotic variable using two different methods of generating chaotic patterns. In an experimental road network, which consists of eighty-nine nodes and one hundred and one two-way links, two different methods of generating chaotic variables have been used for applying the proposed procedure. In addition, results for different amounts of risk and cost have also been analyzed in case study. Results revealed that different cost and risk priorities change the frequencies of selected paths determined for hazmat transportation, but the route convergence of the route to chaos method is better than that of the logistic map equation.

  5. Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

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    2014-01-01

    Background The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators’ self-reported use of Index as a first step towards a validation study. Methods We registered all medical emergency calls to the EMCCs during a 72 h period in a national cross sectional study. We subsequently sent a questionnaire to all EMCC operators in Norway, asking how they use Index. A combined outcome variable “use of Index” was computed through a Likert scale, range 1–5. Regression models were used to examine factors influencing use. Results 2 298 contacts were included. National contact rate was 56/1 000 inhabitants per year, range between EMCCs 34 – 119. Acute contact (life-threatening situations) rate was 21/1 000 per year, range between EMCCs 5 – 31. Index criteria 6 – ’Unresolved problem’ accounts for 20% of the 113 contacts, range between EMCCs 10 – 42%. The mean use of Index was 3.95 (SD 0.39), corresponding to “more than 75% of emergency calls”. There were differences in use of Index on EMCC level, range 3.7 – 4.4, and a multi regression model explained 23.4% of the variation in use. Operators working rotation with ground ambulance services reported reduced use of Index compared to operators not working in rotation, while distinct EMCC focus on Index increased use of Index compared to EMCCs with no focus on Index. Use of electronic records and operators experience were the main reasons given for not using Index. Conclusions There is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level. PMID:24398290

  6. Cognitive patterns of neuroanatomy concepts: Knowledge organizations that emerge from problem solving versus information gathering

    Science.gov (United States)

    Weidner, Jeanne Margaret O'malley

    2000-10-01

    This study was motivated by some of the claims that are found in the literature on Problem-Based Learning (PBL). This instructional technique, which uses case studies as its primary instructional tool, has been advanced as an alternative to traditional instruction in order to foster more meaningful, integrative learning of scientific concepts. Several of the advantages attributed to Problem-Based Learning are that it (1) is generally preferred by students because it appears to foster a more nurturing and enjoyable learning experience, (2) fosters greater retention of knowledge and concepts acquired, and (3) results in increased ability to apply this knowledge toward solving new problems. This study examines the differences that result when students learn neuroanatomy concepts under two instructional contexts: problem solving vs. information gathering. The technological resource provided to students to support learning under each of these contexts was the multimedia program BrainStorm: An Interactive Neuroanatomy Atlas (Coppa & Tancred, 1995). The study explores the influence of context with regard to subjects' performance on objective post-tests, organization of knowledge as measured by Pathfinder Networks, differential use of the multimedia software and discourse differences emerging from the transcripts. The findings support previous research in the literature that problem-solving results in less knowledge acquisition in the short term, greater retention of material over time, and a subjects' preference for the method. However, both the degree of retention and preference were influenced by subjects' prior knowledge of the material in the exercises, as there was a significant difference in performance between the two exercises: for the exercise about which subjects appeared to have greater background information, memory decay was less, and subject attitude toward the problem solving instructional format was more favorable, than for the exercise for which subjects

  7. Species assemblage patterns around a dominant emergent tree are associated with drought resistance.

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    Wyse, Sarah V; Macinnis-Ng, Catriona M O; Burns, Bruce R; Clearwater, Michael J; Schwendenmann, Luitgard

    2013-12-01

    Water availability has long been recognized as an important driver of species distribution patterns in forests. The conifer Agathis australis (D. Don) Lindl. (kauri; Araucariaceae) grows in the species-rich forests of northern New Zealand. It is accompanied by distinctive species assemblages, and during summer the soil beneath A. australis is often significantly drier than soils beneath surrounding broadleaved angiosperm canopy species. We used a shade house dry-down experiment to determine whether species that grow close to A. australis differed in drought tolerance physiology compared with species that rarely grow close to A. australis. Stomatal conductance (g(s)) was plotted against leaf water potential (ψ) to identify drought tolerance strategies. Seedlings of species that occur in close spatial association with A. australis (including A. australis seedlings) were most resistant to drought stress, and all displayed a drought avoidance strategy of either declining gs to maintain ψ or simultaneous declines in g(s) and ψ. The species not commonly occurring beneath A. australis, but abundant in the surrounding forest, were the most drought-sensitive species and succumbed relatively quickly to drought-induced mortality with rapidly declining gs and ψ values. These results were confirmed with diurnal measurements of g(s) and assimilation rates throughout the day, and leaf wilting analysis. We conclude that the varied abilities of the species to survive periods of drought stress as seedlings shapes the composition of the plant communities beneath A. australis trees. Furthermore, forest diversity may be impacted by climate change as the predicted intensification of droughts in northern New Zealand is likely to select for drought-tolerant species over drought-intolerant species.

  8. European Healthy City Network Phase V: patterns emerging for healthy urban planning.

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    Grant, Marcus

    2015-06-01

    There is a tradition of planning cities and their infrastructure to successfully tackle communicable disease arising from urban development. Non-communicable disease follows a different course. Development brings in its wake a basket of adverse health and health equity outcomes that are proving difficult to tackle. In response, within Phase V of the European Healthy Cities Network, municipalities have implemented a range of policy and physical interventions using a settings approach. Owing to the time lag between physical interventions and health outcomes, this research interrogates city activity itself to develop better understanding. Self-reported city case studies and questionnaire data were analysed to reveal patterns using an inductive approach. Findings indicate that some categories of intervention, such as whole city planning and transport, have a systemic impact across the wider determinants of health. Addressing transferability and stakeholder understanding helped cities create conditions for successful outcomes. Cities had varying urban development approaches for tackling climate change. Improvements to current practice are discussed, including; a distinction between supply side and demand side in healthy urban planning; valuing co-benefits and developing integrative approaches to the evidence-base. This evaluative article is important for cities wanting to learn how to maximize benefits to public health through urban development and for researchers exploring, with a systemic approach, the experiences of European cities acting at the interface of urban development and public health. This article also provides recommendations for future phases of the WHO European Healthy Cities programme, posing questions to better address governance and equity in spatial planning.

  9. Seeking the Balance: Risks, Choices and Life Priorities in the Life-Patterns Project, 1998-1999. Working Paper 19.

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    Dwyer, Peter; Harwood, Aramiha; Tyler, Debra

    This paper provides an update on the 1998 findings from an Australian longitudinal study begun in 1991 and titled the Life-Patterns Project. Based on 1,430 returns of the questionnaire and interviews of a sub-sample of 100, it examines implications of patterns beginning to emerge as participants enter their mid-twenties and reassess their…

  10. [The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica].

    Science.gov (United States)

    Gooden, Rachel; Tennant, Ingrid; James, Brian; Augier, Richard; Crawford-Sykes, Annette; Ehikhametalor, Kelvin; Gordon-Strachan, Georgiana; Harding-Goldson, Hyacinth

    2014-01-01

    Emergence delirium is a distressing complication of the use of sevoflurane for general anesthesia. This study sought to determine the incidence of emergence delirium and risk factors in patients at a specialist pediatric hospital in Kingston, Jamaica. This was a cross-sectional, observational study including pediatric patients aged 3-10 years, ASA I and II, undergoing general anesthesia with sevoflurane for elective day-case procedures. Data collected included patients' level of anxiety pre-operatively using the modified Yale Preoperative Anxiety Scale, surgery performed, anesthetic duration and analgesics administered. Postoperatively, patients were assessed for emergence delirium, defined as agitation with non-purposeful movement, restlessness or thrashing; inconsolability and unresponsiveness to nursing and/or parental presence. The need for pharmacological treatment and post-operative complications related to emergence delirium episodes were also noted. 145 children were included, with emergence delirium occurring in 28 (19.3%). Emergence delirium episodes had a mean duration of 6.9±7.8min, required pharmacologic intervention in 19 (67.8%) children and were associated with a prolonged recovery time (49.4±11.9 versus 29.7±10.8min for non-agitated children; p<0.001). Factors positively associated with emergence delirium included younger age (p=0.01, OR 3.3, 95% CI 1.2-8.6) and moderate and severe anxiety prior to induction (p<0.001, OR 5.6, 95% CI 2.3-13.0). Complications of emergence delirium included intravenous line removal (n=1), and surgical site bleeding (n=3). Children of younger age with greater preoperative anxiety are at increased risk of developing emergence delirium following general anesthesia with sevoflurane. The overall incidence of emergence delirium was 19%. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica

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    Rachel Gooden

    2014-12-01

    Full Text Available Background and objectives: Emergence delirium is a distressing complication of the use of sevoflurane for general anesthesia. This study sought to determine the incidence of emergence delirium and risk factors in patients at a specialist pediatric hospital in Kingston, Jamaica. Methods: This was a cross-sectional, observational study including pediatric patients aged 3-10 years, ASA I and II, undergoing general anesthesia with sevoflurane for elective day-case procedures. Data collected included patients' level of anxiety pre-operatively using the modified Yale Preoperative Anxiety Scale, surgery performed, anesthetic duration and analgesics administered. Postoperatively, patients were assessed for emergence delirium, defined as agitation with non-purposeful movement, restlessness or thrashing; inconsolability and unresponsiveness to nursing and/or parental presence. The need for pharmacological treatment and post-operative complications related to emergence delirium episodes were also noted. Results: One hundred and forty-five (145 children were included, with emergence delirium occurring in 28 (19.3%. Emergence delirium episodes had a mean duration of 6.9±7.8 min, required pharmacologic intervention in 19 (67.8% children and were associated with a prolonged recovery time (49.4±11.9 versus 29.7± 10.8 min for non-agitated children; p<0.001. Factors positively associated with emergence delirium included younger age (p = 0.01, OR 3.3, 95% CI 1.2-8.6 and moderate and severe anxiety prior to induction (p <0.001, OR 5.6, 95% CI 2.3-13.0. Complications of emergence delirium included intravenous line removal (n = 1, and surgical site bleeding (n = 3. Conclusion: Children of younger age with greater preoperative anxiety are at increased risk of developing emergence delirium following general anesthesia with sevoflurane. The overall incidence of emergence delirium was 19%.

  12. Geospatial Analysis of Urban Land Use Pattern Analysis for Hemorrhagic Fever Risk - a Review

    Science.gov (United States)

    Izzah, L. N.; Majid, Z.; Ariff, M. A. M.; Fook, C. K.

    2016-09-01

    Human modification of the natural environment continues to create habitats in which vectors of a wide variety of human and animal pathogens (such as Plasmodium, Aedes aegypti, Arenavirus etc.) thrive if unabated with an enormous potential to negatively affect public health. Typical examples of these modifications include impoundments, dams, irrigation systems, landfills and so on that provide enabled environment for the transmission of Hemorrhagic fever such as malaria, dengue, avian flu, Lassa fever etc. Furthermore, contemporary urban dwelling pattern appears to be associated with the prevalence of Hemorrhagic diseases in recent years. These observations are not peculiar to the developing world, as urban expansion also contributes significantly to mosquito and other vectors habitats. This habitats offer breeding ground to some vector virus populations. The key to disease control is developing an understanding of the contribution of human landscape modification to vector-borne pathogen transmission and how a balance may be achieved between human development, public health, and responsible urban land use. A comprehensive review of urban land use Pattern Analysis for Hemorrhagic fever risk has been conducted in this paper. The study found that most of the available literatures dwell more on the impact of urban land use on malaria and dengue fevers; however, studies are yet to be found discussing the implications of urban land use on the risk of Ebola, Lassa and other non-mosquito borne VHFs. A relational model for investigating the influence of urban land use change pattern on the risk of Hemorrhagic fever has been proposed in this study.

  13. A case-control study of physical activity patterns and risk of non-fatal myocardial infarction

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    Gong Jian

    2013-02-01

    Full Text Available Abstract Background The interactive effects of different types of physical activity on cardiovascular disease (CVD risk have not been fully considered in previous studies. We aimed to identify physical activity patterns that take into account combinations of physical activities and examine the association between derived physical activity patterns and risk of acute myocardial infarction (AMI. Methods We examined the relationship between physical activity patterns, identified by principal component analysis (PCA, and AMI risk in a case-control study of myocardial infarction in Costa Rica (N=4172, 1994-2004. The component scores derived from PCA and total METS were used in natural cubic spline models to assess the association between physical activity and AMI risk. Results Four physical activity patterns were retained from PCA that were characterized as the rest/sleep, agricultural job, light indoor activity, and manual labor job patterns. The light indoor activity and rest/sleep patterns showed an inverse linear relation (P for linearity=0.001 and a U-shaped association (P for non-linearity=0.03 with AMI risk, respectively. There was an inverse association between total activity-related energy expenditure and AMI risk but it reached a plateau at high levels of physical activity (P for non-linearity=0.01. Conclusions These data suggest that a light indoor activity pattern is associated with reduced AMI risk. PCA provides a new approach to investigate the relationship between physical activity and CVD risk.

  14. Cardiovascular disease risk factor patterns and their implications for intervention strategies in Vietnam.

    Science.gov (United States)

    Nguyen, Quang Ngoc; Pham, Son Thai; Do, Loi Doan; Nguyen, Viet Lan; Wall, Stig; Weinehall, Lars; Bonita, Ruth; Byass, Peter

    2012-01-01

    Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women-especially at higher ages-who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.

  15. Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study

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    Botti Primo

    2011-03-01

    Full Text Available Abstract Background Delayed neuropsychological sequelae (DNS commonly occur after recovery from acute carbon monoxide (CO poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. Methods We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Results Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%. Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS score Conclusions Our study identified several potential predictive risk factors for DNS. Treatment algorithms based on an appropriate risk-stratification of patients in the Emergency Department might reduce DNS incidence; however, more studies are needed. Adequate follow-up after hospital discharge, aimed at correct recognition of DNS, is also important.

  16. What current literature tells us about sustainable diets: emerging research linking dietary patterns, environmental sustainability, and economics.

    Science.gov (United States)

    Auestad, Nancy; Fulgoni, Victor L

    2015-01-01

    The concept of sustainable diets, although not new, is gaining increased attention across the globe, especially in relation to projected population growth and growing concerns about climate change. As defined by the FAO (Proceedings of the International Scientific Symposium, Biodiversity and Sustainable Diets 2010; FAO 2012), "Sustainable diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations." Consistent and credible science that brings together agriculture, food systems, nutrition, public health, environment, economics, culture, and trade is needed to identify synergies and trade-offs and to inform guidance on vital elements of healthy, sustainable diets. The aim of this article is to review the emerging research on environmental and related economic impacts of dietary patterns, including habitual eating patterns, nutritionally balanced diets, and a variety of different dietary scenarios. Approaches to research designs, methodologies, and data sources are compared and contrasted to identify research gaps and future research needs. To date, it is difficult to assimilate all of the disparate approaches, and more concerted efforts for multidisciplinary studies are needed.

  17. Risks and music - Patterns among young women and men in Sweden

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    M C Bohlin

    2011-01-01

    Full Text Available Music and high levels of sound have not traditionally been associated with risk-taking behaviors. Loud music may intensify and bring more power and meaning to the musical experience, but it can at the same time be harmful to hearing. The present study aims to increase the knowledge about young women′s and men′s risk judgement and behaviour by investigating patterns in adolescent risk activities among 310 adolescents aged 15-20 (143 women; 167 men. The Australian instrument ARQ was used with additional questions on hearing risks and a factor analysis was conducted. The main results showed that the factor structure in the judgement and behavior scale for Swedish adolescents was rather different from the factor structure in the Australian sample. Also, the factor structure was not similar to the Australian sample split on gender. The results are discussed from a gender- and existential perspective on risk taking, and it is emphasized that research on risk behavior needs to reconceptualize stereotypical ideas about gender and the existential period in adolescence.

  18. Risks and music - patterns among young women and men in Sweden.

    Science.gov (United States)

    Bohlin, M C; Sorbring, E; Widén, S E; Erlandsson, S I

    2011-01-01

    Music and high levels of sound have not traditionally been associated with risk-taking behaviors. Loud music may intensify and bring more power and meaning to the musical experience, but it can at the same time be harmful to hearing. The present study aims to increase the knowledge about young women's and men's risk judgement and behaviour by investigating patterns in adolescent risk activities among 310 adolescents aged 15-20 (143 women; 167 men). The Australian instrument ARQ was used with additional questions on hearing risks and a factor analysis was conducted. The main results showed that the factor structure in the judgement a