Grouping and Read-Across Approaches for Risk Assessment of Nanomaterials

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Agnes G. Oomen

2015-10-01

Full Text Available Physicochemical properties of chemicals affect their exposure, toxicokinetics/fate and hazard, and for nanomaterials, the variation of these properties results in a wide variety of materials with potentially different risks. To limit the amount of testing for risk assessment, the information gathering process for nanomaterials needs to be efficient. At the same time, sufficient information to assess the safety of human health and the environment should be available for each nanomaterial. Grouping and read-across approaches can be utilised to meet these goals. This article presents different possible applications of grouping and read-across for nanomaterials within the broader perspective of the MARINA Risk Assessment Strategy (RAS, as developed in the EU FP7 project MARINA. Firstly, nanomaterials can be grouped based on limited variation in physicochemical properties to subsequently design an efficient testing strategy that covers the entire group. Secondly, knowledge about exposure, toxicokinetics/fate or hazard, for example via properties such as dissolution rate, aspect ratio, chemical (non-activity, can be used to organise similar materials in generic groups to frame issues that need further attention, or potentially to read-across. Thirdly, when data related to specific endpoints is required, read-across can be considered, using data from a source material for the target nanomaterial. Read-across could be based on a scientifically sound justification that exposure, distribution to the target (fate/toxicokinetics and hazard of the target material are similar to, or less than, the source material. These grouping and read-across approaches pave the way for better use of available information on nanomaterials and are flexible enough to allow future adaptations related to scientific developments.

ABO blood group and risk of cancer

DEFF Research Database (Denmark)

Vasan, Senthil K; Hwang, Jinseub; Rostgaard, Klaus

2016-01-01

groups and site-specific cancer risk in a large cohort of healthy blood donors from Sweden and Denmark. RESULTS: A total of 1.6 million donors were followed over 27 million person-years (20 million in Sweden and 7 million in Denmark). We observed 119,584 cancer cases. Blood groups A, AB and B were......INTRODUCTION: The associations between ABO blood group and cancer risk have been studied repeatedly, but results have been variable. Consistent associations have only been reported for pancreatic and gastric cancers. MATERIALS AND METHODS: We estimated associations between different ABO blood...... associated either with increased or decreased risk of cancer at 13 anatomical sites (p≤0.05), compared to blood group O. Consistent with assessment using a false discovery rate approach, significant associations with ABO blood group were observed for cancer of the pancreas, breast, and upper gastrointestinal...

Decision Tree Identified Risk Groups with High Suicidal Ideation in South Korea: A Population-Based Study.

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Kim, Hyun Kyung; Kim, Ji Young; Kim, Jong Hyen; Hyoung, Hee Kyoung

2016-01-01

The aim of this study was to identify risk groups with high suicidal ideation among South Korean adults. A descriptive cross-sectional design was adopted using secondary data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5,963 adults aged 19 years and older who participated in the 2011 KNHANES served as participants. The prevalence of suicidal ideation and its related factors, including physical, psychological, health behavioral, and sociodemographic characteristics, were examined. Descriptive statistics and a decision tree were used for data analysis. Nine groups with high suicidal ideation were identified. The coexistence of depression and high levels of stress increased the prevalence of suicidal ideation. The highest risk group was widowed or divorced adults with depression and high levels of stress, and 82.5% of these participants had suicidal ideation (the prevalence rate of this group was 5.7 times higher than the mean suicidal ideation prevalence rate in this study). Public health nurses and community mental health professionals should recognize risk groups with high suicidal ideation, and target these groups when implementing preventive interventions. © 2015 Wiley Periodicals, Inc.

"Where are all the lonely people?" A population-based study of high-risk groups across the life span

DEFF Research Database (Denmark)

Lasgaard, Mathias; Friis, Karina; Shevlin, Mark

2016-01-01

and socio-demographic and health-related factors across multiple age groups. Methods. This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16–102 years. Loneliness was measured using the Three......Item Loneliness Scale. Results. The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Socio......-demographic and health-related factors were associated with an increased risk of severe loneliness in specific age groups. Being female, having a low educational level and living in a deprived area were only associated with loneliness in adolescence/emerging adulthood. Receiving disability pensions and living alone (i...

Adolescent postabortion groups: risk reduction in a school-based health clinic.

Science.gov (United States)

Daly, Joan Ziegler; Ziegler, Robert; Goldstein, Donna J

2004-10-01

A short-term postabortion group for adolescents was developed. Three groups were conducted in an adolescent mental health clinic within an urban high school-based health clinic. The clinical group experiences offered the adolescents an opportunity to integrate the experience of pregnancy and the abortion decision into their lives. At follow up, adolescents who participated in th postabortion counseling group indicated that they chose and used a method of birth control, did not repeat an unplanned pregnancy, and remained in high school.

Gambling Risk Groups are Not All the Same: Risk Factors Amongst Sports Bettors.

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Russell, Alex M T; Hing, Nerilee; Li, En; Vitartas, Peter

2018-03-20

Sports betting is increasing worldwide, with an associated increase in sports betting-related problems. Previous studies have examined risk factors for problem gambling amongst sports bettors and have identified demographic, behavioural, marketing, normative and impulsiveness factors. These studies have generally compared those in problem gambling, or a combination of moderate risk and problem gambling, groups to non-problem gamblers, often due to statistical power issues. However, recent evidence suggests that, at a population level, the bulk of gambling-related harm stems from low risk and moderate risk gamblers, rather than problem gamblers. Thus it is essential to understand the risk factors for each level of gambling-related problems (low risk, moderate risk, problem) separately. The present study used a large sample (N = 1813) to compare each gambling risk group to non-problem gamblers, first using bivariate and then multivariate statistical techniques. A range of demographic, behavioural, marketing, normative and impulsiveness variables were included as possible risk factors. The results indicated that some variables, such as gambling expenditure, number of accounts with different operators, number of different types of promotions used and impulsiveness were significantly higher for all risk groups, while others such as some normative factors, age, gender and particular sports betting variables only applied to those with the highest level of gambling-related problems. The results generally supported findings from previous literature for problem gamblers, and extended these findings to low risk and moderate risk groups. In the future, where statistical power allows, risk factors should be assessed separately for all levels of gambling problems.

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

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Kathy Annunziata

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

Financial risk relationships and adoption of management strategies in physician groups for self-administered injectable drugs.

Science.gov (United States)

Agnew, Jonathan D; Stebbins, Marilyn R; Hickman, David E; Lipton, Helene Levins

2003-01-01

To consider the extent, nature, and range of risk arrangements between physician groups and health maintenance organizations (HMOs) for self-administered injectable (SAI) drugs; to examine types and frequencies of SAI drug-use management strategies adopted by physician groups; and to explore the relationship between locus and level of financial risk for SAIs and physician group strategy adoption. We used a multiple case-study design to select physician groups and their health maintenance organization (HMO) contractual partners in 4 markets in the United States (Northwest, Northeast, Midwest, Southwest). Physician groups in these markets were chosen based on size (e50 physicians) and experience with drug risk (e1 year). Physician groups were asked to identify their 3 major HMO contractual partners in each market. Telephone interviews were conducted from January 2000 to June 2001, with the resulting purposive sample of 37 individuals representing 20 physician groups. We found that the level and locus of SAI financial risk were related to the adoption of management strategies. Physician groups with higher financial risk for SAIs adopted more strategies than lower-risk groups. Groups with SAI financial risk in the medical services capitation (MSC) adopted 9.2 strategies per group. In contrast, groups with SAI financial risk in the pharmacy-risk budget (PRB) averaged 1.5 strategies per group. Groups with SAI financial risk in both the MSC and PRB fell in-between, averaging 4.5 strategies per group. The most frequently adopted strategy was designing evidenced-based therapeutic guidelines, i.e., protocols based on evidence from the peer-reviewed literature used to guide physicians in the treatment of typically chronic conditions (9 groups, 45% of sample). The second most common strategy involved adapting the existing utilization management system to process SAIs (7 groups, 35%) and the establishment of office procedures for internal authorization (5 groups, 25%). The

Risk Analysis Group annual progress report 1984

International Nuclear Information System (INIS)

1985-06-01

The activities of the Risk Analysis Group at Risoe during 1984 are presented. These include descriptions in some detail of work on general development topics and risk analysis performed as contractor. (author)

An approach to grouping species for ecological risk assessment

International Nuclear Information System (INIS)

Hampton, N.L.; VanHorn, R.L.; Morris, R.; Brewer, R.

1994-01-01

The ecological risk assessment (ERA) paradigm acknowledges all levels of ecological organization as having potential for defining assessment and measurement endpoints. However, assessment goals and endpoints are generally concentrated at individual species and population levels. As part of a sitewide, screening-level ERA process at the Idaho National Engineering Laboratory (INEL), a ''functional group'' approach was developed to incorporate assessment at a higher level of ecological organization into the risk analysis process. Functional groups demonstrating biological similarity and similar potential for contaminant exposure were developed using taxonomic, trophic and habitat parameters. As defined, all species are potential surrogates for the other members of the same functional group. Measurement endpoint data for several species may be integrated to address the risk to the group as a whole. The functional group concept was applied throughout the problem formulation, analysis, and risk characterization phases of the assessment process. This approach allows the ERA to be focused on risk to the integrity of individual functional groups, which can subsequently be related to guild and community integrity

Use of focus groups in explaining environmental risks

International Nuclear Information System (INIS)

Wong, J.W.

1994-01-01

Risk assessors need to remember their job is to determine risks which are then balanced against the cost of remediation. Since the ultimate customer is the public, they must be an integral part of both key risk assessment as well as remediation decisions. Focus groups offer a cost effective means to open-quotes get a feelclose quotes for what publics want and don't want. This paper is a kit for using focus groups to test and translate into common language, the risk assessor's ideas and methods. Explaining Monte Carlo methods for a simple aspect of ecological risk assessment is included as an example along with practical tips and a list of what the public equates to risk as they perceive it

Comparing the Central Eight Risk Factors: Do They Differ Across Age Groups of Sex Offenders?

Science.gov (United States)

Wilpert, Julia; van Horn, Joan E; Boonmann, Cyril

2018-02-01

Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most effective in reducing recidivism when based on dynamic risk factors. As studies have found differences of these factors across age, exploring this seems beneficial. The current study investigates the Central Eight (C8) risk factors across six age groups of outpatient sex offenders ( N = 650). Results showed that recidivism rates and age were inversely related from 19 years and up. Half of the C8 did not predict general recidivism at all, substance abuse, antisocial cognition, antisocial associates, and history of antisocial behavior in only one or several age groups. However, factors differed between age groups, with the youngest group demonstrating the most dysfunction in several areas and the oldest group the least. It is concluded that the C8 risk factors seem to lose significance in the older age groups. Results may benefit targeting treatment goals.

Taxonomic analysis of perceived risk: modeling individual and group perceptions within homogeneous hazard domains

International Nuclear Information System (INIS)

Kraus, N.N.; Slovic, P.

1988-01-01

Previous studies of risk perception have typically focused on the mean judgments of a group of people regarding the riskiness (or safety) of a diverse set of hazardous activities, substances, and technologies. This paper reports the results of two studies that take a different path. Study 1 investigated whether models within a single technological domain were similar to previous models based on group means and diverse hazards. Study 2 created a group taxonomy of perceived risk for only one technological domain, railroads, and examined whether the structure of that taxonomy corresponded with taxonomies derived from prior studies of diverse hazards. Results from Study 1 indicated that the importance of various risk characteristics in determining perceived risk differed across individuals and across hazards, but not so much as to invalidate the results of earlier studies based on group means and diverse hazards. In Study 2, the detailed analysis of railroad hazards produced a structure that had both important similarities to, and dissimilarities from, the structure obtained in prior research with diverse hazard domains. The data also indicated that railroad hazards are really quite diverse, with some approaching nuclear reactors in their perceived seriousness. These results suggest that information about the diversity of perceptions within a single domain of hazards could provide valuable input to risk-management decisions

Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms.

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Shomaker, Lauren B; Bruggink, Stephanie; Pivarunas, Bernadette; Skoranski, Amanda; Foss, Jillian; Chaffin, Ella; Dalager, Stephanie; Annameier, Shelly; Quaglia, Jordan; Brown, Kirk Warren; Broderick, Patricia; Bell, Christopher

2017-06-01

(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Parallel-group, randomized controlled pilot trial conducted at a university. Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (psmindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (psmindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138

A Systematic Review of Training Interventions Addressing Sexual Violence against Marginalized At-Risk Groups of Women

Science.gov (United States)

Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

2015-01-01

Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with…

An exposure-based framework for grouping pollutants for a cumulative risk assessment approach: case study of indoor semi-volatile organic compounds.

Science.gov (United States)

Fournier, Kevin; Glorennec, Philippe; Bonvallot, Nathalie

2014-04-01

Humans are exposed to a large number of contaminants, many of which may have similar health effects. This paper presents a framework for identifying pollutants to be included in a cumulative risk assessment approach. To account for the possibility of simultaneous exposure to chemicals with common toxic modes of action, the first step of the traditional risk assessment process, i.e. hazard identification, is structured in three sub-steps: (1a) Identification of pollutants people are exposed to, (1b) identification of effects and mechanisms of action of these pollutants, (1c) grouping of pollutants according to similarity of their mechanism of action and health effects. Based on this exposure-based grouping we can derive "multi-pollutant" toxicity reference values, in the "dose-response assessment" step. The approach proposed in this work is original in that it is based on real exposures instead of a limited number of pollutants from a unique chemical family, as traditionally performed. This framework is illustrated by the case study of semi-volatile organic compounds in French dwellings, providing insights into practical considerations regarding the accuracy of the available toxicological information. This case study illustrates the value of the exposure-based approach as opposed to the traditional cumulative framework, in which chemicals with similar health effects were not always included in the same chemical class. Copyright © 2014 Elsevier Inc. All rights reserved.

A re-examination of the effect of contextual group size on people's attitude to risk

Directory of Open Access Journals (Sweden)

Kazumi Shimizu

2011-02-01

Full Text Available Using Kahneman and Tversky's life-death decision paradigm, Wang and colleagues (e.g., Wang and Johnston, 1995; Wang, 1996a, 1996b, 1996c, 2008; Wang et al., 2001 have shown two characteristic phenomena regarding people's attitude to risk when the contextual group size is manipulated. In both positive and negative frames, people tend to take greater risks in life-death decisions as the contextual group size becomes smaller; this risk-seeking attitude is greater when framed positively than negatively. (This second characteristic often leads to the disappearance of the framing effect in small group contexts comprising of 6 or 60 people. Their results could shed new light on the effect of contextual group size on people's risk choice. However these results are usually observed in laboratory experiments with university student samples. This study aims to examine the external validity of these results through different ways of experimentation and with a different sample base. The first characteristic was replicated in both a face-to-face interview with a randomly selected sample of the Japanese general public, and a web-based experiment with a non-student sample, but not the second.

Modified risk stratification grouping using standard clinical and biopsy information for patients undergoing radical prostatectomy: Results from SEARCH.

Science.gov (United States)

Zumsteg, Zachary S; Chen, Zinan; Howard, Lauren E; Amling, Christopher L; Aronson, William J; Cooperberg, Matthew R; Kane, Christopher J; Terris, Martha K; Spratt, Daniel E; Sandler, Howard M; Freedland, Stephen J

2017-12-01

Prostate cancer is a heterogeneous disease, and risk stratification systems have been proposed to guide treatment decisions. However, significant heterogeneity remains for those with unfavorable-risk disease. This study included 3335 patients undergoing radical prostatectomy without adjuvant radiotherapy in the SEARCH database. High-risk patients were dichotomized into standard and very high-risk (VHR) groups based on primary Gleason pattern, percentage of positive biopsy cores (PPBC), number of NCCN high-risk factors, and stage T3b-T4 disease. Similarly, intermediate-risk prostate cancer was separated into favorable and unfavorable groups based on primary Gleason pattern, PPBC, and number of NCCN intermediate-risk factors. Median follow-up was 78 months. Patients with VHR prostate cancer had significantly worse PSA relapse-free survival (PSA-RFS, P < 0.001), distant metastasis (DM, P = 0.004), and prostate cancer-specific mortality (PCSM, P = 0.015) in comparison to standard high-risk (SHR) patients in multivariable analyses. By contrast, there was no significant difference in PSA-RFS, DM, or PCSM between SHR and unfavorable intermediate-risk (UIR) patients. Therefore, we propose a novel risk stratification system: Group 1 (low-risk), Group 2 (favorable intermediate-risk), Group 3 (UIR and SHR), and Group 4 (VHR). The c-index of this new grouping was 0.683 for PSA-RFS and 0.800 for metastases, compared to NCCN-risk groups which yield 0.666 for PSA-RFS and 0.764 for metastases. Patients classified as VHR have markedly increased rates of PSA relapse, DM, and PCSM in comparison to SHR patients, whereas UIR and SHR patients have similar prognosis. Novel therapeutic strategies are needed for patients with VHR, likely involving multimodality therapy. © 2017 Wiley Periodicals, Inc.

SU-F-T-244: Radiotherapy Risk Estimation Based On Expert Group Survey

International Nuclear Information System (INIS)

Koo, J; Yoon, M; Chung, W; Chung, M; Kim, D

2016-01-01

Purpose: To evaluate the reliability of RPN (Risk Priority Number) decided by expert group and to provide preliminary data for adapting FMEA in Korea. Methods: 1163 Incidents reported in ROSIS for 11 years were used as a real data to be compared with, and were categorized into 146 items. The questionnaire was composed of the 146 items and respondents had to valuate ‘occurrence (O)’, ‘severity (S)’, ‘detectability (D)’ of each item on a scale from 1 to 10 according to the proposed AAPM TG-100 rating scales. 19 medical physicists from 19 different organizations in Korea had participated in the survey. Because the number of ROSIS items was not evenly spread enough to be classified into 10 grades, 1–5 scale was chosen instead of 1–10 and survey result was also fit to 5 grades to compare. Results: The average O,S,D were 1.77, 3.50, 2.13, respectively and the item which had the highest RPN(32) was ‘patient movement during treatment’ in the survey. When comparing items ranked in the top 10 of each survey(O) and ROSIS database, two items were duplicated and ‘Simulation’ and ’Treatment’ were the most frequently ranked RT process in top 10 of survey and ROSIS each. The Chronbach α of each RT process were ranged from 0.74 to 0.99 and p-value was <0.001. When comparing O*D, the average difference was 1.4. Conclusion: This work indicates the deviation between actual risk and expectation. Considering that the respondents were Korean and ROSIS is mainly composed of incidents happened in European countries and some of the top 10 items of ROSIS cannot be applied in radiotherapy procedure in Korea, the deviation could have been came from procedural difference. Moreover, if expert group was consisted of experts from various parts, expectation might have been more accurate. Therefore, further research on radiotherapy risk estimation is needed.

SU-F-T-244: Radiotherapy Risk Estimation Based On Expert Group Survey

Energy Technology Data Exchange (ETDEWEB)

Koo, J; Yoon, M [Korea University, Seoul (Korea, Republic of); Chung, W; Chung, M; Kim, D [Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul (Korea, Republic of)

2016-06-15

Purpose: To evaluate the reliability of RPN (Risk Priority Number) decided by expert group and to provide preliminary data for adapting FMEA in Korea. Methods: 1163 Incidents reported in ROSIS for 11 years were used as a real data to be compared with, and were categorized into 146 items. The questionnaire was composed of the 146 items and respondents had to valuate ‘occurrence (O)’, ‘severity (S)’, ‘detectability (D)’ of each item on a scale from 1 to 10 according to the proposed AAPM TG-100 rating scales. 19 medical physicists from 19 different organizations in Korea had participated in the survey. Because the number of ROSIS items was not evenly spread enough to be classified into 10 grades, 1–5 scale was chosen instead of 1–10 and survey result was also fit to 5 grades to compare. Results: The average O,S,D were 1.77, 3.50, 2.13, respectively and the item which had the highest RPN(32) was ‘patient movement during treatment’ in the survey. When comparing items ranked in the top 10 of each survey(O) and ROSIS database, two items were duplicated and ‘Simulation’ and ’Treatment’ were the most frequently ranked RT process in top 10 of survey and ROSIS each. The Chronbach α of each RT process were ranged from 0.74 to 0.99 and p-value was <0.001. When comparing O*D, the average difference was 1.4. Conclusion: This work indicates the deviation between actual risk and expectation. Considering that the respondents were Korean and ROSIS is mainly composed of incidents happened in European countries and some of the top 10 items of ROSIS cannot be applied in radiotherapy procedure in Korea, the deviation could have been came from procedural difference. Moreover, if expert group was consisted of experts from various parts, expectation might have been more accurate. Therefore, further research on radiotherapy risk estimation is needed.

Suicide among older psychiatric inpatients: an evidence-based study of a high risk group

DEFF Research Database (Denmark)

Erlangsen, Annette; Zarit, Steven H; Tu, Xin

2006-01-01

.1-0.3). In combination with other types of disorder, affective disorders were found to modify an increased risk of suicide. First versus later admission for depression was a better predictor for suicide than age at first hospitalization for depression (before or after age 60 years). More than half of suicides occurred......OBJECTIVE: Older adults have elevated suicide rates, especially in the presence of a psychiatric disorder, yet not much is known about predictors for suicide within this high-risk group. The current study examines the characteristics associated with suicide among older adults who are admitted...... to a psychiatric hospital. METHOD: All persons aged 60 and older living in Denmark who were hospitalized with psychiatric disorders during 1990-2000 were included in the study. Using a case-control design and logistic regression analysis, the authors calculated the suicide risk associated with specific patient...

Culture and group-based emotions: could group-based emotions be dialectical?

Science.gov (United States)

Lu, Minjie; Hamamura, Takeshi; Doosje, Bertjan; Suzuki, Satoko; Takemura, Kosuke

2017-08-01

Group-based emotions are experienced when individuals are engaged in emotion-provoking events that implicate the in-group. This research examines the complexity of group-based emotions, specifically a concurrence of positive and negative emotions, focusing on the role of dialecticism, or a set of folk beliefs prevalent in Asian cultures that views nature and objects as constantly changing, inherently contradictory, and fundamentally interconnected. Study 1 found that dialecticism is positively associated with the complexity of Chinese participants' group-based emotions after reading a scenario depicting a positive intergroup experience. Study 2 found that Chinese participants experienced more complex group-based emotions compared with Dutch participants in an intergroup situation and that this cultural difference was mediated by dialecticism. Study 3 manipulated dialecticism and confirmed its causal effect on complex group-based emotions. These studies also suggested the role of a balanced appraisal of an intergroup situation as a mediating factor.

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

International Nuclear Information System (INIS)

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

1996-06-01

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

Which population groups are most unaware of CVD risks associated with sitting time?

Science.gov (United States)

Duncan, Mitch J; Gilson, Nicholas; Vandelanotte, Corneel

2014-08-01

Prolonged sitting is an emerging risk factor for poor health yet few studies have examined awareness of the risks associated with sitting behaviours. This study identifies the population subgroups with the highest levels of unawareness regarding the cardiovascular disease (CVD) risks associated with sitting behaviours. Adults (n=1256) living in Queensland, Australia completed a telephone-based survey in 2011, analysis conducted in 2013. The survey assessed participant's socio-demographic characteristics, physical activity, sitting behaviours and awareness of CVD risks associated with three sitting behaviours: 1) sitting for prolonged periods, 2), sitting for prolonged periods whilst also engaging in regular physical activity, and 3) breaking up periods of prolonged sitting with short activity breaks. Population sub-groups with the highest levels of unawareness were identified based on socio-demographic and behavioural characteristics using signal detection analysis. Unawareness ranged from 23.3% to 67.0%. Age was the most important variable in differentiating awareness levels; younger adults had higher levels of unawareness. Body mass index, physical activity, TV viewing, employment status and time spent at work also identified population sub-groups. Unawareness of CVD risk for prolonged sitting was moderately high overall. Younger adults had high levels of unawareness on all of the outcomes examined. Copyright © 2014 Elsevier Inc. All rights reserved.

Rational group decision making in risk situations

International Nuclear Information System (INIS)

Yoon, M.H.

1987-01-01

Risk management has received increasing attention recently as methods of quantifying risk have been evolving. This is considered a legitimate tendency in the context of the entirety of risk evaluation which connotes both risk quantification and decisions making thereon. A risk-free society does not appear possible; neither could one have zero competing risks or cost versus benefit resulting out of a risk-abatement effort. What further complicates the risk-decision problem is that there exists more than a single decision maker, who claim their own interests associated with risk decision. Furthermore, their risk perceptions are not at all same that the threshold risk levels for a particular actions are varying. In this dissertation, a brief survey on existing action levels for various sort of risk situations including carcinogens, toxic chemicals, etc., is reported on, with emphasis on nuclear risk situation. A decision theoretic approach is then adopted in both individual and group-level risk management. For the purpose of exemplification, multiplicative utility theory is applied for nuclear power risk; attributes derived for this specific purpose are discussed

Culture and group-based emotions? : Could group-based emotions be dialectical

NARCIS (Netherlands)

Lu, M.; Hamamura, T.; Doosje, B.; Suzuki, S.; Takemura, K.

2016-01-01

Group-based emotions are experienced when individuals are engaged in emotion-provoking events that implicate the in-group. This research examines the complexity of group-based emotions, specifically a concurrence of positive and negative emotions, focusing on the role of dialecticism, or a set of

A mathematical model for stratification of LADA risk groups

OpenAIRE

Tat'yana Mikhaylovna Tikhonova

2014-01-01

Aim. To stratify risk groups via discriminant analysis based on the most clinically relevant indications of LADA onset derived from medical history.Materials and Methods. Present study included 141 patients with diabetes mellitus (DM) of whom 65 had preliminary diagnosis of LADA, 40 patients were diagnosed with type 1 diabetes mellitus (T1DM) and 36 – with type 2 diabetes mellitus (T2DM). Discriminant analysis was performed to evaluate the differences between the clinical onsets in study grou...

A balanced hazard ratio for risk group evaluation from survival data.

Science.gov (United States)

Branders, Samuel; Dupont, Pierre

2015-07-30

Common clinical studies assess the quality of prognostic factors, such as gene expression signatures, clinical variables or environmental factors, and cluster patients into various risk groups. Typical examples include cancer clinical trials where patients are clustered into high or low risk groups. Whenever applied to survival data analysis, such groups are intended to represent patients with similar survival odds and to select the most appropriate therapy accordingly. The relevance of such risk groups, and of the related prognostic factors, is typically assessed through the computation of a hazard ratio. We first stress three limitations of assessing risk groups through the hazard ratio: (1) it may promote the definition of arbitrarily unbalanced risk groups; (2) an apparently optimal group hazard ratio can be largely inconsistent with the p-value commonly associated to it; and (3) some marginal changes between risk group proportions may lead to highly different hazard ratio values. Those issues could lead to inappropriate comparisons between various prognostic factors. Next, we propose the balanced hazard ratio to solve those issues. This new performance metric keeps an intuitive interpretation and is as simple to compute. We also show how the balanced hazard ratio leads to a natural cut-off choice to define risk groups from continuous risk scores. The proposed methodology is validated through controlled experiments for which a prescribed cut-off value is defined by design. Further results are also reported on several cancer prognosis studies, and the proposed methodology could be applied more generally to assess the quality of any prognostic markers. Copyright © 2015 John Wiley & Sons, Ltd.

Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer.

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Ester Vilaprinyo

Full Text Available The one-size-fits-all paradigm in organized screening of breast cancer is shifting towards a personalized approach. The present study has two objectives: 1 To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2 To estimate the gain in terms of cost and harm reductions using risk-based screening with respect to the usual practice. We used a probabilistic model and input data from Spanish population registries and screening programs, as well as from clinical studies, to estimate the benefit, harm, and costs over time of 2,624 screening strategies, uniform or risk-based. We defined four risk groups, low, moderate-low, moderate-high and high, based on breast density, family history of breast cancer and personal history of breast biopsy. The risk-based strategies were obtained combining the exam periodicity (annual, biennial, triennial and quinquennial, the starting ages (40, 45 and 50 years and the ending ages (69 and 74 years in the four risk groups. Incremental cost-effectiveness and harm-benefit ratios were used to select the optimal strategies. Compared to risk-based strategies, the uniform ones result in a much lower benefit for a specific cost. Reductions close to 10% in costs and higher than 20% in false-positive results and overdiagnosed cases were obtained for risk-based strategies. Optimal screening is characterized by quinquennial or triennial periodicities for the low or moderate risk-groups and annual periodicity for the high-risk group. Risk-based strategies can reduce harm and costs. It is necessary to develop accurate measures of individual risk and to work on how to implement risk-based screening strategies.

Managing wildfire events: risk-based decision making among a group of federal fire managers

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Robyn S. Wilson; Patricia L. Winter; Lynn A. Maguire; Timothy. Ascher

2011-01-01

Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206...

ABO Blood Group and Risk of Thromboembolic and Arterial Disease

DEFF Research Database (Denmark)

Vasan, Senthil K; Rostgaard, Klaus; Majeed, Ammar

2016-01-01

BACKGROUND: ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies. METHODS AND RESULTS: We used the SCANDAT2...... (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987......-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis...

Strategy for distribution of influenza vaccine to high-risk groups and children.

Science.gov (United States)

Longini, Ira M; Halloran, M Elizabeth

2005-02-15

Despite evidence that vaccinating schoolchildren against influenza is effective in limiting community-level transmission, the United States has had a long-standing government strategy of recommending that vaccine be concentrated primarily in high-risk groups and distributed to those people who keep the health system and social infrastructure operating. Because of this year's influenza vaccine shortage, a plan was enacted to distribute the limited vaccine stock to these groups first. This vaccination strategy, based on direct protection of those most at risk, has not been very effective in reducing influenza morbidity and mortality. Although it is too late to make changes this year, the current influenza vaccine crisis affords the opportunity to examine an alternative for future years. The alternative plan, supported by mathematical models and influenza field studies, would be to concentrate vaccine in schoolchildren, the population group most responsible for transmission, while also covering the reachable high-risk groups, who would also receive considerable indirect protection. In conjunction with a plan to ensure an adequate vaccine supply, this alternative influenza vaccination strategy would help control interpandemic influenza and be instrumental in preparing for pandemic influenza. The effectiveness of the alternative plan could be assessed through nationwide community studies.

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups.

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Schneider, S; Seither, B; Tönges, S; Schmitt, H

2006-04-01

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

Food groups and nutrient intake and risk of colorectal cancer: a hospital-based case-control study in Spain.

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Banqué, Marta; Raidó, Blanca; Masuet, Cristina; Ramon, Josep M

2012-04-01

Although evidence supports that colorectal cancer (CRC) has an environmental etiology, the potential influence of diet appears to be one of the most important components. We studied the relation between food groups and nutrient intake and the risk of CRC. A hospital-based case-control study was conducted in Spain between 2007 and 2009. The authors matched 245 patients with incident histologically confirmed CRC by age, gender, and date of admission with 490 controls. Information about nutrient intake was gathered by using a semiquantitative frequency food questionnaire. Univariate analysis was done with individual food items. Odds ratios (ORs) for consecutive tertiles of nutrient intake were computed after allowance for sociodemographic variables and consumption of food groups. Vitamin B6 (OR: 0.26), vitamin D (OR: 0.45), vitamin E (OR: 0.42), polyunsaturated fatty acids (OR: 0.57), and fiber (OR: 0.40) were inversely associated with CRC, whereas carbohydrates (OR: 1.82) were significantly associated with CRC risk for the upper tertile. In multivariate analysis adjusting for major covariables (energy, age, and gender), vitamin D (OR:0.45), vitamin E (OR:0.36), and fiber (OR:0.46) remained associated with CRC. Data suggest that the etiology of colorectal cancer is not due to lifestyle and dietary patterns being important the effect of single nutrients.

Seroprevalence of Brucellosis and Risk Factors Related to High Risk Occupational Groups in Kazeroon, South of Iran

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S Beheshti

2010-03-01

Full Text Available Background: Brucellosis is a major zoonosis worldwide. Many people for their professions are at higher risk of contracting the disease. Objective: To determine the seroprevalence of brucellosis and its risk factors in a group of high risk professions. Methods: In a cross-sectional study, all personnel or students of veterinary schools, slaughters and butchers working in the city were invited to participate (n=141. A comparison group (n=44 randomly selected from patients who were selected at random from people attended our healthcare center for reasons other than the infectious diseases. Results: 4 veterinarians, 15 veterinary assistants, 42 veterinarian students, 52 butchers, 17 slaughters, 8 slaughterhouse workers and 3 chefs made the first group and 14 storekeepers, 5 students of engineering, 11 clerks, 13 freelance workers, and 1 high school student made the comparison group. While the rate of consumption of most of the studied dairy products was almost similar in both groups, comparison group patients consumed more often milk (p<0.001 and cream (p<0.001 than the high risk group. 11 (7.8%; 95% CI: 3.4%–12.2% cases from high risk group and none of the comparison group were found seropositive for Brucella. Conclusion: Profession is the main factor in seropositivity. Consumption of dairy products and raw milk is not associated with a higher risk of seropositivity.

Risk and culture: variations in dioxin risk perceptions, behavioral preferences among social groups in South Korea

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Seohyun Park

2014-10-01

Full Text Available Objectives This study examined variations in the perceptions of dioxin risk among social groups defined by geographical living location, environmental education, and occupation. Dioxin risk perceptions were analyzed according to values, risk awareness, knowledge, and behavioral preferences. Methods A quasi-experimental survey was designed and conducted on individuals from seven experimental groups in Jeonju city, South Korea, including: people living near incineration facilities; people living far from incineration facilities; governmental experts; nongovernmental organization members; office workers in developmental institutes or banks; students who were enrolled in environmental-related classes; and students who were enrolled in business-related classes. Results The results show variations among groups in values, awareness and behavioral preferences. Particular attention should be given to the result that groups with higher connectedness- to-nature values show higher willingness-to-act (WTA for risk reduction. Result s can be summarized as follows. First, awareness is associated with one’s geographical setting. Second, values and WTA behaviors are related to one’s environmental-related education and occupation. Third, values are significantly related to WTA behaviors. Conclusions Different cultures, in terms of values or worldview, among groups influence their perceptions of dioxin risk and choices of risk reduction behaviors. It is important to consider values in communicating complicated long-term risk management involving public participation. Further research should be continuously conducted on the effects of multiple dimensions of values on one’s WTA for risk reduction behaviors.

Support for At-Risk Girls: A School-Based Mental Health Nursing Initiative.

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Adamshick, Pamela

2015-09-01

Mental health problems often go undiagnosed or unaddressed until a crisis or extreme event brings the problem to the forefront. Youth are particularly at risk for lack of identification and treatment in regard to mental health issues. This article describes an advanced nursing practice mental health initiative for at-risk teenage girls based on Hildegard Peplau's nursing theory, group process, and healing through holistic health approaches. A support group, RICHES, was developed with focus on core components of relationships, identity, communication, health, esteem, and support. The acronym RICHES was chosen as the name of the support group. Selected themes and issues addressed in this school-based support group are illustrated in case vignettes. Through a collaborative approach with the community and school, this practice initiative presents a unique healing process that extends knowledge in the realm of intervention with at-risk teenage girls. Further research is needed on the efficacy of support groups to modify risk factors and to address goals for primary prevention in at-risk teenage girls. © The Author(s) 2014.

Risk-matching behavior in microcredit group formation: evidence from northern Ethiopia

NARCIS (Netherlands)

Berhane Tesfay, G.; Gardebroek, C.; Moll, H.A.J.

2009-01-01

Theoretical models on group lending assume the formation of groups of homogenous risk types. Recent theoretical and empirical findings challenge this view arguing that when markets for insurance are missing, risk homogeneity may not hold any more and risk heterogeneity can be the optimal outcome.

Risk-based safety indicators

International Nuclear Information System (INIS)

Szikszai, T.

1997-01-01

The presentation discusses the following issues: The objectives of the risk-based indicator programme. The characteristics of the risk-based indicators. The objectives of risk-based safety indicators - in monitoring safety; in PSA applications. What indicators? How to produce the risk based indicators? PSA requirements

Artificial intelligence on the identification of risk groups for osteoporosis, a general review.

Science.gov (United States)

Cruz, Agnaldo S; Lins, Hertz C; Medeiros, Ricardo V A; Filho, José M F; da Silva, Sandro G

2018-01-29

The goal of this paper is to present a critical review on the main systems that use artificial intelligence to identify groups at risk for osteoporosis or fractures. The systems considered for this study were those that fulfilled the following requirements: range of coverage in diagnosis, low cost and capability to identify more significant somatic factors. A bibliographic research was done in the databases, PubMed, IEEExplorer Latin American and Caribbean Center on Health Sciences Information (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, and Science Direct searching the terms "Neural Network", "Osteoporosis Machine Learning" and "Osteoporosis Neural Network". Studies with titles not directly related to the research topic and older data that reported repeated strategies were excluded. The search was carried out with the descriptors in German, Spanish, French, Italian, Mandarin, Portuguese and English; but only studies written in English were found to meet the established criteria. Articles covering the period 2000-2017 were selected; however, articles prior to this period with great relevance were included in this study. Based on the collected research, it was identified that there are several methods in the use of artificial intelligence to help the screening of risk groups of osteoporosis or fractures. However, such systems were limited to a specific ethnic group, gender or age. For future research, new challenges are presented. It is necessary to develop research with the unification of different databases and grouping of the various attributes and clinical factors, in order to reach a greater comprehensiveness in the identification of risk groups of osteoporosis. For this purpose, the use of any predictive tool should be performed in different populations with greater participation of male patients and inclusion of a larger age range for the

A metaanalysis of perceptual organization in schizophrenia, schizotypy, and other high-risk groups based on variants of the Embedded Figures Task.

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Kirsten Rebecca Panton

2016-02-01

Full Text Available Current research on perceptual organization in schizophrenia frequently employs shapes with regularly sampled contours (fragmented stimuli, in noise fields composed of similar elements, to elicit visual abnormalities. However, perceptual organization is multi-factorial and, in earlier studies, continuous contours have also been employed in tasks assessing the ability to extract shapes from a background. We conducted a systematic review and meta-analysis of studies using closed-contour stimuli, including the Embedded Figures Test (EFT and related tasks, both in people with schizophrenia and in healthy schizotypes and relatives, considered at increased risk for psychosis. Eleven studies met the selection criteria for inclusion in the meta-analysis, including six that used a between-groups study design (i.e. perceptual organization abilities of schizophrenia/high-risk groups were compared to healthy or clinical controls, and five that treated schizophrenia symptoms or schizotypy traits and indices of perceptual organization as continuous variables. Effect sizes and heterogeneity statistics were calculated, and the risk of publication bias was explored. A significant, moderate effect for EFT performance was found with studies that compared performance of schizophrenia/high-risk groups to a healthy or patient comparison group (d = -.523, p<.001. However, significant heterogeneity was also found amongst the schizotypy, but not schizophrenia studies, as well as studies using accuracy, but not reaction time as a measure of performance. A non-significant correlation was found for the studies that examined schizophrenia symptoms or schizotypy traits as continuous variables (r = .012, p = .825. These results suggest that deficits in perceptual organization of non-fragmented stimuli are found when differences between schizophrenia/high-risk groups and comparison groups are maximized. These findings should motivate further investigation of perceptual

ABO blood group and esophageal carcinoma risk: from a case-control study in Chinese population to meta-analysis.

Science.gov (United States)

Wang, Wei; Liu, Lei; Wang, Zhiwei; Lu, Xiaopeng; Wei, Min; Lin, Tianlong; Zhang, Yixin; Jiang, Songqi; Wang, Qiang; Cao, Ziang; Shi, Minxin

2014-10-01

The association between ABO blood group and the risk of esophageal carcinoma (EC) in previously published studies is uncertain and conflicting. The aim of the current study was to determine the correlation of ABO blood group with EC risk via a case-control study and meta-analysis. We performed a population-based case-control study of 3,595 cases and 41,788 controls in Chinese population to evaluate the association between ABO blood group and EC risk. Then, a comprehensive meta-analysis combining our original data and previously published data was conducted to clearly discern the real relationship. The strength of association was measured by odds ratios (ORs) with 95% confidence intervals (CI). In our case-control study, the risk of EC in blood group B was significantly higher than that in non-B groups (A, O, and AB) (OR = 1.15, 95% CI 1.09-1.21). Compared with non-O groups (A, B, and AB), individuals with blood group O demonstrated a reduced risk of EC (OR = 0.90, 95% CI 0.85-0.94). The meta-analysis also indicated that blood group B was associated with significantly higher EC risk (OR = 1.20, 95% CI 1.10-1.31), and people with blood group O had a decreased EC risk (OR = 0.94, 95% CI 0.90-0.99). Neither the case-control study nor the meta-analysis produced any significant association of blood group A or AB with EC risk. Results from our case-control study and the followed meta-analysis confirmed that there was an increased risk of EC in blood group B individuals, whereas a decreased risk of EC was observed in blood group O individuals.

Risk based modelling

International Nuclear Information System (INIS)

Chapman, O.J.V.; Baker, A.E.

1993-01-01

Risk based analysis is a tool becoming available to both engineers and managers to aid decision making concerning plant matters such as In-Service Inspection (ISI). In order to develop a risk based method, some form of Structural Reliability Risk Assessment (SRRA) needs to be performed to provide a probability of failure ranking for all sites around the plant. A Probabilistic Risk Assessment (PRA) can then be carried out to combine these possible events with the capability of plant safety systems and procedures, to establish the consequences of failure for the sites. In this way the probability of failures are converted into a risk based ranking which can be used to assist the process of deciding which sites should be included in an ISI programme. This paper reviews the technique and typical results of a risk based ranking assessment carried out for nuclear power plant pipework. (author)

Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States

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Rupal M. Patel

2017-01-01

Full Text Available This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM among Gujarati Asian Indians (AIs in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n=34 or a control group (n=36 that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p<0.0005 and waist circumference (p=0.04 significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US.

A Psychoeducational School-Based Group Intervention for Socially Anxious Children

Science.gov (United States)

Vassilopoulos, Stephanos P.; Brouzos, Andreas; Damer, Diana E.; Mellou, Angeliki; Mitropoulou, Alexandra

2013-01-01

This study investigated the impact of a psychoeducational group for social anxiety aimed at elementary children. An 8-week psychoeducational program based on empirically validated risk factors was designed. Interventions included cognitive restructuring, anxiety management techniques, and social skills training. Pre-and posttest data from 3 groups…

Assessment of credit risk based on fuzzy relations

Science.gov (United States)

Tsabadze, Teimuraz

2017-06-01

The purpose of this paper is to develop a new approach for an assessment of the credit risk to corporate borrowers. There are different models for borrowers' risk assessment. These models are divided into two groups: statistical and theoretical. When assessing the credit risk for corporate borrowers, statistical model is unacceptable due to the lack of sufficiently large history of defaults. At the same time, we cannot use some theoretical models due to the lack of stock exchange. In those cases, when studying a particular borrower given that statistical base does not exist, the decision-making process is always of expert nature. The paper describes a new approach that may be used in group decision-making. An example of the application of the proposed approach is given.

School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups

DEFF Research Database (Denmark)

Andersen, Anette; Holstein, Bjørn E; Due, Pernille

2006-01-01

Purpose: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors......) was measured by parental occupation. RESULTS: Among girls, exposures to school-related risk factors were more prevalent in lower socio-economic groups. Poor school satisfaction was associated with drunkenness among girls from high SEP, odds ratio (OR) = 2.98 (0.73-12.16). Among boys from high SEP autonomy...

Formation of potential radiation risk groups to render timely targeted medical care: Lessons of Chernobyl

International Nuclear Information System (INIS)

Ivanov, V. K.; Kashcheev, V. V.; Zamulaeva, I. A.; Saenko, A. S.; Orlova, N. V.; Smirnova, S. G.; Korelo, A. M.; Gorsky, A. I.; Maksioutov, M. A.

2012-01-01

The paper discusses technology for establishing potential cancer risk groups, based on methods of molecular and radiation epidemiology. Assay of gene mutations at the T-cell receptor (TCR) locus as the method of molecular epidemiology was used for measuring the frequency of TCR-mutations in 320 nuclear workers of the Inst. of Physics and Power Engineering (IPPE). The method of radiation epidemiology was applied to the estimation of attributable risk fraction (ARF) for solid cancers in these groups. The main estimates of radiation risk after the Chernobyl accident are in close agreement with the International Commission on Radiological Protection (ICRP) Publication, 103 models published in 2007. In nuclear workers of the IPPE with ARF ≥ 10%, the increased level of TCR-mutations occurs more often (risk ratio=9.7; 95% CI: 2.9; 32.1). (authors)

Prevalence of workplace bullying and risk groups

DEFF Research Database (Denmark)

Ortega, Adriana; Høgh, Annie; Pejtersen, Jan Hyld

2009-01-01

OBJECTIVES: To estimate the prevalence of bullying and to identify risk groups in a representative population sample. METHODS: The data for this study was taken from the second Danish Psychosocial Work Environment Study (DPWES). The sample consisted of 3,429 employees between 20 and 59-years......: These findings suggest that types of work and gender ratio are risk factors in the onset of workplace bullying. Future studies should take into account the type of work and the gender ratio of the organization....

Social comparison framing in health news and its effect on perceptions of group risk.

Science.gov (United States)

Bigman, Cabral A

2014-01-01

News about health disparities often compares health risks faced by different demographic groups. Does this social comparison produce a contrast effect? It was hypothesized that when two racial groups are compared, people would perceive the relatively more at-risk group to be more, and the less at-risk group to be less, at-risk than if the same risk information was presented without the comparative reference group. Three experiments with Black and White respondents tested effects of intergroup social comparison framing (SCF) on perceptions of risk for sexually transmitted infections and skin cancer. SCF (including one White and two Black disparity frames) did not raise respondents' perceived risk regarding the more at-risk racial group, but consistently lowered respondents' risk ratings for the less at-risk racial group. The finding that the same statistic was perceived differently in comparative and noncomparative contexts underscores the importance of considering effects of communication about disparities.

Temporal trends in cardiovascular disease risk factors among white, South Asian, Chinese and black groups in Ontario, Canada, 2001 to 2012: a population-based study.

Science.gov (United States)

Chiu, Maria; Maclagan, Laura C; Tu, Jack V; Shah, Baiju R

2015-08-10

To determine ethnic-specific temporal trends in cardiovascular risk factors in Ontario between 2001 and 2012. A population-based repeated cross-sectional study. Ontario, Canada. 219,276 participants of the Canadian Community Health Survey (205,326 white, 5620 South Asian, 4368 Chinese and 3962 black) during the period 2001 to 2012. Age-standardised ethnic-sex-specific prevalence of cardiovascular risk factors for three time periods: 2001-2004, 2005-2008 and 2009-2012 among Canada's four major ethnic groups: white, South Asian, Chinese and black. During the study period, the prevalence of diabetes increased 2.3-fold (p = 0.0001) among South Asian males and 1.9-fold (p = 0.02) among black females. The prevalence of obesity (body mass index ≥ 30 kg/m(2)) increased over time across all ethnic groups, with the largest relative increases observed among males of Chinese (2.1-fold increase, p = 0.04) and black (1.7-fold increase, p = 0.06) descent. The prevalence of hypertension increased the most among black females. Smoking prevalence decreased by more than 20% among South Asian, Chinese and white females. Overall, South Asian males and black males and females showed the greatest declines in cardiovascular health over the study period. We observed important ethnic differences in the temporal trends in cardiovascular risk factor profiles in Ontario. Awareness of the direction and magnitude of these risk factor trends may be useful in informing targeted strategies for preventing cardiovascular diseases in multiethnic populations. 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.

An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group.

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Gordon Mansergh

2010-08-01

Full Text Available Substance use during sex is associated with sexual risk behavior among men who have sex with men (MSM, and MSM continue to be the group at highest risk for incident HIV in the United States. The objective of this study is to test the efficacy of a group-based, cognitive-behavioral intervention to reduce risk behavior of substance-using MSM, compared to a randomized attention-control group and a nonrandomized standard HIV-testing group.Participants (n = 1,686 were enrolled in Chicago, Los Angeles, New York City, and San Francisco and randomized to a cognitive-behavioral intervention or attention-control comparison. The nonrandomized group received standard HIV counseling and testing. Intervention group participants received six 2-h group sessions focused on reducing substance use and sexual risk behavior. Attention-control group participants received six 2-h group sessions of videos and discussion of MSM community issues unrelated to substance use, sexual risk, and HIV/AIDS. All three groups received HIV counseling and testing at baseline. The sample reported high-risk behavior during the past 3 mo prior to their baseline visit: 67% reported unprotected anal sex, and 77% reported substance use during their most recent anal sex encounter with a nonprimary partner. The three groups significantly (p0.05 from each other at 3-, 6-, and 12-mo follow-up. Outcomes for the 2-arm comparisons were not significantly different at 12-mo follow-up (e.g., unprotected anal sex, odds ratio = 1.14, confidence interval = 0.86-1.51, nor at earlier time points. Similar results were found for each outcome variable in both 2- and 3-arm comparisons.These results for reducing sexual risk behavior of substance-using MSM are consistent with results of intervention trials for other populations, which collectively suggest critical challenges for the field of HIV behavioral interventions. Several mechanisms may contribute to statistically indistinguishable reductions in risk

Experience with multiple control groups in a large population-based case-control study on genetic and environmental risk factors.

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Pomp, E R; Van Stralen, K J; Le Cessie, S; Vandenbroucke, J P; Rosendaal, F R; Doggen, C J M

2010-07-01

We discuss the analytic and practical considerations in a large case-control study that had two control groups; the first control group consisting of partners of patients and the second obtained by random digit dialling (RDD). As an example of the evaluation of a general lifestyle factor, we present body mass index (BMI). Both control groups had lower BMIs than the patients. The distribution in the partner controls was closer to that of the patients, likely due to similar lifestyles. A statistical approach was used to pool the results of both analyses, wherein partners were analyzed with a matched analysis, while RDDs were analyzed without matching. Even with a matched analysis, the odds ratio with partner controls remained closer to unity than with RDD controls, which is probably due to unmeasured confounders in the comparison with the random controls as well as intermediary factors. However, when studying injuries as a risk factor, the odds ratio remained higher with partner control subjects than with RRD control subjects, even after taking the matching into account. Finally we used factor V Leiden as an example of a genetic risk factor. The frequencies of factor V Leiden were identical in both control groups, indicating that for the analyses of this genetic risk factor the two control groups could be combined in a single unmatched analysis. In conclusion, the effect measures with the two control groups were in the same direction, and of the same order of magnitude. Moreover, it was not always the same control group that produced the higher or lower estimates, and a matched analysis did not remedy the differences. Our experience with the intricacies of dealing with two control groups may be useful to others when thinking about an optimal research design or the best statistical approach.

Differences in conventional cardiovascular risk factors in two ethnic groups in India.

Science.gov (United States)

Garg, Priyanka Rani; Kabita, Salam; Singh, Huidrom Suraj; Saraswathy, Kallur Nava; Sinha, Ekata; Kalla, Aloke Kumar; Chongtham, Dhanaraj Singh

2012-01-01

Studies have been carried out at national and international levels to assess ethnic variations in the prevalence of cardiovascular diseases and their risk factors. However, ethnic variations in the contribution of various risk factors to complex diseases have been scarcely studied. Our study examined such variations in two ethnic groups in India, namely, Meiteis of Manipur (northeast India) and Aggarwals of Delhi (north India). Through random sampling, we selected 635 participants from the Meitei community and 181 Aggarwals from the Aggarwal Dharmarth Hospital, Delhi. Patients with coronary artery disease (CAD) and hypertension were identified based on their recent medical diagnostic history. Anthropometric parameters such as height, weight, waist and hip circumferences along with physiological parameters (blood pressures, both systolic and diastolic) and biochemical parameter (lipid profile) were measured for all study participants. Patient parameters were available from the medical reports recorded when patients were first diagnosed. Among CAD individuals, the Aggarwals showed higher mean values of weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TC), low density lipoprotein (LDL), and very low density lipoprotein (VLDL) but had lower high density lipoprotein (HDL) levels than the Meiteis. The same trend for weight, BMI and lipid parameters could be seen among hypertensive individuals. In step-wise regression analysis, SBP, LDL and TG were found to significantly contribute to the risk for CAD in the Aggarwals; whereas in the Meiteis, SBP, VLDL, HDL, TC and LDL were found to significantly contribute to the risk for CAD. In hypertensive Aggarwal participants, SBP, DBP and waist-to-hip ratio were significant contributors for hypertension; whereas SBP, DBP, and height contributed significantly to risk for hypertension among the Meiteis. We found marked differences in conventional risk

Use of nonstatistical techniques for pattern recognition to detect risk groups among liquidators of the Chernobyl NPP accident aftereffects

International Nuclear Information System (INIS)

Blinov, N.N.; Guslistyj, V.P.; Misyurev, A.V.; Novitskaya, N.N.; Snigireva, G.P.

1993-01-01

Attempt of using of the nonstatistical techniques for pattern recognition to detect the risk groups among liquidators of the Chernobyl NPP accident aftereffects was described. 14 hematologic, biochemical and biophysical blood serum parameters of the group of liquidators of the Chernobyl NPP accident impact as well as the group of donors free of any radiation dose (controlled group) were taken as the diagnostic parameters. Modification of the nonstatistical techniques for pattern recognition based on the assessment calculations were used. The patients were divided into risk group at the truth ∼ 80%

Men's perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men's Sheds, Australia.

Science.gov (United States)

Liddle, Jeannine L M; Lovarini, Meryl; Clemson, Lindy M; Jang, Haeyoung; Willis, Karen; Lord, Stephen R; Sherrington, Catherine

2017-05-01

Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group-based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi-structured interviews during June and July 2015 which were audio-recorded and transcribed. Data were coded and analysed using constant comparative methods. Over-arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male-friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action. © 2016 John Wiley & Sons Ltd.

Lowering Cardiovascular Disease Risk for People with Severe Mental Illnesses in Primary Care: A Focus Group Study.

Science.gov (United States)

Burton, Alexandra; Osborn, David; Atkins, Lou; Michie, Susan; Gray, Ben; Stevenson, Fiona; Gilbert, Hazel; Walters, Kate

2015-01-01

People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem. To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses. 75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis. Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting. We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.

Grey situation group decision-making method based on prospect theory.

Science.gov (United States)

Zhang, Na; Fang, Zhigeng; Liu, Xiaqing

2014-01-01

This paper puts forward a grey situation group decision-making method on the basis of prospect theory, in view of the grey situation group decision-making problems that decisions are often made by multiple decision experts and those experts have risk preferences. The method takes the positive and negative ideal situation distance as reference points, defines positive and negative prospect value function, and introduces decision experts' risk preference into grey situation decision-making to make the final decision be more in line with decision experts' psychological behavior. Based on TOPSIS method, this paper determines the weight of each decision expert, sets up comprehensive prospect value matrix for decision experts' evaluation, and finally determines the optimal situation. At last, this paper verifies the effectiveness and feasibility of the method by means of a specific example.

Evaluating a web-based health risk assessment with tailored feedback: what does an expert focus group yield compared to a web-based end-user survey?

Science.gov (United States)

Vosbergen, Sandra; Mahieu, Guy R; Laan, Eva K; Kraaijenhagen, Roderik A; Jaspers, Monique Wm; Peek, Niels

2014-01-02

Increasingly, Web-based health applications are developed for the prevention and management of chronic diseases. However, their reach and utilization is often disappointing. Qualitative evaluations post-implementation can be used to inform the optimization process and ultimately enhance their adoption. In current practice, such evaluations are mainly performed with end-user surveys. However, a review approach by experts in a focus group may be easier to administer and might provide similar results. The aim of this study was to assess whether industrial design engineers in a focus group would address the same issues as end users in a Web-based survey when evaluating a commercial Web-based health risk assessment (HRA) with tailored feedback. Seven Dutch companies used the HRA as part of their corporate health management strategy. Employees using the HRA (N=2289) and 10 independent industrial designers were invited to participate in the study. The HRA consisted of four components: (1) an electronic health questionnaire, (2) biometric measurements, (3) laboratory evaluation, and (4) individually tailored feedback generated by decision support software. After participating in the HRA as end users, both end users and designers evaluated the program. End users completed an evaluation questionnaire that included a free-text field. Designers participated in a focus group discussion. Constructs from user satisfaction and technology acceptance theories were used to categorize and compare the remarks from both evaluations. We assessed and qualitatively analyzed 294 remarks of 189 end users and 337 remarks of 6 industrial designers, pertaining to 295 issues in total. Of those, 137 issues were addressed in the end-user survey and 148 issues in the designer focus group. Only 7.3% (10/137) of the issues addressed in the survey were also addressed in the focus group. End users made more remarks about the usefulness of the HRA and prior expectations that were not met. Designers made

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

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Ritu Nehra

2013-12-01

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

Learning to communicate risk information in groups

Directory of Open Access Journals (Sweden)

Hsuchi Ting

2008-12-01

Full Text Available Despite vigorous research on risk communication, little is known about the social forces that drive these choices. Erev, Wallsten, and Neal (1991 showed that forecasters learn to select verbal or numerical probability estimates as a function of which mode yields on average the larger group payoffs. We extend the result by investigating the effect of group size on the speed with which forecasters converge on the better communication mode. On the basis of social facilitation theory we hypothesized that small groups induce less arousal and anxiety among their members than do large groups when performing new tasks, and therefore that forecasters in small groups will learn the better communication mode more quickly. This result obtained in Experiment 1, which compared groups of size 3 to groups of size 5 or 6. To test whether social loafing rather than social facilitation was mediating the effects, Experiment 2 compared social to personal feedback holding group size constant at 3 members. Learning was faster in the personal feedback condition, suggesting that social facilitation rather than loafing underlay the results.

When are emotions related to group-based appraisals? A comparison between group-based emotions and general group emotions.

Science.gov (United States)

Kuppens, Toon; Yzerbyt, Vincent Y

2014-12-01

In the literature on emotions in intergroup relations, it is not always clear how exactly emotions are group-related. Here, we distinguish between emotions that involve appraisals of immediate group concerns (i.e., group-based emotions) and emotions that do not. Recently, general group emotions, measured by asking people how they feel "as a group member" but without specifying an object for these emotions, have been conceptualized as reflecting appraisals of group concerns. In contrast, we propose that general group emotions are best seen as emotions about belonging to a group. In two studies, general group emotions were closely related to emotions that are explicitly measured as belonging emotions. Two further studies showed that general group emotions were not related to appraisals of immediate group concerns, whereas group-based emotions were. We argue for more specificity regarding the group-level aspects of emotion that are tapped by emotion measures. © 2014 by the Society for Personality and Social Psychology, Inc.

Risk-based screening combined with a PCR-based test for group B streptococci diminishes the use of antibiotics in laboring women.

Science.gov (United States)

Khalil, Mohammed R; Uldbjerg, Niels; Thorsen, Poul B; Henriksen, Birgitte; Møller, Jens K

2017-08-01

To assess the performance of a polymerase chain reaction - group B streptococci test (PCR-GBS test) - in deciding antibiotic prophylaxis in term laboring women. In this observational study, we enrolled 902 unselected Danish term pregnant women. During labor, midwives obtained vaginal swabs that were used for both GBS cultures (reference standard) and for the PCR-GBS test. Furthermore, we recorded the presence of risk factors for EOGBS (Early Onset Group B Streptococcal disease): (1) Bacteriuria during current pregnancy, (2) Prior infant with EOGBS (3) Temperature above 38.0°C during labor, and (4) Rupture of membranes ≥18h. The prevalence of GBS carriers was 12% (104 of 902), the sensitivity of the PCR-GBS test 83% (86 of 104), and the specificity 97% (774 of 798). Among the 108 with one or more EOGBS-risk factors, GBS was present in 23% (25 of 108), the sensitivity 92% (23 of 25), and the specificity 89% (74 of 83). In programs that aim to treat all laboring women with vaginal GBS-colonization (12% in the present study) with penicillin, the PCR-GBS will perform well (sensitivity 83% and specificity 97%). In programs aiming to treat only GBS-carriers among those with risk factors of EOGBS, a reduction of penicillin usage by two-thirds from 12% to 4% may be possible. Copyright © 2017 Elsevier B.V. All rights reserved.

ABO Blood Group and Dementia Risk--A Scandinavian Record-Linkage Study.

Directory of Open Access Journals (Sweden)

Senthil K Vasan

Full Text Available Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined the relationship between ABO blood group and dementia-related disorders in detail.We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient and cause of death registers to investigate the relationship between blood groups and risk of different types of dementia. The incident rate ratios were estimated using log-linear Poisson regression models.Among 1,598,294 donors followed over 24 million person-years of observation we ascertained 3,615 cases of Alzheimer's disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer's disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors aged 70 years or older except for a slight, but significantly decreased risk of all dementia combined in subjects with blood group A (IRR, 0.93; 95% confidence interval [CI], 0.88-0.98, compared to those with blood group O.Our results provide no evidence that ABO blood group influences the risk of dementia.

Group dynamics of zebra and wildebeest in a woodland savanna: effects of predation risk and habitat density.

Directory of Open Access Journals (Sweden)

Maria Thaker

Full Text Available BACKGROUND: Group dynamics of gregarious ungulates in the grasslands of the African savanna have been well studied, but the trade-offs that affect grouping of these ungulates in woodland habitats or dense vegetation are less well understood. We examined the landscape-level distribution of groups of blue wildebeest, Connochaetes taurinus, and Burchell's zebra, Equus burchelli, in a predominantly woodland area (Karongwe Game Reserve, South Africa; KGR to test the hypothesis that group dynamics are a function of minimizing predation risk from their primary predator, lion, Panthera leo. METHODOLOGY/PRINCIPAL FINDINGS: Using generalized linear models, we examined the relative importance of habitat type (differing in vegetation density, probability of encountering lion (based on utilization distribution of all individual lions in the reserve, and season in predicting group size and composition. We found that only in open scrub habitat, group size for both ungulate species increased with the probability of encountering lion. Group composition differed between the two species and was driven by habitat selection as well as predation risk. For both species, composition of groups was, however, dominated by males in open scrub habitats, irrespective of the probability of encountering lion. CONCLUSIONS/SIGNIFICANCE: Distribution patterns of wildebeest and zebra groups at the landscape level directly support the theoretical and empirical evidence from a range of taxa predicting that grouping is favored in open habitats and when predation risk is high. Group composition reflected species-specific social, physiological and foraging constraints, as well as the importance of predation risk. Avoidance of high resource open scrub habitat by females can lead to loss of foraging opportunities, which can be particularly costly in areas such as KGR, where this resource is limited. Thus, landscape-level grouping dynamics are species specific and particular to the

Supplier Risk Assessment Based on Best-Worst Method and K-Means Clustering: A Case Study

Directory of Open Access Journals (Sweden)

Merve Er Kara

2018-04-01

Full Text Available Supplier evaluation and selection is one of the most critical strategic decisions for developing a competitive and sustainable organization. Companies have to consider supplier related risks and threats in their purchasing decisions. In today’s competitive and risky business environment, it is very important to work with reliable suppliers. This study proposes a clustering based approach to group suppliers based on their risk profile. Suppliers of a company in the heavy-machinery sector are assessed based on 17 qualitative and quantitative risk types. The weights of the criteria are determined by using the Best-Worst method. Four factors are extracted by applying Factor Analysis to the supplier risk data. Then k-means clustering algorithm is applied to group core suppliers of the company based on the four risk factors. Three clusters are created with different risk exposure levels. The interpretation of the results provides insights for risk management actions and supplier development programs to mitigate supplier risk.

Lowering Cardiovascular Disease Risk for People with Severe Mental Illnesses in Primary Care: A Focus Group Study.

Directory of Open Access Journals (Sweden)

Alexandra Burton

Full Text Available People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem.To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses.75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis.Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting.We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.

Johnson Space Center's Risk and Reliability Analysis Group 2008 Annual Report

Science.gov (United States)

Valentine, Mark; Boyer, Roger; Cross, Bob; Hamlin, Teri; Roelant, Henk; Stewart, Mike; Bigler, Mark; Winter, Scott; Reistle, Bruce; Heydorn,Dick

2009-01-01

The Johnson Space Center (JSC) Safety & Mission Assurance (S&MA) Directorate s Risk and Reliability Analysis Group provides both mathematical and engineering analysis expertise in the areas of Probabilistic Risk Assessment (PRA), Reliability and Maintainability (R&M) analysis, and data collection and analysis. The fundamental goal of this group is to provide National Aeronautics and Space Administration (NASA) decisionmakers with the necessary information to make informed decisions when evaluating personnel, flight hardware, and public safety concerns associated with current operating systems as well as with any future systems. The Analysis Group includes a staff of statistical and reliability experts with valuable backgrounds in the statistical, reliability, and engineering fields. This group includes JSC S&MA Analysis Branch personnel as well as S&MA support services contractors, such as Science Applications International Corporation (SAIC) and SoHaR. The Analysis Group s experience base includes nuclear power (both commercial and navy), manufacturing, Department of Defense, chemical, and shipping industries, as well as significant aerospace experience specifically in the Shuttle, International Space Station (ISS), and Constellation Programs. The Analysis Group partners with project and program offices, other NASA centers, NASA contractors, and universities to provide additional resources or information to the group when performing various analysis tasks. The JSC S&MA Analysis Group is recognized as a leader in risk and reliability analysis within the NASA community. Therefore, the Analysis Group is in high demand to help the Space Shuttle Program (SSP) continue to fly safely, assist in designing the next generation spacecraft for the Constellation Program (CxP), and promote advanced analytical techniques. The Analysis Section s tasks include teaching classes and instituting personnel qualification processes to enhance the professional abilities of our analysts

Urban adolescent high-risk sexual behavior: corroboration of focus group discussions through pile-sorting. The AIDS Youth Research Team.

Science.gov (United States)

Stanton, B F; Aronson, R; Borgatti, S; Galbraith, J; Feigelman, S

1993-01-01

Risk activities for acquisition of the human immunodeficiency virus (HIV) remain prevalent among urban adolescents. While interdisciplinary approaches to examine the variables contributing to risk/protective behaviors have been promoted, strategies for such explorations require further formulation. Recently we employed focus group discussions to explore factors placing urban adolescents at risk for engaging in HIV risk behaviors. The focus group format enables substantial interaction on a topic in a limited time period, but does not always provide expression of the full range of behavioral options. In this study we investigated the use of pile-sorts for confirmation of impressions from focus group discussions among 57 urban youths aged 10-14. The pile-sorts revealed some support for most of the views expressed in the group discussions. However, the sorts revealed more variability in views than was expressed in the group discussions. Substantial gender and age-based differences in perceptions were revealed with potentially important intervention implications.

Depression evaluation in an attendance group for high-risk pregnant women

OpenAIRE

Adriana Said Daher Baptista; Makilim Nunes Baptista

2005-01-01

The goal of this study was to verify the variation of depression symptomatology in an informative high-risk post-partum group of pregnant (GAGER). Six high-risk pregnant women, from a University Hospital participated in this research, and they were evaluated four times: first, before forming the group; second, after two participations in this group; third, 24 to 36 hours after partum; and, four weeks post-partum. The instruments used were a Psychological Clinic Interview and, the Edinburgh Po...

Parent Training with High-Risk Immigrant Chinese Families: A Pilot Group Randomized Trial Yielding Practice-Based Evidence

Science.gov (United States)

Lau, Anna S.; Fung, Joey J.; Ho, Lorinda Y.; Liu, Lisa L.; Gudino, Omar G.

2011-01-01

We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families.…

Effects of Community-Based Collaborative Group Characteristics on Social Capital

Science.gov (United States)

Wagner, Cheryl L.; Fernandez-Gimenez, Maria E.

2009-10-01

Recent research suggests that community-based collaboration may build social capital—defined as trust, norms of reciprocity, and networks. Social capital may improve a group’s ability to collaborate, manage risk, innovate, and adapt to change. We used mail surveys of group participants and key informant interviews to assess whether the following collaborative group characteristics affected social capital built within 10 collaborative groups in northwest Colorado: perceived success, conflict, activeness, stakeholder diversity, previous collaboration experience, similar values and beliefs, group size, group age, and initial social capital. Perceived success and initial levels of social capital were the strongest predictors of current levels of and changes in social capital over time. Collaboration experience negatively influenced current levels of trust. Our results suggest that collaborative groups may need to consider the outcomes of collaborative interactions in order to build social capital.

77 FR 53059 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2012-08-30

...'' framework that includes (1) Risk-based capital requirements for credit risk, market risk, and operational... default and credit quality migration risk for non-securitization credit products. With respect to... securitization positions, the revisions assign a specific risk- weighting factor based on the credit rating of a...

Risk-based safety indicators

International Nuclear Information System (INIS)

Sedlak, J.

2001-12-01

The report is structured as follows: 1. Risk-based safety indicators: Typology of risk-based indicators (RBIs); Tools for defining RBIs; Requirements for the PSA model; Data sources for RBIs; Types of risks monitored; RBIs and operational safety indicators; Feedback from operating experience; PSO model modification for RBIs; RBI categorization; RBI assessment; RBI applications; Suitable RBI applications. 2. Proposal for risk-based indicators: Acquiring information from operational experience; Method of acquiring safety relevance coefficients for the systems from a PSA model; Indicator definitions; On-line indicators. 3. Annex: Application of RBIs worldwide. (P.A.)

Holocaust exposure and subsequent suicide risk: a population-based study.

Science.gov (United States)

Bursztein Lipsicas, Cendrine; Levav, Itzhak; Levine, Stephen Z

2017-03-01

To examine the association between the extent of genocide exposure and subsequent suicide risk among Holocaust survivors. Persons born in Holocaust-exposed European countries during the years 1922-1945 that immigrated to Israel by 1965 were identified in the Population Registry (N = 209,429), and followed up for suicide (1950-2014). They were divided into three groups based on likely exposure to Nazi persecution: those who immigrated before (indirect; n = 20,229; 10%), during (partial direct; n = 17,189; 8%), and after (full direct; n = 172,061; 82%) World War II. Groups were contrasted for suicide risk, accounting for the extent of genocide in their respective countries of origin, high (>70%) or lower levels (Holocaust survivors (full direct exposure) as a resilient group. A tentative mechanism for higher vulnerability to suicide risk of the partial direct exposure group from countries with higher genocide exposure includes protracted guilt feelings, having directly witnessed atrocities and escaped death.

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

International Nuclear Information System (INIS)

Lefere, Philippe; Silva, Celso; Gryspeerdt, Stefaan; Rodrigues, António; Vasconcelos, Rita; Teixeira, Ricardo; Gouveia, Francisco Henriques de

2013-01-01

Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. Materials and methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. Results: 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6–99.9% 95% CI), 90.97% (87.8–93.4% 95% CI), 56.52% (45.8–66.7% 95% CI), 99.75% (98.4–99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7–100% 95% CI), 87.07% (83.6–89.9% 95% CI), 34.78% (25.3–45.5% 95% CI) and 100% (98.8–100% 95% CI), respectively. Conclusion: In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Lefere, Philippe, E-mail: radiologie@skynet.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Silva, Celso, E-mail: caras@uma.pt [Human Anatomy of Medical Course, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Gryspeerdt, Stefaan, E-mail: stefaan@sgryspeerdt.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Rodrigues, António, E-mail: nucleo@nid.pt [Nucleo Imagem Diagnostica, Rua 5 De Outubro, 9000-216 Funchal (Portugal); Vasconcelos, Rita, E-mail: rita@uma.pt [Department of Engineering and Mathematics, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Teixeira, Ricardo, E-mail: j.teixeira1947@gmail.com [Department of Gastroenterology, Central Hospital of Funchal, Avenida Luís de Camões, 9004513 Funchal (Portugal); Gouveia, Francisco Henriques de, E-mail: fhgouveia@netmadeira.com [LANA, Pathology Centre, Rua João Gago, 10, 9000-071 Funchal (Portugal)

2013-06-15

Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. Materials and methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. Results: 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6–99.9% 95% CI), 90.97% (87.8–93.4% 95% CI), 56.52% (45.8–66.7% 95% CI), 99.75% (98.4–99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7–100% 95% CI), 87.07% (83.6–89.9% 95% CI), 34.78% (25.3–45.5% 95% CI) and 100% (98.8–100% 95% CI), respectively. Conclusion: In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer.

The third spatial dimension risk approach for individual risk and group risk in multiple use of space

International Nuclear Information System (INIS)

Suddle, Shahid; Ale, Ben

2005-01-01

Buildings above roads and railways are examples of multiple use of space. Safety is one of the critical issues for such projects. Risk analyses can be undertaken to investigate what safety measures that are required to realise these projects. The results of these analyses can also be compared to risk acceptance criteria, if they are applicable. In The Netherlands, there are explicit criteria for acceptability of individual risk and societal risk. Traditionally calculations of individual risk result in contours of equal risk on a map and thus are considered in two-dimensional space only. However, when different functions are layered the third spatial dimension, height, becomes an important parameter. The various activities and structures above and below each other impose mutual risks. There are no explicit norms or policies about how to deal with the individual or group risk approach in the third dimension. This paper proposes an approach for these problems and gives some examples. Finally, the third dimension risk approach is applied in a case study of Bos en Lommer, Amsterdam

When are emotions related to group-based appraisals? : A comparison between group-based emotions and general group emotions

NARCIS (Netherlands)

Kuppens, Toon; Yzerbyt, Vincent Y.

2014-01-01

In the literature on emotions in intergroup relations, it is not always clear how exactly emotions are group-related. Here, we distinguish between emotions that involve appraisals of immediate group concerns (i.e., group-based emotions) and emotions that do not. Recently, general group emotions,

[Making up tuberculosis risk groups from decreed contingents].

Science.gov (United States)

Kucherov, A L; Il'icheva, E Iu

2001-01-01

The paper provides materials to make up risk groups from decreed contingents by using the database developed and introduced in the Novomoskovsk district, as well as a programme for rapid determination of the risk of tuberculosis. This procedure reduces a scope of fluorographic surveys among the decreed contingents, as well as their expenditures by 60%. Moreover, it may be useful for professional choice in the employment of the decreed persons, which may promote a decrease in the incidence of tuberculosis among them.

Risk-based ranking of dominant contributors to maritime pollution events

International Nuclear Information System (INIS)

Wheeler, T.A.

1993-01-01

This report describes a conceptual approach for identifying dominant contributors to risk from maritime shipping of hazardous materials. Maritime transportation accidents are relatively common occurrences compared to more frequently analyzed contributors to public risk. Yet research on maritime safety and pollution incidents has not been guided by a systematic, risk-based approach. Maritime shipping accidents can be analyzed using event trees to group the accidents into 'bins,' or groups, of similar characteristics such as type of cargo, location of accident (e.g., harbor, inland waterway), type of accident (e.g., fire, collision, grounding), and size of release. The importance of specific types of events to each accident bin can be quantified. Then the overall importance of accident events to risk can be estimated by weighting the events' individual bin importance measures by the risk associated with each accident bin. 4 refs., 3 figs., 6 tabs

Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model.

Science.gov (United States)

Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

2013-05-28

To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.

Risk-based classification system of nanomaterials

International Nuclear Information System (INIS)

Tervonen, Tommi; Linkov, Igor; Figueira, Jose Rui; Steevens, Jeffery; Chappell, Mark; Merad, Myriam

2009-01-01

Various stakeholders are increasingly interested in the potential toxicity and other risks associated with nanomaterials throughout the different stages of a product's life cycle (e.g., development, production, use, disposal). Risk assessment methods and tools developed and applied to chemical and biological materials may not be readily adaptable for nanomaterials because of the current uncertainty in identifying the relevant physico-chemical and biological properties that adequately describe the materials. Such uncertainty is further driven by the substantial variations in the properties of the original material due to variable manufacturing processes employed in nanomaterial production. To guide scientists and engineers in nanomaterial research and application as well as to promote the safe handling and use of these materials, we propose a decision support system for classifying nanomaterials into different risk categories. The classification system is based on a set of performance metrics that measure both the toxicity and physico-chemical characteristics of the original materials, as well as the expected environmental impacts through the product life cycle. Stochastic multicriteria acceptability analysis (SMAA-TRI), a formal decision analysis method, was used as the foundation for this task. This method allowed us to cluster various nanomaterials in different ecological risk categories based on our current knowledge of nanomaterial physico-chemical characteristics, variation in produced material, and best professional judgments. SMAA-TRI uses Monte Carlo simulations to explore all feasible values for weights, criteria measurements, and other model parameters to assess the robustness of nanomaterial grouping for risk management purposes.

The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report.

Science.gov (United States)

Monclair, Tom; Brodeur, Garrett M; Ambros, Peter F; Brisse, Hervé J; Cecchetto, Giovanni; Holmes, Keith; Kaneko, Michio; London, Wendy B; Matthay, Katherine K; Nuchtern, Jed G; von Schweinitz, Dietrich; Simon, Thorsten; Cohn, Susan L; Pearson, Andrew D J

2009-01-10

The International Neuroblastoma Risk Group (INRG) classification system was developed to establish a consensus approach for pretreatment risk stratification. Because the International Neuroblastoma Staging System (INSS) is a postsurgical staging system, a new clinical staging system was required for the INRG pretreatment risk classification system. To stage patients before any treatment, the INRG Task Force, consisting of neuroblastoma experts from Australia/New Zealand, China, Europe, Japan, and North America, developed a new INRG staging system (INRGSS) based on clinical criteria and image-defined risk factors (IDRFs). To investigate the impact of IDRFs on outcome, survival analyses were performed on 661 European patients with INSS stages 1, 2, or 3 disease for whom IDRFs were known. In the INGRSS, locoregional tumors are staged L1 or L2 based on the absence or presence of one or more of 20 IDRFs, respectively. Metastatic tumors are defined as stage M, except for stage MS, in which metastases are confined to the skin, liver, and/or bone marrow in children younger than 18 months of age. Within the 661-patient cohort, IDRFs were present (ie, stage L2) in 21% of patients with stage 1, 45% of patients with stage 2, and 94% of patients with stage 3 disease. Patients with INRGSS stage L2 disease had significantly lower 5-year event-free survival than those with INRGSS stage L1 disease (78% +/- 4% v 90% +/- 3%; P = .0010). Use of the new staging (INRGSS) and risk classification (INRG) of neuroblastoma will greatly facilitate the comparison of risk-based clinical trials conducted in different regions of the world.

Risk Assessment Review Group report to the U.S. Nuclear Regulatory Commission

International Nuclear Information System (INIS)

Lewis, H.W.; Budnitz, R.J.; Kouts, H.J.C.; Loewenstein, W.B.; Rowe, W.D.; von Hippel, F.; Zachariasen, F.

1978-09-01

The Risk Assessment Review Group was organized by the U.S. Nuclear Regulatory Commission on July 1, 1977, with four elements to its charter: clarify the achievements and limitations of WASH-1400, the ''Rasmussen Report''; assess the peer comments thereon, and responses to those comments; study the present state of such risk assessment methodology; and recommend to the Commission how (and whether) such methodology can be used in the regulatory and licensing process. Areas of study include: risk assessment methodologies; statistical issues; completeness; the data base; and the WASH-1400 assessment of the damage to human health from radiation after a postulated accident. Specific items discussed include: Browns Ferry; common cause failure; human factors; format and scrutability; the peer review process; earthquakes; risk perception; allegations by UCS concerning WASH-1400 treatment of quality assurance and quality control; current role of probabilistic methods in the regulatory process; acts of violence; ATWS; influence of design defects in quality assurance failures; and calculation of population doses from given releases of radionuclides

A procedure for grouping food consumption data for use in food allergen risk assessment

DEFF Research Database (Denmark)

Birot, Sophie; Madsen, Charlotte Bernhard; Kruizinga, Astrid G.

2017-01-01

Food allergic subjects need to avoid the allergenic food that triggers their allergy. However, foods can also contain unintended allergens. Food manufacturers or authorities need to perform a risk assessment to be able to decide if unintended allergen presence constitutes a risk to food allergic...... consumers. One of the input parameters in risk assessment is the amount of a given food consumed in a meal. There has been little emphasis on how food consumption data can be used in food allergen risk assessment. The aim of the study was to organize the complex datasets from National Food Consumption...... Surveys from different countries (France, Netherlands and Denmark) to be manageable in food allergen risk assessment. To do this, a two-step method was developed. First, based on initial groups of similar food items, the homogeneity of consumption was evaluated using a customized clustering method. Then...

Did our current initial treatment practice change after EAU/ESPU vesicoureteral reflux risk grouping?

Science.gov (United States)

Tokat, Eda; Gurocak, Serhat; Ure, Iyimser; Acar, Cenk; Sınık, Zafer; Tan, Mustafa Ozgur

2018-06-02

The "European Association of Urology (EAU) Guidelines on Vesicoureteral Reflux (VUR) in Children (September 2012)" established risk classification by analyzing and defining risk factors for each patient. In this study we aimed to investigate how our initial treatment procedures were affected by EAU/ESPU guideline vesicoureteral reflux risk grouping and to compare the early clinical results of treatments performed before and after the risk classification in our patients with VUR. 334 renal units with regular clinical follow-up who were treated owing to VUR (vesicoureteral reflux) between years 2009 and 2017 were retrospectively reviewed. Preoperative clinical parameters such as grade and laterality of reflux, presence of renal scar, initial and follow-up treatments, findings of medical treatment and surgical procedures were analyzed. The initial medical and surgical methods were compared by categorizing patients according to risk groups before and after 2013. Mean age and follow-up duration were 71.4(6-216) months and 47(4-141) months, respectively. Among the preoperative parameters, only high EAU risk group (p = 0.01) and treating lower urinary tract symptoms (p age, sex, and presence of renal scar at DMSA were not affecting the success of treatment significantly. While no significant difference in medical and surgical treatment rates is observed after risk grouping system in low risk group, the percentages of patients who are treated with surgical methods initially were significantly decreased in moderate and high risk groups (p = 0.002 and p = 0.012, respectively). We determined that VUR risk grouping did not change clinical success significantly in all risk groups. Despite the fact that EAU/ESPU VUR risk classification changed our current practice in terms of initial treatment method, this different approach did not seem to affect early clinical success positively. There is still an absolute need for studies with larger sample size and long

Risks identification and ranking using AHP and group decision making technique: Presenting “R index”

Directory of Open Access Journals (Sweden)

Safar Fazli

2013-02-01

Full Text Available One of the primary concerns in project development is to detect all sorts of risks associated with a particular project. The main objective of this article is to identify the risks in the construction project and to grade them based on their importance on the project. The designed indicator in this paper is the combinational model of the Analytical Hierarchal Process (AHP method and the group decision – making applied for risks measurement and ranking. This indicator is called "R" which includes three main steps: creating the risks broken structure (RBS, obtaining each risk weight and efficacy, and finally performing the model to rank the risks. A questionnaire is used for gathering data. Based on the results of this survey, there are important risks associated with construction projects. There we need to use some guidelines to reduce the inherent risks including recognition of the common risks beside the political risks; suggestion of a simple, understandable, and practical model; and using plenty of the experts and specialists' opinions through applying step. After analyzing data, the final result from applying R index showed that the risk “economic changes / currency rate and inflation change" has the most importance for the analysis. In the other words, if these risks occur, the project may face with the more threats and it is suggested that an organization should centralize its equipment, personnel, cost, and time on the risk more than ever. The most obvious issue in this paper is a tremendous difference between an importance of the financial risks and the other risks.

Early Home-Based Intervention in the Netherlands for Children at Familial Risk of Dyslexia

Science.gov (United States)

van Otterloo, Sandra G.; van der Leij, Aryan; Henrichs, Lotte F.

2009-01-01

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n = 23) received a specific training in phoneme awareness and letter knowledge. A control group (n = 25) received…

Risk perception among women receiving genetic counseling: a population-based follow-up study

DEFF Research Database (Denmark)

Mikkelsen, Ellen M; Sunde, Lone; Johansen, Christoffer

2007-01-01

-up study of 213 women who received genetic counseling for hereditary breast and ovarian cancer, 319 women who underwent mammography (Reference Group I), and a random sample of 1070 women from the general population (Reference Group II). RESULTS: Women who received genetic counseling decreased...... counseling, compared to a reduction of 5% (p=0.03) and 2% (p=0.01) in Reference Groups I and II, respectively. Risk communicated only in words, inaccurate risk perception at baseline, and presence of a familial mutation appeared to be predictors of inaccurate risk perception 12 months after counseling......BACKGROUND: We aimed to explore the impact of genetic counseling on perceived personal lifetime risk of breast cancer, the accuracy of risk perception, and possible predictors of inaccurate risk perception 1 year following counseling. METHODS: We conducted a population-based prospective follow...

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection

Science.gov (United States)

Lin, Hui; Wang, Zhou-Jing

2017-01-01

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice. PMID:28926985

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection.

Science.gov (United States)

Lin, Hui; Wang, Zhou-Jing

2017-09-17

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice.

Diagnosis and Management of High Risk Group for Gastric Cancer

Science.gov (United States)

Yoon, Hyuk; Kim, Nayoung

2015-01-01

Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

How young people communicate risks of snowmobiling in northern Norway: a focus group study.

Science.gov (United States)

Mehus, Grete; Germeten, Sidsel; Henriksen, Nils

2011-04-01

This study aims to understand how the risks of snowmobiling are communicated among northern Norwegian youths. Study design. A qualitative design with focus group interviews was chosen. Interviews centred on safety precautions and estimation of risks related to snowmobiling and driving patterns. Eighty-one students (31 girls and 50 boys) aged between 16 and 23 years from 8 high schools were interviewed in 17 focus groups that were segregated by gender. Interview data were analysed using qualitative content analysis. Boys and girls communicated differently about risks. Peer-group conformity appeared stronger among boys than girls. Boys did not spontaneously relate risks to their snowmobile activities, while girls did. Boys focused upon training, coping and balance between control and lack of control while driving. Girls talked about risks, were aware of risks and sought to avoid risky situations, in contrast to boys. Boys' risk communication in groups was about how to manage challenging situations. Their focus overall was on trying to maintain control while simultaneously testing their limits. Three risk categories emerged: those who drive as they ought to (mostly girls), those who occasionally take some risks (boys and girls) and those who are extreme risk-takers (a smaller number of boys). Perceptions of and communication about risk are related to gender, peer group and familiarity with risk-taking when snowmobiling. Northern Norwegian boys' driving behaviour highlights a specific need for risk reduction, but this must also draw upon factors such as acceptance of social and cultural codes and common sense related to snowmobiling.

The effects of adding group-based lifestyle counselling to individual counselling on changes in plasma glucose levels in a randomized controlled trial: The Inter99 study

DEFF Research Database (Denmark)

Lau, C.; Vistisen, D.; Toft, U.

2011-01-01

AimThis study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes. MethodsIn a population-based study of 6784......% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738...... participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10...

Risk-Based Sampling: I Don't Want to Weight in Vain.

Science.gov (United States)

Powell, Mark R

2015-12-01

Recently, there has been considerable interest in developing risk-based sampling for food safety and animal and plant health for efficient allocation of inspection and surveillance resources. The problem of risk-based sampling allocation presents a challenge similar to financial portfolio analysis. Markowitz (1952) laid the foundation for modern portfolio theory based on mean-variance optimization. However, a persistent challenge in implementing portfolio optimization is the problem of estimation error, leading to false "optimal" portfolios and unstable asset weights. In some cases, portfolio diversification based on simple heuristics (e.g., equal allocation) has better out-of-sample performance than complex portfolio optimization methods due to estimation uncertainty. Even for portfolios with a modest number of assets, the estimation window required for true optimization may imply an implausibly long stationary period. The implications for risk-based sampling are illustrated by a simple simulation model of lot inspection for a small, heterogeneous group of producers. © 2015 Society for Risk Analysis.

Evaluation of risk management and financial performance of BMW Group

OpenAIRE

Mysina, Amira

2017-01-01

Effective risk and financial management possess a great challenge for the multinational companies operating globally. Despite the increasing development of diverse hedging strategies against foreign exchange risk, global firms cannot fully foresee and measure the degree of the impact of foreign currency fluctuations. This paper aims to evaluate the exchange risk management and financial performance of the BMW Group from the year 2005 to 2016. Moreover, this paper is devoted to provide explana...

Risk-based classification system of nanomaterials

Energy Technology Data Exchange (ETDEWEB)

Tervonen, Tommi, E-mail: t.p.tervonen@rug.n [University of Groningen, Faculty of Economics and Business (Netherlands); Linkov, Igor, E-mail: igor.linkov@usace.army.mi [US Army Research and Development Center (United States); Figueira, Jose Rui, E-mail: figueira@ist.utl.p [Technical University of Lisbon, CEG-IST, Centre for Management Studies, Instituto Superior Tecnico (Portugal); Steevens, Jeffery, E-mail: jeffery.a.steevens@usace.army.mil; Chappell, Mark, E-mail: mark.a.chappell@usace.army.mi [US Army Research and Development Center (United States); Merad, Myriam, E-mail: myriam.merad@ineris.f [INERIS BP 2, Societal Management of Risks Unit/Accidental Risks Division (France)

2009-05-15

Various stakeholders are increasingly interested in the potential toxicity and other risks associated with nanomaterials throughout the different stages of a product's life cycle (e.g., development, production, use, disposal). Risk assessment methods and tools developed and applied to chemical and biological materials may not be readily adaptable for nanomaterials because of the current uncertainty in identifying the relevant physico-chemical and biological properties that adequately describe the materials. Such uncertainty is further driven by the substantial variations in the properties of the original material due to variable manufacturing processes employed in nanomaterial production. To guide scientists and engineers in nanomaterial research and application as well as to promote the safe handling and use of these materials, we propose a decision support system for classifying nanomaterials into different risk categories. The classification system is based on a set of performance metrics that measure both the toxicity and physico-chemical characteristics of the original materials, as well as the expected environmental impacts through the product life cycle. Stochastic multicriteria acceptability analysis (SMAA-TRI), a formal decision analysis method, was used as the foundation for this task. This method allowed us to cluster various nanomaterials in different ecological risk categories based on our current knowledge of nanomaterial physico-chemical characteristics, variation in produced material, and best professional judgments. SMAA-TRI uses Monte Carlo simulations to explore all feasible values for weights, criteria measurements, and other model parameters to assess the robustness of nanomaterial grouping for risk management purposes.

Risk-based configuration control

International Nuclear Information System (INIS)

Szikszai, T.

1997-01-01

The presentation discusses the following issues: The Configuration Control; The Risk-based Configuration Control (during power operation mode, and during shutdown mode). PSA requirements. Use of Risk-based Configuration Control System. Configuration Management (basic elements, benefits, information requirements)

Screening Models for Cardiac Risk Evaluation in Emergency Abdominal Surgery. I. Evaluation of the Intraoperative Period Risk based on Data from the Preoperative Period

Directory of Open Access Journals (Sweden)

Mikhail Matveev

2008-04-01

Full Text Available A classification of intraoperative cardio-vascular complications (CVC was performed, based on data from 466 patients subjected to emergency surgery, due to severe abdominal surgical diseases or traumas, in accordance with the severe criteria of ACC/AHA for CVC in noncardiac surgery. There were 370 intraoperative CVC registered, distributed as follows: groups with low risk (148, moderate risk (200, and high risk (22. Patient groups were formed, according to the CVC risk level, during the intraoperative period, for which the determinant factor for the group distribution of patients was the complication with the highest risk. Individual data was collected for each patient, based on 65 indices: age, physical status, diseases, surgical interventions, anaesthesiological information, intra and postoperative cardio-vascular complications, disease outcome, causes of death, cardiovascular disease anamnesis, anamnesis of all other nonsurgical diseases present, laboratory results, results from all imaging and instrumental examinations, etc. On the basis of these indices, a new distribution of the risk factors was implemented, into groups with different levels of risk of CVC during intraoperative period. This result is a solid argument, substantiating the proposal to introduce these adjustments for determining the severity of CVC in the specific conditions of emergency abdominal surgery.

A risk-based approach to health criteria for radon indoors -report on a WHO initiative

International Nuclear Information System (INIS)

Steinhaeusler, F.

1994-01-01

The World Health Organization (WHO), Regional Office for Europe, organised a meeting of a working group on indoor air quality in Eilat, Israel, from 28 March to 4 April 1993. The aim was to develop a risk-based approach to health criteria for radon indoors. The Group reviewed the latest epidemiological data from occupational and non-occupational radon exposure, animal experiments and dosimetry. The Group issued 14 conclusions and 23 recommendations on radon related risk to health, on risk management and risk communication. In summary, radon was confirmed as a human carcinogen. Indoor radon exposures resulting in individual risks exceeding 10 -3 per year are to be considered as severe and risk reduction programmes implemented. Guidance on risk management and communication is offered to national authorities. (author)

[National health fund and morbidity-based risk structure equalization with focus on haemophilia].

Science.gov (United States)

König, T

2010-11-01

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

Home-based exercise program and fall-risk reduction in older adults with multiple sclerosis: phase 1 randomized controlled trial.

Science.gov (United States)

Sosnoff, Jacob J; Finlayson, Marcia; McAuley, Edward; Morrison, Steve; Motl, Robert W

2014-03-01

To determine the feasibility, safety, and efficacy of a home-based exercise intervention targeting fall risk in older adults with multiple sclerosis. A randomized controlled pilot trial. A home-based exercise program. Participants were randomly allocated to either a home-based exercise intervention group (n = 13) or a waiting list control group (n = 14). The exercise group completed exercises targeting lower muscle strength and balance three times a week for 12 weeks. The control group continued normal activity. Fall risk (Physiological Profile Assessment scores), balance (Berg Balance Scale), and walking testing prior to and immediately following the 12-week intervention. Each outcome measure was placed in an analysis of covariance with group as the between-subject factor and baseline values as the covariate. Effect sizes were calculated. Twelve participants from the control group and ten from the exercise group completed the study. There were no related adverse events. Fall risk was found to decrease in the exercise group following the intervention (1.1 SD 1.0 vs. 0.6 SD 0.6) while there was an increase in fall risk in the control group (1.9 SD 1.5 vs. 2.2 SD 1.9). Effect sizes for most outcomes were large (η(2) > 0.15). Home-based exercise was found to be feasible, safe, and effective for reducing physiological fall risk in older adults with multiple sclerosis. Our findings support the implementation of a larger trial to reduce fall risk in persons with multiple sclerosis.

Association of cardiometabolic risk factors and dental caries in a population-based sample of youths

Directory of Open Access Journals (Sweden)

Kelishadi Roya

2010-04-01

Full Text Available Abstract Background Cardiovascular disease (CVD risk factors begin from early life and track onto adulthood. Oral and dental diseases share some risk factors with CVD, therefore by finding a clear relation between dental diseases and cardiometabolic risk factors; we can then predict the potential risk of one based on the presence of the other. This study aimed to compare the prevalence of dental caries between two groups of age-matched adolescents with and without CVD risk factors. Methods In this case-control study, the decayed, missing and filled surfaces (DMFS, based on the criteria of the World Health Organization, were compared in two groups of equal number (n = 61 in each group of population-based sample of adolescents with and without CVD risk factors who were matched for sex and age group. Results The study participants had a median age 13 y 5 mo, age range 11 y 7 mo to 16 y 1 mo, with male-to-female proportion of 49/51. We found significant difference between the mean values of DMFS, body mass index, waist and hip circumferences, as well as serum lipid profile in the case and control groups. Significant correlations were documented for DMFS with TC (r = 0.54, p = 0.02, LDL-C (r = 0.55, p = 0.01 and TG (r = 0.52, p = 0.04 in the case group; with LDL-C (r = 0.47, p = 0.03 in the whole study participants and with TC in control s(r = 0.45, p = 0.04. Conclusions Given the significant associations between dental caries and CVD risk factors among adolescents, more attention should be paid to oral health, as one of the topics to be taken into account in primordial/primary prevention of cardiometabolic disorders.

Risk-based regulation: Challenges and opportunities

International Nuclear Information System (INIS)

Bari, R.A.

1995-01-01

Over the last twenty years, man has witnessed a gradual but steady movement toward increased usage of risk-based methods and results in the regulatory process. The ''risk perspective'' as a supportive view to existing (non-risk-based or deterministic) information used in decision making has a firm foothold now in most countries that regulate nuclear power. Furthermore, in the areas outside the nuclear power field, such as health risk assessment, risk-based information is used increasingly to make decisions on potential impacts of chemical, biological, and radiological exposures. Some of the principal concepts and issues that are pertinent to risk-based regulation are reviewed. There is a growing interest in most countries in the use of risk-based methods and results to facilitate decision-making associated with regulatory processes. A summary is presented of the challenges and opportunities related to expanded use of risk-based regulation

ABO and RhD blood groups and gestational hypertensive disorders: a population-based cohort study.

Science.gov (United States)

Lee, B K; Zhang, Z; Wikman, A; Lindqvist, P G; Reilly, M

2012-09-01

To examine the association between ABO and RhD blood groups and gestational hypertensive disorders in a large population-based cohort. Cohort study. Risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, estimated by odds ratios for maternal ABO blood group and RhD status. National health registers of Sweden. All singleton deliveries in Sweden born to first-time mothers during the period 1987-2002 [total n = 641 926; any gestational hypertensive disorders, n = 39 011 (6.1%); pre-eclampsia cases, n = 29 337 (4.6%); severe pre-eclampsia cases, n = 8477 (1.3%)]. Using blood group O as a reference, odds ratios of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia were obtained from logistic regression models adjusted for potential confounding factors. Gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia. Compared with blood group O, all non-O blood groups had modest but statistically significantly higher odds of pre-eclampsia. Blood group AB had the highest risk for pre-eclampsia (OR = 1.10, 95% CI 1.04-1.16) and severe pre-eclampsia (OR = 1.18, 95% CI 1.07-1.30). RhD-positive mothers had a small increased risk for pre-eclampsia (OR = 1.07, 95% CI 1.03-1.10). In the largest study on this topic to date, women with AB blood group have the highest risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, whereas women with O blood group have the lowest risks of developing these disorders. Although the magnitude of increased risk is small, this finding may help improve our understanding of the etiology of pre-eclampsia. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Citizen involvement in flood risk governance: flood groups and networks

Directory of Open Access Journals (Sweden)

Twigger-Ross Clare

2016-01-01

Full Text Available Over the past decade has been a policy shift withinUK flood risk management towards localism with an emphasis on communities taking ownership of flood risk. There is also an increased focus on resilience and, more specifically, on community resilience to flooding. This paper draws on research carried out for UK Department for Environment Food and Rural Affairs to evaluate the Flood Resilience Community Pathfinder (FRCP scheme in England. Resilience is conceptualised as multidimensional and linked to exisiting capacities within a community. Creating resilience to flooding is an ongoing process of adaptation, learning from past events and preparing for future risks. This paper focusses on the development of formal and informal institutions to support improved flood risk management: institutional resilience capacity. It includes new institutions: e.g. flood groups, as well as activities that help to build inter- and intra- institutional resilience capacity e.g. community flood planning. The pathfinder scheme consisted of 13 projects across England led by local authorities aimed at developing community resilience to flood risk between 2013 – 2015. This paper discusses the nature and structure of flood groups, the process of their development, and the extent of their linkages with formal institutions, drawing out the barriers and facilitators to developing institutional resilience at the local level.

76 FR 1889 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2011-01-11

... ``three-pillar'' framework that includes (i) risk-based capital requirements for credit risk, market risk... incremental risk capital requirement to capture default and credit quality migration risk for non... (advanced approaches rules) (collectively, the credit risk capital rules) \\8\\ by requiring any bank subject...

Infective Endocarditis and Cancer Risk: A Population-Based Cohort Study.

Science.gov (United States)

Sun, Li-Min; Wu, Jung-Nan; Lin, Cheng-Li; Day, Jen-Der; Liang, Ji-An; Liou, Li-Ren; Kao, Chia-Hung

2016-03-01

This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan.We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk.A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98-2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis.This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy.

Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

International Nuclear Information System (INIS)

Hwang, Y.; Kim, Y.; Chung, I.-M.; Ryu, J.; Park, H.

2010-01-01

Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

Clinical risk stratification optimizes value of biomarkers to predict new-onset heart failure in a community-based cohort.

Science.gov (United States)

Brouwers, Frank P; van Gilst, Wiek H; Damman, Kevin; van den Berg, Maarten P; Gansevoort, Ron T; Bakker, Stephan J L; Hillege, Hans L; van Veldhuisen, Dirk J; van der Harst, Pim; de Boer, Rudolf A

2014-09-01

We aim to identify and quantify the value of biomarkers for incident new-onset heart failure (HF) in a community-based cohort and subgroups based on cardiovascular risk and evaluate the prognostic value of 13 biomarkers for HF with reduced and preserved ejection fraction. Thirteen biomarkers reflecting diverse pathophysiologic domains were examined in 8569 HF-free participants in Prevention of Vascular and Renal Endstage Disease (mean age, 49 years; 50% men). Subjects were categorized in 2 risk groups based on cardiovascular history. Incremental value per biomarker was assessed using Harrell C-indices. One hundred sixty-eight subjects (2.4%) were diagnosed with new-onset HF in the low-risk group (n=6915; Framingham Risk Score, 5.9%) and 206 (12.2%) subjects in the high-risk group (n=1654; Framingham Risk Score, 18.6%). The association of natriuretic peptides, adrenomedullin, endothelin, and galectin-3 with new-onset HF was stronger in the high-risk group (all Prisk for new-onset HF between both risk groups. The best model for new-onset HF included the combination of N-terminal pro-B-type natriuretic peptide, troponin-T, and urinary albumin excretion, increasing model accuracy to 0.81 (9.5%, Prisk group. Except for a modest effect of cystatin-C, no biomarker was associated with increased risk for HF with preserved ejection fraction. Risk stratification increases the incremental value per biomarker to predict new-onset HF, especially HF with reduced ejection fraction. We suggest that routine biomarker testing should be limited to the use of natriuretic peptides and troponin-T in patients with increased cardiovascular risk. © 2014 American Heart Association, Inc.

Risk strata-based therapy and outcome in stage Ib-IIa carcinoma cervix: single-centre ten-year experience.

Science.gov (United States)

Kundargi, Rajshekar S; Guruprasad, B; Rathod, Praveen Shankar; Shakuntala, Pn; Shobha, K; Pallavi, Vr; Uma Devi, K; Bafna, Ud

2013-01-01

To review the outcome of stage (Ib, IIa), cervical cancer patients were primarily treated with radical hysterectomy and risk-based postoperative therapy. Between January 2001 and December 2011, 601 cases underwent surgery followed by tailored therapy. Patients were classified into low risk (pelvic lymph node negative, tumour less than 4 cm, no evidence of lympho-vascular invasion, less than one-third of thickness of surgical stoma involved), intermediate risk (positive lympho-vascular space invasion, tumour size more than 4 cm, and deep invasion of cervical stroma), and high risk (pelvic lymph node involved, positive parametrial, or vaginal margins) groups. Postoperative adju-vant therapy in the form of radiotherapy alone to those with intermediate risk and chemo-radiotherapy to those with high risk was given to patients. The median follow-up was 60 months. The majority of patients had intermediate risk. The overall event-free survival (EFS) at five years was 74.37%, with EFS of 86.5% in those from the low-risk group, 73% in those from the intermediate-risk group, and 64% in those from the high-risk group. In conclusion, risk strata-based adjuvant postoperative therapy is able to provide a favourable outcome in patients with stage Ib-IIa cervical cancer with a nearly 11% improvement in survival compared with historical control.

RiskREP: Risk-Based Security Requirements Elicitation and Prioritization

OpenAIRE

Herrmann, Andrea; Morali, A.; Etalle, Sandro; Wieringa, Roelf J.; Niedrite, Laila; Strazdina, Renate; Wangler, Benkt

2011-01-01

Companies are under pressure to be in control of their assets but at the same time they must operate as efficiently as possible. This means that they aim to implement “good-enough security‿ but need to be able to justify their security investment plans. In this paper, we present a Risk-Based Requirements Prioritization method (RiskREP) that extends misuse case-based methods with IT architecture based risk assessment and countermeasure definition and prioritization. Countermeasure prioritizati...

12 CFR 567.6 - Risk-based capital credit risk-weight categories.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Risk-based capital credit risk-weight... CAPITAL Regulatory Capital Requirements § 567.6 Risk-based capital credit risk-weight categories. (a) Risk...)(2) of this section), plus risk-weighted recourse obligations, direct credit substitutes, and certain...

Combining social and genetic networks to study HIV transmission in mixing risk groups

NARCIS (Netherlands)

Zarrabi, N.; Prosperi, M.C.F.; Belleman, R.G.; Di Giambenedetto, S.; Fabbiani, M.; De Luca, A.; Sloot, P.M.A.

2013-01-01

Reconstruction of HIV transmission networks is important for understanding and preventing the spread of the virus and drug resistant variants. Mixing risk groups is important in network analysis of HIV in order to assess the role of transmission between risk groups in the HIV epidemic. Most of the

Health-based risk adjustment: is inpatient and outpatient diagnostic information sufficient?

Science.gov (United States)

Lamers, L M

Adequate risk adjustment is critical to the success of market-oriented health care reforms in many countries. Currently used risk adjusters based on demographic and diagnostic cost groups (DCGs) do not reflect expected costs accurately. This study examines the simultaneous predictive accuracy of inpatient and outpatient morbidity measures and prior costs. DCGs, pharmacy cost groups (PCGs), and prior year's costs improve the predictive accuracy of the demographic model substantially. DCGs and PCGs seem complementary in their ability to predict future costs. However, this study shows that the combination of DCGs and PCGs still leaves room for cream skimming.

Risk-based maintenance-Techniques and applications

International Nuclear Information System (INIS)

Arunraj, N.S.; Maiti, J.

2007-01-01

Plant and equipment, however well designed, will not remain safe or reliable if it is not maintained. The general objective of the maintenance process is to make use of the knowledge of failures and accidents to achieve the possible safety with the lowest possible cost. The concept of risk-based maintenance was developed to inspect the high-risk components usually with greater frequency and thoroughness and to maintain in a greater manner, to achieve tolerable risk criteria. Risk-based maintenance methodology provides a tool for maintenance planning and decision making to reduce the probability of failure of equipment and the consequences of failure. In this paper, the risk analysis and risk-based maintenance methodologies were identified and classified into suitable classes. The factors affecting the quality of risk analysis were identified and analyzed. The applications, input data and output data were studied to understand their functioning and efficiency. The review showed that there is no unique way to perform risk analysis and risk-based maintenance. The use of suitable techniques and methodologies, careful investigation during the risk analysis phase, and its detailed and structured results are necessary to make proper risk-based maintenance decisions

Managing Climate Risk. Integrating Adaptation into World Bank Group Operations

International Nuclear Information System (INIS)

Van Aalst, M.

2006-08-01

Climate change is already taking place, and further changes are inevitable. Developing countries, and particularly the poorest people in these countries, are most at risk. The impacts result not only from gradual changes in temperature and sea level but also, in particular, from increased climate variability and extremes, including more intense floods, droughts, and storms. These changes are already having major impacts on the economic performance of developing countries and on the lives and livelihoods of millions of poor people around the world. Climate change thus directly affects the World Bank Group's mission of eradicating poverty. It also puts at risk many projects in a wide range of sectors, including infrastructure, agriculture, human health, water resources, and environment. The risks include physical threats to the investments, potential underperformance, and the possibility that projects will indirectly contribute to rising vulnerability by, for example, triggering investment and settlement in high-risk areas. The way to address these concerns is not to separate climate change adaptation from other priorities but to integrate comprehensive climate risk management into development planning, programs, and projects. While there is a great need to heighten awareness of climate risk in Bank work, a large body of experience on climate risk management is already available, in analytical work, in country dialogues, and in a growing number of investment projects. This operational experience highlights the general ingredients for successful integration of climate risk management into the mainstream development agenda: getting the right sectoral departments and senior policy makers involved; incorporating risk management into economic planning; engaging a wide range of nongovernmental actors (businesses, nongovernmental organizations, communities, and so on); giving attention to regulatory issues; and choosing strategies that will pay off immediately under current

Association of ABO blood groups and major ischaemic heart disease risk factors

International Nuclear Information System (INIS)

Lutf-Ullah, L.; Akhtar, B.; Noor-Us-Saba; Hanif, A.; Khan, B.Z.; Bukhshi, I.M.

2010-01-01

To study the association of ABO blood groups with major ischaemic heart disease risk factors. Setting: Department of Cardiology, Mayo hospital, Lahore over a period of two years from January 2008 to December 2009. Study Design: Analytic comparative study. Subjects and Methods: The study group included 907 patients of ischaemic heart disease (IHD). The distribution of ABO blood groups in IHD patients was compared for presence or absence of major IHD risk factors. Data was analyzed using SPSS 16. ANOVA and Chi-square tests for significance were used. P-value less than 0.05 was taken as significant. Results: In this study, the following pattern of ABO blood groups was observed in IHD patients : blood group A 251 (27.67%); blood group B 329 (36.27%); blood group O 235 (25.91%); blood group AB 92 (10.14%). We found no relation-ship of ABO blood groups with age (p-value = 0.234), gender (p-value = 0.093), hypertension (p-value = 0.230), diabetes mellitus (p-value = 0.801), family history of IHD (p-value = 0.277), transverse ear lobe crease (p-value = 0.231), total cholesterol (p-value = 0.797), triglycerides (p-value = 0.351), low density lipoprotein (p-value = 0.078), high density lipoprotein (p-value = 0.114). Similarly no relationship was found of smoking, weight, height and body mass index with ABO blood groups, p-values 0.428, 0.528, 0.908 and 0.455 respectively. Conclusion: There is no association of ABO blood groups and major ischaemic heart disease risk factors. (author)

Identifying Critical Nutrient Intake in Groups at Risk of Poverty in Europe: The CHANCE Project Approach

Science.gov (United States)

Nikolić, Marina; Glibetić, Maria; Gurinović, Mirjana; Milešević, Jelena; Khokhar, Santosh; Chillo, Stefania; Abaravicius, Jonas Algis; Bordoni, Alessandra; Capozzi, Francesco

2014-01-01

The aim of the CHANCE project is to develop novel and affordable nutritious foods to optimize the diet and reduce the risk of diet-related diseases among groups at risk of poverty (ROP). This paper describes the methodology used in the two initial steps to accomplish the project’s objective as follows: 1. a literature review of existing data and 2. an identification of ROP groups with which to design and perform the CHANCE nutritional survey, which will supply new data that is useful for formulating the new CHANCE food. Based on the literature review, a low intake of fruit and vegetables, whole grain products, fish, energy, fiber, vitamins B1, B2, B3, B6, B12 and C, folate, calcium, magnesium, iron, potassium and zinc and a high intake of starchy foods, processed meat and sodium were apparent. However, the available data appeared fragmented because of the different methodologies used in the studies. A more global vision of the main nutritional problems that are present among low-income people in Europe is needed, and the first step to achieve this goal is the use of common criteria to define the risk of poverty. The scoring system described here represents novel criteria for defining at-risk-of-poverty groups not only in the CHANCE-participating countries but also all over Europe. PMID:24699195

Identifying Critical Nutrient Intake in Groups at Risk of Poverty in Europe: The CHANCE Project Approach

Directory of Open Access Journals (Sweden)

Marina Nikolić

2014-04-01

Full Text Available The aim of the CHANCE project is to develop novel and affordable nutritious foods to optimize the diet and reduce the risk of diet-related diseases among groups at risk of poverty (ROP. This paper describes the methodology used in the two initial steps to accomplish the project’s objective as follows: 1. a literature review of existing data and 2. an identification of ROP groups with which to design and perform the CHANCE nutritional survey, which will supply new data that is useful for formulating the new CHANCE food. Based on the literature review, a low intake of fruit and vegetables, whole grain products, fish, energy, fiber, vitamins B1, B2, B3, B6, B12 and C, folate, calcium, magnesium, iron, potassium and zinc and a high intake of starchy foods, processed meat and sodium were apparent. However, the available data appeared fragmented because of the different methodologies used in the studies. A more global vision of the main nutritional problems that are present among low-income people in Europe is needed, and the first step to achieve this goal is the use of common criteria to define the risk of poverty. The scoring system described here represents novel criteria for defining at-risk-of-poverty groups not only in the CHANCE-participating countries but also all over Europe.

Identifying critical nutrient intake in groups at risk of poverty in Europe: the CHANCE project approach.

Science.gov (United States)

Nikolić, Marina; Glibetić, Maria; Gurinović, Mirjana; Milešević, Jelena; Khokhar, Santosh; Chillo, Stefania; Abaravicius, Jonas Algis; Bordoni, Alessandra; Capozzi, Francesco

2014-04-02

The aim of the CHANCE project is to develop novel and affordable nutritious foods to optimize the diet and reduce the risk of diet-related diseases among groups at risk of poverty (ROP). This paper describes the methodology used in the two initial steps to accomplish the project's objective as follows: 1. a literature review of existing data and 2. an identification of ROP groups with which to design and perform the CHANCE nutritional survey, which will supply new data that is useful for formulating the new CHANCE food. Based on the literature review, a low intake of fruit and vegetables, whole grain products, fish, energy, fiber, vitamins B1, B2, B3, B6, B12 and C, folate, calcium, magnesium, iron, potassium and zinc and a high intake of starchy foods, processed meat and sodium were apparent. However, the available data appeared fragmented because of the different methodologies used in the studies. A more global vision of the main nutritional problems that are present among low-income people in Europe is needed, and the first step to achieve this goal is the use of common criteria to define the risk of poverty. The scoring system described here represents novel criteria for defining at-risk-of-poverty groups not only in the CHANCE-participating countries but also all over Europe.

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

Science.gov (United States)

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

2017-01-01

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

Sudden Cardiac arrest Risk profile in a group of amateur level ...

African Journals Online (AJOL)

... males and females in this group of university basketball players showed varying signs of SCA risk, with the overall risk being reasonably low, albeit abnormalities were highlighted in some and Marfanoid characteristics were clearly evident in others. Key words: Sudden cardiac arrest; Basketball players, Marfan syndrome; ...

The Association between ABO and Rh Blood Groups and Risk of Endometriosis in Iranian Women.

Science.gov (United States)

Malekzadeh, Farideh; Moini, Ashraf; Amirchaghmaghi, Elham; Daliri, Leila; Akhoond, Mohammad Reza; Talebi, Mehrak; Hosseini, Rihaneh

2018-06-01

Endometriosis is a common gynaecological disease that affects quality of life for women. Several studies have revealed that both environmental and genetic factors contribute to the development of endometriosis. The aim of this study was to investigate the distribution of ABO and Rh blood groups in Iranian women with endometriosis who presented to two referral infertility centers in Tehran, Iran. In this case-control study, women who referred to Royan Institute and Arash Women's Hospital for diagnostic laparoscopy between 2013 and 2014 were assessed. Based on the laparoscopy findings, we categorized the women into two groups: endometriosis and control (women without endometriosis and normal pelvis). Chi-square and logistic regression tests were used for data analysis. In this study, we assessed 433 women, of which 213 patients were assigned to the endometriosis group while the remaining 220 subjects comprised the control group. The most frequent ABO blood group was O (40.6%). The least frequent blood group was AB (4.8%). In terms of Rh blood group, Rh+ (90.1%) was more frequent than Rh- (9.9%). There was no significant correlation between ABO (P=0.091) and Rh (P=0.55) blood groups and risk of endometriosis. Also, there was no significant difference between the two groups with regards to the stage of endometriosis and distribution of ABO and Rh blood groups (P>0.05). Although the O blood group was less dominant in Iranian women with endometriosis, we observed no significant correlation between the risk of endometriosis and the ABO and Rh blood groups. Endometriosis severity was not correlated to any of these blood groups. Copyright© by Royan Institute. All rights reserved.

Risk based surveillance for vector borne diseases

DEFF Research Database (Denmark)

Bødker, Rene

of samples and hence early detection of outbreaks. Models for vector borne diseases in Denmark have demonstrated dramatic variation in outbreak risk during the season and between years. The Danish VetMap project aims to make these risk based surveillance estimates available on the veterinarians smart phones...... in Northern Europe. This model approach may be used as a basis for risk based surveillance. In risk based surveillance limited resources for surveillance are targeted at geographical areas most at risk and only when the risk is high. This makes risk based surveillance a cost effective alternative...... sample to a diagnostic laboratory. Risk based surveillance models may reduce this delay. An important feature of risk based surveillance models is their ability to continuously communicate the level of risk to veterinarians and hence increase awareness when risk is high. This is essential for submission...

Enhancing the effectiveness of IST through risk-based techniques

Energy Technology Data Exchange (ETDEWEB)

Floyd, S.D.

1996-12-01

Current IST requirements were developed mainly through deterministic-based methods. While this approach has resulted in an adequate level of safety and reliability for pumps and valves, insights from probabilistic safety assessments suggest a better safety focus can be achieved at lower costs. That is, some high safety impact pumps and valves are currently not tested under the IST program and should be added, while low safety impact valves could be tested at significantly greater intervals than allowed by the current IST program. The nuclear utility industry, through the Nuclear Energy Institute (NEI), has developed a draft guideline for applying risk-based techniques to focus testing on those pumps and valves with a high safety impact while reducing test frequencies on low safety impact pumps and valves. The guideline is being validated through an industry pilot application program that is being reviewed by the U.S. Nuclear Regulatory Commission. NEI and the ASME maintain a dialogue on the two groups` activities related to risk-based IST. The presenter will provide an overview of the NEI guideline, discuss the methodological approach for applying risk-based technology to IST and provide the status of the industry pilot plant effort.

Trends in high-risk sexual behaviors among general population groups in China: a systematic review.

Science.gov (United States)

Cai, Rui; Richardus, Jan Hendrik; Looman, Caspar W N; de Vlas, Sake J

2013-01-01

The objective of this review was to investigate whether Chinese population groups that do not belong to classical high risk groups show an increasing trend of engaging in high-risk sexual behaviors. We systematically searched the English and Chinese literature on sexual risk behaviors published between January 1980 and March 2012 in PubMed and the China National Knowledge Infrastructure (CNKI). We included observational studies that focused on population groups other than commercial sex workers (CSWs) and their clients, and men who have sex with men (MSM) and quantitatively reported one of the following indicators of recent high-risk sexual behavior: premarital sex, commercial sex, multiple sex partners, condom use or sexually transmitted infections (STIs). We used generalized linear mixed model to examine the time trend in engaging in high-risk sexual behaviors. We included 174 observational studies involving 932,931 participants: 55 studies reported on floating populations, 73 on college students and 46 on other groups (i.e. out-of-school youth, rural residents, and subjects from gynecological or obstetric clinics and premarital check-up centers). From the generalized linear mixed model, no significant trends in engaging in high-risk sexual behaviors were identified in the three population groups. Sexual risk behaviors among certain general population groups have not increased substantially. These groups are therefore unlikely to incite a STI/HIV epidemic among the general Chinese population. Because the studied population groups are not necessarily representative of the general population, the outcomes found may not reflect those of the general population.

Defining risk groups to yellow fever vaccine-associated viscerotropic disease in the absence of denominator data.

Science.gov (United States)

Seligman, Stephen J; Cohen, Joel E; Itan, Yuval; Casanova, Jean-Laurent; Pezzullo, John C

2014-02-01

Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available.

Pregnant Women's Perceptions of the Risks and Benefits of Disclosure During Web-Based Mental Health E-Screening Versus Paper-Based Screening: Randomized Controlled Trial.

Science.gov (United States)

Kingston, Dawn; Biringer, Anne; Veldhuyzen van Zanten, Sander; Giallo, Rebecca; McDonald, Sarah; MacQueen, Glenda; Vermeyden, Lydia; Austin, Marie-Paule

2017-10-20

Pregnant women's perceptions of the risks and benefits during mental health screening impact their willingness to disclose concerns. Early research in violence screening suggests that such perceptions may vary by mode of screening, whereby women view the anonymity of e-screening as less risky than other approaches. Understanding whether mode of screening influences perceptions of risk and benefit of disclosure is important in screening implementation. The objective of this randomized controlled trial was to compare the perceptions of pregnant women randomized to a Web-based screening intervention group and a paper-based screening control group on the level of risk and benefit they perceive in disclosing mental health concerns to their prenatal care provider. A secondary objective was to identify factors associated with women's perceptions of risk and benefit of disclosure. Pregnant women recruited from maternity clinics, hospitals, and prenatal classes were computer-randomized to a fully automated Web-based e-screening intervention group or a paper-based control. The intervention group completed the Antenatal Psychosocial Health Assessment and the Edinburgh Postnatal Depression Scale on a computer tablet, whereas the control group completed them on paper. The primary outcome was women's perceptions of the risk and benefits of mental health screening using the Disclosure Expectations Scale (DES). A completer analysis was conducted. Statistical significance was set at Pcontrol (n=331) groups. There were no significant baseline differences between groups. The mode of screening was not associated with either perceived risk or benefit of screening. There were no differences in groups in the mean scores of the risk and benefit of disclosure subscales. Over three-quarters of women in both intervention and control groups perceived that mental health screening was beneficial. However, 43.1% (272/631) of women in both groups reported feeling very, moderately, or somewhat

Providing web-based mental health services to at-risk women.

Science.gov (United States)

Lipman, Ellen L; Kenny, Meghan; Marziali, Elsa

2011-08-19

We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show

High risk of non-sentinel node metastases in a group of breast cancer patients with micrometastases in the sentinel node.

Science.gov (United States)

Tvedskov, Tove Filtenborg; Jensen, Maj-Britt; Lisse, Ida Marie; Ejlertsen, Bent; Balslev, Eva; Kroman, Niels

2012-11-15

Axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel nodes is under debate. We aimed to establish two models to predict non-sentinel node (NSN) metastases in patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes, to guide the decision for ALND. A total of 1,577 breast cancer patients with micrometastases and 304 with ITC in sentinel nodes, treated by sentinel lymph node dissection and ALND in 2002-2008 were identified in the Danish Breast Cancer Cooperative Group database. Risk of NSN metastases was calculated according to clinicopathological variables in a logistic regression analysis. We identified tumor size, proportion of positive sentinel nodes, lymphovascular invasion, hormone receptor status and location of tumor in upper lateral quadrant of the breast as risk factors for NSN metastases in patients with micrometastases. A model based on these risk factors identified 5% of patients with a risk of NSN metastases on nearly 40%. The model was however unable to identify a subgroup of patients with a very low risk of NSN metastases. Among patients with ITC, we identified tumor size, age and proportion of positive sentinel nodes as risk factors. A model based on these risk factors identified 32% of patients with risk of NSN metastases on only 2%. Omission of ALND would be acceptable in this group of patients. In contrast, ALND may still be beneficial in the subgroup of patients with micrometastases and a high risk of NSN metastases. Copyright © 2012 UICC.

Risk management or mind control? Possible messages in the report by the working group on the risk management of low-dose exposures

International Nuclear Information System (INIS)

Onai, Takayuki; Shirabe, Masashi

2012-01-01

Fukushima accident discharged a large amount of radioactive materials to the air and brought about a long-term low-dose radiation exposure risk in contaminated area. In December 2011 the government working group (WG) on the risk management of low-dose radiation exposure issued the report on subjects: (1) health effects from annual radiation exposure of 20 mSv, (2) special consideration necessary for children and pregnant women and (3) proper way communicating citizens on radioactive materials and radiation doses in relation to health risks from low-dose radiation exposure. This article recommended making radiation protection strategies based on discussions among experts, government and citizens in consideration of “uncertainty” of scientific knowledge, and it criticized the WG's report mainly in the following respects. 1) The report mixed evacuation order level and ICRP's reference level in its discussion on “20 mSv”. 2) It was over-optimistic and frequently misleading on health risks of low-dose radiation. For example, it sometimes discussed the risks employing data and knowledge against recommendations of international authorities like UNSCEAR and ICRP. 3) It regarded Fukushima residents’ anxieties and stresses to be controlled as the only source of health risks. This attitude offered a counterpoint to UNSCEAR's deliberate attitude to “radiophobia”. 4) Against the spirit of ICRP Publ.111, only experts of WG made decisions about radiation protection in the absence of stakeholders. As its result, 5) risk communication recommended in the report was not interactive, in fact, based on “deficit model” of science communication. (author)

The effects of adding group-based lifestyle counselling to individual counselling on changes in plasma glucose levels in a randomized controlled trial: the Inter99 study.

Science.gov (United States)

Lau, C; Vistisen, D; Toft, U; Tetens, I; Glümer, C; Pedersen, O; Jørgensen, T; Borch-Johnsen, K

2011-12-01

This study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes. In a population-based study of 6784 participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738 participants free of diabetes at baseline (1999-2001) and with at least one FPG and/or 2hPG measurement during 5 years of follow-up were included in the analyses. Differences in changes of plasma glucose between groups A and B were analyzed using multilevel linear regression. For FPG, crude 5-year changes were significantly different between the two groups (group A: -0.003 mmol/L vs group B: -0.079 mmol/L; P=0.0427). After adjusting for relevant confounders, no differences in FPG changes were observed (P=0.116). Also, no significant differences in the 5-year changes in 2hPG between the two groups were observed (group A: - 0.127 mmol/L vs group B: -0.201 mmol/L; P=0.546). Offering additional group-based intervention to a high-risk population subgroup had no clinical effects on changes in plasma glucose beyond those of individualized multifactorial interventions. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Early home-based intervention in the Netherlands for children at familial risk of dyslexia

NARCIS (Netherlands)

van Otterloo, S.G.; van der Leij, A.; Henrichs, L.F.

2009-01-01

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and

Risk-based and deterministic regulation

International Nuclear Information System (INIS)

Fischer, L.E.; Brown, N.W.

1995-07-01

Both risk-based and deterministic methods are used for regulating the nuclear industry to protect the public safety and health from undue risk. The deterministic method is one where performance standards are specified for each kind of nuclear system or facility. The deterministic performance standards address normal operations and design basis events which include transient and accident conditions. The risk-based method uses probabilistic risk assessment methods to supplement the deterministic one by (1) addressing all possible events (including those beyond the design basis events), (2) using a systematic, logical process for identifying and evaluating accidents, and (3) considering alternative means to reduce accident frequency and/or consequences. Although both deterministic and risk-based methods have been successfully applied, there is need for a better understanding of their applications and supportive roles. This paper describes the relationship between the two methods and how they are used to develop and assess regulations in the nuclear industry. Preliminary guidance is suggested for determining the need for using risk based methods to supplement deterministic ones. However, it is recommended that more detailed guidance and criteria be developed for this purpose

Deoxynivalenol Exposure in Norway, Risk Assessments for Different Human Age Groups

Science.gov (United States)

Sundheim, Leif; Lillegaard, Inger Therese; Fæste, Christiane Kruse; Brantsæter, Anne-Lise; Brodal, Guro; Eriksen, Gunnar Sundstøl

2017-01-01

Deoxynivalenol (DON) is the most common mycotoxin in Norwegian cereals, and DON is detected in most samples of crude cereal grain and cereal food commodities such as flour, bran, and oat flakes. The Norwegian Scientific Committee for Food Safety assessed the risk for adverse effects of deoxynivalenol (DON) in different age groups of the domestic population. This review presents the main results from the risk assessment, supplemented with some recently published data. Impairment of the immune system together with reduced feed intake and weight gain are the critical effects of DON in experimental animals on which the current tolerable daily intake was established. Based on food consumption and occurrence data, the mean exposure to DON in years with low and high levels of DON in the flour, respectively, were in the range of or up to two times the Tolerable Daily Intake (TDI) in 1-year-old infants and 2-year-old children. In years with high mean DON concentration, the high (95th-percentile) exposure exceeded the TDI by up to 3.5 times in 1-, 2- , 4-, and 9-year-old children. The assessment concluded that exceeding the TDI in infants and children is of concern. The estimated dietary DON intakes in adolescent and adult populations are in the range of the TDI or below, and are not a health concern. Acute human exposure to DON is not of concern in any age group. PMID:28165414

Deoxynivalenol Exposure in Norway, Risk Assessments for Different Human Age Groups

Directory of Open Access Journals (Sweden)

Leif Sundheim

2017-02-01

Full Text Available Deoxynivalenol (DON is the most common mycotoxin in Norwegian cereals, and DON is detected in most samples of crude cereal grain and cereal food commodities such as flour, bran, and oat flakes. The Norwegian Scientific Committee for Food Safety assessed the risk for adverse effects of deoxynivalenol (DON in different age groups of the domestic population. This review presents the main results from the risk assessment, supplemented with some recently published data. Impairment of the immune system together with reduced feed intake and weight gain are the critical effects of DON in experimental animals on which the current tolerable daily intake was established. Based on food consumption and occurrence data, the mean exposure to DON in years with low and high levels of DON in the flour, respectively, were in the range of or up to two times the Tolerable Daily Intake (TDI in 1-year-old infants and 2-year-old children. In years with high mean DON concentration, the high (95th-percentile exposure exceeded the TDI by up to 3.5 times in 1-, 2- , 4-, and 9-year-old children. The assessment concluded that exceeding the TDI in infants and children is of concern. The estimated dietary DON intakes in adolescent and adult populations are in the range of the TDI or below, and are not a health concern. Acute human exposure to DON is not of concern in any age group.

Investigation of zoonotic infections in risk groups in Ordu University ...

African Journals Online (AJOL)

2016-02-15

Feb 15, 2016 ... 2017 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow. Abstract. Aims:Zoonotic ... Investigation of zoonotic infections in risk groups in ..... of Cystic Echinococcosis in Veterinary Surgeons. Turkish ...

Projection of human immunodeficiency virus among high-risk groups in Malaysia.

Science.gov (United States)

Mondal, Md Nazrul Islam; Shitan, Mahendran

2013-01-01

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) presents a serious healthcare threat to young individuals in Malaysia and worldwide. This study aimed to identify trends in HIV-related risk behaviors among recognized high-risk groups and to estimate HIV transmission up to the year 2015. Data and necessary information were obtained from the Ministry of Health Malaysia, published reports from the World Health Organization and United Nations Program on HIV/AIDS, and other articles. The Estimation and Projection Package was used to estimate HIV transmission. The results of the present study revealed that within the high-risk groups, intravenous drug users (IDUs) had the highest prevalence rate of HIV transmission, followed by patients with sexually transmitted infections (STIs), female sex workers (SWs), and men who have sex with men (MSM). Within these at-risk populations, patients with STIs have the highest prevalence of HIV, followed by IDUs, MSM, and SWs. If the transmission rate continues to increase, the situation will worsen; therefore, there is an urgent need for a comprehensive prevention program to control HIV transmission in Malaysia.

Waste area grouping 2 Phase I task data report: Ecological risk assessment and White Oak Creek watershed screening ecological risk assessment

Energy Technology Data Exchange (ETDEWEB)

Efroymson, R.A.; Jackson, B.L.; Jones, D.S. [and others

1996-05-01

This report presents an ecological risk assessment for Waste Area Grouping (WAG) 2 based on the data collected in the Phase I remedial investigation (RI). It serves as an update to the WAG 2 screening ecological risk assessment that was performed using historic data. In addition to identifying potential ecological risks in WAG 2 that may require additional data collection, this report serves to determine whether there are ecological risks of sufficient magnitude to require a removal action or some other expedited remedial process. WAG 2 consists of White Oak Creek (WOC) and its tributaries downstream of the Oak Ridge National Laboratory (ORNL) main plant area, White Oak Lake (WOL), the White Oak Creek Embayment of the Clinch River, associated flood plains, and the associated groundwater. The WOC system drains the WOC watershed, an area of approximately 16.8 km{sup 2} that includes ORNL and associated WAGs. The WOC system has been exposed to contaminants released from ORNL and associated operations since 1943 and continues to receive contaminants from adjacent WAGs.

Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs.

Science.gov (United States)

Kramer, Erik J; Dodington, James; Hunt, Ava; Henderson, Terrell; Nwabuo, Adaobi; Dicker, Rochelle; Juillard, Catherine

2017-09-01

Violent injury is the second most common cause of death among 15- to 24-year olds in the US. Up to 58% of violently injured youth return to the hospital with a second violent injury. Hospital-based violence intervention programs (HVIPs) have been shown to reduce injury recidivism through intensive case management. However, no validated guidelines for risk assessment strategies in the HVIP setting have been reported. We aimed to use qualitative methods to investigate the key components of risk assessments employed by HVIP case managers and to propose a risk assessment model based on this qualitative analysis. An established academic hospital-affiliated HVIP served as the nexus for this research. Thematic saturation was reached with 11 semi-structured interviews and two focus groups conducted with HVIP case managers and key informants identified through snowball sampling. Interactions were analyzed by a four-member team using Nvivo 10, employing the constant comparison method. Risk factors identified were used to create a set of models presented in two follow-up HVIP case managers and leadership focus groups. Eighteen key themes within seven domains (environment, identity, mental health, behavior, conflict, indicators of lower risk, and case management) and 141 potential risk factors for use in the risk assessment framework were identified. The most salient factors were incorporated into eight models that were presented to the HVIP case managers. A 29-item algorithmic structured professional judgment model was chosen. We identified four tiers of risk factors for violent reinjury that were incorporated into a proposed risk assessment instrument, VRRAI. Copyright © 2017 Elsevier Inc. All rights reserved.

Dutch home-based pre-reading intervention with children at familial risk of dyslexia

NARCIS (Netherlands)

van Otterloo, S.G.; van der Leij, A.

2009-01-01

Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected

Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

Science.gov (United States)

Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

2009-04-30

The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to

Risk-Sensitive Multiagent Decision-Theoretic Planning Based on MDP and One-Switch Utility Functions

Directory of Open Access Journals (Sweden)

Wei Zeng

2014-01-01

Full Text Available In high stakes situations decision-makers are often risk-averse and decision-making processes often take place in group settings. This paper studies multiagent decision-theoretic planning under Markov decision processes (MDPs framework with considering the change of agent’s risk attitude as his wealth level varies. Based on one-switch utility function that describes agent’s risk attitude change with his wealth level, we give the additive and multiplicative aggregation models of group utility and adopt maximizing expected group utility as planning objective. When the wealth level approaches infinity, the characteristics of optimal policy are analyzed for the additive and multiplicative aggregation model, respectively. Then a backward-induction method is proposed to divide the wealth level interval from negative infinity to initial wealth level into subintervals and determine the optimal policy in states and subintervals. The proposed method is illustrated by numerical examples and the influences of agent’s risk aversion parameters and weights on group decision-making are also analyzed.

A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

Science.gov (United States)

Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

2015-12-01

Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Community Savings Groups, Financial Security, and HIV Risk Among Female Sex Workers in Iringa, Tanzania.

Science.gov (United States)

Mantsios, Andrea; Galai, Noya; Mbwambo, Jessie; Likindikoki, Samuel; Shembilu, Catherine; Mwampashi, Ard; Beckham, S W; Leddy, Anna; Davis, Wendy; Sherman, Susan; Kennedy, Caitlin; Kerrigan, Deanna

2018-02-24

This study assessed the association between community savings group participation and consistent condom use (CCU) among female sex workers (FSW) in Iringa, Tanzania. Using cross-sectional data from a survey of venue-based FSW (n = 496), logistic regression was used to examine the associations between financial indicators including community savings group participation and CCU. Over one-third (35%) of the women participated in a savings group. Multivariable regression results indicated that participating in a savings group was significantly associated with nearly two times greater odds of CCU with new clients in the last 30 days (aOR = 1.77, 95% CI 1.10-2.86). Exploratory mediation analysis indicated that the relationship between savings group participation and CCU was partially mediated by financial security, as measured by monthly income. Findings indicate that community savings groups may play an important role in reducing sexual risk behaviors of FSW and hold promise as part of comprehensive, community-led HIV prevention strategies among FSW.

Risk-based methodology for USNRC inspections

International Nuclear Information System (INIS)

Wong, S.M.; Holahan, G.M.; Chung, J.W.; Johnson, M.R.

1995-01-01

This paper describes the development and trial applications of a risk-based methodology to enhance the inspection processes for US nuclear power plants. Objectives of risk-based methods to complement prescriptive engineering approaches in US Nuclear Regulatory Commission (USNRC) inspection programs are presented. Insights from time-dependent risk profiles of plant configurational from Individual Plant Evaluation (IPE) studies were integrated to develop a framework for optimizing inspection efforts in NRC regulatory initiatives. Lessons learned from NRC pilot applications of the risk-based methodology for evaluation of the effectiveness of operational risk management programs at US nuclear power plant sites are also discussed

Tsunami risk assessment for facility group over a wide area using inundation assessment method considering energy conservation law

International Nuclear Information System (INIS)

Fukutani, Yo; Imamura, Fumihiko; Tokunaga, Takeshi; Sato, Ichiro

2015-01-01

We propose a quantitative evaluation method of overall tsunami risk that the entire facility group over a wide area holds. We considerably reduced the calculation cost for tsunami inundation depth by adopting the evaluation method using energy conservation law as compared with the evaluation method using non-linear long wave equation. For financial institutions such as banks and insurance companies with contractors over a wide area and business companies with multiple their assets and facilities in various places, the proposed evaluation method in this study could be a useful approach to implement their risk-based management decisions for tsunami risk. (author)

Ethnicity and skin autofluorescence-based risk-engines for cardiovascular disease and diabetes mellitus.

Directory of Open Access Journals (Sweden)

Muhammad Saeed Ahmad

Full Text Available Skin auto fluorescence (SAF is used as a proxy for the accumulation of advanced glycation end products (AGEs and has been proposed to stratify patients into cardiovascular disease (CVD and diabetes mellitus (DM risk groups. This study evaluates the effects of seven different ethnicities (Arab, Central-East African, Eastern Mediterranean, European, North African, South Asian and Southeast Asian and gender on SAF as well as validating SAF assessment as a risk estimation tool for CVD and DM in an Arabian cohort. SAF data from self-reported healthy 2,780 individuals, collated from three independent studies, has been linear modelled using age and gender as a covariate. A cross-study harmonized effect size (Cohens'd is provided for each ethnicity. Furthermore, new data has been collected from a clinically well-defined patient group of 235 individuals, to evaluate SAF as a clinical tool for DM and CVD-risk estimation in an Arab cohort. In an Arab population, SAF-based CVD and/or DM risk-estimation can be improved by referencing to ethnicity and gender-specific SAF values. Highest SAF values were observed for the North African population, followed by East Mediterranean, Arab, South Asian and European populations. The South Asian population had a slightly steeper slope in SAF values with age compared to other ethnic groups. All ethnic groups except Europeans showed a significant gender effect. When compared with a European group, effect size was highest for Eastern Mediterranean group and lowest for South Asian group. The Central-East African and Southeast Asian ethnicity matched closest to the Arab and Eastern Mediterranean ethnicities, respectively. Ethnic and gender-specific data improves performance in SAF-based CVD and DM risk estimation. The provided harmonized effect size allows a direct comparison of SAF in different ethnicities. For the first time, gender differences in SAF are described for North African and East Mediterranean populations.

Risk-based SMA for Cubesats

Science.gov (United States)

Leitner, Jesse

2016-01-01

This presentation conveys an approach for risk-based safety and mission assurance applied to cubesats. This presentation accompanies a NASA Goddard standard in development that provides guidance for building a mission success plan for cubesats based on the risk tolerance and resources available.

Group based prenatal care in a low-and high risk population in the Netherlands: a study protocol for a stepped wedge cluster randomized controlled trial.

Science.gov (United States)

van Zwicht, Birgit S; Crone, Matty R; van Lith, Jan M M; Rijnders, Marlies E B

2016-11-15

CenteringPregnancy (CP) is a multifaceted group based care-model integrated in routine prenatal care, combining health assessment, education, and support. CP has shown some positive results on perinatal outcomes. However, the effects are less obvious when limited to the results of randomized controlled trials: as there are few trials and there is a variation in reported outcomes. Furthermore, former research was mostly conducted in the United States of America and in specific (often high risk) populations. Our study aims to evaluate the effects of CP in the Netherlands in a general population of pregnant women (low and high risk). Furthermore we aim to explore the mechanisms leading to the eventual effects by measuring potential mediating factors. We will perform a stepped wedge cluster randomized controlled trial, in a Western region in the Netherlands. Inclusion criteria are care, women in the intervention period (starting at the randomized time-point) will be offered the choice between individual care or CP. Primary outcomes are maternal and neonatal morbidity, retrieved from a national routine database. Secondary outcomes are health behavior, psychosocial outcomes, satisfaction, health care utilization and process outcomes, collected through self-administered questionnaires, group-evaluations and individual interviews. We will conduct intention-to-treat analyses. Also a per protocol analysis will be performed comparing the three subgroups: control group, CP-participants and non-CP-participants, using multilevel techniques to account for clustering effects. This study contributes to the evidence regarding the effect of CP and gives a first indication of the effect and implementation of CP in both low and high-risk pregnancies in a high-income Western society other than the USA. Also, measuring factors that are hypothesized to mediate the effect of CP will enable to explain the mechanisms that lead to effects on maternal and neonatal outcomes. Dutch Trial

Food groups for allergen risk assessment: Combining food consumption data from different countries in Europe

DEFF Research Database (Denmark)

Birot, Sophie; Madsen, Charlotte Bernhard; Kruizinga, Astrid G

2018-01-01

To prevent allergic reactions, food producers have to be able to make a knowledge based decision on whether to label their products with precautionary labelling. As many manufactured food products are sold in different countries across Europe, the allergen risk assessment should be estimated...... at the European levels. As currently, there are no pan-European food data suitable for food allergy risk assessment. The aim of this paper is to investigate if consumption data, at a meal level, from National Food Consumption Surveys, can be combined to form a common Food Consumption database. In this first...... attempt we developed a procedure to investigate, if national food consumption data can be combined and grouped using data from Netherlands, France and Denmark. The homogeneity of consumption patterns and the relevance of difference in risk of allergic reaction were compared, using a fixed framework...

Identifying potential risk situations for humans when removing horses from groups

DEFF Research Database (Denmark)

Hartmann, Elke; Søndergaard, Eva; Keeling, Linda J.

2012-01-01

Removing a horse from its social group may be considered risky, both for the handler and the horse, because other horses can interfere in the catching process. The main aim of this study was to identify where and when these risk situations occur while removing a horse from its group. A potential...

7 CFR 407.13 - Group risk plan for forage.

Science.gov (United States)

2010-01-01

... acres of hay in the county, as specified in the actuarial documents. The actuarial documents will... a period for forage regrowth. 2. Crop Insured The insured crop will be the forage types shown on the... the Group Risk Plan Common Policy, acreage seeded to forage after July 1 of the previous crop year...

Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

Science.gov (United States)

Zhao, N-N; Zeng, K-X; Wang, Y-L; Sheng, P-J; Tang, C-Z; Xiao, P; Liu, X-W

2017-12-01

To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.

Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

Science.gov (United States)

Abd ElHafeez, Samar; Bolignano, Davide; D’Arrigo, Graziella; Dounousi, Evangelia; Tripepi, Giovanni; Zoccali, Carmine

2018-01-01

Objectives While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. Design, setting and participants We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. Outcome measurement The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. Results In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%–90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%–51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). Conclusion In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies. PMID:29326180

Noninvasive Computed Tomography-based Risk Stratification of Lung Adenocarcinomas in the National Lung Screening Trial.

Science.gov (United States)

Maldonado, Fabien; Duan, Fenghai; Raghunath, Sushravya M; Rajagopalan, Srinivasan; Karwoski, Ronald A; Garg, Kavita; Greco, Erin; Nath, Hrudaya; Robb, Richard A; Bartholmai, Brian J; Peikert, Tobias

2015-09-15

Screening for lung cancer using low-dose computed tomography (CT) reduces lung cancer mortality. However, in addition to a high rate of benign nodules, lung cancer screening detects a large number of indolent cancers that generally belong to the adenocarcinoma spectrum. Individualized management of screen-detected adenocarcinomas would be facilitated by noninvasive risk stratification. To validate that Computer-Aided Nodule Assessment and Risk Yield (CANARY), a novel image analysis software, successfully risk stratifies screen-detected lung adenocarcinomas based on clinical disease outcomes. We identified retrospective 294 eligible patients diagnosed with lung adenocarcinoma spectrum lesions in the low-dose CT arm of the National Lung Screening Trial. The last low-dose CT scan before the diagnosis of lung adenocarcinoma was analyzed using CANARY blinded to clinical data. Based on their parametric CANARY signatures, all the lung adenocarcinoma nodules were risk stratified into three groups. CANARY risk groups were compared using survival analysis for progression-free survival. A total of 294 patients were included in the analysis. Kaplan-Meier analysis of all the 294 adenocarcinoma nodules stratified into the Good, Intermediate, and Poor CANARY risk groups yielded distinct progression-free survival curves (P < 0.0001). This observation was confirmed in the unadjusted and adjusted (age, sex, race, and smoking status) progression-free survival analysis of all stage I cases. CANARY allows the noninvasive risk stratification of lung adenocarcinomas into three groups with distinct post-treatment progression-free survival. Our results suggest that CANARY could ultimately facilitate individualized management of incidentally or screen-detected lung adenocarcinomas.

Understanding personal risk of oropharyngeal cancer: risk-groups for oncogenic oral HPV infection and oropharyngeal cancer.

Science.gov (United States)

D'Souza, G; McNeel, T S; Fakhry, C

2017-12-01

Incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing. There is interest in identifying healthy individuals most at risk for development of oropharyngeal cancer to inform screening strategies. All data are from 2009 to 2014, including 13 089 people ages 20-69 in the National Health and Nutrition Examination Survey (NHANES), oropharyngeal cancer cases from the Surveillance, Epidemiology, and End Results (SEER 18) registries (representing ∼28% of the US population), and oropharyngeal cancer mortality from National Center for Health Statistics (NCHS). Primary study outcomes are (i) prevalence of oncogenic HPV DNA in an oral rinse and gargle sample, and (ii) incident oropharyngeal squamous cell cancer. Oncogenic oral HPV DNA is detected in 3.5% of all adults age 20-69 years; however, the lifetime risk of oropharyngeal cancer is low (37 per 10 000). Among men 50-59 years old, 8.1% have an oncogenic oral HPV infection, 2.1% have an oral HPV16 infection, yet only 0.7% will 'ever' develop oropharyngeal cancer in their lifetime. Oncogenic oral HPV prevalence was higher in men than women, and increased with number of lifetime oral sexual partners and tobacco use. Men who currently smoked and had ≥5 lifetime oral sexual partners had 'elevated risk' (prevalence = 14.9%). Men with only one of these risk factors (i.e. either smoked and had 2-4 partners or did not smoke and had ≥5 partners) had 'medium risk' (7.3%). Regardless of what other risk factors participants had, oncogenic oral HPV prevalence was 'low' among those with only ≤1 lifetime oral sexual partner (women = 0.7% and men = 1.7%). Screening based upon oncogenic oral HPV detection would be challenging. Most groups have low oncogenic oral HPV prevalence. In addition to the large numbers of individuals who would need to be screened to identify prevalent oncogenic oral HPV, the lifetime risk of developing oropharyngeal caner among those with infection remains

Providing web-based mental health services to at-risk women

Directory of Open Access Journals (Sweden)

Kenny Meghan

2011-08-01

Full Text Available Abstract Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7, adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15. Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group

Application of risk-based methods for inspection of nuclear power plant components

International Nuclear Information System (INIS)

Balkey, K.R.

1992-01-01

In-service inspections (ISIs) can play a significant role in minimizing equipment and structural failures. All aspects of inspections, i.e., objectives, method, timing, and the acceptance criteria for detected flaws can affect the probability of component failure. Where ISI programs exist, they are primarily based on prior experience and engineering judgment. At best, some include an implicit consideration of risk (probability of failure multiplied by consequence). Since late 1988, a multidisciplined American Society of Mechanical Engineers (ASME) Research Task Force on Risk-Based Inspection Guidelines has been addressing the general question of how to formally incorporate risk considerations into plans and requirements for the ISI of components and structural systems. The task force and steering committee that guided the project have concluded that appropriate analytical methods exist for evaluating and quantifying risks associated with pressure boundary and structural failures. With the support of about a dozen industry and government organizations, the research group has recommended a general methodology for establishing a risk-based inspection program that could be applied to any nuclear system or structural system

Impact of sickle cell trait on the thrombotic risk associated with non-O blood groups in northern Nigeria.

Science.gov (United States)

Ahmed, Sagir G; Kagu, Modu B; Ibrahim, Umma A; Bukar, Audu A

2015-10-01

The non-O blood group is an established risk factor for deep vein thrombosis (DVT), while controversy surrounds the role of sickle cell trait (SCT) as a risk factor for DVT. We hypothesised that if SCT is a risk factor for DVT, individuals with non-O blood groups and SCT (Hb AS) would have a higher risk of DVT than their counterparts with non-O blood groups and normal haemoglobin phenotype (Hb AA). We retrospectively analysed the prevalence of SCT and non-O blood groups among 148 DVT patients with control subjects in order to determine the role of SCT as a risk factor for DVT and its impact on the risk of DVT among patients with non-O blood groups. In comparison with control subjects, DVT patients had significantly higher prevalences of SCT (35.1% vs 27.7%, p=0.04) and non-O blood groups (68.9% vs 45.9%, p=0.02). The odds ratios for DVT due to SCT, non-O blood groups with normal Hb phenotype (Hb AA) and non-O blood groups with SCT (Hb AS) were 1.3, 2.4 and 3.5, respectively. These results suggest that SCT by itself is a weak risk factor for DVT but it has the potential of escalating the DVT risk among patients with non-O blood groups. The combined effects of elevated clotting factors (non-O group effect) and increased clotting factor activation (SCT effect) were responsible for the escalated DVT risk among patients with co-inheritance of non-O blood groups and SCT. Co-inheritance of SCT and non-O blood group is, therefore, an important mixed risk factor for DVT. This should be taken into account when assessing DVT risk profiles of patients in Africa and other parts of the world where the SCT is prevalent.

Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups.

Science.gov (United States)

Chen, Stephen T; Siddarth, Prabha; Ercoli, Linda M; Merrill, David A; Torres-Gil, Fernando; Small, Gary W

2014-01-01

Previous research has identified modifiable risk factors for Alzheimer's disease (AD) in older adults. Research is limited on the potential link between these risk factors and subjective memory impairment (SMI), which may precede AD and other dementias. Examination of these potential relationships may help identify those at risk for AD at a stage when interventions may delay or prevent further memory problems. The objective of this study was to determine whether risk factors for AD are associated with SMI among different age groups. Trained interviewers conducted daily telephone surveys (Gallup-Healthways) of a representative community sample of 18,614 U.S. respondents, including 4,425 younger (age 18 to 39 years), 6,365 middle-aged (40 to 59 years), and 7,824 older (60 to 99 years) adults. The surveyors collected data on demographics, lifestyles, and medical information. Less education, smoking, hypertension, diabetes, less exercise, obesity and depression, and interactions among them, were examined for associations with SMI. Weighted logistic regressions and chi-square tests were used to calculate odds ratios and confidence intervals for SMI with each risk factor and pairwise interactions across age groups. Depression, less education, less exercise, and hypertension were significantly associated with SMI in all three age groups. Several interactions between risk factors were significant in younger and middle-aged adults and influenced their associations with SMI. Frequency of SMI increased with age and number of risk factors. Odds of having SMI increased significantly with just having one risk factor. These results indicate that modifiable risk factors for AD are also associated with SMI, suggesting that these relationships occur in a broad range of ages and may be targeted to mitigate further memory problems. Whether modifying these risk factors reduces SMI and the eventual incidence of AD and other dementias later in life remains to be determined.

Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups.

Directory of Open Access Journals (Sweden)

Stephen T Chen

Full Text Available INTRODUCTION: Previous research has identified modifiable risk factors for Alzheimer's disease (AD in older adults. Research is limited on the potential link between these risk factors and subjective memory impairment (SMI, which may precede AD and other dementias. Examination of these potential relationships may help identify those at risk for AD at a stage when interventions may delay or prevent further memory problems. The objective of this study was to determine whether risk factors for AD are associated with SMI among different age groups. METHOD: Trained interviewers conducted daily telephone surveys (Gallup-Healthways of a representative community sample of 18,614 U.S. respondents, including 4,425 younger (age 18 to 39 years, 6,365 middle-aged (40 to 59 years, and 7,824 older (60 to 99 years adults. The surveyors collected data on demographics, lifestyles, and medical information. Less education, smoking, hypertension, diabetes, less exercise, obesity and depression, and interactions among them, were examined for associations with SMI. Weighted logistic regressions and chi-square tests were used to calculate odds ratios and confidence intervals for SMI with each risk factor and pairwise interactions across age groups. RESULTS: Depression, less education, less exercise, and hypertension were significantly associated with SMI in all three age groups. Several interactions between risk factors were significant in younger and middle-aged adults and influenced their associations with SMI. Frequency of SMI increased with age and number of risk factors. Odds of having SMI increased significantly with just having one risk factor. CONCLUSIONS: These results indicate that modifiable risk factors for AD are also associated with SMI, suggesting that these relationships occur in a broad range of ages and may be targeted to mitigate further memory problems. Whether modifying these risk factors reduces SMI and the eventual incidence of AD and other

Westinghouse Owners Group Risk-Informed Regulation Efforts: Options 2 and 3

International Nuclear Information System (INIS)

Brown, Jason A.; Osterrieder, Robert A.; Lutz, Robert J.; Dingler, Maurice; Ward, Lewis A.

2002-01-01

The U.S. Nuclear Regulatory Commission (NRC) has initiated efforts to incorporate risk-informed methods to redefine the scope of the existing 10 CFR 50 regulations (Option 2) and to change the technical requirements of the regulations (Option 3). The overall objectives of these efforts are to enhance plant safety, provide a framework for risk-informed regulations, add flexibility to plant operations, and reduce regulatory burden. The Westinghouse Owners Group (WOG) has a variety of active programs in the risk-informed area, including a program in the Option 2 and Option 3 areas. These two programs will be summarized including the benefits and the technical approach. The purpose of Option 2 is to make changes to the overall scope of structures, systems and components (SSCs) covered by 10 CFR 50 requiring special treatment by formulating new risk-informed safety classification categories that are linked to current definitions of safety-related and important-to-safety. This initiative would permit possible changes to the current special treatment requirements based on risk insights. The Nuclear Energy Institute (NEI) has developed an Option 2 implementation guideline (NEI 00-04 Draft Revision B). The WOG has initiated a program to validate the NEI guideline and to provide an initial cost-benefit assessment of the revised categorization and treatment under Option 2 via trial application to two systems at both Surry Unit 1 and Wolf Creek. The WOG Option 2 program includes consideration of all of the components in the selected systems, regardless of whether or not they are modeled in the respective plant probabilistic risk assessment (PRA) studies. As a result, quantitative risk measures are not available for many of the components being considered. In this case, the WOG program will provide valuable input to the NEI guideline. Additionally, the WOG program extends the use of both of the dominant methodologies for risk-informed ISI (RI-ISI) to address repair and

HOW INTERNAL RISK - BASED AUDIT APPRAISES THE EVALUATION OF RISKS MANAGEMENT

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N. Dorosh

2017-09-01

Full Text Available The article deals with the nature and function of the internal risk-based audit process approach to create patterns of risks and methods of evaluation. Deals with the relationship between the level of maturity of the risk of the company and the method of risk-based internal audit. it was emphasized that internal auditing provides an independent and objective opinion to an organization’s management as to whether its risks are being managed to acceptable levels.

Tumor mutational load and immune parameters across metastatic Renal Cell Carcinoma (mRCC) risk groups

Science.gov (United States)

de Velasco, Guillermo; Miao, Diana; Voss, Martin H.; Hakimi, A. Ari; Hsieh, James J.; Tannir, Nizar M.; Tamboli, Pheroze; Appleman, Leonard J.; Rathmell, W. Kimryn; Van Allen, Eliezer M.; Choueiri, Toni K.

2016-01-01

Patients with metastatic renal cell carcinoma (mRCC) have better overall survival when treated with nivolumab, a cancer immunotherapy that targets the immune checkpoint inhibitor programmed cell death 1 (PD-1), rather than everolimus (a chemical inhibitor of mTOR and immunosuppressant). Poor-risk mRCC patients treated with nivolumab seemed to experience the greatest overall survival benefit, compared to patients with favorable or intermediate-risk, in an analysis of the CheckMate-025 trial subgroup of the Memorial Sloan Kettering Cancer Center (MSKCC) prognostic risk groups. Here we explore whether tumor mutational load and RNA expression of specific immune parameters could be segregated by prognostic MSKCC risk strata and explain the survival seen in the poor-risk group. We queried whole exome transcriptome data in RCC patients (n = 54) included in The Cancer Genome Atlas that ultimately developed metastatic disease or were diagnosed with metastatic disease at presentation and did not receive immune checkpoint inhibitors. Nonsynonymous mutational load did not differ significantly by MSKCC risk group, nor was the expression of cytolytic genes –granzyme A and perforin – or selected immune checkpoint molecules different across MSKCC risk groups. In conclusion, this analysis found that mutational load and expression of markers of an active tumor microenvironment did not correlate with MSKCC risk prognostic classification in mRCC. PMID:27538576

Are the blood groups of women with preeclampsia a risk factor for the development of hypertension postpartum?

Science.gov (United States)

Avci, Deniz; Karagoz, Hatice; Ozer, Ozerhan; Esmeray, Kubra; Bulut, Kadir; Aykas, Fatma; Cetinkaya, Ali; Uslu, Emine; Karahan, Samet; Basak, Mustafa; Erden, Abdulsamet

2016-01-01

Preeclampsia (PE) is a pregnancy-related disorder characterized by hypertension (HT) and proteinuria noticeable after 20 weeks of gestation. PE is now considered as a cardiovascular disease risk factor and a number of studies have shown that experiencing PE increases the prevalence of various cardiovascular risk factors, such as metabolic syndrome and HT. In this study, we aimed to investigate any possible relationship between the ABO/Rh blood group system and PE in Turkey. In the second part of the study, we examined the relationship between the ABO blood group system and development of HT after PE. A total of 250 patients with PE from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. Patients were classified according to blood groups (A, B, AB, and O) and Rh status (+/-). There was a significant difference between the patients with PE and the control group in terms of distribution of ABO blood groups and the percentage of group AB was found to be higher in patients with PE compared to the control group (P=0.029). The risk of developing PE was significantly higher in group AB than other blood groups (P=0.006). The risk of developing HT after PE was significantly higher in group O than other blood groups (P=0.004). In this study, we found that the patients with blood group AB have a higher risk for PE. The patients with PE of blood group O are at high risk of developing HT, and Rh factor was identified as another risk at this point and these patients should be closely followed postpartum.

Risk perception in an interest group context: an examination of the TMI restart issue

International Nuclear Information System (INIS)

Soderstrom, E.J.; Sorensen, J.H.; Copenhaver, E.D.; Carnes, S.A.

1984-01-01

Human response to environmental hazards and risks has been the subject of considerable research by social scientists. Work has traditionally focused on either individual response to the risks of an ongoing or future threat (hazards research), or group and organizational response to a specific disaster event (disaster research). As part of a larger investigation of the restart of the Unit 1 reactor at Three Mile Island (TMI), the response of interest groups active in the restart issue to the continued threat of TMI and to future risks due to restart was examined. After reviewing the restart issue in general, the local dimensions of the restart issue from interest group perspectives are discussed. A method for defining appropriate issues at the community level is reviewed. Differences in the perceived local impacts of alternative decisions, and systems of beliefs associated with differing perceptions are discussed. Finally, the implications of interest group versus individual perceptions of local issues for decision making about TMI, in particular, and about technological hazards management, in general, are discussed. Associated implications for determining socially acceptable risk levels are identified

Eielson Air Force Base OU-1 baseline risk assessment

International Nuclear Information System (INIS)

Jarvis, M.T.; Jarvis, T.T.; Van Houten, N.C.; Lewis, R.E.

1993-09-01

This Baseline Risk Assessment report is the second volume in a set of three volumes for operable Unit 1 (OU-1). The companion documents contain the Remedial Investigation and the Feasibility Study. Operable Unit 1 (OU-1) is one of several groups of hazardous waste sites located at Eielson Air Force Base (AFB) near Fairbanks, Alaska. The operable units at Eielson are typically characterized by petroleum, oil, lubricant/solvent contamination, and by the presence of organics floating at the water table. In 1989 and 1990, firms under contract to the Air Force conducted field studies to gather information about the extent of chemical contamination in soil, groundwater, and soil air pore space (soil gas) at the site. This report documents the results of a baseline risk assessment, which uses the 1989 and 1991 site characterization database to quantify the potential human health risk associated with past Base industrial activities in the vicinity of OU-1. Background data collected in 1992 were also used in the preparation of this report

Patient clusters in acute, work-related back pain based on patterns of disability risk factors.

Science.gov (United States)

Shaw, William S; Pransky, Glenn; Patterson, William; Linton, Steven J; Winters, Thomas

2007-02-01

To identify subgroups of patients with work-related back pain based on disability risk factors. Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later. A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group. Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

International consensus for neuroblastoma molecular diagnostics: report from the International Neuroblastoma Risk Group (INRG) Biology Committee

Science.gov (United States)

Ambros, P F; Ambros, I M; Brodeur, G M; Haber, M; Khan, J; Nakagawara, A; Schleiermacher, G; Speleman, F; Spitz, R; London, W B; Cohn, S L; Pearson, A D J; Maris, J M

2009-01-01

Neuroblastoma serves as a paradigm for utilising tumour genomic data for determining patient prognosis and treatment allocation. However, before the establishment of the International Neuroblastoma Risk Group (INRG) Task Force in 2004, international consensus on markers, methodology, and data interpretation did not exist, compromising the reliability of decisive genetic markers and inhibiting translational research efforts. The objectives of the INRG Biology Committee were to identify highly prognostic genetic aberrations to be included in the new INRG risk classification schema and to develop precise definitions, decisive biomarkers, and technique standardisation. The review of the INRG database (n=8800 patients) by the INRG Task Force finally enabled the identification of the most significant neuroblastoma biomarkers. In addition, the Biology Committee compared the standard operating procedures of different cooperative groups to arrive at international consensus for methodology, nomenclature, and future directions. Consensus was reached to include MYCN status, 11q23 allelic status, and ploidy in the INRG classification system on the basis of an evidence-based review of the INRG database. Standardised operating procedures for analysing these genetic factors were adopted, and criteria for proper nomenclature were developed. Neuroblastoma treatment planning is highly dependant on tumour cell genomic features, and it is likely that a comprehensive panel of DNA-based biomarkers will be used in future risk assignment algorithms applying genome-wide techniques. Consensus on methodology and interpretation is essential for uniform INRG classification and will greatly facilitate international and cooperative clinical and translational research studies. PMID:19401703

Identifying drug risk perceptions in Danish youths: Ranking exercises in focus groups

DEFF Research Database (Denmark)

Demant, Jakob; Ravn, Signe

2010-01-01

Abstract: Background: This paper develops an analytical approach for understanding the perceptions of risks associated with drugs among youths in general. These perceptions are central in order to understand how certain drugs become popular, leading to increasing prevalence of use, while others do...... not. As such, this approach can become an efficient policy tool. Methods: Focus groups are used to investigate risk perceptions. We develop a specific methodology that combines a ranking exercise with discourse theory as an analytical approach. This methodology produces detailed information...... and provides a relatively efficient way of investigating normative risk perceptions at a national or subcultural level. The paper develops this methodology in relation to a Danish case with 12 focus group interviews with youths aged from 17 to 22. Results: The analysis identifies five discourses articulated...

Identifying drug risk perceptions in Danish youths: Ranking exercises in focus groups

DEFF Research Database (Denmark)

Demant, Jakob Johan; Ravn, Signe

2010-01-01

not. As such, this approach can become an efficient policy tool. Methods: Focus groups are used to investigate risk perceptions. We develop a specific methodology that combines a ranking exercise with discourse theory as an analytical approach. This methodology produces detailed information......Abstract: Background: This paper develops an analytical approach for understanding the perceptions of risks associated with drugs among youths in general. These perceptions are central in order to understand how certain drugs become popular, leading to increasing prevalence of use, while others do...... and provides a relatively efficient way of investigating normative risk perceptions at a national or subcultural level. The paper develops this methodology in relation to a Danish case with 12 focus group interviews with youths aged from 17 to 22. Results: The analysis identifies five discourses articulated...

Pedestrian safety management using the risk-based approach

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Romanowska Aleksandra

2017-01-01

Full Text Available The paper presents a concept of a multi-level pedestrian safety management system. Three management levels are distinguished: strategic, tactical and operational. The basis for the proposed approach to pedestrian safety management is a risk-based method. In the approach the elements of behavioural and systemic theories were used, allowing for the development of a formalised and repeatable procedure integrating the phases of risk assessment and response to the hazards of road crashes involving pedestrians. Key to the method are tools supporting pedestrian safety management. According to the risk management approach, the tools can be divided into two groups: tools supporting risk assessment and tools supporting risk response. In the paper attention is paid to selected tools supporting risk assessment, with particular emphasis on the methods for estimating forecasted pedestrian safety measures (at strategic, national and regional level and identification of particularly dangerous locations in terms of pedestrian safety at tactical (regional and local and operational level. The proposed pedestrian safety management methods and tools can support road administration in making rational decisions in terms of road safety, safety of road infrastructure, crash elimination measures or reducing the consequences suffered by road users (particularly pedestrians as a result of road crashes.

RISK LOAN PORTFOLIO OPTIMIZATION MODEL BASED ON CVAR RISK MEASURE

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Ming-Chang LEE

2015-07-01

Full Text Available In order to achieve commercial banks liquidity, safety and profitability objective requirements, loan portfolio risk analysis based optimization decisions are rational allocation of assets.  The risk analysis and asset allocation are the key technology of banking and risk management.  The aim of this paper, build a loan portfolio optimization model based on risk analysis.  Loan portfolio rate of return by using Value-at-Risk (VaR and Conditional Value-at-Risk (CVaR constraint optimization decision model reflects the bank's risk tolerance, and the potential loss of direct control of the bank.  In this paper, it analyze a general risk management model applied to portfolio problems with VaR and CVaR risk measures by using Using the Lagrangian Algorithm.  This paper solves the highly difficult problem by matrix operation method.  Therefore, the combination of this paper is easy understanding the portfolio problems with VaR and CVaR risk model is a hyperbola in mean-standard deviation space.  It is easy calculation in proposed method.

Prevalence of and risk factors for high-risk human papillomavirus infection: a population-based study from Hetian, Xinjiang, China

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Mayinuer Niyazi

2016-01-01

Full Text Available Human papillomavirus (HPV infection contributes to most cases of cervical cancer, and HPV genotypes exhibit different distributions according to geographic region. This study evaluates the prevalence of HPV infection in Hetian Prefecture, Xinjiang, and establishes risk factors associated with high-risk HPV (HR-HPV genotypes in this region. In this cross-sectional, population-based study, 883 healthy women 15-54 years of age were enrolled. All participants completed a questionnaire regarding sociocultural and sexual activity characteristics. Visual inspections with acetic acid, colposcopies and biopsies were performed using the Preventive Oncology International microbiopsy protocol for pathological diagnosis. Cervical epithelial tissue specimens were collected and tested for HPV using linear array assays. According to the results of HR-HPV infection status, individuals infected with HR-HPV were classified into one group, and the remaining individuals were classified into the control group. The risk factors for HR-HPF infection were analyzed. The participants included 66 women (7.47% with HR-HPV, 10 women (1.13% with low-risk HPV, and 14 women (1.59% with HPV of unknown risk. The five most prevalent types of HR-HPV were HPV-16 (0.31%, HPV-51 (0.08%, HPV-31 (0.07%, HPV-58 (0.07%, and HPV-39 (0.06%. Vulvovaginal ulcers and vulvovaginal inflammation were found in 190 participants (21.52% and 256 participants (28.99%, respectively. The HR-HPV and control groups significantly differed with respect to age at first marriage, number of marriages, and the presence of vulvovaginal ulcers and vulvovaginal inflammation (p<0.05. Based on this study, an immunization strategy targeting HPV-16 should be prioritized in Hetian Prefecture. These findings contribute to the understanding of HPV infection.

Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

Science.gov (United States)

van Otterloo, Sandra G.; van der Leij, Aryan

2009-01-01

Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

Risk-based inspection of nuclear power plants

International Nuclear Information System (INIS)

Masopust, R.

1995-01-01

A multidiscipline research programme was developed in the USA to establish risk-based inspections for NPP structures and equipment components. Based on this US research effort, the risk-based procedure for developing inspection guidelines for NPPs is described. The procedure includes the definition of systems, qualitative risk assessment, qualitative risk analysis and development of the inspection programme. The method, when adopted and modified, is recommended also for risk-based inspections of structures and equipment of WWER-type NPPs. A pilot application of the method to unit 1 of the Surry NPP is summarized. (Z.S.) 1 tab., 1 fig., 5 refs

Mobile Phone-Based Lifestyle Intervention for Reducing Overall Cardiovascular Disease Risk in Guangzhou, China: A Pilot Study

Directory of Open Access Journals (Sweden)

Zhiting Liu

2015-12-01

Full Text Available With the rapid and widespread adoption of mobile devices, mobile phones offer an opportunity to deliver cardiovascular disease (CVD interventions. This study evaluated the efficacy of a mobile phone-based lifestyle intervention aimed at reducing the overall CVD risk at a health management center in Guangzhou, China. We recruited 589 workers from eight work units. Based on a group-randomized design, work units were randomly assigned either to receive the mobile phone-based lifestyle interventions or usual care. The reduction in 10-year CVD risk at 1-year follow-up for the intervention group was not statistically significant (–1.05%, p = 0.096. However, the mean risk increased significantly by 1.77% (p = 0.047 for the control group. The difference of the changes between treatment arms in CVD risk was –2.83% (p = 0.001. In addition, there were statistically significant changes for the intervention group relative to the controls, from baseline to year 1, in systolic blood pressure (–5.55 vs. 6.89 mmHg; p < 0.001, diastolic blood pressure (–6.61 vs. 5.62 mmHg; p < 0.001, total cholesterol (–0.36 vs. –0.10 mmol/L; p = 0.005, fasting plasma glucose (–0.31 vs. 0.02 mmol/L; p < 0.001, BMI (–0.57 vs. 0.29 kg/m2; p < 0.001, and waist hip ratio (–0.02 vs. 0.01; p < 0.001. Mobile phone-based intervention may therefore be a potential solution for reducing CVD risk in China.

Noninvasive Computed Tomography–based Risk Stratification of Lung Adenocarcinomas in the National Lung Screening Trial

Science.gov (United States)

Maldonado, Fabien; Duan, Fenghai; Raghunath, Sushravya M.; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Garg, Kavita; Greco, Erin; Nath, Hrudaya; Robb, Richard A.; Bartholmai, Brian J.

2015-01-01

Rationale: Screening for lung cancer using low-dose computed tomography (CT) reduces lung cancer mortality. However, in addition to a high rate of benign nodules, lung cancer screening detects a large number of indolent cancers that generally belong to the adenocarcinoma spectrum. Individualized management of screen-detected adenocarcinomas would be facilitated by noninvasive risk stratification. Objectives: To validate that Computer-Aided Nodule Assessment and Risk Yield (CANARY), a novel image analysis software, successfully risk stratifies screen-detected lung adenocarcinomas based on clinical disease outcomes. Methods: We identified retrospective 294 eligible patients diagnosed with lung adenocarcinoma spectrum lesions in the low-dose CT arm of the National Lung Screening Trial. The last low-dose CT scan before the diagnosis of lung adenocarcinoma was analyzed using CANARY blinded to clinical data. Based on their parametric CANARY signatures, all the lung adenocarcinoma nodules were risk stratified into three groups. CANARY risk groups were compared using survival analysis for progression-free survival. Measurements and Main Results: A total of 294 patients were included in the analysis. Kaplan-Meier analysis of all the 294 adenocarcinoma nodules stratified into the Good, Intermediate, and Poor CANARY risk groups yielded distinct progression-free survival curves (P < 0.0001). This observation was confirmed in the unadjusted and adjusted (age, sex, race, and smoking status) progression-free survival analysis of all stage I cases. Conclusions: CANARY allows the noninvasive risk stratification of lung adenocarcinomas into three groups with distinct post-treatment progression-free survival. Our results suggest that CANARY could ultimately facilitate individualized management of incidentally or screen-detected lung adenocarcinomas. PMID:26052977

Risk-based remediation: Approach and application

International Nuclear Information System (INIS)

Frishmuth, R.A.; Benson, L.A.

1995-01-01

The principle objective of remedial actions is to protect human health and the environment. Risk assessments are the only defensible tools available to demonstrate to the regulatory community and public that this objective can be achieved. Understanding the actual risks posed by site-related contamination is crucial to designing cost-effective remedial strategies. All to often remedial actions are overdesigned, resulting in little to no increase in risk reduction while increasing project cost. Risk-based remedial actions have recently been embraced by federal and state regulators, industry, government, the scientific community, and the public as a mechanism to implement rapid and cost-effective remedial actions. Emphasizing risk reduction, rather than adherence to ambiguous and generic standards, ensures that only remedial actions required to protect human health and the environment at a particular site are implemented. Two sites are presented as case studies on how risk-based approaches are being used to remediate two petroleum hydrocarbon contaminated sites. The sites are located at two US Air Force Bases, Wurtsmith Air Force Base (AFB) in Oscoda, Michigan and Malmstrom AFB in Great Falls, Montana

Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups.

Science.gov (United States)

Hartung, Danielle; Stadeler, Martina; Grieshaber, Romano; Keller, Sylvia; Jahreis, Gerhard

2010-03-22

Although work related risk factors associated with Cardiovascular Diseases (CD) have been well researched, there is no detailed knowledge regarding disparate occupational groups each with a different risk exposition. Therefore, two occupational groups (chefs and office workers) were compared with a focus on nutritional and psychosocial factors. Two groups of subjects were tested for work and diet-related risks of CD (45 chefs and 48 office workers). The groups matched both for gender (male) and age (30 to 45 years). The study included a medical check-up, bioelectrical impedance analysis as well as an evaluation of questionnaires on health, nutritional behaviour and coping capacity. In addition, volunteers were required to compile a 7-day-dietary-record and collect their urine 24 h prior to their check-up. Blood samples drawn were analysed for glucose and lipid metabolism, homocysteine, vitamin B12, folic acid; C-reactive protein, uric acid, red blood cell fatty acids, plant sterols, antioxidative capacity and oxidative stress. On average, the chefs showed one risk factor more compared to the office workers. The most frequent risk factors in both groups included overweight/obesity (chef group [CG]: 62.2%; office group [OG]: 58.3%) and elevated TC (CG: 62.2%; OG: 43.8%]. Moreover, although the chefs often had higher CRP-concentrations (40.0%), more office workers suffered from hypertension (37.5%).Chefs showed significant higher concentrations of saturated fatty acids and oleic acid, whereas docosahexaenoic acid, Omega-6- and trans fatty acids were found more frequently in the red blood cell membranes of office workers. While there were no significant differences in analysed plant sterols between the two occupational groups, 7,8-dihydro-8-oxo-2'-deoxyguanosine was significantly increased in office workers.Concerning the work-related psychosocial factors, the chefs were characterised by a stronger subjective importance of work, a greater degree of professional

Developing points-based risk-scoring systems in the presence of competing risks.

Science.gov (United States)

Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

2016-09-30

Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

A newly identified group of adolescents at "invisible" risk for psychopathology and suicidal behavior: findings from the SEYLE study.

Science.gov (United States)

Carli, Vladimir; Hoven, Christina W; Wasserman, Camilla; Chiesa, Flaminia; Guffanti, Guia; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean Pierre; Keeley, Helen; Postuvan, Vita; Saiz, Pilar; Varnik, Airi; Wasserman, Danuta

2014-02-01

This study explored the prevalence of risk behaviors (excessive alcohol use, illegal drug use, heavy smoking, reduced sleep, overweight, underweight, sedentary behavior, high use of Internet/TV/videogames for reasons not related to school or work, and truancy), and their association with psychopathology and self-destructive behaviors, in a sample of 12,395 adolescents recruited in randomly selected schools across 11 European countries. Latent class analysis identified three groups of adolescents: a low-risk group (57.8%) including pupils with low or very low frequency of risk behaviors; a high-risk group (13.2%) including pupils who scored high on all risk behaviors, and a third group ("invisible" risk, 29%) including pupils who were positive for high use of Internet/TV/videogames for reasons not related to school or work, sedentary behavior and reduced sleep. Pupils in the "invisible" risk group, compared with the high-risk group, had a similar prevalence of suicidal thoughts (42.2% vs. 44%), anxiety (8% vs. 9.2%), subthreshold depression (33.2% vs. 34%) and depression (13.4% vs. 14.7%). The prevalence of suicide attempts was 5.9% in the "invisible" group, 10.1% in the high-risk group and 1.7% in the low-risk group. The prevalence of all risk behaviors increased with age and most of them were significantly more frequent among boys. Girls were significantly more likely to experience internalizing (emotional) psychiatric symptoms. The "invisible" group may represent an important new intervention target group for potentially reducing psychopathology and other untoward outcomes in adolescence, including suicidal behavior. Copyright © 2014 World Psychiatric Association.

Risk assessment of occupational groups working in open pit mining: Analytic Hierarchy Process

Directory of Open Access Journals (Sweden)

Yaşar Kasap

2017-01-01

Full Text Available In open pit mining it is possible to prevent industrial accidents and the results of industrial accidents such as deaths, physical disabilities and financial loss by implementing risk analyses in advance. If the probabilities of different occupational groups encountering various hazards are determined, workers’ risk of having industrial accidents and catching occupational illnesses can be controlled. In this sense, the aim of this study was to assess the industrial accidents which occurred during open pit coal production in the Turkish Coal Enterprises (TCE Garp Lignite unit between 2005 and 2010 and to analyze the risks using the Analytic Hierarchy Process (AHP. The analyses conducted with AHP revealed that the greatest risk in open pit mining is landslides, the most risky occupational group is unskilled labourers and the most common hazards are caused by landslides and transportation/hand tools/falling.

Disposal Notifications and Quarterly Membership Updates for the Utility Solid Waste Group Members’ Risk-Based Approvals to Dispose of PCB Remediation Waste Under Title 40 of the Code of Federal Regulations Section 761.61(c)

Science.gov (United States)

Disposal Notifications and Quarterly Membership Updates for the Utility Solid Waste Group Members’ Risk-Based Approvals to Dispose of Polychlorinated Biphenyl (PCB) Remediation Waste Under Title 40 of the Code of Federal Regulations Section 761.61(c)

Nuclear insurance risk assessment using risk-based methodology

International Nuclear Information System (INIS)

Wendland, W.G.

1992-01-01

This paper presents American Nuclear Insurers' (ANI's) and Mutual Atomic Energy Liability Underwriters' (MAELU's) process and experience for conducting nuclear insurance risk assessments using a risk-based methodology. The process is primarily qualitative and uses traditional insurance risk assessment methods and an approach developed under the auspices of the American Society of Mechanical Engineers (ASME) in which ANI/MAELU is an active sponsor. This process assists ANI's technical resources in identifying where to look for insurance risk in an industry in which insurance exposure tends to be dynamic and nonactuarial. The process is an evolving one that also seeks to minimize the impact on insureds while maintaining a mutually agreeable risk tolerance

Identifying groups at risk for 1-year membership termination from a fitness center at enrollment

Directory of Open Access Journals (Sweden)

Stephanie A. Hooker

2016-12-01

Full Text Available The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a healthy, (b unhealthy, (c poor psychological wellness, and (d poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007 and the unhealthy group (OR = 2.40, p = 0.037 were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01. Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention.

Exclusive image guided IMRT vs. radical prostatectomy followed by postoperative IMRT for localized prostate cancer: a matched-pair analysis based on risk-groups

International Nuclear Information System (INIS)

Azelie, Caroline; Créhange, Gilles; Gauthier, Mélanie; Mirjolet, Céline; Cormier, Luc; Martin, Etienne; Peignaux-Casasnovas, Karine; Truc, Gilles; Chamois, Jérôme; Maingon, Philippe

2012-01-01

To investigate whether patients treated for a localized prostate cancer (PCa) require a radical prostatectomy followed by postoperative radiotherapy or exclusive radiotherapy, in the modern era of image guided IMRT. 178 patients with PCa were referred for daily exclusive image guided IMRT (IG-IMRT) using an on-line 3D ultra-sound based system and 69 patients were referred for postoperative IMRT without image guidance after radical prostatectomy (RP + IMRT). Patients were matched in a 1:1 ratio according to their baseline risk group before any treatment. Late toxicity was scored using the CTV v3.0 scale. Biochemical failure was defined as a postoperative PSA ≤ 0.1 ng/mL followed by 1 consecutive rising PSA for the postoperative group of patients and by the Phoenix definition (nadir + 2 ng/mL) for the group of patients treated with exclusive radiotherapy. A total of 98 patients were matched (49:49). From the start of any treatment, the median follow-up was 56.6 months (CI 95% = [49.6-61.2], range [18.2-115.1]). No patient had late gastrointestinal grade ≥ 2 toxicity in the IG-IMRT group vs. 4% in the RP + IMRT group. Forty two percent of the patients in both groups had late grade ≥ 2 genitourinary toxicity. The 5-year FFF rates in the IG-IMRT group and in the RP + IMRT groups were 93.1% [80.0-97.8] and 76.5% [58.3-87.5], respectively (p = 0.031). Patients with a localized PCa treated with IG-IMRT had better oncological outcome than patients treated with RP + IMRT. Further improvements in postoperative IMRT using image guidance and dose escalation are urgently needed

13 CFR 120.1000 - Risk-Based Lender Oversight.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Risk-Based Lender Oversight. 120.1000 Section 120.1000 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1000 Risk-Based Lender Oversight. (a) Risk-Based Lender...

Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement.

Science.gov (United States)

van Hest, N A; Aldridge, R W; de Vries, G; Sandgren, A; Hauer, B; Hayward, A; Arrazola de Oñate, W; Haas, W; Codecasa, L R; Caylà, J A; Story, A; Antoine, D; Gori, A; Quabeck, L; Jonsson, J; Wanlin, M; Orcau, Å; Rodes, A; Dedicoat, M; Antoun, F; van Deutekom, H; Keizer, St; Abubakar, I

2014-03-06

In low-incidence countries in the European Union (EU), tuberculosis (TB) is concentrated in big cities, especially among certain urban high-risk groups including immigrants from TB high-incidence countries, homeless people, and those with a history of drug and alcohol misuse. Elimination of TB in European big cities requires control measures focused on multiple layers of the urban population. The particular complexities of major EU metropolises, for example high population density and social structure, create specific opportunities for transmission, but also enable targeted TB control interventions, not efficient in the general population, to be effective or cost effective. Lessons can be learnt from across the EU and this consensus statement on TB control in big cities and urban risk groups was prepared by a working group representing various EU big cities, brought together on the initiative of the European Centre for Disease Prevention and Control. The consensus statement describes general and specific social, educational, operational, organisational, legal and monitoring TB control interventions in EU big cities, as well as providing recommendations for big city TB control, based upon a conceptual TB transmission and control model.

40 CFR 280.97 - Insurance and risk retention group coverage.

Science.gov (United States)

2010-07-01

... UNDERGROUND STORAGE TANKS (UST) Financial Responsibility § 280.97 Insurance and risk retention group coverage... information and the brackets deleted: (1) Endorsement Name: [name of each covered location] Address: [address... liability, and exclusions of the policy.] I hereby certify that the wording of this instrument is identical...

Childhood Risk Factors in Substance Abuse Among a Group of Abuser 20-30 Year-Old Group in Tehran

Directory of Open Access Journals (Sweden)

A.R. Zahiredin

2004-01-01

Full Text Available Substance use disorder is the second most common psychiatric disorders and is far more prevalent among young adults (ages;18-34y/0. Because of its importance and main effect in society, this study performed for evaluation of association fourteen childhood and adoleseence pathologic factors with substance use disorder among a group of abuser (20-30/0that referred to five addiction center in Tehran . The sample consist 100 patient: including 50 case and 50 control who were selected by DSM- IV based semi-structured diagnostic interviews for decrease memory biases in this retrospective cohart study. The patient’s parents also evaluated by DSM- IV based Semi-structured diagnostic interviews. The analysis showed significant relation between: parents control on the siblings, addiction in relatives of pt (except parents, addicted peers and friends, to be affected with the peers and friends and substance use disorder at the ages (20-30y/o. There wasn’t any association between: Disruptive childhood behaviors (under 11y/o, diagnosed medical illness (under 11y/o diagnosed Psychiatric illness (under 6 mo , family size, socio economic state and substance use disorder at the age(20-30y/0 . Finally some childhood and adolescence pathologic factors has association with Substance use disorder at the ages ( 20-30y/5 that these can be used for education all planning , prevention , design high risk group and remedical plans.

Group differences in risk across three domains using an expanded measure of sexual orientation.

Science.gov (United States)

Loosier, Penny S; Dittus, Patricia J

2010-12-01

The purpose of this study was to highlight associations between sexual orientation and risk outcomes in late adolescence and early adulthood using an expanded measure of sexual orientation. Recent data indicate higher levels of risk behavior in a newly identified population, mostly heterosexuals, as compared to heterosexuals. Comparisons among groups using an expanded measure of sexual orientation such as this, however, often do not include all possible groups or may restrict comparisons between groups. Data were derived from the National Longitudinal Study of Adolescent Health (Add Health); participants identified as heterosexual, mostly heterosexual, bisexual, mostly gay, or gay. Main risk outcomes were parental mistreatment, home displacement, thoughts of suicide, depressive symptoms, frequency of drinking, and delinquency. A priori planned comparisons examined differences between: (a) heterosexual vs. mostly heterosexual, (b) gay vs. mostly gay, (c) mostly heterosexual vs. bisexual, (d) mostly gay vs. bisexual, (e) mostly heterosexual vs. mostly gay, (f) heterosexual vs. gay, (g) heterosexual vs. bisexual, and (h) gay vs. bisexual. Mostly heterosexual youth were at significantly greater risk than heterosexual youth on all outcomes but did not differ from bisexual or mostly gay youth. Heterosexuals were at lower risk as compared to mostly heterosexuals and bisexuals. This study provides further evidence of differential risk associations for sexual minorities.

Risk profiles and corporate social responsibility for socially disadvantaged groups

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Serbanescu Cosmin

2017-07-01

Full Text Available Developing a suitable mechanism to stimulate the effective redeployment of capital to social activities can be designed using the corporate social responsibility (CSR concept. Informational asymmetry about the real state of social risks influences the effectiveness of allocations in social protection. Reducing information asymmetries can be achieved by providing the corporations with socially determined risk profiles based on predetermined patterns. Offering concrete lines of action following the risk profiles approach which to base investment decisions of companies in CSR can maximize the results of such a mechanism. In a previous study the authors have developed a theoretical model for determining the poverty risk profile. This study aims to present the practical application of the theoretical model and to provide comments on some errors. Hence, the authors analyzed Buzau county municipalities in presenting the highest risk level determined by the theoretical model and related causes and performed an impact assessment of an investment in CSR based on a model. Specifically, the authors evaluated the impact of reducing the risk of poverty for a suitable investment in CSR. In the second part of the study, the authors analyzed the types of errors that can be found in the municipalities risk profile model due to the granularity of the data. Thus, for the error of over-inclusion, the authors assessed social allocative efficiency at the community level using benchmarking analysis, Data Envelopment respectively and analyzed the data of the under-inclusion error in Buzau county villages. The paper aims to analyze the relative limits on quantitative models and risk of poverty and the practical implementation of these types of models in the development of corporate social responsibility. The study provides also a useful tool which can be made available to companies in order to increase the vulnerable groups’ life quality and the satisfaction of

Assessment of independent risk factors of conversion into psychosis in the ultra-high risk state group of patients

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Marta Gawłowska

2010-12-01

Full Text Available Background: The aim of this study was the independent psychosis risk factors assessment in a group of subjects fulfilling the criteria of at risk mental state, under specialist outpatient psychiatric care. Participants: Seventy-one patients – 33 women and 38 men, were involved into this study, aged on average 17.34, all under psychiatric care. The patients were recruited into the study in the sequence of their outpatient clinic admission. The criterion to be included into the study was the diagnosis of ultra-high risk state (UHRS – defined according to the Australian research group principles. Subsequently, the patients were divided into subgroups according to the clinical features of their mental state. Method: The author’s demographic questionnaire was applied in the study. Information regarding the family history of psychosis was obtained from patients and/or their relatives or carers. The patients’ mental state was assessed monthly – according to the presence of psychotic symptoms, change of their incidence and duration, presence of depressive symptoms or aggressive behaviour (measured by a three-level scale. On the basis of the obtained information, we evaluated: 1 conversion into psychosis time – measured from diagnosing of UHRS to the development of full-symptom psychosis, 2 therapeutic methods used (psychotherapy, pharmacotherapy or both, 3 use of psychoactive substances after being diagnosed with UHRS, 4 presence of serious life stressors (the patients’ subjective estimation – during the six-month period preceding the conversion into psychosis. Results: 1 In the UHRS group of patients, staying under professional outpatient psychiatric care, the use of marijuana was an independent risk factor of conversion into psychosis. 2 In the investigated group of patients with at risk mental state we did not find any correlation between modulating factors (including: therapeutic methods used, depressive symptoms, aggression or

Anxiety and depression symptoms among women attending group-based patient education courses for hereditary breast and ovarian cancer

OpenAIRE

List?l, Wenche; H?berg-Vetti, Hildegunn; Eide, Geir Egil; Bjorvatn, Cathrine

2017-01-01

Background Women carrying BRCA-mutations are facing significant challenges, including decision making regarding surveillance and risk-reducing surgery. They often report that they are left alone with these important decisions. In order to enhance the genetic counselling session we organized a group-based patient education (GPE) course for women with BRCA-mutations. The study aims were to characterize women attending a group-based patient education (GPE) course for hereditary breast and ovaria...

A Novel Dynamic Algorithm for IT Outsourcing Risk Assessment Based on Transaction Cost Theory

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Guodong Cong

2015-01-01

Full Text Available With the great risk exposed in IT outsourcing, how to assess IT outsourcing risk becomes a critical issue. However, most of approaches to date need to further adapt to the particular complexity of IT outsourcing risk for either falling short in subjective bias, inaccuracy, or efficiency. This paper proposes a dynamic algorithm of risk assessment. It initially forwards extended three layers (risk factors, risks, and risk consequences of transferring mechanism based on transaction cost theory (TCT as the framework of risk analysis, which bridges the interconnection of components in three layers with preset transferring probability and impact. Then, it establishes an equation group between risk factors and risk consequences, which assures the “attribution” more precisely to track the specific sources that lead to certain loss. Namely, in each phase of the outsourcing lifecycle, both the likelihood and the loss of each risk factor and those of each risk are acquired through solving equation group with real data of risk consequences collected. In this “reverse” way, risk assessment becomes a responsive and interactive process with real data instead of subjective estimation, which improves the accuracy and alleviates bias in risk assessment. The numerical case proves the effectiveness of the algorithm compared with the approach forwarded by other references.

Male sex workers: Are we ignoring a risk group in Mumbai, India?

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Shinde Santosh

2009-01-01

Full Text Available Background: Male sex workers (MSWs have recently been recognized as an important risk group for sexually transmitted infections (STIs including human immunodeficiency virus (HIV infection. Although there are global studies on MSWs, few such studies describe the behavioral patterns and STIs among this population in India. Methods: MSWs were evaluated at the Humsafar trust, a community based organization situated in suburban Mumbai, India. We report on the demographics, sexual behaviors, and STIs including HIV of these sex workers. Results: Of the 75 MSWs, 24 were men and 51 were transgenders. The mean age of the group was 23.3 (+ 4.9 years. About 15% were married or lived with a permanent partner. Of these individuals, 85% reported sex work as a main source of income and 15% as an additional source. All the individuals reported anal sex (87% anal receptive sex and 13% anal insertive sex. About 13% of MSWs had never used a condom. The HIV prevalence was 33% (17% in men vs 41% in transgenders, P = 0.04. The STI prevalence was 60% (58% in men vs 61% in transgenders, P = 0.8. Syphilis was the most common STI (28% in these MSWs. HIV was associated with being a transgender (41 vs 17%, P = 0.04, age > 26 years (57 vs 28%, P = 0.04, more than one year of sex work (38 vs 8%, P = 0.05, and income < Rs. 2000 per month (62 vs 27%, P = 0.02. Conclusions: The MSWs have high-risk behaviors, low consistent condom use, and high STI/HIV infections. These groups should be the focus of intensive public health interventions aimed at reduction of risky sexual practices, and STI/HIV prevention and care.

Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review.

Science.gov (United States)

Abd ElHafeez, Samar; Bolignano, Davide; D'Arrigo, Graziella; Dounousi, Evangelia; Tripepi, Giovanni; Zoccali, Carmine

2018-01-10

While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%-90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%-51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

NUTRITION BASED ON DIFFERENT ORIGIN OF FATS AS A RISK FACTOR FOR CEREBROVASCULAR INSULT

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Gordana Petrović-Oggiano

2011-06-01

Full Text Available Cerebrovascular insult (CVI is one of leading causes of mortality and morbidity worldwide, with significant influence of lifestyle on its development.The aim of this study was to investigate the different risk factors and their impact on hyperlipidaemia in two ethnic groups of patients who were hospitalized after CVI during two years.The total of 230 patients, 35-65 years old, with the ischemic CVI who had been hospitalized and treated at the Clinical Center Priština were included in our study. The patients were divided into two groups: group A (n=130- Muslim patients, and group S (n=100 – Orthodox patients. Their antropometric and serum lipid parameters were measured and nutritional habits were assessed by food frequency questionnaire (FFQ.The patients from both groups were classified as adipose, with BMI in males around 33, and in females 28-30. Percentage of body fat was also high in both groups, especially in women (p<0.001, without significant difference between groups A and S. Physical activity was very low in both studied groups. In the group A, 86.92% patients with CVI were physically inactive, while in the group S the percentage amounted to 92% (p<0.001. The number of smokers was rather high in both groups, particularly in group S (89% and more than a half (53% of examinees had been smoking for more than 10 years. Almost all smokers consumed more than 20 cigarettes per day (83%. In group A, there were 35% of non-smokers (p<0.001.The average diastolic blood pressure value in the groups A and S (Table 6,7 was 97.97±4.75 mmHg and 100.82±6.71 mmHg, respectively, while systolic pressure was 174.27±3.18 mmHg in group A and 183.73±11.39 mmHg in group S. In spite of different lifestyles in both groups, the studied risk factors were proved to have significant influence on the onset of hyperlipidemia. The S group patients whose diet was predominantly based on animal fats had significantly higher risk in comparison to the group whose diet

Using risk analysis in Health Impact Assessment: the impact of different relative risks for men and women in different socio-economic groups

DEFF Research Database (Denmark)

Nilunger, Louise; Diderichsen, Finn; Burström, Bo

2004-01-01

The aim of this study is to contribute to the emerging field of quantification of Health Impact Assessment (HIA), by analysing how different relative risks affect the burden of disease for various socio-economic groups (SES). Risk analysis, utilising attributable and impact fraction, raises several...... methodological considerations. The present study illustrates this by measuring the impact of changed distribution levels of smoking on lung cancer, ischemic heart disease (IHD), chronic obstructive lung disorder (COLD) and stroke for the highest and lowest socio-economic groups measured in disability adjusted...... the highest and lowest socio-economic groups may decrease by 75% or increase by 21% depending on the size of the relative risk. Assuming the same smoking prevalence for the lowest socio-economic group as for the highest (impact fraction), then the inequality may decrease by 7-26%. Consequently, the size...

The self-regulatory role of anticipated group-based shame and guilt in inhibiting in-group favoritism

NARCIS (Netherlands)

Shepherd, Lee; Spears, Russell; Manstead, Antony Stephen

2013-01-01

In three studies, we examined whether the anticipation of group-based guilt and shame inhibits in-group favoritism. In Studies 1 and 2, anticipated group-based shame negatively predicted in-group favoritism; in neither study did anticipated group-based guilt uniquely predict in-group favoritism. In

A model-based risk management framework

Energy Technology Data Exchange (ETDEWEB)

Gran, Bjoern Axel; Fredriksen, Rune

2002-08-15

The ongoing research activity addresses these issues through two co-operative activities. The first is the IST funded research project CORAS, where Institutt for energiteknikk takes part as responsible for the work package for Risk Analysis. The main objective of the CORAS project is to develop a framework to support risk assessment of security critical systems. The second, called the Halden Open Dependability Demonstrator (HODD), is established in cooperation between Oestfold University College, local companies and HRP. The objective of HODD is to provide an open-source test bed for testing, teaching and learning about risk analysis methods, risk analysis tools, and fault tolerance techniques. The Inverted Pendulum Control System (IPCON), which main task is to keep a pendulum balanced and controlled, is the first system that has been established. In order to make risk assessment one need to know what a system does, or is intended to do. Furthermore, the risk assessment requires correct descriptions of the system, its context and all relevant features. A basic assumption is that a precise model of this knowledge, based on formal or semi-formal descriptions, such as UML, will facilitate a systematic risk assessment. It is also necessary to have a framework to integrate the different risk assessment methods. The experiences so far support this hypothesis. This report presents CORAS and the CORAS model-based risk management framework, including a preliminary guideline for model-based risk assessment. The CORAS framework for model-based risk analysis offers a structured and systematic approach to identify and assess security issues of ICT systems. From the initial assessment of IPCON, we also believe that the framework is applicable in a safety context. Further work on IPCON, as well as the experiences from the CORAS trials, will provide insight and feedback for further improvements. (Author)

Risk group dependence of dose-response for biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer

International Nuclear Information System (INIS)

Levegruen, Sabine; Jackson, Andrew; Zelefsky, Michael J.; Venkatraman, Ennapadam S.; Skwarchuk, Mark W.; Schlegel, Wolfgang; Fuks, Zvi; Leibel, Steven A.; Ling, C. Clifton

2002-01-01

Background and purpose: We fit phenomenological tumor control probability (TCP) models to biopsy outcome after three-dimensional conformal radiation therapy (3D-CRT) of prostate cancer patients to quantify the local dose-response of prostate cancer. Materials and methods: We analyzed the outcome after photon beam 3D-CRT of 103 patients with stage T1c-T3 prostate cancer treated at Memorial Sloan-Kettering Cancer Center (MSKCC) (prescribed target doses between 64.8 and 81 Gy) who had a prostate biopsy performed ≥2.5 years after end of treatment. A univariate logistic regression model based on D mean (mean dose in the planning target volume of each patient) was fit to the whole data set and separately to subgroups characterized by low and high values of tumor-related prognostic factors T-stage ( 6), and pre-treatment prostate-specific antigen (PSA) (≤10 ng/ml vs. >10 ng/ml). In addition, we evaluated five different classifications of the patients into three risk groups, based on all possible combinations of two or three prognostic factors, and fit bivariate logistic regression models with D mean and the risk group category to all patients. Dose-response curves were characterized by TCD 50 , the dose to control 50% of the tumors, and γ 50 , the normalized slope of the dose-response curve at TCD 50 . Results: D mean correlates significantly with biopsy outcome in all patient subgroups and larger values of TCD 50 are observed for patients with unfavorable compared to favorable prognostic factors. For example, TCD 50 for high T-stage patients is 7 Gy higher than for low T-stage patients. For all evaluated risk group definitions, D mean and the risk group category are independent predictors of biopsy outcome in bivariate analysis. The fit values of TCD 50 show a clear separation of 9-10.6 Gy between low and high risk patients. The corresponding dose-response curves are steeper (γ 50 =3.4-5.2) than those obtained when all patients are analyzed together (γ 50 =2

Increased Risk of Acute Cholecystitis in Patients with Spinal cord injury: A Nationwide Population-Based Cohort Study.

Science.gov (United States)

Hsu, Cherng-Lan; Wang, Mei-Ting; Ho, Yu-Chun; Pan, Shin-Liang

2017-10-31

Retrospective cohort study. To evaluate the risk of acute cholecystitis (AC) in patients with spinal cord injury (SCI) based on a nationwide sample. Prior research evaluating the risk of AC in patients with SCI is limited. Moreover, since most previous studies on the association between AC and SCI used case-series designs, little is known about the relative risk of SCI patients developing AC from a longitudinal follow-up, compared with individuals without SCI. We used the data from Taiwan's National Health Insurance Research Database. The SCI group consisted of 11523 patients with SCI aged between 20 to 90 years. Propensity score matching procedure was employed to minimize potential confounding effects arising from the imbalance in the baseline characteristics. A total of 23046 propensity score-matched patients without SCI were enrolled in the non-SCI group. We compared the incidence of AC between these two groups, and assessed the impact of SCI on the risk of developing AC. In the SCI and non-SCI groups, the respective incidence rates of AC were 36.9 (95% confidence interval [CI], 30.0 to 44.8) and 25.2 (95% CI, 21.2 to 29.8) per 10000 person-years. As compared to the non-SCI group, the hazard ratio for the SCI group of AC was 1.71 (95% CI, 1.22 to 2.41, P = 0.0018); and the cumulative incidence of AC of the SCI group was higher than that of the non-SCI group (P = 0.0036). This population-based cohort study showed that there was an increased risk of AC in patients with SCI. 3.

Pregnancy hormone concentrations across ethnic groups: implications for later cancer risk.

Science.gov (United States)

Potischman, Nancy; Troisi, Rebecca; Thadhani, Ravi; Hoover, Robert N; Dodd, Kevin; Davis, William W; Sluss, Patrick M; Hsieh, Chung-Cheng; Ballard-Barbash, Rachel

2005-06-01

A variety of in utero factors have been associated with risk of adult cancers, particularly birth weight, toxemia, and gestational age. These factors are thought to reflect hormonal exposures during pregnancy. We hypothesized that the prenatal hormonal milieu may explain part of the variation in cancer rates across ethnic groups, for example, the higher incidence of breast cancer in the Caucasian compared with Hispanic women and the higher incidence of prostate and lower incidence of testicular cancers among African-Americans compared with Caucasians. We measured hormones in early pregnancy blood samples from three ethnic groups in a health care plan in Boston, MA. Mean levels of androstenedione, testosterone, estrone, and prolactin were significantly lower in Caucasian women compared with Hispanic women. Although not statistically significant, estradiol levels were lower in Caucasian compared with Hispanic or African-American women. Concentrations of androstenedione, testosterone, and progesterone were notably higher in African-American compared with Caucasian or Hispanic women. These data are consistent with hypotheses that in utero hormonal exposures may explain some of the ethnic group differences in cancer risk.

Group-Based Active Learning of Classification Models.

Science.gov (United States)

Luo, Zhipeng; Hauskrecht, Milos

2017-05-01

Learning of classification models from real-world data often requires additional human expert effort to annotate the data. However, this process can be rather costly and finding ways of reducing the human annotation effort is critical for this task. The objective of this paper is to develop and study new ways of providing human feedback for efficient learning of classification models by labeling groups of examples. Briefly, unlike traditional active learning methods that seek feedback on individual examples, we develop a new group-based active learning framework that solicits label information on groups of multiple examples. In order to describe groups in a user-friendly way, conjunctive patterns are used to compactly represent groups. Our empirical study on 12 UCI data sets demonstrates the advantages and superiority of our approach over both classic instance-based active learning work, as well as existing group-based active-learning methods.

Long-term survival in pre-specified groups at risk in the Oslo Study, 1972-1973.

Science.gov (United States)

Holme, Ingar

2015-03-01

Using the Oslo Study of 1972-1973, we wished to compare the long-term mortality pattern up to 40 years, in both the healthy cardiovascular groups at supposedly high and low risk, and in some groups having cardiovascular disease at screening. At the screening, 16,203 (63% of those invited) men aged 40-49 years participated. Study groups were identified by means of questionnaires regarding diseases, blood pressure and measurements of total cholesterol, triglycerides and glucose. We identified six groups: very high cholesterol, very high blood pressure, very high glucose, non-smoking with non-elevated such risk factors, from a randomized diet and antismoking trial, and a randomized drug treatment in mild-to-moderate hypertension. Statistical analyses were by Cox regression analysis, with Kaplan-Meier graphs. The supposedly low-risk group had a total mortality of one-third of other groups, such as: men with hypertension, diabetes or hypercholesterolemia, or those whom participated in the two trials. Between these latter groups, we found 2-5 years of difference in their median survival time, but their absolute risk stayed at rather high levels through all the years, with the median remaining a lifetime that was 3-8 years shorter than the men whom were free of known cardiovascular disease, diabetes or hypertension. The long-term preventive effects on total mortality seem large, if the levels of the classical risk factors of blood pressure, total cholesterol and glucose can be adequately controlled, concurrently with a non-smoking behavior. The study indicated that non-smoking and a low total cholesterol value were the most important contributors to extended survival. © 2015 the Nordic Societies of Public Health.

Risk Probability Estimating Based on Clustering

DEFF Research Database (Denmark)

Chen, Yong; Jensen, Christian D.; Gray, Elizabeth

2003-01-01

of prior experiences, recommendations from a trusted entity or the reputation of the other entity. In this paper we propose a dynamic mechanism for estimating the risk probability of a certain interaction in a given environment using hybrid neural networks. We argue that traditional risk assessment models...... from the insurance industry do not directly apply to ubiquitous computing environments. Instead, we propose a dynamic mechanism for risk assessment, which is based on pattern matching, classification and prediction procedures. This mechanism uses an estimator of risk probability, which is based...

Cardiometabolic risk in Canada: a detailed analysis and position paper by the cardiometabolic risk working group.

Science.gov (United States)

Leiter, Lawrence A; Fitchett, David H; Gilbert, Richard E; Gupta, Milan; Mancini, G B John; McFarlane, Philip A; Ross, Robert; Teoh, Hwee; Verma, Subodh; Anand, Sonia; Camelon, Kathryn; Chow, Chi-Ming; Cox, Jafna L; Després, Jean-Pierre; Genest, Jacques; Harris, Stewart B; Lau, David C W; Lewanczuk, Richard; Liu, Peter P; Lonn, Eva M; McPherson, Ruth; Poirier, Paul; Qaadri, Shafiq; Rabasa-Lhoret, Rémi; Rabkin, Simon W; Sharma, Arya M; Steele, Andrew W; Stone, James A; Tardif, Jean-Claude; Tobe, Sheldon; Ur, Ehud

2011-01-01

The concepts of "cardiometabolic risk," "metabolic syndrome," and "risk stratification" overlap and relate to the atherogenic process and development of type 2 diabetes. There is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. With the objectives of clarifying these concepts and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group reviewed the evidence related to emerging cardiovascular risk factors and Canadian guideline recommendations in order to present a detailed analysis and consolidated approach to the identification and management of cardiometabolic risk. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider risk factors related to ethnicity in order to appropriately evaluate everyone in their diverse patient populations. Copyright © 2011 Elsevier Inc. All rights reserved.

Cardiovascular disease and ABO blood-groups in Africans. Are blood-group A individuals at higher risk of ischemic disease?: A pilot study.

Science.gov (United States)

Ba, Djibril Marie; Sow, Mamadou Saidou; Diack, Aminata; Dia, Khadidiatou; Mboup, Mouhamed Cherif; Fall, Pape Diadie; Fall, Moussa Daouda

2017-12-01

Since the discovery of the ABO blood group system by Karl Landsteiner in 1901, several reports have suggested an important involvement of the ABO blood group system in the susceptibility to thrombosis. Assessing that non-O blood groups in particular A blood group confer a higher risk of venous and arterial thrombosis than group O.Epidemiologic data are typically not available for all racial and ethnics groups.The purpose of this pilot study was to identify a link between ABO blood group and ischemic disease (ID) in Africans, and to analyze whether A blood group individuals were at higher risk of ischemic disease or not. A total of 299 medical records of patients over a three-year period admitted to the cardiology and internal medicine department of military hospital of Ouakam in Senegal were reviewed. We studied data on age, gender, past history of hypertension, diabetes, smoking, sedentarism, obesity, hyperlipidemia, use of estrogen-progestin contraceptives and blood group distribution.In each blood group type, we evaluated the prevalence of ischemic and non-ischemic cardiovascular disease. The medical records were then stratified into two categories to evaluate incidence of ischemic disease: Group 1: Patients carrying blood-group A and Group 2: Patients carrying blood group non-A (O, AB and B). Of the 299 patients whose medical records were reviewed, 92 (30.8%) were carrying blood group A, 175 (58.5%) had blood group O, 13 (4.3%) had blood group B, and 19 (6.4%) had blood group AB.The diagnosis of ischemic disease (ID) was higher in patients with blood group A (61.2%) than in other blood groups, and the diagnosis of non-ischemic disease (NID) was higher in patients with blood group O (73.6%) compared to other groups. In patients with blood group B or AB compared to non-B or non-AB, respectively there was no statistically significant difference in ID incidence.Main risk factor for ID was smoking (56.5%), hypertension (18.4%) and diabetes (14.3%).In our study

Impact of shutdown risk on risk-based assessment of technical specifications

International Nuclear Information System (INIS)

Deriot, S.

1992-10-01

This paper describes the current work performed by the Research and Development Division of EDF concerning risk-based assessment of Operating Technical Specifications (OTS). The current risk-based assessment of OTS at EDF is presented. Then, the level 1 Probabilistic Safety Assessment of unit 3 of the Paluel nuclear power station (called PSA 1300) is described. It is fully computerized and takes into account the risk in shutdown states. A case study is presented. It shows that the fact of considering shutdown risk suggests that the current OTS should be modified

Risk-based decisionmaking (Panel)

Energy Technology Data Exchange (ETDEWEB)

Smith, T.H.

1995-12-31

By means of a panel discussion and extensive audience interaction, explore the current challenges and progress to date in applying risk considerations to decisionmaking related to low-level waste. This topic is especially timely because of the proposed legislation pertaining to risk-based decisionmaking and because of the increased emphasis placed on radiological performance assessments of low-level waste disposal.

Investigation of zoonotic infections in risk groups in Ordu University ...

African Journals Online (AJOL)

Investigation of zoonotic infections in risk groups in Ordu University Hospital, Turkey. ... Aims: Zoonotic diseases, which are a major public health problem in our city, have a negative impact on public health and also cause economic losses due to yield losses of animals and deaths. This study was carried out to determine ...

Relative Risks of Thrombosis and Bleeding in Different ABO Blood Groups.

Science.gov (United States)

Franchini, Massimo; Lippi, Giuseppe

2016-03-01

The ABO blood group system is composed of complex carbohydrate molecules (i.e., the A, B, and H determinants) that are widely expressed on the surface of red blood cells and in a variety of other cell and tissues. Along with their pivotal role in transfusion and transplantation medicine, the ABO antigens participate in many other physiological processes and, in particular, are important determinants of von Willebrand factor and factor VIII circulating plasma levels. The precise influence of the ABO system on hemostasis has led the way to the investigation of a putative implication in the risk of developing cardiovascular disorders. Along with the underlying molecular mechanisms, the current knowledge on the role of ABO blood group antigens in both the thrombotic and hemorrhagic risk will be summarized in this narrative review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Combining ungrouped and grouped wildfire data to estimate fire risk

KAUST Repository

Hernandez-Magallanes, I.

2013-10-11

© 2013 John Wiley & Sons, Ltd. Frequently, models are required to combine information obtained from different data sources and on different scales. In this work, we are interested in estimating the risk of wildfire ignition in the USA for a particular time and location by merging two levels of data, namely, individual points and aggregate count of points into areas. The data for federal lands consist of the point location and time of each fire. Nonfederal fires are aggregated by county for a particular year. The probability model is based on the wildfire point process. Assuming a smooth intensity function, a locally weighted likelihood fit is used, which incorporates the group effect. A logit model is used under the assumption of the existence of a latent process, and fuel conditions are included as a covariate. The model assessment is based on a residual analysis, while the False Discovery Rate detects spatial patterns. A benefit of the proposed model is that there is no need of arbitrary aggregation of individual fires into counts. A map of predicted probability of ignition for the Midwest US in 1990 is included. The predicted ignition probabilities and the estimated total number of expected fires are required for the allocation of resources.

A newly identified group of adolescents at “invisible” risk for psychopathology and suicidal behavior: findings from the SEYLE study

Science.gov (United States)

Carli, Vladimir; Hoven, Christina W; Wasserman, Camilla; Chiesa, Flaminia; Guffanti, Guia; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean Pierre; Keeley, Helen; Postuvan, Vita; Saiz, Pilar; Varnik, Airi; Wasserman, Danuta

2014-01-01

This study explored the prevalence of risk behaviors (excessive alcohol use, illegal drug use, heavy smoking, reduced sleep, overweight, underweight, sedentary behavior, high use of Internet/TV/videogames for reasons not related to school or work, and truancy), and their association with psychopathology and self-destructive behaviors, in a sample of 12,395 adolescents recruited in randomly selected schools across 11 European countries. Latent class analysis identified three groups of adolescents: a low-risk group (57.8%) including pupils with low or very low frequency of risk behaviors; a high-risk group (13.2%) including pupils who scored high on all risk behaviors, and a third group (“invisible” risk, 29%) including pupils who were positive for high use of Internet/TV/videogames for reasons not related to school or work, sedentary behavior and reduced sleep. Pupils in the “invisible” risk group, compared with the high-risk group, had a similar prevalence of suicidal thoughts (42.2% vs. 44%), anxiety (8% vs. 9.2%), subthreshold depression (33.2% vs. 34%) and depression (13.4% vs. 14.7%). The prevalence of suicide attempts was 5.9% in the “invisible” group, 10.1% in the high-risk group and 1.7% in the low-risk group. The prevalence of all risk behaviors increased with age and most of them were significantly more frequent among boys. Girls were significantly more likely to experience internalizing (emotional) psychiatric symptoms. The “invisible” group may represent an important new intervention target group for potentially reducing psychopathology and other untoward outcomes in adolescence, including suicidal behavior. PMID:24497256

Development of new risk based regulations

International Nuclear Information System (INIS)

Nielsen, L.

1999-01-01

A short presentation of the oil and gas industry in Norway, and a brief overview of the regulatory regime in the petroleum sector in Norway is given. Risk analysis has been performed in Norway since 1981 and the various applications will be described. These risk analyses are quite different from a nuclear PSA and some of these differences will be commented. Risk based optimisation techniques such as RCM (Reliability Centred Maintenance) and Risk Based Inspection is used in the industry, with very limited support from the risk analysis. Some of the limitation that exist when such techniques are imported from other industries will be commented on. NPD (Norwegian Petroleum Directorate) is revising our regulations and some of the future plants when it comes to risk informed regulatory requirements will be presented. (au)

Lipid profiles and ischemic stroke risk: variations by sex within racial/ethnic groups.

Science.gov (United States)

Gezmu, Tefera; Schneider, Dona; Demissie, Kitaw; Lin, Yong; Giordano, Christine; Gizzi, Martin S

2014-01-01

Evidence implicates lipid abnormalities as important but modifiable risk factors for stroke. This study assesses whether hypercholesterolemia can be used to predict the risk for etiologic subtypes of ischemic stroke between sexes within racial/ethnic groups. Data elements related to stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290 acute stroke admissions between 2006 and 2010 at a regional stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014). All women, except South Asian women, had higher mean plasma total cholesterol and higher blood circulating low-density lipoprotein levels (≥100 mg/dL) than men at the time of their admissions. The incidence of large-artery atherosclerosis (LAA) was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and high-density lipoproteins and triglycerides as predictors showed inconsistent associations between lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women stroke patients may be at increased risk for stroke etiologic subtype LAA than men. Although the higher prevalence of stroke risk factors examined in this study predicts the increase in the incidence of the disease, lack of knowledge/awareness and lack of affordable treatments for stroke risk factors among women and immigrants/non-US-born subpopulations may explain the observed associations.

Risk factors for acute stroke among South Asians compared to other racial/ethnic groups.

Science.gov (United States)

Gezmu, Tefera; Schneider, Dona; Demissie, Kitaw; Lin, Yong; Gizzi, Martin S

2014-01-01

Studies of racial/ethnic variations in stroke rarely consider the South Asian population, one of the fastest growing sub-groups in the United States. This study compared risk factors for stroke among South Asians with those for whites, African-Americans, and Hispanics. Data on 3290 stroke patients were analyzed to examine risk differences among the four racial/ethnic groups. Data on 3290 patients admitted to a regional stroke center were analyzed to examine risk differences for ischemic stroke (including subtypes of small and large vessel disease) among South Asians, whites, African Americans and Hispanics. South Asians were younger and had higher rates of diabetes mellitus, blood pressure, and fasting blood glucose levels than other race/ethnicities. Prevalence of diabetic and antiplatelet medication use, as well as the incidence of small-artery occlusion ischemic stroke was also higher among South Asians. South Asians were almost a decade younger and had comparable socioeconomic levels as whites; however, their stroke risk factors were comparable to that of African Americans and Hispanics. Observed differences in stroke may be explained by dietary and life style choices of South Asian-Americans, risk factors that are potentially modifiable. Future population and epidemiologic studies should consider growing ethnic minority groups in the examination of the nature, outcome, and medical care profiles of stroke.

A risk assessment approach to evaluating food safety based on product surveillance

NARCIS (Netherlands)

Notermans, S.; Nauta, M.J.; Jansen, J.; Jouve, J.L.; Mead, G.C.

1998-01-01

This paper outlines a risk assessment approach to food safety evaluation, which is based on testing a particular type of food, or group of similar foods, for relevant microbial pathogens. The results obtained are related to possible adverse effects on the health of consumers. The paper also gives an

Staircase falls: High-risk groups and injury characteristics in 464 patients

NARCIS (Netherlands)

Boele van Hensbroek, P.; Mulder, S.; Luitse, J. S. K.; van Ooijen, M. R.; Goslings, J. C.

2009-01-01

Introduction: Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. Objective: To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups

Risk factors for child maltreatment in an Australian population-based birth cohort.

Science.gov (United States)

Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie

2017-02-01

Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Substance use and risk behaviors of out-of-treatment cocaine base paste and cocaine hydrochloride users].

Science.gov (United States)

Santis B, Rodrigo; Hidalgo C, Carmen Gloria; Hayden C, Viviana; Anselmo M, Enzo; Rodríguez T, Jorge; Cartajena de la M, Fernando; Dreyse D, Jorge; Torres B, Rafael

2007-01-01

In Chile, cocaine base paste (CBP) is the illegal substance that produces the highest rate of addiction. Nonetheless, a marginal number of users receive treatment each year. To compare the consumption patterns and risk behavior of CBP and cocaine hydrochloride (CH) users who do not attend rehabilitation services. In a prospective research design, through a study methodology called Privileged Access Interview of hidden populations, 28 surveyors recruited 231 CBP users (group 1) and 236 CH users (group 2). The Risk Behavior Questionnaire was applied in four communities of Metropolitan Santiago, that have the highest prevalence of PBC and CH use. CBP users showed higher schools drop-out and unemployment rates. Subjects of both groups were predominantly polysubstance and polyaddicted users. The severity of addiction to CBP of group 1 was significantly higher than the severity of addiction to CH of group 2 (5.5 versus 5.1: psexual risk behaviors, antisocial behavior, self infliction of injuries, suicide attempt and child neglect. A higher vulnerability was shown for users of CBP than those of CH. Attention is drawn to the need for developing community interventions in order to alter substance abuse and the risk behavior of these vulnerable groups.

Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group

Science.gov (United States)

Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H.; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A. N.; Lübbert, Michael; Greenberg, Peter L.; Bennett, John M.; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L.; Ohyashiki, Kazuma; Le Beau, Michelle M.; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R.; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

2015-01-01

International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%–20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34+) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34+ peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34+ blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). PMID:25344522

Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group.

Science.gov (United States)

Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A N; Lübbert, Michael; Greenberg, Peter L; Bennett, John M; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L; Ohyashiki, Kazuma; Le Beau, Michelle M; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

2015-02-01

International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%-20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34(+)) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34(+) peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34(+) blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). Copyright© Ferrata Storti Foundation.

Additivity of Feature-based and Symmetry-based Grouping Effects in Multiple Object Tracking

Directory of Open Access Journals (Sweden)

Chundi eWang

2016-05-01

Full Text Available Multiple object tracking (MOT is an attentional process wherein people track several moving targets among several distractors. Symmetry, an important indicator of regularity, is a general spatial pattern observed in natural and artificial scenes. According to the laws of perceptual organization proposed by Gestalt psychologists, regularity is a principle of perceptual grouping, such as similarity and closure. A great deal of research reported that feature-based similarity grouping (e.g., grouping based on color, size, or shape among targets in MOT tasks can improve tracking performance. However, no additive feature-based grouping effects have been reported where the tracking objects had two or more features. Additive effect refers to a greater grouping effect produced by grouping based on multiple cues instead of one cue. Can spatial symmetry produce a similar grouping effect similar to that of feature similarity in MOT tasks? Are the grouping effects based on symmetry and feature similarity additive? This study includes four experiments to address these questions. The results of Experiments 1 and 2 demonstrated the automatic symmetry-based grouping effects. More importantly, an additive grouping effect of symmetry and feature similarity was observed in Experiments 3 and 4. Our findings indicate that symmetry can produce an enhanced grouping effect in MOT and facilitate the grouping effect based on color or shape similarity. The where and what pathways might have played an important role in the additive grouping effect.

Early home-based intervention in the Netherlands for children at familial risk of dyslexia.

Science.gov (United States)

van Otterloo, Sandra G; van der Leij, Aryan; Henrichs, Lotte F

2009-08-01

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10 min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition. (c) 2008 John Wiley & Sons, Ltd.

Affirmation, acknowledgment of in-group responsibility, group-based guilt, and support for reparative measures.

Science.gov (United States)

Cehajić-Clancy, Sabina; Effron, Daniel A; Halperin, Eran; Liberman, Varda; Ross, Lee D

2011-08-01

Three studies, 2 conducted in Israel and 1 conducted in Bosnia and Herzegovina, demonstrated that affirming a positive aspect of the self can increase one's willingness to acknowledge in-group responsibility for wrongdoing against others, express feelings of group-based guilt, and consequently provide greater support for reparation policies. By contrast, affirming one's group, although similarly boosting feelings of pride, failed to increase willingness to acknowledge and redress in-group wrongdoing. Studies 2 and 3 demonstrated the mediating role of group-based guilt. That is, increased acknowledgment of in-group responsibility for out-group victimization produced increased feelings of guilt, which in turn increased support for reparation policies to the victimized group. Theoretical and applied implications are discussed.

Designing and evaluating risk-based surveillance systems

DEFF Research Database (Denmark)

Willeberg, Preben; Nielsen, Liza Rosenbaum; Salman, Mo

2012-01-01

Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions...... with prudent use of resources while maintaining acceptable system performance. High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most...... applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting...

Cost effectiveness of risk-based closures at UST sites

International Nuclear Information System (INIS)

Scruton, K.M.; Baker, J.N.

1995-01-01

Risk-based closures have been achieved at Underground Storage Tank (UST) sites throughout the country for a major transportation company. The risk-based closures were cost-effective because a streamlined risk-based approach was used instead of the generic baseline risk assessment approach. USEPA has recently provided guidance encouraging the use of risk-based methodology for achieving closure at UST sites. The risk-based approach used in achieving the site closures involved an identification of potential human and ecological receptors and exposure pathways, and a comparison of maximum onsite chemical concentrations to applicable or relevant and appropriate requirements (ARARs). The ARARs used in the evaluation included Federal and/or State Maximum Contaminant Levels (MCLs) for groundwater and risk-based screening levels for soils. If the maximum concentrations were above the screening levels, a baseline risk assessment was recommended. In several instances, however, the risk-based approach resulted in a regulatory agency acceptance of a ''no further action'' alternative at UST sites which did not pose a significant threat to human health and the environment. The cost of the streamlined risk-based approach is approximately $3,500, while a baseline risk assessment for the same UST site could cost up to $10,000 or more. The use of the streamlined risk-based approach has proven to be successful for achieving a ''no further action'' outcome for the client at a reasonable cost

Dietary patterns, food groups, and rectal cancer risk in Whites and African-Americans.

Science.gov (United States)

Williams, Christina Dawn; Satia, Jessie A; Adair, Linda S; Stevens, June; Galanko, Joseph; Keku, Temitope O; Sandler, Robert S

2009-05-01

Associations between individual foods and nutrients and colorectal cancer have been inconsistent, and few studies have examined associations between food, nutrients, dietary patterns, and rectal cancer. We examined the relationship between food groups and dietary patterns and risk for rectal cancer in non-Hispanic Whites and African-Americans. Data were from the North Carolina Colon Cancer Study-Phase II and included 1,520 Whites (720 cases, 800 controls) and 384 African-Americans (225 cases, 159 controls). Diet was assessed using the Diet History Questionnaire. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals. Among Whites, non-whole grains and white potatoes were associated with elevated risk for rectal cancer whereas fruit, vegetables, dairy, fish, and poultry were associated with reduced risk. In African-Americans, high consumption of other fruit and added sugar suggested elevated risk. We identified three major dietary patterns in Whites and African-Americans. The high fat/meat/potatoes pattern was observed in both race groups but was only positively associated with risk in Whites (odds ratio, 1.84; 95% confidence interval, 1.03-3.15). The vegetable/fish/poultry and fruit/whole grain/dairy patterns in Whites had significant inverse associations with risk. In African-Americans, there was a positive dose-response for the fruit/vegetables pattern (P(trend) pattern (P(trend) dietary patterns with rectal cancer risk differ between Whites and African-Americans, highlighting the importance of examining diet and cancer relationships in racially diverse populations.

Gender-associated analysis of high-risk groups for mental health problems in law-enforcement officers

Directory of Open Access Journals (Sweden)

Vitaliy Omelyanovich

2017-11-01

Full Text Available Background. Mental disorders prevention in specific professional groups is impossible without scientifically substantiated allocation of groups with increased neuropsychiatric and psychosomatic disorders risk. This fact indicates the need to study the gender, age and professional characteristics in law enforcement workers who already have problems with psychological adaptation. Methods and materials. The study involved 1630 law enforcement officers (1,301 men and 329 women who were evaluated with the Symptom Checklist-90-R (SCL-90-R. As the statistical methods were used the partial regression calculation coefficient η2, cohort calculation risk measures, φ*-total Fischer transformation method, and single-factor dispersion Fisher's analysis. Results. According to gender characteristics, the problems with psychological adaptation in men were significantly less pronounced than in women (φ*=1.79; p=0.37. These data were confirmed by the cohort calculation and risk measures results: men – 0.261, women – 0.349 (the psychological disadaptation risk in women was 1.3 times higher than men. There weren’t any statistically significant age differences between the representatives of both gender groups with psychological adaptation disturbances and healthy ones (φ* ≤1.19; p≥0.1. Among patients who suffered from psychosomatic diseases, were men over the age of 35 (φ* ≥2.28; p≤0.0001 and women over 26 years old (φ*= 2.16; p=0.014 prevailed. There were significantly fewer people among men with psychosomatic illnesses with 4-9 years of professional working experience than in a healthy group. On the contrary, there were significantly more patients in a law enforcement workers group with 10-15 years working experience than in the healthy one (φ*>1.73; p<0.0001. Conclusion. The risk of mental health problems in female police officers is much higher than in men. Disadaptation development is not related to the age and length of working

Risk factors for acute stroke among South Asians compared to other racial/ethnic groups.

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Tefera Gezmu

Full Text Available BACKGROUND: Studies of racial/ethnic variations in stroke rarely consider the South Asian population, one of the fastest growing sub-groups in the United States. This study compared risk factors for stroke among South Asians with those for whites, African-Americans, and Hispanics. METHODS: Data on 3290 stroke patients were analyzed to examine risk differences among the four racial/ethnic groups. Data on 3290 patients admitted to a regional stroke center were analyzed to examine risk differences for ischemic stroke (including subtypes of small and large vessel disease among South Asians, whites, African Americans and Hispanics. RESULTS: South Asians were younger and had higher rates of diabetes mellitus, blood pressure, and fasting blood glucose levels than other race/ethnicities. Prevalence of diabetic and antiplatelet medication use, as well as the incidence of small-artery occlusion ischemic stroke was also higher among South Asians. South Asians were almost a decade younger and had comparable socioeconomic levels as whites; however, their stroke risk factors were comparable to that of African Americans and Hispanics. DISCUSSION: Observed differences in stroke may be explained by dietary and life style choices of South Asian-Americans, risk factors that are potentially modifiable. Future population and epidemiologic studies should consider growing ethnic minority groups in the examination of the nature, outcome, and medical care profiles of stroke.

Any of them will do: In-group identification, out-group entitativity, and gang membership as predictors of group-based retribution.

Science.gov (United States)

Vasquez, Eduardo A; Wenborne, Lisa; Peers, Madeline; Alleyne, Emma; Ellis, Kirsty

2015-05-01

In non-gang populations, the degree of identification with an in-group and perceptions of out-group entitativity, the perception of an out-group as bonded or unified, are important contributors to group-based aggression or vicarious retribution. The link between these factors and group-based aggression, however, has not been examined in the context of street gangs. The current study assessed the relationship among in-group identification, perceptions of out-group entitativity, and the willingness to retaliate against members of rival groups who did not themselves attack the in-group among juvenile gang and non-gang members in London. Our results showed the predicted membership (gang/non-gang) × in-group identification × entitativity interaction. Decomposition of the three-way interaction by membership revealed a significant identification × entitativity interaction for gang, but not for non-gang members. More specifically, gang members who identify more strongly with their gang and perceived a rival group as high on entitativity were more willing to retaliate against any of them. In addition, entitativity was a significant predictor of group-based aggression after controlling for gender, in-group identification, and gang membership. Our results are consistent with socio-psychological theories of group-based aggression and support the proposal that such theories are applicable for understanding gang-related violence. Aggr. Behav. 41:242-252, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol

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Laan Eva K

2012-03-01

Full Text Available Abstract Background Physical inactivity, unhealthy dietary habits, smoking and high alcohol consumption are recognized risk factors for cardiovascular disease and cancer. Web-based health risk assessments with tailored feedback seem promising in promoting a healthy lifestyle. This study evaluates the effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour, conducted in a worksite setting. Methods/Design The web-based health risk assessment starts with a questionnaire covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. Prognostic models are used to estimate individual cardiovascular risks. In case of high risk further biometric and laboratory evaluation is advised. All participants receive individually-tailored feedback on their responses to the health risk assessment questionnaire. The study uses a quasi-experimental design with a waiting list control group. Data are collected at baseline (T0 and after six months (T1. Within each company, clusters of employees are allocated to either the intervention or the control group. Primary outcome is lifestyle behaviour, expressed as the sum of five indicators namely physical activity, nutrition, smoking behaviour, alcohol consumption, and symptoms of burnout. Multilevel regression analysis will be used to answer the main research question and to correct for clustering effects. Baseline differences between the intervention and control group in the distribution of characteristics with a potential effect on lifestyle change will be taken into account in further analyses using propensity scores. Discussion This study will increase insight into the effectiveness of health risk assessments with tailored feedback and into conditions that may modify the effectiveness. This information can be used to design effective interventions for lifestyle behaviour change among employees. Trial

Nature Disaster Risk Evaluation with a Group Decision Making Method Based on Incomplete Hesitant Fuzzy Linguistic Preference Relations

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Ming Tang

2018-04-01

Full Text Available Because the natural disaster system is a very comprehensive and large system, the disaster reduction scheme must rely on risk analysis. Experts’ knowledge and experiences play a critical role in disaster risk assessment. The hesitant fuzzy linguistic preference relation is an effective tool to express experts’ preference information when comparing pairwise alternatives. Owing to the lack of knowledge or a heavy workload, information may be missed in the hesitant fuzzy linguistic preference relation. Thus, an incomplete hesitant fuzzy linguistic preference relation is constructed. In this paper, we firstly discuss some properties of the additive consistent hesitant fuzzy linguistic preference relation. Next, the incomplete hesitant fuzzy linguistic preference relation, the normalized hesitant fuzzy linguistic preference relation, and the acceptable hesitant fuzzy linguistic preference relation are defined. Afterwards, three procedures to estimate the missing information are proposed. The first one deals with the situation in which there are only n − 1 known judgments involving all the alternatives; the second one is used to estimate the missing information of the hesitant fuzzy linguistic preference relation with more known judgments; while the third procedure is used to deal with ignorance situations in which there is at least one alternative with totally missing information. Furthermore, an algorithm for group decision making with incomplete hesitant fuzzy linguistic preference relations is given. Finally, we illustrate our model with a case study about flood disaster risk evaluation. A comparative analysis is presented to testify the advantage of our method.

Nature Disaster Risk Evaluation with a Group Decision Making Method Based on Incomplete Hesitant Fuzzy Linguistic Preference Relations.

Science.gov (United States)

Tang, Ming; Liao, Huchang; Li, Zongmin; Xu, Zeshui

2018-04-13

Because the natural disaster system is a very comprehensive and large system, the disaster reduction scheme must rely on risk analysis. Experts' knowledge and experiences play a critical role in disaster risk assessment. The hesitant fuzzy linguistic preference relation is an effective tool to express experts' preference information when comparing pairwise alternatives. Owing to the lack of knowledge or a heavy workload, information may be missed in the hesitant fuzzy linguistic preference relation. Thus, an incomplete hesitant fuzzy linguistic preference relation is constructed. In this paper, we firstly discuss some properties of the additive consistent hesitant fuzzy linguistic preference relation. Next, the incomplete hesitant fuzzy linguistic preference relation, the normalized hesitant fuzzy linguistic preference relation, and the acceptable hesitant fuzzy linguistic preference relation are defined. Afterwards, three procedures to estimate the missing information are proposed. The first one deals with the situation in which there are only n-1 known judgments involving all the alternatives; the second one is used to estimate the missing information of the hesitant fuzzy linguistic preference relation with more known judgments; while the third procedure is used to deal with ignorance situations in which there is at least one alternative with totally missing information. Furthermore, an algorithm for group decision making with incomplete hesitant fuzzy linguistic preference relations is given. Finally, we illustrate our model with a case study about flood disaster risk evaluation. A comparative analysis is presented to testify the advantage of our method.

Risk based inspection for atmospheric storage tank

Science.gov (United States)

Nugroho, Agus; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

2016-04-01

Corrosion is an attack that occurs on a metallic material as a result of environment's reaction.Thus, it causes atmospheric storage tank's leakage, material loss, environmental pollution, equipment failure and affects the age of process equipment then finally financial damage. Corrosion risk measurement becomesa vital part of Asset Management at the plant for operating any aging asset.This paper provides six case studies dealing with high speed diesel atmospheric storage tank parts at a power plant. A summary of the basic principles and procedures of corrosion risk analysis and RBI applicable to the Process Industries were discussed prior to the study. Semi quantitative method based onAPI 58I Base-Resource Document was employed. The risk associated with corrosion on the equipment in terms of its likelihood and its consequences were discussed. The corrosion risk analysis outcome used to formulate Risk Based Inspection (RBI) method that should be a part of the atmospheric storage tank operation at the plant. RBI gives more concern to inspection resources which are mostly on `High Risk' and `Medium Risk' criteria and less on `Low Risk' shell. Risk categories of the evaluated equipment were illustrated through case study analysis outcome.

A risk-based microbiological criterion that uses the relative risk as the critical limit

DEFF Research Database (Denmark)

Andersen, Jens Kirk; Nørrung, Birgit; da Costa Alves Machado, Simone

2015-01-01

A risk-based microbiological criterion is described, that is based on the relative risk associated to the analytical result of a number of samples taken from a food lot. The acceptable limit is a specific level of risk and not a specific number of microorganisms, as in other microbiological...... criteria. The approach requires the availability of a quantitative microbiological risk assessment model to get risk estimates for food products from sampled food lots. By relating these food lot risk estimates to the mean risk estimate associated to a representative baseline data set, a relative risk...... estimate can be obtained. This relative risk estimate then can be compared with a critical value, defined by the criterion. This microbiological criterion based on a relative risk limit is particularly useful when quantitative enumeration data are available and when the prevalence of the microorganism...

Reducing skin cancer risk: an intervention based on protection motivation theory.

Science.gov (United States)

McClendon, B T; Prentice-Dunn, S

2001-05-01

Caucasian college students who intentionally tanned participated in a brief skin cancer intervention based on protection motivation theory (PMT). This intervention targeted skin appearance and consisted of brief lectures, a comprehensive essay, video clips about a young man who died of melanoma, and short discussions. Compared to a waitlist control group, the intervention group showed increases on PMT variables and intentions at post-test. The waitlist group later received the intervention and showed similar increases. Additionally, all but one PMT variable maintained post-test levels at a one-month follow-up. Photographs taken at post-test and at the one-month follow-up were judged by raters blind to the hypothesis. Seventy-two percent of participants were judged to have lighter skin whereas only 16 percent had darker skin. These results provide additional support for theory-based methods for changing maladaptive attitudes and behaviors associated with skin cancer risk.

Associated Behavioral Risks in a Group of Women During Pregnancy from Mures District

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Florina Ruţa

2015-09-01

Full Text Available Background. It is well-known that the exposure during pregnancy to lifestyle risk factors can affect thehealth both for the mother and the fetus. There are many risk factors for pregnancy, including: smoking, alcohol consumption, sedentary pattern, irregular daily meal serving plan, lack of knowledge regarding health prevention. The main objective of our study was to assess the practices, knowledge and attitudes towards lifestyle risk behaviors during pregnancy in a group of women from Tirgu-Mures area.

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

Science.gov (United States)

Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Oximeter-based autonomic state indicator algorithm for cardiovascular risk assessment.

Science.gov (United States)

Grote, Ludger; Sommermeyer, Dirk; Zou, Ding; Eder, Derek N; Hedner, Jan

2011-02-01

Cardiovascular (CV) risk assessment is important in clinical practice. An autonomic state indicator (ASI) algorithm based on pulse oximetry was developed and validated for CV risk assessment. One hundred forty-eight sleep clinic patients (98 men, mean age 50 ± 13 years) underwent an overnight study using a novel photoplethysmographic sensor. CV risk was classified according to the European Society of Hypertension/European Society of Cardiology (ESH/ESC) risk factor matrix. Five signal components reflecting cardiac and vascular activity (pulse wave attenuation, pulse rate acceleration, pulse propagation time, respiration-related pulse oscillation, and oxygen desaturation) extracted from 99 randomly selected subjects were used to train the classification algorithm. The capacity of the algorithm for CV risk prediction was validated in 49 additional patients. Each signal component contributed independently to CV risk prediction. The sensitivity and specificity of the algorithm to distinguish high/low CV risk in the validation group were 80% and 77%, respectively. The area under the receiver operating characteristic curve for high CV risk classification was 0.84. β-Blocker treatment was identified as an important factor for classification that was not in line with the ESH/ESC reference matrix. Signals derived from overnight oximetry recording provide a novel potential tool for CV risk classification. Prospective studies are warranted to establish the value of the ASI algorithm for prediction of outcome in CV disease.

Identification of target risk groups for population-based Clostridium difficile infection prevention strategies using a population attributable risk approach.

Science.gov (United States)

Oh, Sung-Hee; Kang, Hye-Young

2018-01-01

We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days. The population attributable risk (PAR) percent for risk factors was estimated using odds ratios (ORs) obtained from the case-control study. Overall, the strongest CDI-associated risk factors, which have significant contributions to the CDI burden as well, were the experience of gastroenteritis (OR=5.08, PAR%=17.09%) and use of antibiotics (OR=1.69, PAR%=19.00%), followed by the experiences of female pelvic infection, irritable bowel syndrome, inflammatory bowel disease, and pneumonia, and use of proton-pump inhibitors (OR=1.52-2.37, PAR%=1.95-2.90). The control of risk factors that had strong association with CDI and affected large proportions of total CDI cases would be beneficial for CDI prevention. We suggest performing CDI testing for symptomatic patients with gastroenteritis and implementing antibiotics stewardship. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Backtesting for Risk-Based Regulatory Capital

NARCIS (Netherlands)

Kerkhof, F.L.J.; Melenberg, B.

2002-01-01

In this paper we present a framework for backtesting all currently popular risk measurement methods (including value-at-risk and expected shortfall) using the functional delta method.Estimation risk can be taken explicitly into account.Based on a simulation study we provide evidence that tests for

Risk based limits for Operational Safety Requirements

International Nuclear Information System (INIS)

Cappucci, A.J. Jr.

1993-01-01

OSR limits are designed to protect the assumptions made in the facility safety analysis in order to preserve the safety envelope during facility operation. Normally, limits are set based on ''worst case conditions'' without regard to the likelihood (frequency) of a credible event occurring. In special cases where the accident analyses are based on ''time at risk'' arguments, it may be desirable to control the time at which the facility is at risk. A methodology has been developed to use OSR limits to control the source terms and the times these source terms would be available, thus controlling the acceptable risk to a nuclear process facility. The methodology defines a new term ''gram-days''. This term represents the area under a source term (inventory) vs time curve which represents the risk to the facility. Using the concept of gram-days (normalized to one year) allows the use of an accounting scheme to control the risk under the inventory vs time curve. The methodology results in at least three OSR limits: (1) control of the maximum inventory or source term, (2) control of the maximum gram-days for the period based on a source term weighted average, and (3) control of the maximum gram-days at the individual source term levels. Basing OSR limits on risk based safety analysis is feasible, and a basis for development of risk based limits is defensible. However, monitoring inventories and the frequencies required to maintain facility operation within the safety envelope may be complex and time consuming

HIV prevalence by ethnic group covaries with prevalence of herpes simplex virus-2 and high-risk sex in Uganda: An ecological study.

Science.gov (United States)

Kenyon, Chris R

2018-01-01

HIV prevalence varies from 1.7% to 14.8% between ethnic groups in Uganda. Understanding the factors responsible for this heterogeneity in HIV spread may guide prevention efforts. We evaluated the relationship between HIV prevalence by ethnic group and a range of risk factors as well as the prevalence of herpes simplex virus-2 (HSV-2), syphilis and symptomatic STIs in the 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey-a two stage, nationally representative, population based survey of 15-59-year-olds. Spearman's correlation was used to assess the relationship between HIV prevalence and each variable. There was a positive association between HIV prevalence and HSV-2, symptomatic STIs and high-risk sex (sex with a non-cohabiting, non-marital partner) for women. Non-significant positive associations were present between HIV and high-risk sex for men and lifetime number of partners for men and women. Variation in sexual behavior may contribute to the variations in HIV, HSV-2 and other STI prevalence by ethnic group in Uganda. Further work is necessary to delineate which combinations of risk factors determine differential STI spread in Uganda.

Risk-based decision analysis for groundwater operable units

International Nuclear Information System (INIS)

Chiaramonte, G.R.

1995-01-01

This document proposes a streamlined approach and methodology for performing risk assessment in support of interim remedial measure (IRM) decisions involving the remediation of contaminated groundwater on the Hanford Site. This methodology, referred to as ''risk-based decision analysis,'' also supports the specification of target cleanup volumes and provides a basis for design and operation of the groundwater remedies. The risk-based decision analysis can be completed within a short time frame and concisely documented. The risk-based decision analysis is more versatile than the qualitative risk assessment (QRA), because it not only supports the need for IRMs, but also provides criteria for defining the success of the IRMs and provides the risk-basis for decisions on final remedies. For these reasons, it is proposed that, for groundwater operable units, the risk-based decision analysis should replace the more elaborate, costly, and time-consuming QRA

Passengers, Participants, Partners and Practitioners. Working with Risk To Empower Groups.

Science.gov (United States)

Brown, Heather

2000-01-01

Participant responsibility in outdoor education programs is placed on a continuum from passenger status through participant and partner to practitioner. Corresponding leader roles are directive, coaching, supporting, and delegating. The disempowering effects of the passenger approach to risk management and the value of teaching a group to manage…

Birth order and mortality in two ethno-linguistic groups: Register-based evidence from Finland.

Science.gov (United States)

Saarela, Jan; Cederström, Agneta; Rostila, Mikael

2016-06-01

Previous research has documented an association between birth order and suicide, although no study has examined whether it depends on the cultural context. Our aim was to study the association between birth order and cause-specific mortality in Finland, and whether it varies by ethno-linguistic affiliation. We used data from the Finnish population register, representing a 5% random sample of all Finnish speakers and a 20% random sample of Swedish speakers, who lived in Finland in any year 1987-2011. For each person, there was a link to all children who were alive in 1987. In total, there were 254,059 siblings in 96,387 sibling groups, and 9797 deaths. We used Cox regressions stratified by each siblings group and estimated all-cause and cause-specific mortality risks during the period 1987-2011. In line with previous research from Sweden, deaths from suicide were significantly associated with birth order. As compared to first-born, second-born had a suicide risk of 1.27, third-born of 1.35, and fourth- or higher-born of 1.72, while other causes of death did not display an evident and consistent birth-order pattern. Results for the Finnish-speaking siblings groups were almost identical to those based on both ethno-linguistic groups. In the Swedish-speaking siblings groups, there was no increase in the suicide risk by birth order, but a statistically not significant tendency towards an association with other external causes of death and deaths from cardiovascular diseases. Our findings provided evidence for an association between birth order and suicide among Finnish speakers in Finland, while no such association was found for Swedish speakers, suggesting that the birth order effect might depend on the cultural context. Copyright © 2016 Elsevier Ltd. All rights reserved.

Perioperative treatment of hemophilia A patients: blood group O patients are at risk of bleeding complications.

Science.gov (United States)

Hazendonk, H C A M; Lock, J; Mathôt, R A A; Meijer, K; Peters, M; Laros-van Gorkom, B A P; van der Meer, F J M; Driessens, M H E; Leebeek, F W G; Fijnvandraat, K; Cnossen, M H

2016-03-01

ESSENTIALS: Targeting of factor VIII values is a challenge during perioperative replacement therapy in hemophilia. This study aims to identify the extent and predictors of factor VIII underdosing and overdosing. Blood group O predicts underdosing and is associated with perioperative bleeding. To increase quality of care and cost-effectiveness of treatment, refining of dosing is obligatory. Perioperative administration of factor VIII (FVIII) concentrate in hemophilia A may result in both underdosing and overdosing, leading to respectively a risk of bleeding complications and unnecessary costs. This retrospective observational study aims to identify the extent and predictors of underdosing and overdosing in perioperative hemophilia A patients (FVIII levels < 0.05 IU mL(-1)). One hundred nineteen patients undergoing 198 elective, minor, or major surgical procedures were included (median age 40 years, median body weight 75 kg). Perioperative management was evaluated by quantification of perioperative infusion of FVIII concentrate and achieved FVIII levels. Predictors of underdosing and (excessive) overdosing were analyzed by logistic regression analysis. Excessive overdosing was defined as upper target level plus ≥ 0.20 IU mL(-1). Depending on postoperative day, 7-45% of achieved FVIII levels were under and 33-75% were above predefined target ranges as stated by national guidelines. A potential reduction of FVIII consumption of 44% would have been attained if FVIII levels had been maintained within target ranges. Blood group O and major surgery were predictive of underdosing (odds ratio [OR] 6.3, 95% confidence interval [CI] 2.7-14.9; OR 3.3, 95% CI 1.4-7.9). Blood group O patients had more bleeding complications in comparison to patients with blood group non-O (OR 2.02, 95% CI 1.00-4.09). Patients with blood group non-O were at higher risk of overdosing (OR 1.5, 95% CI 1.1-1.9). Additionally, patients treated with bolus infusions were at higher risk of excessive

Pilot Study of a Computer-Based Parental Questionnaire and Visual Profile of Obesity Risk in Healthy Preschoolers.

Science.gov (United States)

Davies, Marilyn A; Terhorst, Lauren; Zhang, Peng; Nakonechny, Amanda J; Nowalk, Mary Patricia

2015-01-01

This group field-tested a computer-based, parental questionnaire entitled the Childhood Obesity Risk Questionnaire 2-5 (CORQ 2-5) designed to assess obesity risk in healthy preschoolers. COR 2-5 generates a profile of seven obesity risk factors. Field studies provided good internal reliability data and evidence of discriminant validity for the CORQ 2-5. Pediatric nurse clinicians found the CORQ 2-5 profile to be clinically relevant. The CORQ 2-5 is a promising measure of obesity risk in preschoolers who attend community-based health centers for their wellchild visits and who are not yet obese. CORQ 2-5 is intended to guide provider-parental obesity risk discussions. Copyright © 2015 Elsevier Inc. All rights reserved.

School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

Science.gov (United States)

Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

2007-01-01

The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

Task-based dermal exposure models for regulatory risk assessment.

Science.gov (United States)

Warren, Nicholas D; Marquart, Hans; Christopher, Yvette; Laitinen, Juha; VAN Hemmen, Joop J

2006-07-01

The regulatory risk assessment of chemicals requires the estimation of occupational dermal exposure. Until recently, the models used were either based on limited data or were specific to a particular class of chemical or application. The EU project RISKOFDERM has gathered a considerable number of new measurements of dermal exposure together with detailed contextual information. This article describes the development of a set of generic task-based models capable of predicting potential dermal exposure to both solids and liquids in a wide range of situations. To facilitate modelling of the wide variety of dermal exposure situations six separate models were made for groupings of exposure scenarios called Dermal Exposure Operation units (DEO units). These task-based groupings cluster exposure scenarios with regard to the expected routes of dermal exposure and the expected influence of exposure determinants. Within these groupings linear mixed effect models were used to estimate the influence of various exposure determinants and to estimate components of variance. The models predict median potential dermal exposure rates for the hands and the rest of the body from the values of relevant exposure determinants. These rates are expressed as mg or microl product per minute. Using these median potential dermal exposure rates and an accompanying geometric standard deviation allows a range of exposure percentiles to be calculated.

Radiofrequency electromagnetic fields emitted from base stations of DECT cordless phones and the risk of glioma and meningioma (Interphone Study Group, Germany)

DEFF Research Database (Denmark)

Schüz, Joachim; Böhler, Eva; Schlehofer, Brigitte

2006-01-01

The objective of this study was to test the hypothesis that exposure to continuous low-level radiofrequency electromagnetic fields (RF EMFs) increases the risk of glioma and meningioma. Participants in a population-based case-control study in Germany on the risk of brain tumors in relation...... to cellular phone use were 747 incident brain tumor cases between the ages of 30 and 69 years and 1494 matched controls. The exposure measure of this analysis was the location of a base station of a DECT (Digital Enhanced Cordless Telecommunications) cordless phone close to the bed, which was used as a proxy...

Giving in to Group Pressure: The Impact of Socialization and Risk on Perceived Outcomes

Science.gov (United States)

McIntyre, Katharine A.; Platania, Judith

2009-01-01

The current study applies the perspective of decision theory to understanding how choices are made in an in-group setting involving social pressure and risk. Two hundred sixty-one undergraduate students provided assessments of consequences associated with illegally consuming alcohol in different environments with differing degrees of risk. In…

Dutch home-based pre-reading intervention with children at familial risk of dyslexia.

Science.gov (United States)

van Otterloo, Sandra G; van der Leij, Aryan

2009-12-01

Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small effect on a composite score of phoneme awareness (d = 0.29) and a large effect on receptive letter knowledge (d = 0.88). In first grade, however, this did not result in beneficial effects for the experimental group in word reading and spelling. Results are compared to three former intervention studies in The Netherlands and comparable studies from Denmark and Australia.

Comparison of mental distress in patients with low back pain and a population-based control group measured by Symptoms Check List

DEFF Research Database (Denmark)

Christensen, Jan; Fisker, Annette; Mortensen, Erik Lykke

2015-01-01

. The objective of this study was to compare mental symptoms and distress as measured by the Symptoms Check List-90 in sick-listed or at risk of being sick-listed patients with low back pain with a population-based control group. METHODS: Mental distress was compared in a group of patients with low back pain (n......=770) and a randomly selected population-based reference group (n=909). Established Danish cut-off values for mental distress were used to evaluate the mental distress status in the low back pain and control group and logistic regression was used to calculate odds ratios for the Global Severity Index......PURPOSE: Mental distress is common in persons experiencing low back pain and who are sick-listed or at risk of being sick-listed. It is, however, not known how mental distress measured by the Symptoms Check List-90 differs between patients with low back pain and the general population...

Risk management of radiation therapy. Survey by north Japan radiation therapy oncology group

International Nuclear Information System (INIS)

Aoki, Masahiko; Abe, Yoshinao; Yamada, Shogo; Hareyama, Masato; Nakamura, Ryuji; Sugita, Tadashi; Miyano, Takashi

2004-01-01

A North Japan Radiation Oncology Group (NJRTOG) survey was carried out to disclose the risk management of radiation therapy. During April 2002, we sent questionnaires to radiation therapy facilities in northern Japan. There were 31 replies from 27 facilities. Many incidents and accidents were reported, including old cases. Although 60% of facilities had a risk management manual and/or risk manager, only 20% had risk management manuals for radiation therapy. Eighty five percent of radiation oncologists thought that incidents may be due to a lack of manpower. Ninety percent of radiation oncologists want to know the type of cases happened in other facilities. The risk management system is still insufficient for radiation therapy. We hope that our data will be a great help to develop risk management strategies for radiation therapy for all radiation oncologists in Japan. (author)

Multi-criteria aid for group decision making on gas pipeline risk analysis; Apoio multicriterio a decisao em grupo na analise de risco em gasodutos

Energy Technology Data Exchange (ETDEWEB)

Lopes, Yuri G.; Cavalcante, Cristiano A.V.; Brito, Anderson J. de M.; Almeida, Adiel T. de [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)

2008-07-01

Risks are, by nature, subjective, and therefore, complex. They present multidimensional aspects and involve various stakeholders. The pipelines transmission and distribution of natural gas (NG) involve various scenarios of risks, resulting from the distinct environments where the supply chain of NG is inserted. This paper proposes a multi criteria model for group decision support, based on the GDSS PROMETHEE approach, for risk assessment in pipelines sections. The proposed model aims to establish a ranking between the sections of a pipeline network, in order to provide insights to the definition of risk mitigation actions. (author)

The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

Science.gov (United States)

Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

2017-07-25

Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

Research needs for risk-informed, performance-based regulations

International Nuclear Information System (INIS)

Thadani, A.C.

1997-01-01

This article summarizes the activities of the Office of Research of the NRC, both from a historical aspect as well as it applies to the application of risk-based decision making. The office has been actively involved in problems related to understanding risks related to core accidents, to understanding the problem of aging of reactor components and materials from years of service, and toward the understanding and analysis of severe accidents. In addition new policy statements regarding the role of risk assessment in regulatory applications has given focus for the need of further work. The NRC has used risk assessment in regulatory questions in the past but in a fairly ad hoc sort of manner. The new policies will clearly require a better defined application of risk assessment, and help for people evaluating applications in judging the applicability of such applications when a component of them is based on risk-based decision making. To address this, standard review plans are being prepared to serve as guides for such questions. In addition, with regulatory decisions being allowed to be based upon risk-based decisions, it is necessary to have an adequate data base prepared, and made publically available, to support such a position

Risk of Debt-Based Financing in Indonesian Islamic Banking

Directory of Open Access Journals (Sweden)

Kharisya Ayu Effendi

2017-05-01

Full Text Available The purpose of this study is to know the risk of debt-based financing in Islamic banking in Indonesia by using an accounting based calculation, those are NPF analysis, Credit risk Z-score and Altman Z-score. This study is telling about the risk of debt-based finacing on Indonesian Islamic banking using an accounting based measurement, those are NPF analysis, Credit Risk Z-score analysis and Altman Z-score analysis. The data was obtained from 2011 to 2015 from the website of each bank. The result is a risk on debt-based financing on Indonesian Islamic banking is low. The measurement using 3 accounting based measurement tool gives a consistent result, that is Indonesian Islamic banking use a debt-based financing have a high financial stability and a low risk.DOI: 10.15408/aiq.v9i2.4821

The more from East-Asian, the better: risk prediction of colorectal cancer risk by GWAS-identified SNPs among Japanese.

Science.gov (United States)

Abe, Makiko; Ito, Hidemi; Oze, Isao; Nomura, Masatoshi; Ogawa, Yoshihiro; Matsuo, Keitaro

2017-12-01

Little is known about the difference of genetic predisposition for CRC between ethnicities; however, many genetic traits common to colorectal cancer have been identified. This study investigated whether more SNPs identified in GWAS in East Asian population could improve the risk prediction of Japanese and explored possible application of genetic risk groups as an instrument of the risk communication. 558 Patients histologically verified colorectal cancer and 1116 first-visit outpatients were included for derivation study, and 547 cases and 547 controls were for replication study. Among each population, we evaluated prediction models for the risk of CRC that combined the genetic risk group based on SNPs from GWASs in European-population and a similarly developed model adding SNPs from GWASs in East Asian-population. We examined whether adding East Asian-specific SNPs would improve the discrimination. Six SNPs (rs6983267, rs4779584, rs4444235, rs9929218, rs10936599, rs16969681) from 23 SNPs by European-based GWAS and five SNPs (rs704017, rs11196172, rs10774214, rs647161, rs2423279) among ten SNPs by Asian-based GWAS were selected in CRC risk prediction model. Compared with a 6-SNP-based model, an 11-SNP model including Asian GWAS-SNPs showed improved discrimination capacity in Receiver operator characteristic analysis. A model with 11 SNPs resulted in statistically significant improvement in both derivation (P = 0.0039) and replication studies (P = 0.0018) compared with six SNP model. We estimated cumulative risk of CRC by using genetic risk group based on 11 SNPs and found that the cumulative risk at age 80 is approximately 13% in the high-risk group while 6% in the low-risk group. We constructed a more efficient CRC risk prediction model with 11 SNPs including newly identified East Asian-based GWAS SNPs (rs704017, rs11196172, rs10774214, rs647161, rs2423279). Risk grouping based on 11 SNPs depicted lifetime difference of CRC risk. This might be useful for

A Patient Risk Model of Chemotherapy-Induced Febrile Neutropenia: Lessons Learned From the ANC Study Group.

Science.gov (United States)

Lyman, Gary H; Poniewierski, Marek S

2017-12-01

Neutropenia and its complications, including febrile neutropenia (FN), represent major toxicities associated with cancer chemotherapy, resulting in considerable morbidity, mortality, and costs. The myeloid growth factors such as granulocyte colony-stimulating factor (G-CSF) have been shown to reduce the risk of neutropenia complications while enabling safe and effective chemotherapy dose intensity. Concerns about the high costs of these agents along with limited physician adherence to clinical practice guidelines, resulting in both overuse and underuse, has stimulated interest in models for individual patient risk assessment to guide appropriate use of G-CSF. In a model developed and validated by the ANC Study Group, half of patients were classified as high risk and half as low risk based on patient-, disease-, and treatment-related factors. This model has been further validated in an independent patient population. Physician-assessed risk of FN, as well as the decision to use prophylactic CSF, has been shown to correlate poorly with the FN risk estimated by the model. Additional modeling efforts in both adults and children receiving cancer treatment have been reported. Identification of patients at a high individual risk for FN and its consequences may offer the potential for optimal chemotherapy delivery and patient outcomes. Likewise, identification of patients at low risk for neutropenic events may reduce costs when such supportive care is not warranted. This article reviews and summarizes FN modeling studies and the opportunities for personalizing supportive care in patients receiving chemotherapy. Copyright © 2017 by the National Comprehensive Cancer Network.

Blood group AB is protective factor for gestational diabetes mellitus: a prospective population-based study in Tianjin, China.

Science.gov (United States)

Zhang, Cuiping; Li, Yi; Wang, Leishen; Sun, Shurong; Liu, Gongshu; Leng, Junhong; Guo, Jia; Lv, Li; Li, Weidong; Zhang, Cuilin; Hu, Gang; Yu, Zhijie; Yang, Xilin

2015-09-01

The ABO blood types are associated with cancers, cardiovascular diseases and type 2 diabetes mellitus but whether they are also associated with gestational diabetes mellitus (GDM) is unknown. We examined the relationship between the ABO blood types and the risk of GDM in a prospective population-based Chinese cohort. From 2010 to 2012, we recruited 14,198 pregnant women within the first 12 weeks of gestation in Tianjin, China. All women had a glucose challenge test (GCT) at 24-28 gestational weeks, followed by a 75-g 2-h oral glucose tolerance test if the results from GCT were ≥7.8 mmol/L. GDM was diagnosed based on the glucose cut-points of the International Association of Diabetes and Pregnancy Study Group criteria. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for traditional risk factors. Stratified analysis was performed by family history of diabetes (yes versus no). Sensitivity analyses were also performed by using the World Health Organization (WHO) criteria for GDM. Women with blood groups A, B or O (i.e. non-AB) were associated with increased risk of GDM as compared with those with blood group AB (adjusted OR: 1.44, 95% CI: 1.13-1.83). Sensitivity analyses showed that the result was consistent using WHO criteria. The adjusted OR of blood group non-AB versus AB for GDM was enhanced among women with a family history of diabetes (2.69, 1.21-5.96) and attenuated among those without (1.33, 1.03-1.71). Blood group AB was a protective factor against GDM in pregnant Chinese women. Copyright © 2015 John Wiley & Sons, Ltd.

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

Directory of Open Access Journals (Sweden)

Hyun-Soo Kim

2016-01-01

Full Text Available Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

Science.gov (United States)

Kim, Hyun-Soo; Lee, Moo-Sik; Hong, Jee-Young

2016-01-01

The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

Area-level poverty and preterm birth risk: A population-based multilevel analysis

Science.gov (United States)

DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

2008-01-01

Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB rate of PTB poverty and increased through the 4th quartile (4.9%), p poverty was significantly associated with PTB risk. PTB risk (poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

ABO Blood Group and Dementia Risk--A Scandinavian Record-Linkage Study

DEFF Research Database (Denmark)

Vasan, Senthil K; Rostgaard, Klaus; Ullum, Henrik

2015-01-01

,615 cases of Alzheimer's disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer's disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors......BACKGROUND: Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined...... the relationship between ABO blood group and dementia-related disorders in detail. METHODS: We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient...

Waste Contaminants at Military Bases Working Group report

International Nuclear Information System (INIS)

1993-01-01

The Waste Contaminants at Military Bases Working Group has screened six prospective demonstration projects for consideration by the Federal Advisory Committee to Develop On-Site Innovative Technologies (DOIT). These projects include the Kirtland Air Force Base Demonstration Project, the March Air Force Base Demonstration Project, the McClellan Air Force Base Demonstration Project, the Williams Air Force Base Demonstration Project, and two demonstration projects under the Air Force Center for Environmental Excellence. A seventh project (Port Hueneme Naval Construction Battalion Center) was added to list of prospective demonstrations after the September 1993 Working Group Meeting. This demonstration project has not been screened by the working group. Two additional Air Force remediation programs are also under consideration and are described in Section 6 of this document. The following information on prospective demonstrations was collected by the Waste Contaminants at Military Bases Working Group to assist the DOIT Committee in making Phase 1 Demonstration Project recommendations. The remainder of this report is organized into seven sections: Work Group Charter's mission and vision; contamination problems, current technology limitations, and institutional and regulatory barriers to technology development and commercialization, and work force issues; screening process for initial Phase 1 demonstration technologies and sites; demonstration descriptions -- good matches;demonstration descriptions -- close matches; additional candidate demonstration projects; and next steps

Perceived Benefits and Challenges of a Risk-Based Approach to Multidisciplinary Chronic Kidney Disease Care: A Qualitative Descriptive Study.

Science.gov (United States)

Smekal, Michelle D; Tam-Tham, Helen; Finlay, Juli; Donald, Maoliosa; Benterud, Eleanor; Thomas, Chandra; Quinn, Robert R; Tam, Kin; Manns, Braden J; Tonelli, Marcello; Bello, Aminu; Tangri, Navdeep; Hemmelgarn, Brenda R

2018-01-01

The kidney failure risk equation (KFRE) provides an estimate of risk of progression to kidney failure, and may guide clinical care. We aimed to describe patient, family, and health care provider's perspectives of the perceived benefits and challenges of using a risk-based approach to guide care delivery for patients with advanced chronic kidney disease (CKD), and refine implementation based on their input. We used qualitative methodology to explore perceived benefits and challenges of implementing a risk-based approach (using the KFRE) to determine eligibility for multidisciplinary CKD care in Southern Alberta. We obtained perspectives from patients and families through focus groups, as well as input from health care providers through interviews and open-ended responses from an online survey. Twelve patients/family members participated in 2 focus groups, 16 health care providers participated in an interview, and 40 health care providers responded to the survey. Overall, participants felt that a KFRE-based approach had the potential to improve efficiency of the clinics by targeting care to patients at highest risk of kidney failure; however, they also expressed concerns about the impact of loss of services for lower risk individuals. Participants also articulated concerns about a perceived lack of capacity for adequate CKD patient care in the community. Our implementation strategy was modified as a result of participants' feedback. We identified benefits and challenges to implementation of a risk-based approach to guide care of patients with advanced CKD. Based on these results, our implementation strategy has been modified by removing the category of referral back to primary care alone, and instead having that decision made jointly by nephrologists and patients among low-risk patients.

Variation in the risk for liver and gallbladder cancers in socioeconomic and occupational groups in Sweden with etiological implications.

Science.gov (United States)

Ji, Jianguang; Hemminki, Kari

2005-09-01

To examine the associations between socioeconomic/occupational factors and liver cancer at various anatomic sites (including primary liver, gallbladder and other cancers). We carried out a follow-up study on the economically active Swedish population, based on the Swedish Family-Cancer Database. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated in different social classes and occupations. For primary liver cancer, farmers were at a decreased risk; increased risks were observed for male sales agents, journalists, seamen, waiters, cooks and female beverage manufacture workers. Similar patterns were observed for gallbladder cancer; workers employed as journalists, sales agents, cooks and stewards, and public safety workers showed increased risk. Only male transport workers showed increased risk of cancers in other parts. Occupations with high consumption of alcohol and/or high prevalence of smoking associated with a risk of liver and gallbladder cancers. The present study suggests that the effects of socioeconomic factors on liver cancer of different subsites are similar; alcohol drinking is a risk factor of gallbladder cancer because of the covariation of primary liver and gallbladder cancers in occupational groups.

Perception of mobile phone and base station risks.

Science.gov (United States)

Siegrist, Michael; Earle, Timothy C; Gutscher, Heinz; Keller, Carmen

2005-10-01

Perceptions of risks associated with mobile phones, base stations, and other sources of electromagnetic fields (EMF) were examined. Data from a telephone survey conducted in the German- and French-speaking parts of Switzerland are presented (N = 1,015). Participants assessed both risks and benefits associated with nine different sources of EMF. Trust in the authorities regulating these hazards was assessed as well. In addition, participants answered a set of questions related to attitudes toward EMF and toward mobile phone base stations. According to respondents' assessments, high-voltage transmission lines are the most risky source of EMF. Mobile phones and mobile phone base stations received lower risk ratings. Results showed that trust in authorities was positively associated with perceived benefits and negatively associated with perceived risks. People who use their mobile phones frequently perceived lower risks and higher benefits than people who use their mobile phones infrequently. People who believed they lived close to a base station did not significantly differ in their level of risks associated with mobile phone base stations from people who did not believe they lived close to a base station. Regarding risk regulation, a majority of participants were in favor of fixing limiting values based on the worst-case scenario. Correlations suggest that belief in paranormal phenomena is related to level of perceived risks associated with EMF. Furthermore, people who believed that most chemical substances cause cancer also worried more about EMF than people who did not believe that chemical substances are that harmful. Practical implications of the results are discussed.

SU-F-T-243: Major Risks in Radiotherapy. A Review Based On Risk Analysis Literature

Energy Technology Data Exchange (ETDEWEB)

López-Tarjuelo, J; Guasp-Tortajada, M; Iglesias-Montenegro, N; Monasor-Denia, P [Servicio de Radiofísica y Protección Radiológica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España/Spain (Spain); Bouché-Babiloni, A; Morillo-Macías, V; Ferrer-Albiach, C [Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España/Spain (Spain)

2016-06-15

Purpose: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. Methods: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques. We selected only the works containing a detailed ranked series of elements or failure modes and focused on the first fully reported quartile as much. Afterward, we sorted the risk elements according to a regular radiotherapy procedure so that the resulting groups were cited in several works and be ranked in this way. Results: 29 references published between 2007 and February 2016 were studied. Publication trend has been generally rising. The most employed analysis has been the Failure mode and effect analysis (FMEA). Among references, we selected 20 works listing 258 ranked risk elements. They were sorted into 31 groups appearing at least in two different works. 11 groups appeared in at least 5 references and 5 groups did it in 7 or more papers. These last sets of risks where choosing another set of images or plan for planning or treating, errors related with contours, errors in patient positioning for treatment, human mistakes when programming treatments, and planning errors. Conclusion: There is a sufficient amount and variety of references for identifying which failure modes or elements should be addressed in a radiotherapy department before attempting a specific analysis. FMEA prevailed, but other studies such as “risk matrix” or “occurrence × severity” analyses can also lead professionals’ efforts. Risk associated with human actions ranks very high; therefore, they should be automated or at least peer-reviewed.

SU-F-T-243: Major Risks in Radiotherapy. A Review Based On Risk Analysis Literature

International Nuclear Information System (INIS)

López-Tarjuelo, J; Guasp-Tortajada, M; Iglesias-Montenegro, N; Monasor-Denia, P; Bouché-Babiloni, A; Morillo-Macías, V; Ferrer-Albiach, C

2016-01-01

Purpose: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. Methods: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques. We selected only the works containing a detailed ranked series of elements or failure modes and focused on the first fully reported quartile as much. Afterward, we sorted the risk elements according to a regular radiotherapy procedure so that the resulting groups were cited in several works and be ranked in this way. Results: 29 references published between 2007 and February 2016 were studied. Publication trend has been generally rising. The most employed analysis has been the Failure mode and effect analysis (FMEA). Among references, we selected 20 works listing 258 ranked risk elements. They were sorted into 31 groups appearing at least in two different works. 11 groups appeared in at least 5 references and 5 groups did it in 7 or more papers. These last sets of risks where choosing another set of images or plan for planning or treating, errors related with contours, errors in patient positioning for treatment, human mistakes when programming treatments, and planning errors. Conclusion: There is a sufficient amount and variety of references for identifying which failure modes or elements should be addressed in a radiotherapy department before attempting a specific analysis. FMEA prevailed, but other studies such as “risk matrix” or “occurrence × severity” analyses can also lead professionals’ efforts. Risk associated with human actions ranks very high; therefore, they should be automated or at least peer-reviewed.

Lipid profiles and ischemic stroke risk: variations by sex within racial/ethnic groups

Directory of Open Access Journals (Sweden)

Gezmu T

2014-05-01

Full Text Available Tefera Gezmu,1 Dona Schneider,1 Kitaw Demissie,2 Yong Lin,2 Christine Giordano,3 Martin S Gizzi4 1Edward J. Bloustein School of Planning and Public Policy, Rutgers, the State University of New Jersey, New Brunswick, NJ, 2Rutgers School of Public Health, Department of Epidemiology, Piscataway, NJ, 3Rutgers New Jersey Medical School, Newark, NJ, 4New Jersey Neuroscience Institute at JFK Medical Center and Seton Hall University, Edison, NJ, USA Abstract: Evidence implicates lipid abnormalities as important but modifiable risk factors for stroke. This study assesses whether hypercholesterolemia can be used to predict the risk for etiologic subtypes of ischemic stroke between sexes within racial/ethnic groups. Data elements related to stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290 acute stroke admissions between 2006 and 2010 at a regional stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014. All women, except South Asian women, had higher mean plasma total cholesterol and higher blood circulating low-density lipoprotein levels (≥100 mg/dL than men at the time of their admissions. The incidence of large-artery atherosclerosis (LAA was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and high-density lipoproteins and triglycerides as predictors showed inconsistent associations between lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women stroke patients may be at increased risk for stroke etiologic subtype LAA than men. Although the higher prevalence of stroke

Econometric analyses of microfinance credit group formation, contractual risks and welfare impacts in Northern Ethiopia

NARCIS (Netherlands)

Berhane Tesfay, G.

2009-01-01

Key words
Microfinance, joint liability, contractual risk, group formation, risk-matching, impact evaluation, Panel data econometrics, dynamic panel probit, trend models, fixed-effects, composite counterfactuals, propensity score matching, farm households, Ethiopia.

Lack of

Risk-based inspection--Development of guidelines

International Nuclear Information System (INIS)

1993-07-01

Effective inservice inspection programs can play a significant role in minimizing equipment and structural failures. Most of the current inservice inspection programs for light water reactor (LWR) nuclear power plant components are based on experience and engineers' qualitative judgment. These programs include only an implicit consideration of risk, which combines the probability of failure of a component under its operation and loading conditions and the consequences of such failure, if it occurs. This document recommends appropriate methods for establishing a risk-based inspection program for LWR nuclear power plant components. The process has been built from a general methodology (Volume 1) and has been expanded to involve five major steps: defining the system; evaluating qualitative risk assessment results; using this and information from plant probabilistic risk assessments to perform a quantitative risk analysis; selecting target failure probabilities; and developing an inspection program for components using economic decision analysis and structural reliability assessment methods

Health-based risk neutralization in private disability insurance

NARCIS (Netherlands)

Wijnvoord, Elisabeth C.; Buitenhuis, Jan; Brouwer, Sandra; van der Klink, Jac J. L.; de Boer, Michiel R.

2016-01-01

Background: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention.

Health-based risk neutralization in private disability insurance

NARCIS (Netherlands)

Wijnvoord, Elisabeth C; Buitenhuis, Jan; Brouwer, Sandra; van der Klink, Jac J L; de Boer, Michiel R

2016-01-01

BACKGROUND: Exclusions are used by insurers to neutralize higher than average risks of sickness absence (SA). However, differentiating risk groups according to one's medical situation can be seen as discrimination against people with health problems in violation of a 2006 United Nations convention.

A Simple Model to Rank Shellfish Farming Areas Based on the Risk of Disease Introduction and Spread.

Science.gov (United States)

Thrush, M A; Pearce, F M; Gubbins, M J; Oidtmann, B C; Peeler, E J

2017-08-01

The European Union Council Directive 2006/88/EC requires that risk-based surveillance (RBS) for listed aquatic animal diseases is applied to all aquaculture production businesses. The principle behind this is the efficient use of resources directed towards high-risk farm categories, animal types and geographic areas. To achieve this requirement, fish and shellfish farms must be ranked according to their risk of disease introduction and spread. We present a method to risk rank shellfish farming areas based on the risk of disease introduction and spread and demonstrate how the approach was applied in 45 shellfish farming areas in England and Wales. Ten parameters were used to inform the risk model, which were grouped into four risk themes based on related pathways for transmission of pathogens: (i) live animal movement, (ii) transmission via water, (iii) short distance mechanical spread (birds) and (iv) long distance mechanical spread (vessels). Weights (informed by expert knowledge) were applied both to individual parameters and to risk themes for introduction and spread to reflect their relative importance. A spreadsheet model was developed to determine quantitative scores for the risk of pathogen introduction and risk of pathogen spread for each shellfish farming area. These scores were used to independently rank areas for risk of introduction and for risk of spread. Thresholds were set to establish risk categories (low, medium and high) for introduction and spread based on risk scores. Risk categories for introduction and spread for each area were combined to provide overall risk categories to inform a risk-based surveillance programme directed at the area level. Applying the combined risk category designation framework for risk of introduction and spread suggested by European Commission guidance for risk-based surveillance, 4, 10 and 31 areas were classified as high, medium and low risk, respectively. © 2016 Crown copyright.

Maternal genital tract colonisation by group-b streptococcus: a hospital based study

International Nuclear Information System (INIS)

Najmi, N.; Sikandar, R.; Zuberi, N.F.

2013-01-01

Objectives: To determine the prevalence of Group B Streptococcus genital tract infection in pregnant women and to determine the risk factors for its colonisation. Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi and Sobhraj Hospital, Karachi, from May to August 2007. Pregnant women at 35-37 weeks gestation attending antenatal clinic at these hospitals constituted the study population. Based on stratified sampling, 405 patients were recruited. High vaginal swabs of these patients were taken in order to calculate the prevalence of infection at each hospital. Logistic regression was used to evaluate the risk factor association. SPSS 11.5 was used for statistical analysis. Results: The overall prevalence of colonisation was 17% (n=69) (95% CI: 13.4-20.7). Of the 155(38.27%) women at the Aga Khan Hospital, 35(22.6%) were positive, while among the 250 (61.72%) women at Sobhraj Hospital, the prevalence was 13.6% (n=34). The colonisation was found to be significantly associated inversely with the body mass index of the patient (OR 0.91; 95% CI: 0.08-1.0). Conclusion: Group B Streptococcus screening should be an integral part of antenatal care and should be offered to all pregnant women. (author)

Finding Risk Groups by Optimizing Artificial Neural Networks on the Area under the Survival Curve Using Genetic Algorithms.

Science.gov (United States)

Kalderstam, Jonas; Edén, Patrik; Ohlsson, Mattias

2015-01-01

We investigate a new method to place patients into risk groups in censored survival data. Properties such as median survival time, and end survival rate, are implicitly improved by optimizing the area under the survival curve. Artificial neural networks (ANN) are trained to either maximize or minimize this area using a genetic algorithm, and combined into an ensemble to predict one of low, intermediate, or high risk groups. Estimated patient risk can influence treatment choices, and is important for study stratification. A common approach is to sort the patients according to a prognostic index and then group them along the quartile limits. The Cox proportional hazards model (Cox) is one example of this approach. Another method of doing risk grouping is recursive partitioning (Rpart), which constructs a decision tree where each branch point maximizes the statistical separation between the groups. ANN, Cox, and Rpart are compared on five publicly available data sets with varying properties. Cross-validation, as well as separate test sets, are used to validate the models. Results on the test sets show comparable performance, except for the smallest data set where Rpart's predicted risk groups turn out to be inverted, an example of crossing survival curves. Cross-validation shows that all three models exhibit crossing of some survival curves on this small data set but that the ANN model manages the best separation of groups in terms of median survival time before such crossings. The conclusion is that optimizing the area under the survival curve is a viable approach to identify risk groups. Training ANNs to optimize this area combines two key strengths from both prognostic indices and Rpart. First, a desired minimum group size can be specified, as for a prognostic index. Second, the ability to utilize non-linear effects among the covariates, which Rpart is also able to do.

The characteristics and mortality risk factors for acute kidney injury in different age groups in China-a cross sectional study.

Science.gov (United States)

Wei, Qing; Liu, Hong; Tu, Yan-; Tang, Ri-Ning; Wang, Yan-Li; Pan, Ming-Ming; Liu, Bi-Cheng

2016-10-01

Age is an independent risk factor for acute kidney injury (AKI). The causes and outcomes of AKI in children, middle-aged, and older patients are different. The objective of this country-based study was to identify the characteristics and mortality factors for AKI in different age groups in China. Using data from 374,286 adult patients (≥18 years) admitted to 44 study hospitals, we investigated the characteristics and mortality risk factors for AKI in four different age groups: 18-39 years of age, 40-59 years of age, 60-79 years of age, and ≥80 years of age. The identification criteria for AKI included the 2012 KDIGO AKI definition and an expanded criterion. The country-based survey included 7604 AKI patients (7604/374,286, 2.03%). The proportions of AKI in the four age groups were 11.52%, 30.79%, 41.03%, and 16.66%, respectively. In any age group, the patients with AKI stage 1 were the majority (43.4%, 42.4%, 46.4%, and 52.2%, respectively), and the most common classification of AKI was pre-renal AKI (44.3%, 51.3%, 52.3%, and 56.4%, respectively). The higher AKI peak stage occurred for the in-hospital mortality factors for AKI in all age groups; except for the AKI stage 2 patients in the 18-39 age group. The characteristics and mortality factors for AKI vary by age in China. Elderly patients were the primary population with AKI, and the most common type of AKI was pre-renal AKI. Special caution should be taken to the old population in hospitalized patients to prevent the pre-renal AKI.

Application of REVEAL-W to risk-based configuration control

International Nuclear Information System (INIS)

Dezfuli, H.; Meyer, J.; Modarres, M.

1994-01-01

Over the past two years, the concept of risk-based configuration control has been introduced to the US Nuclear Regulatory Commission and the nuclear industry. Converting much of the current, deterministically based regulation of nuclear power plants to risk-based regulation can result in lower levels of risk while relieving unnecessary burdens on power plant operators and regulatory staff. To achieve the potential benefits of risk-based configuration control, the risk models developed for nuclear power plants should be (1) flexible enough to effectively support necessary risk calculations, and (2) transparent enough to encourage their use by all parties. To address these needs, SCIENTECH, Inc., has developed the PC-based REVEAL W (formerly known as SMART). This graphic-oriented and user-friendly application software allows the user to develop transparent complex logic models based on the concept of the master plant logic diagram. The logic model is success-oriented and compact. The analytical capability built into REVEAL W is generic, so the software can support different types of risk-based evaluations, such as probabilistic safety assessment, accident sequence precursor analysis, design evaluation and configuration management. In this paper, we focus on the application of REVEAL W to support risk-based configuration control of nuclear power plants. (author)

Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.

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Seitz, Holli H; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M; Armstrong, Katrina; Cappella, Joseph N

2016-10-01

This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. 2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Laboratory-Based Intermountain Validated Exacerbation (LIVE Score Identifies Chronic Obstructive Pulmonary Disease Patients at High Mortality Risk

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Denitza P. Blagev

2018-06-01

Full Text Available Background: Identifying COPD patients at high risk for mortality or healthcare utilization remains a challenge. A robust system for identifying high-risk COPD patients using Electronic Health Record (EHR data would empower targeting interventions aimed at ensuring guideline compliance and multimorbidity management. The purpose of this study was to empirically derive, validate, and characterize subgroups of COPD patients based on routinely collected clinical data widely available within the EHR.Methods: Cluster analysis was used in 5,006 patients with COPD at Intermountain to identify clusters based on a large collection of clinical variables. Recursive Partitioning (RP was then used to determine a preferred tree that assigned patients to clusters based on a parsimonious variable subset. The mortality, COPD exacerbations, and comorbidity profile of the identified groups were examined. The findings were validated in an independent Intermountain cohort and in external cohorts from the United States Veterans Affairs (VA and University of Chicago Medicine systems.Measurements and Main Results: The RP algorithm identified five LIVE Scores based on laboratory values: albumin, creatinine, chloride, potassium, and hemoglobin. The groups were characterized by increasing risk of mortality. The lowest risk, LIVE Score 5 had 8% 4-year mortality vs. 56% in the highest risk LIVE Score 1 (p < 0.001. These findings were validated in the VA cohort (n = 83,134, an expanded Intermountain cohort (n = 48,871 and in the University of Chicago system (n = 3,236. Higher mortality groups also had higher COPD exacerbation rates and comorbidity rates.Conclusions: In large clinical datasets across different organizations, the LIVE Score utilizes existing laboratory data for COPD patients, and may be used to stratify risk for mortality and COPD exacerbations.

New approach for risk based inspection of H2S based Process Plants

International Nuclear Information System (INIS)

Vinod, Gopika; Sharma, Pavan K.; Santosh, T.V.; Hari Prasad, M.; Vaze, K.K.

2014-01-01

Highlights: • Study looks into improving the consequence evaluation in risk based inspection. • Ways to revise the quantity factors used in qualitative approach. • New approach based on computational fluid dynamics along with probit mathematics. • Demonstrated this methodology along with a suitable case study for the said issue. - Abstract: Recent trend in risk informed and risk based approaches in life management issues have certainly put the focus on developing estimation methods for real risk. Idea of employing risk as an optimising measure for in-service inspection, termed as risk based inspection, was accepted in principle from late 80s. While applying risk based inspection, consequence of failure from each component needs to be assessed. Consequence evaluation in a Process Plant is a crucial task. It may be noted that, in general, the number of components to be considered for life management is very large and hence the consequence evaluation resulting from their failures (individually) is a laborious task. Screening of critical components is usually carried out using simplified qualitative approach, which primarily uses influence factors for categorisation. This necessitates logical formulation of influence factors and their ranges with a suitable technical basis for acceptance from regulators. This paper describes application of risk based inspection for H 2 S based Process Plant along with the approach devised for handling the influence factor related to the quantity of H 2 S released

One size does not fit all: HIV testing preferences differ among high-risk groups in Northern Tanzania.

Science.gov (United States)

Ostermann, Jan; Njau, Bernard; Mtuy, Tara; Brown, Derek S; Mühlbacher, Axel; Thielman, Nathan

2015-01-01

In order to maximize the effectiveness of "Seek, Test, and Treat" strategies for curbing the HIV epidemic, new approaches are needed to increase the uptake of HIV testing services, particularly among high-risk groups. Low HIV testing rates among such groups suggest that current testing services may not align well with the testing preferences of these populations. Female bar workers and male mountain porters have been identified as two important high-risk groups in the Kilimanjaro Region of Tanzania. We used conventional survey methods and a discrete choice experiment (DCE), a preference elicitation method increasingly applied by economists and policy-makers to inform health policy and services, to analyze trade-offs made by individuals and quantify preferences for HIV testing services. Bivariate descriptive statistics were used to analyze differences in survey responses across groups. Compared to 486 randomly selected community members, 162 female bar workers and 194 male Kilimanjaro porters reported 2-3 times as many lifetime sexual partners (p porters preferred testing in venues where antiretroviral therapy was readily available. Both high-risk groups were less averse to traveling longer distances to test compared to their community counterparts. These results expose systematic differences in HIV testing preferences across high-risk populations compared to their community peers. Tailoring testing options to the preferences of high-risk populations should be evaluated as a means of improving uptake of testing in these populations.

Impact of two common xeroderma pigmentosum group D (XPD gene polymorphisms on risk of prostate cancer.

Directory of Open Access Journals (Sweden)

Yuanyuan Mi

Full Text Available BACKGROUND: DNA repair genes (EG: xeroderma pigmentosum group D, XPD may affect the capacity of encoded DNA repair enzymes to effectively remove DNA adducts or lesions, which may result in enhanced cancer risk. The association between XPD gene polymorphisms and the susceptibility of prostate cancer (PCa was inconsistent in previous studies. METHODOLOGY/PRINCIPAL FINDINGS: A meta-analysis based on 9 independent case-control studies involving 3165 PCa patients and 3539 healthy controls for XPD Gln751Lys SNP (single nucleotide polymorphism and 2555 cases and 3182 controls for Asn312Asp SNP was performed to address this association. Meanwhile, odds ratio (OR and 95% confidence intervals (CIs were used to evaluate this relationship. Statistical analysis was performed with STATA10.0. No significant association was found between XPD Gln751Lys SNP and PCa risk. On the other hand, in subgroup analysis based on ethnicity, associations were observed in Asian (eg. Asn vs. Asp: OR = 1.34, 95%CI = 1.16-1.55; Asn/Asn+Asn/Asp vs. Asp/Asp: OR = 1.23, 95%CI = 1.07-1.42 and African (eg. Asn vs. Asp: OR = 1.31, 95%CI = 1.01-1.70; Asn/Asn vs. Asp/Asp: OR = 1.71, 95%CI = 1.03-7.10 populations for Asn312Asp SNP. Moreover, similar associations were detected in hospital-based controls studies; the frequency of Asn/Asn genotype in early stage of PCa men was poorly higher than those in advanced stage of PCa men (OR = 1.45, 95%CI = 1.00-2.11. CONCLUSION/SIGNIFICANCE: Our investigations demonstrate that XPD Asn312Asp SNP not the Gln751Lys SNP, might poorly increase PCa risk in Asians and Africans, moreover, this SNPs may associate with the tumor stage of PCa. Further studies based on larger sample size and gene-environment interactions should be conducted to determine the role of XPD gene polymorphisms in PCa risk.

The association between gestational weight gain and risk of stillbirth: a population-based cohort study.

Science.gov (United States)

Yao, Ruofan; Park, Bo Y; Foster, Sarah E; Caughey, Aaron B

2017-10-01

To estimate the risk of stillbirth associated with excessive and inadequate weight gain during pregnancy. Retrospective cohort study using the Texas vital records database between 2006 and 2011, with 2,230,310 births (5502 stillbirths) was included for analysis. Pregnancies were categorized as adequate weight gain, excessive weight gain, inadequate weight gain, or weight loss based on the Institute of Medicine 2009 recommendations. Hazard ratios (HRs) for stillbirth were estimated for each gestational weight-gain stratum using adequate weight gain as the comparison group. The analysis was performed separately for each body mass index (BMI) class. Both inadequate weight gain and weight loss were associated with an increased risk of stillbirth for all BMI classes except the morbidly obese group. Highest risk was seen in weight-loss groups after 36 completed weeks (normal weight: HR = 18.85 [8.25-43.09]; overweight: HR = 5.87 [2.99-11.55]; obese: HR = 3.44 [2.34-5.05]). Weight loss was associated with reduced stillbirth risk in morbidly obese women between 24 and 28 weeks (HR = 0.56 [0.34-0.95]). Excess weight gain was associated with an increased risk of stillbirth among obese and morbidly obese women, with highest risk after 36 completed weeks (obese: HR = 2.00 [1.55-2.58]; morbidly obese: HR = 3.16 [2.17-4.62]). In contrast, excess weight gain was associated with reduced risk of stillbirth in normal-weight women between 24 and 28 weeks (HR = 0.57 [0.44-0.70]) and in overweight women between 29 and 33 weeks (HR = 0.62 [0.45-0.85]). Analysis for the underweight group was limited by sample size. Both excessive weight gain and inadequate weight gain were not associated with stillbirth in this group. Stillbirth risk increased with inadequate weight gain and weight loss in all BMI classes except the morbidly obese group, where weight demonstrated a protective effect. Conversely, excessive weight gain was associated with higher risk of stillbirth among

Heart rate variability based on risk stratification for type 2 diabetes mellitus.

Science.gov (United States)

Silva-E-Oliveira, Julia; Amélio, Pâmela Marina; Abranches, Isabela Lopes Laguardia; Damasceno, Dênis Derly; Furtado, Fabianne

2017-01-01

To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score and was classified as low risk (n=26), slightly elevated risk (n=41), moderate risk (n=27) and high risk (n=32). To measure heart rate variability, a heart-rate monitor Polar S810i® was employed to obtain RR series for each individual, at rest, for 5 minutes, followed by analysis of linear and nonlinear indexes. The groups at higher risk of type 2 diabetes mellitus had significantly lower linear and nonlinear heart rate variability indexes. The individuals at high risk for type 2 diabetes mellitus have lower heart rate variability. Avaliar a variabilidade da frequência cardíaca em adultos com diferentes níveis de risco para diabetes mellitus tipo 2. O grau de risco para diabetes mellitus tipo 2 de 130 participantes (41 homens) foi avaliado pelo questionário Finnish Diabetes Risk Score. Os participantes foram classificados em baixo risco (n=26), risco levemente elevado (n=41), risco moderado (n=27) e alto risco (n=32). Para medir a variabilidade da frequência cardíaca, utilizou-se o frequencímetro Polar S810i® para obter séries de intervalo RR para cada indivíduo, em repouso, durante 5 minutos; posteriormente, realizou-se análise por meio de índices lineares e não-lineares. O grupo com maior risco para diabetes mellitus tipo 2 teve uma diminuição significante nos índices lineares e não-lineares da variabilidade da frequência cardíaca. Os resultados apontam que indivíduos com risco alto para diabetes mellitus tipo 2 tem menor variabilidade da frequência cardíaca. To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score

[Susceptibility to strategy of the drug component of the IPHCC+RxGroups classification system in a risk-adjusted morbidity compensation scheme--a conceptional and data-supported analysis].

Science.gov (United States)

Behrend, C; Felder, S; Busse, R

2007-01-01

A report commissioned by the German Ministry of Health recommends to the existing scheme for calculating risk-adjusted transfers to sickness funds supplement with the IPHCC+RxGroups method. The method is based on inpatient diagnoses and prescribed drugs as health status measures deduced from prior use. The present study investigates the sickness fund's expected net return from gaming based on the drug component of the risk adjuster. The study explores three possible strategies using the RxGroups method. For the stimulations, insurees are assigned to additional indications or to higher valued RxGroups within the same indication. Then, costs and financial benefits attributable to the altered drug use are estimated and compared with the status quo. The study uses 2000 and 2001 sample data of more than 370,000 insurees of Germany's company-based sickness funds system (BKK). While upgrading increases overall costs, it can be beneficial for the individual sickness funds. Their net return crucially depends on the number of sickness funds gaming the system: the more participating in the game, the smaller is the average net return. Moreover, not participating often is even worse, which in turn points to a prisoner's dilemma. When extending the risk adjustment scheme in social health insurance, the German legislator should take into account the perverse incentives of risk adjusters such as the described prescription drug model.

Learners’ views about cloud computing-based group activities

Directory of Open Access Journals (Sweden)

Yildirim Serkan

2017-01-01

Full Text Available Thanks to its use independently of time and place during the process of software development and by making it easier to access to information with mobile technologies, cloud based environments attracted the attention of education world and this technology started to be used in various activities. In this study, for programming education, the effects of extracurricular group assignments in cloud based environments on learners were evaluated in terms of group work satisfaction, ease of use and user satisfaction. Within the scope of computer programming education lasting eight weeks, a total of 100 students participated in the study including 34 men and 66 women. Participants were divided into groups of at least three people considering the advantages of cooperative learning in programming education. In this study carried out in both conventional and cloud based environments, between groups factorial design was used as research design. The data collected by questionnaires of opinions of group work were examined with quantitative analysis method. According to the study results extracurricular learning activities as group activity created satisfaction. However, perceptions of easy use of the environment and user satisfaction were partly positive. Despite the similar understandings; male participants were easier to perceive use of cloud computing based environments. Some variables such as class level, satisfaction, computer and internet usage time do not have any effect on satisfaction and perceptions of ease of use. Evening class students stated that they found it easy to use cloud based learning environments and became more satisfied with using these environments besides being happier with group work than daytime students.

Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia

Science.gov (United States)

Ly, Sowath; Ouk, Vara; Chanroeurn, Hak; Thavary, Saem; Boroath, Ban; Canestri, Ana; Viretto, Gérald; Delfraissy, Jean-François; Ségéral, Olivier

2016-01-01

Background Lopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity. Methods We carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for > 1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG). Results Of 115 patients enrolled—mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years—40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention. PMID:27579612

Approaching application of risk-based inspection to ASME code section XI

International Nuclear Information System (INIS)

Hedden, Owen F.

1995-01-01

This paper will describe current efforts within the ASME Boiler and Pressure Vessel Committee's Subcommittee on Nuclear Inservice Inspection to introduce risk-based technology to optimize inservice inspection of nuclear power plants. The subcommittee is responsible for the content of ASME Boiler and Pressure Vessel Code Section XI, Rules for Inservice Inspection of Nuclear Power Plant Components. The paper will first provide the historical background for the inspection program currently in Section XI. It will then describe the development of new technology through the ASME Center for Research and Technology Development program. Next, the work now going on in two of the groups under the Section XI committee will be described in detail. Each of these two efforts is directed toward the application of new risk-based inspection technology to nuclear piping systems. Finally, the directions of additional research and applications of the technology will be discussed. (author)

Personalized treatment of women with early breast cancer: a risk-group specific cost-effectiveness analysis of adjuvant chemotherapy accounting for companion prognostic tests OncotypeDX and Adjuvant!Online.

Science.gov (United States)

Jahn, Beate; Rochau, Ursula; Kurzthaler, Christina; Hubalek, Michael; Miksad, Rebecca; Sroczynski, Gaby; Paulden, Mike; Bundo, Marvin; Stenehjem, David; Brixner, Diana; Krahn, Murray; Siebert, Uwe

2017-10-16

Due to high survival rates and the relatively small benefit of adjuvant therapy, the application of personalized medicine (PM) through risk stratification is particularly beneficial in early breast cancer (BC) to avoid unnecessary harms from treatment. The new 21-gene assay (OncotypeDX, ODX) is a promising prognostic score for risk stratification that can be applied in conjunction with Adjuvant!Online (AO) to guide personalized chemotherapy decisions for early BC patients. Our goal was to evaluate risk-group specific cost effectiveness of adjuvant chemotherapy for women with early stage BC in Austria based on AO and ODX risk stratification. A previously validated discrete event simulation model was applied to a hypothetical cohort of 50-year-old women over a lifetime horizon. We simulated twelve risk groups derived from the joint application of ODX and AO and included respective additional costs. The primary outcomes of interest were life-years gained, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness (ICER). The robustness of results and decisions derived were tested in sensitivity analyses. A cross-country comparison of results was performed. Chemotherapy is dominated (i.e., less effective and more costly) for patients with 1) low ODX risk independent of AO classification; and 2) low AO risk and intermediate ODX risk. For patients with an intermediate or high AO risk and an intermediate or high ODX risk, the ICER is below 15,000 EUR/QALY (potentially cost effective depending on the willingness-to-pay). Applying the AO risk classification alone would miss risk groups where chemotherapy is dominated and thus should not be considered. These results are sensitive to changes in the probabilities of distant recurrence but not to changes in the costs of chemotherapy or the ODX test. Based on our modeling study, chemotherapy is effective and cost effective for Austrian patients with an intermediate or high AO risk and an intermediate or high

Flood Risk Assessment Based On Security Deficit Analysis

Science.gov (United States)

Beck, J.; Metzger, R.; Hingray, B.; Musy, A.

Risk is a human perception: a given risk may be considered as acceptable or unac- ceptable depending on the group that has to face that risk. Flood risk analysis of- ten estimates economic losses from damages, but neglects the question of accept- able/unacceptable risk. With input from land use managers, politicians and other stakeholders, risk assessment based on security deficit analysis determines objects with unacceptable risk and their degree of security deficit. Such a risk assessment methodology, initially developed by the Swiss federal authorities, is illustrated by its application on a reach of the Alzette River (Luxembourg) in the framework of the IRMA-SPONGE FRHYMAP project. Flood risk assessment always involves a flood hazard analysis, an exposed object vulnerability analysis, and an analysis combing the results of these two previous analyses. The flood hazard analysis was done with the quasi-2D hydraulic model FldPln to produce flood intensity maps. Flood intensity was determined by the water height and velocity. Object data for the vulnerability analysis, provided by the Luxembourg government, were classified according to their potential damage. Potential damage is expressed in terms of direct, human life and secondary losses. A thematic map was produced to show the object classification. Protection goals were then attributed to the object classes. Protection goals are assigned in terms of an acceptable flood intensity for a certain flood frequency. This is where input from land use managers and politicians comes into play. The perception of risk in the re- gion or country influences the protection goal assignment. Protection goals as used in Switzerland were used in this project. Thematic maps showing the protection goals of each object in the case study area for a given flood frequency were produced. Com- parison between an object's protection goal and the intensity of the flood that touched the object determine the acceptability of the risk and the

Bioassay-based risk assessment of complex mixtures

International Nuclear Information System (INIS)

Donnelly, K.C.; Huebner, H.J.

1996-01-01

The baseline risk assessment often plays an integral role in various decision-making processes at Superfund sites. The present study reports on risk characterizations prepared for seven complex mixtures using biological and chemical analysis. Three of the samples (A, B, and C) were complex mixtures of polycyclic aromatic hydrocarbons (PAHs) extracted from coal tar; while four samples extracted from munitions-contaminated soil contained primarily nitroaromatic hydrocarbons. The chemical-based risk assessment ranked sample C as least toxic, while the risk associated with samples A and B was approximately equal. The microbial bioassay was in general agreement for the coal tar samples. The weighted activity of the coal tar extracts in Salmonella was 4,960 for sample C, and 162,000 and 206,000 for samples A and B, respectively. The bacterial mutagenicity of 2,4,6-trinitrotoluene contaminated soils exhibited an indirect correlation with chemical-based risk assessment. The aqueous extract of sample 004 induced 1,292 net revertants in Salmonella, while the estimated risk to ingestion and dermal adsorption was 2E-9. The data indicate that the chemical-based risk assessment accurately predicted the genotoxicity of the PAHs, while the accuracy of the risk assessment for munitions contaminated soils was limited due to the presence of metabolites of TNT degradation. The biological tests used in this research provide a valuable compliment to chemical analysis for characterizing the genotoxic risk of complex mixtures

Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

12 CFR 652.70 - Risk-based capital level.

Science.gov (United States)

2010-01-01

... risk-based capital level is the sum of the following amounts: (a) Credit and interest rate risk. The... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Risk-based capital level. 652.70 Section 652.70 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FEDERAL AGRICULTURAL MORTGAGE...

Association between ABO and Rh Blood Groups and Risk of Preeclampsia: A Case-Control Study from Iran.

Science.gov (United States)

Aghasadeghi, Firoozeh; Saadat, Mostafa

2017-04-15

Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality. There is a genetic component in the development of PE with estimated heritability around 0.47. Several studies have investigated the association between maternal ABO blood groups (OMIM 110300) and risk of PE, with contradictory results have emerged. Considering that there is no study in this filed from Iranian population, the present case-control study was carried out at Shiraz (south-west Iran). In this study 331 women; 121 pregnant with PE and 210 normotensive pregnant women were included. Using blood group O (for ABO blood groups) or Rh+ (for Rh blood groups) as a reference, odds ratios (ORs) and its 95% confidence intervals (95% CI) of PE risk were estimated from logistic regression analysis. Although the A (OR = 0.67, 95% CI = 0.39-1.17, P = 0.165), B (OR = 0.86, 95% CI = 0.48-1.53, P = 0.615) and AB (OR = 1.14, 95% CI = 0.37-3.45, P = 0.812) phenotypes showed lower risks compared with the O blood group, statistical analysis indicated that there was no significant association between ABO phenotypes and risk of PE. The frequency of Rh- phenotype was higher among PE patients compared with the control group. However, the association was not significant (OR = 1.79, 95% CI = 0.69-4.65, P = 0.229). Adjusted ORs for age of participants and parity did not change the above-mentioned associations. Our present findings indicate that there is no association between ABO and Rh blood groups and risk of PE in Iranian population.

Application of risk-based methods to inservice testing of check valves

Energy Technology Data Exchange (ETDEWEB)

Closky, N.B.; Balkey, K.R.; McAllister, W.J. [and others

1996-12-01

Research efforts have been underway in the American Society of Mechanical Engineers (ASME) and industry to define appropriate methods for the application of risk-based technology in the development of inservice testing (IST) programs for pumps and valves in nuclear steam supply systems. This paper discusses a pilot application of these methods to the inservice testing of check valves in the emergency core cooling system of Georgia Power`s Vogtle nuclear power station. The results of the probabilistic safety assessment (PSA) are used to divide the check valves into risk-significant and less-risk-significant groups. This information is reviewed by a plant expert panel along with the consideration of appropriate deterministic insights to finally categorize the check valves into more safety-significant and less safety-significant component groups. All of the more safety-significant check valves are further evaluated in detail using a failure modes and causes analysis (FMCA) to assist in defining effective IST strategies. A template has been designed to evaluate how effective current and emerging tests for check valves are in detecting failures or in finding significant conditions that are precursors to failure for the likely failure causes. This information is then used to design and evaluate appropriate IST strategies that consider both the test method and frequency. A few of the less safety-significant check valves are also evaluated using this process since differences exist in check valve design, function, and operating conditions. Appropriate test strategies are selected for each check valve that has been evaluated based on safety and cost considerations. Test strategies are inferred from this information for the other check valves based on similar check valve conditions. Sensitivity studies are performed using the PSA model to arrive at an overall IST program that maintains or enhances safety at the lowest achievable cost.

A risk-based sensor placement methodology

International Nuclear Information System (INIS)

Lee, Ronald W.; Kulesz, James J.

2008-01-01

A risk-based sensor placement methodology is proposed to solve the problem of optimal location of sensors to protect population against the exposure to, and effects of, known and/or postulated chemical, biological, and/or radiological threats. Risk is calculated as a quantitative value representing population at risk from exposure at standard exposure levels. Historical meteorological data are used to characterize weather conditions as the frequency of wind speed and direction pairs. The meteorological data drive atmospheric transport and dispersion modeling of the threats, the results of which are used to calculate risk values. Sensor locations are determined via an iterative dynamic programming algorithm whereby threats detected by sensors placed in prior iterations are removed from consideration in subsequent iterations. In addition to the risk-based placement algorithm, the proposed methodology provides a quantification of the marginal utility of each additional sensor. This is the fraction of the total risk accounted for by placement of the sensor. Thus, the criteria for halting the iterative process can be the number of sensors available, a threshold marginal utility value, and/or a minimum cumulative utility achieved with all sensors

Dutch home-based pre-reading intervention with children at familial risk of dyslexia

OpenAIRE

van Otterloo, Sandra G.; van der Leij, Aryan

2009-01-01

Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small effect on a composite score of phoneme awareness (d = 0.29) and a large effect on receptive letter knowledge (d  = 0.88). In first grade, however, t...

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

Science.gov (United States)

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

2017-12-01

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

Area-level poverty and preterm birth risk: A population-based multilevel analysis

Directory of Open Access Journals (Sweden)

Muglia Louis A

2008-09-01

Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

Risk-based configuration control system: Analysis and approaches

International Nuclear Information System (INIS)

Samanta, P.K.; Kim, I.S.; Vesely, W.E.; Lofgren, E.V.

1989-01-01

This paper presents an evaluation of the configuration risks associated with the operation of a nuclear power plant and the approaches to control these risks using risk-based configuration control considerations. In that context, the actual and maximum potential configuration risks at a plant are analyzed and the alternative types criteria for a risk-based configuration control systems are described. The risk-based configuration calculations which are studied here focus on the core-melt frequency impacts from given plant configurations. By calculating the core-melt frequency for given configurations, the configurations which cause large core-melt frequency increases can be identified and controlled. The duration time in which the configuration can exist can then be limited or the core-melt frequency level associated with the configuration can be reduced by various actions. Furthermore, maintenances and tests can be scheduled to avoid the configurations which cause large core-melt frequency increases. Present technical specifications do not control many of these configurations which can cause large core-melt frequency increases but instead focus on many risk-unimportant allowed outage times. Hence, risk-based configuration management can be effectively used to reduce core-melt frequency associated risks at a plant and at the same time can provide flexibility in plant operation. The alternative strategies for controlling the core-melt frequency and other risk contributions include: (1) controlling the increased risk level which is associated with the configuration; (2) controlling the individual configuration risk which is associated with a given duration of a configuration; (3) controlling the time period configuration risk from configurations which occur in a time period

Integrating scientific and local knowledge to inform risk-based management approaches for climate adaptation

Directory of Open Access Journals (Sweden)

Nathan P. Kettle

2014-01-01

Full Text Available Risk-based management approaches to climate adaptation depend on the assessment of potential threats, and their causes, vulnerabilities, and impacts. The refinement of these approaches relies heavily on detailed local knowledge of places and priorities, such as infrastructure, governance structures, and socio-economic conditions, as well as scientific understanding of climate projections and trends. Developing processes that integrate local and scientific knowledge will enhance the value of risk-based management approaches, facilitate group learning and planning processes, and support the capacity of communities to prepare for change. This study uses the Vulnerability, Consequences, and Adaptation Planning Scenarios (VCAPS process, a form of analytic-deliberative dialogue, and the conceptual frameworks of hazard management and climate vulnerability, to integrate scientific and local knowledge. We worked with local government staff in an urbanized barrier island community (Sullivan’s Island, South Carolina to consider climate risks, impacts, and adaptation challenges associated with sea level rise and wastewater and stormwater management. The findings discuss how the process increases understanding of town officials’ views of risks and climate change impacts to barrier islands, the management actions being considered to address of the multiple impacts of concern, and the local tradeoffs and challenges in adaptation planning. We also comment on group learning and specific adaptation tasks, strategies, and needs identified.

Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

Directory of Open Access Journals (Sweden)

Islam Md Mofizul

2007-10-01

Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

A comparative analysis of cardiovascular disease risk profiles of five Pacific ethnic groups assessed in New Zealand primary care practice: PREDICT CVD-13.

Science.gov (United States)

Grey, Corina; Wells, Sue; Riddell, Tania; Pylypchuk, Romana; Marshall, Roger; Drury, Paul; Elley, Raina; Ameratunga, Shanthi; Gentles, Dudley; Erick-Peletiy, Stephanie; Bell, Fionna; Kerr, Andrew; Jackson, Rod

2010-11-05

Data on the cardiovascular disease risk profiles of Pacific peoples in New Zealand is usually aggregated and treated as a single entity. Little is known about the comparability or otherwise of cardiovascular disease (CVD) risk between different Pacific groups. To compare CVD risk profiles for the main Pacific ethnic groups assessed in New Zealand primary care practice to determine if it is reasonable to aggregate these data, or if significant differences exist. A web-based clinical decision support system for CVD risk assessment and management (PREDICT) has been implemented in primary care practices in nine PHOs throughout Auckland and Northland since 2002, covering approximately 65% of the population of these regions. Between 2002 and January 2009, baseline CVD risk assessments were carried out on 11,642 patients aged 35-74 years identifying with one or more Pacific ethnic groups (4933 Samoans, 1724 Tongans, 1366 Cook Island Maori, 880 Niueans, 1341 Fijians and 1398 people identified as Other Pacific or Pacific Not Further Defined). Fijians were subsequently excluded from the analyses because of a probable misclassification error that appears to combine Fijian Indians with ethnic Fijians. Prevalences of smoking, diabetes and prior history of CVD, as well as mean total cholesterol/HDL ratio, systolic and diastolic blood pressures, and Framingham 5-year CVD risk were calculated for each Pacific group. Age-adjusted risk ratios and mean differences stratified by gender were calculated using Samoans as the reference group. Cook Island women were almost 60% more likely to smoke than Samoan women. While Tongan men had the highest proportion of smoking (29%) among Pacific men, Tongan women had the lowest smoking proportion (10%) among Pacific women. Tongan women and Niuean men and women had a higher burden of diabetes than other Pacific ethnic groups, which were 20-30% higher than their Samoan counterparts. Niuean men and women had lower blood pressure levels than all

Blocking the benefit of group-based HIV-prevention efforts during adolescence: the problem of HIV-related stigma.

Science.gov (United States)

Barker, David H; Swenson, Rebecca R; Brown, Larry K; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Diclemente, Ralph J; Salazar, Laura F; Romer, Daniel

2012-04-01

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study.

Science.gov (United States)

Cadmus-Bertram, Lisa; Nelson, Sandahl H; Hartman, Sheri; Patterson, Ruth E; Parker, Barbara A; Pierce, John P

2016-08-01

Excess weight and physical inactivity are modifiable risk factors for breast cancer. Behavioral intervention is particularly important among women with an elevated risk profile. This trial tested an intervention that trained women to use a self-monitoring website to increase activity and lose weight. Women with BMI ≥27.5 kg/m(2) at elevated breast cancer risk were randomized to the intervention (N = 71) or usual care (N = 34). The intervention group received telephone-based coaching and used web-based self-monitoring tools. At 6 months, significant weight loss was observed in the intervention group (4.7 % loss from starting weight; SD = 4.7 %) relative to usual care (0.4 % gain; SD = 3.0 %) (p web- and phone-based approach produced modest but significant improvements in weight and physical activity for women at elevated breast cancer risk.

Effectiveness of Neuromuscular Training Based on the Neuromuscular Risk Profile.

Science.gov (United States)

Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

2017-07-01

The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown. Purpose/Hypotheses: To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries. Controlled laboratory study. Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II). TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.

Risk-based performance indicators

International Nuclear Information System (INIS)

Azarm, M.A.; Boccio, J.L.; Vesely, W.E.; Lofgren, E.

1987-01-01

The purpose of risk-based indicators is to monitor plant safety. Safety is measured by monitoring the potential for core melt (core-melt frequency) and the public risk. Targets for these measures can be set consistent with NRC safety goals. In this process, the performance of safety systems, support systems, major components, and initiating events can be monitored using measures such as unavailability, failure or occurrence frequency. The changes in performance measures and their trends are determined from the time behavior of monitored measures by differentiation between stochastical and actual variations. Therefore, degradation, as well as improvement in the plant safety performance, can be determined. The development of risk-based performance indicators will also provide the means to trace a change in the safety measures to specific problem areas which are amenable to root cause analysis and inspection audits. In addition, systematic methods will be developed to identify specific improvement policies using the plant information system for the identified problem areas. The final product of the performance indicator project will be a methodology, and an integrated and validated set of software packages which, if properly interfaced with the logic model software of a plant, can monitor the plant performance as plant information is provided as input

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

Science.gov (United States)

Muzik, Maria; Rosenblum, Katherine L; Alfafara, Emily A; Schuster, Melisa M; Miller, Nicole M; Waddell, Rachel M; Stanton Kohler, Emily

2015-06-01

Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate

Risk-based decision making for terrorism applications.

Science.gov (United States)

Dillon, Robin L; Liebe, Robert M; Bestafka, Thomas

2009-03-01

This article describes the anti-terrorism risk-based decision aid (ARDA), a risk-based decision-making approach for prioritizing anti-terrorism measures. The ARDA model was developed as part of a larger effort to assess investments for protecting U.S. Navy assets at risk and determine whether the most effective anti-terrorism alternatives are being used to reduce the risk to the facilities and war-fighting assets. With ARDA and some support from subject matter experts, we examine thousands of scenarios composed of 15 attack modes against 160 facility types on two installations and hundreds of portfolios of 22 mitigation alternatives. ARDA uses multiattribute utility theory to solve some of the commonly identified challenges in security risk analysis. This article describes the process and documents lessons learned from applying the ARDA model for this application.

Strategies and criteria for risk-based configuration control

International Nuclear Information System (INIS)

Samanta, P.K.; Kim, I.S.; Vesely, W.E.

1991-01-01

A configuration, as used here, is a set of component operability or statuses that define the state of a nuclear power plant. Risk-based configuration control is the management of component configurations using a risk perspective to control risk and assure safety. If the component configurations that have high risk implications do not occur then the risk from the operation of nuclear power plants would be minimal. The control of component configurations, i.e., the management of component statuses, so that the risk from components being unavailable is minimized, becomes difficult because the status of a standby safety system component is often not apparent unless it is tested. In this paper, we discuss the strategies and criteria for risk-based configuration control in nuclear power plants. In developing these strategies and criteria, the primary objective is to obtain more direct risk control but the added benefit is the effective use of plant resources. Implementation of such approaches can result in replacement/modification of parts of Technical Specifications. Specifically, the risk impact or safety impact of a configuration depends upon four factors: (1) The configuration components which are simultaneously down (i.e., inoperable); (2) the backup components which are known to be up (i.e., operable); (3) the duration of time the configuration exists (the outage time); and (4) the frequency at which the configuration occurs. Risk-based configuration control involves managing these factors using risk analyses and risk insights. In this paper, we discuss each of the factors and illustrate how they can be controlled. The information and the tools needed in implementing configuration control are also discussed. The risk-based calculation requirements in achieving the control are also delineated. 4 refs., 4 figs., 1 tab

Risk of leukemia among survivors of testicular cancer: a population-based study of 42,722 patients

DEFF Research Database (Denmark)

Howard, R.; Gilbert, E.; Lynch, C.F.

2008-01-01

PURPOSE: The aim of this study is to quantify excess absolute risk (EAR) and excess relative risk (ERR) of secondary leukemia among a large population-based group of testicular cancer survivors. METHODS: We identified 42,722 1-year survivors of testicular cancer within 14 population-based cancer...... registries in Europe and North America (1943-2002). Poisson regression analysis was used to model EAR (per 100,000 person-years [PY]) and ERR of secondary leukemia. Cumulative risks were calculated using a competing risk model. RESULTS: Secondary leukemia developed in 89 patients (EAR = 10.8 per 100,000 PY......, 95% confidence interval [CI] = 7.6-14.6; ERR = 1.6, 95%CI = 1.0-2.2). Statistically significantly elevated risks were observed for acute myeloid leukemia (AML) (EAR = 7.2, 95%CI = 4.7-10.2) and acute lymphoblastic leukemia (EAR = 1.3, 95%CI = 0.4-2.8). In multivariate analyses, AML risk was higher...

Risk-based decision making and risk management of European Union regional programs

Directory of Open Access Journals (Sweden)

Michalopoulos Evangelos

2008-01-01

Full Text Available This paper presents a generalized method for management decision making incorporating risk assessment techniques. The risk based decision making methodology is applied to European Union expenditure programs used to implement its regional policy, such as the community support framework, community initiatives, special initiatives and other European policies. An example is presented for the development of an audit (inspection program in the region of West Macedonia, Greece, during the implementation of the 3rd Community Structural Support Framework Operational Program. The generic nature of the method permits its use in the management of similar European regional programs in Greece and other European countries. It is also applicable to many other industries interested in applying risk-based management decisions to physical or process based systems. .

A Policy Intervention Study to Identify High-Risk Groups to Prevent Industrial Accidents in Republic of Korea.

Science.gov (United States)

Yi, Kwan Hyung; Lee, Seung Soo

2016-09-01

The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

Summary Record of the 15th Meeting of the Working Group on Risk Assessment (WGRISK)

International Nuclear Information System (INIS)

2015-01-01

The main mission of the working group on risk assessment (WGRISK) is to advance the understanding and utilisation of probabilistic safety assessment (PSA) in ensuring the continued safety of nuclear installations in member countries. While PSA methodology has matured greatly over the years, further work is required. WGRISK has been active in several of these areas, including: human reliability; software reliability; low power and shutdown risk. In order to maintain a current perspective, the working group collaborates and assists other working groups within the CSNI, such as operating experience and organisational factors as well as keeping close co-ordination with other international organisations. Over the past twenty years, the NEA PWG5 and now WGRISK have looked at the technology and methods used for identifying contributors to risk and assessing their importance. Work during much of this period was concentrated on Level-1 PSA methodology. In recent years the focus has shifted into more specific PSA methodologies and risk-informed applications. This document summarizes the content of the 15. Meeting of WGRISK: - presentation of the new WGRISK Bureau, - Approval of the 14. WGRISK Meeting Summary Record [NEA/SEN/SIN/WGRISK (2013)1], - Use and Development of PSA in NEA Member Countries and by other International Organisations, - Report by the WGRISK Secretariat on the current WGRISK programme of work, actions taken by CSNI and CNRA and other recent developments in OECD/NEA, - Development of BPGs on failure mode taxonomy for reliability assessment of digital I and C systems for PSA [Task 2010-3], - Update Use of OECD Data Project Products in PSA [Task 2011-1], - Status report on the common WGHOF/WGRISK HRA Task, - Outcome on the International Workshop on PSA of Natural External Hazards Including Earthquakes, April 2014 [Task 2012-1], - Status report on the International Workshop on Fire PRA [Task 2012-2], - PSA insights relating to the loss of electrical sources

Effects of a general practice-based intervention on diet, body mass index and blood lipids in patients at cardiovascular risk

NARCIS (Netherlands)

Woollard, J.; Burke, V.; Beilin, L.J.; Verheijden, M.W.; Bulsara, M.K.

2003-01-01

Background General practice-based health-promotion programmes implemented by nurse-counsellors may reduce cardiovascular risk factors, particularly in patients at increased risk. Neither change in fat intake nor serum cholesterol differed significantly between groups. Body mass index increased in

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

Science.gov (United States)

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

2009-10-01

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

The joint effects of risk status, gender, early literacy and cognitive skills on the presence of dyslexia among a group of high-risk Chinese children.

Science.gov (United States)

Wong, Simpson W L; McBride-Chang, Catherine; Lam, Catherine; Chan, Becky; Lam, Fanny W F; Doo, Sylvia

2012-02-01

This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by paediatricians. The age-5 performances on various literacy and cognitive tasks, gender and group status (familial risk or language delayed) were used to predict developmental dyslexia 2 years later using logistic regression analysis. Results showed that greater risk of dyslexia was related to slower rapid automatized naming, lower scores on morphological awareness, Chinese character recognition and English letter naming, and gender (boys had more risk). Three logistic equations were generated for estimating individual risk of dyslexia. The strongest models were those that included all print-related variables (including speeded number naming, character recognition and letter identification) and gender, with about 70% accuracy or above. Early identification of those Chinese children at risk for dyslexia can facilitate better dyslexia risk management. Copyright © 2012 John Wiley & Sons, Ltd.

RiskREP: Risk-Based Security Requirements Elicitation and Prioritization (extended version)

NARCIS (Netherlands)

Herrmann, Andrea; Morali, A.

2010-01-01

Today, companies are required to be in control of the security of their IT assets. This is especially challenging in the presence of limited budgets and conflicting requirements. Here, we present Risk-Based Requirements Elicitation and Prioritization (RiskREP), a method for managing IT security

The prostate cancer risk stratification (ProCaRS) project: Recursive partitioning risk stratification analysis

International Nuclear Information System (INIS)

Rodrigues, George; Lukka, Himu; Warde, Padraig; Brundage, Michael; Souhami, Luis; Crook, Juanita; Cury, Fabio; Catton, Charles; Mok, Gary; Martin, Andre-Guy; Vigneault, Eric; Morris, Jim; Warner, Andrew; Gonzalez Maldonado, Sandra; Pickles, Tom

2013-01-01

Background: The Genitourinary Radiation Oncologists of Canada (GUROC) published a three-group risk stratification (RS) system to assist prostate cancer decision-making in 2001. The objective of this project is to use the ProCaRS database to statistically model the predictive accuracy and clinical utility of a proposed new multi-group RS schema. Methods: The RS analyses utilized the ProCaRS database that consists of 7974 patients from four Canadian institutions. Recursive partitioning analysis (RPA) was utilized to explore the sub-stratification of groups defined by the existing three-group GUROC scheme. 10-fold cross-validated C-indices and the Net Reclassification Index were both used to assess multivariable models and compare the predictive accuracy of existing and proposed RS systems, respectively. Results: The recursive partitioning analysis has suggested that the existing GUROC classification system could be altered to accommodate as many as six separate and statistical unique groups based on differences in BFFS (C-index 0.67 and AUC 0.70). GUROC low-risk patients would be divided into new favorable-low and low-risk groups based on PSA ⩽6 and PSA >6. GUROC intermediate-risk patients can be subclassified into low-intermediate and high-intermediate groups. GUROC high-intermediate-risk is defined as existing GUROC intermediate-risk with PSA >=10 AND either T2b/c disease or T1T2a disease with Gleason 7. GUROC high-risk patients would be subclassified into an additional extreme-risk group (GUROC high-risk AND (positive cores ⩾87.5% OR PSA >30). Conclusions: Proposed RS subcategories have been identified by a RPA of the ProCaRS database

Sero-epidemiological study of Lyme disease among high-risk population groups in eastern Slovakia.

Science.gov (United States)

Zákutná, Ľubica; Dorko, Erik; Mattová, Eva; Rimárová, Kvetoslava

2015-01-01

IIntroduction and objective. The aim of the presented cross-sectional sero-epidemiological study was to determine the current presence of antibodies against B. burgdorferi s.l. in the high-risk groups of the Slovak population, and to identify potential risk factors to LB infections. A group of 277 agricultural and forestry workers - persons with frequent stay in the countryside and employees of State Border and Customs Police - from years 2011-2012 in the Eastern Slovakia were examined in order to assess the seroprevalence of anti-Borrelia antibodies. Sera were screened by commercial enzyme-linked immunosorbent assay (ELISA). The study subjects completed a questionnaires with general demographic, epidemiological and clinical data. The results were evaluated statistically. A 25.3% presence of positive and 8.7% presence of borderline IgG antibodies was detected in all investigated groups. The seroprevalence of B. burgdorferi s.l. was significantly higher (P<0.05) among the agricultural and forestry workers when compared to employees of State Border and Customs Police. Higher seropositivity was observed in older subjects over 30 years of age (P=0.004) than those who were younger, and also in males (P=0.045). A significant number of persons with rheumatologic conditions was statistically higher (P=0.020) in the group with seropositivity than in the group with seronegativity. The presented study confirms the higher risk of Borrelia infection in individuals with frequent exposure to ticks in eastern Slovakia. The seropositivity tests confirmed the highest seropositivity in agriculture and forestry workers, middle positivity was confirmed among other sector workers, and lowest positivity in policemen and employees of the Customs and Border Inspection. The outputs also simultaneously filling the gap of missing seroprevalence data among these exposed groups.

12 CFR 932.3 - Risk-based capital requirement.

Science.gov (United States)

2010-01-01

... credit risk capital requirement, its market risk capital requirement, and its operations risk capital... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk-based capital requirement. 932.3 Section 932.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND...

The prevalence of metabolic syndrome and cardiovascular risk factors in a group of obese Saudi children and adolescents: A hospital-based

International Nuclear Information System (INIS)

Taha, Doris; Ahmed, Omaima; Sadiq Bakr bin

2009-01-01

We assessed the distribution of risk factors associated with the metabolic syndrome in a group of obese Saudi children and adolescents. No previous studies had addressed this issue in the Saudi pediatric population. We retrospectively reviewed the medical records of patients evaluated for obesity between 2004 and 2008 and collected data on age, weight, height, body mass index (BMI), BP, fasting lipid profile, fasting glucose, insulin concentrations, and insulin resistance based on the homeostasis assessment model-insulin resistance (HOMA-IR) score. Obesity was defined as a BMI above the 95th percentile for age and gender and metabolic syndrome was diagnosed according to standard criteria. We studied 57 obese Saudi children and adolescents with a mean (standard deviation) age of 9.8 (3.5) years. Mean weight and body mass index (BMI) were 63.7 (28.3) kg and 31.6 (8.0) kg/m 2 , respectively. Systolic BP was elevated in 24 (42%) of the 57 subjects. Of the 39 children who had a lipid profile in their records, 10 had hypertriglyceridemia, 8 had hypercholesterolemia, 6 had elevated LDL cholesterol levels, and 6 had low HDL cholesterol levels. Impaired fasting glucose was found in 10 of 38 patients in which it was measured, and 9 of 25 patients had fasting hyperinsulinemia. Eleven of 37 patients (29.7%) met the diagnosis of the metabolic syndrome. Diastolic BP correlated positively with BMI (r=0.440, P =.001), and HDL cholesterol correlated negatively with weight and BMI (r=-0.487, P =.002 and r=-0.317, P =.05). HOMA-IR correlated positively with BMI and triglyceride levels and negatively with HDL cholesterol levels. Obese Saudi children and adolescents have multiple risk factors associated with metabolic syndrome. (author)

Risk associated with toxic blooms of marine phytoplankton functional groups on Artemia franciscana

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Ana D’ors

2014-08-01

Full Text Available Objective: To study mortality of copepod Artemia franciscana against the occurrence of harmful marine algae and possible toxicological changes exhibited by binary and tertiary combinations of these harmful algae toxins. Methods: Tweenty four hours acute toxicity assays were performed with selected concentrations of Alexandrium minutum, Prorocentrum lima and Nitzschia N1c1 living cells. Additionally, the results were analyzed using the median-effect/combination index (CI-isobologram equation to assess possible changes in the toxic effect induced by phytoplankton functional groups. Results: Biotoxin equivalent values obtained by immunodetection were (2.12±0.10, (8.60±1.30 and (4.32±1.67 pg/cell for saxitoxin, okadaic acid and domoic acid, respectively. The 24-h LC50 values estimated to saxitoxin and okadaic acid equivalents were 4.06 and 6.27 µg/L, significantly below the value obtained for Nitzschia N1c1, which was established at 467.33 µg/L. CI analysis applied on phytoplankton assemblages showed that both ternary mixture as the binary combinations exhibited antagonic action on toxic effects in Artemia nauplii, which were significantly lower than the toxic effect exhibited by each species studied. Conclusions: These results show that, although these harmful algae represent a serious risk to estuarine zooplankton community, the presence of phytoplankton functional groups within the same bloom can reduce the potential risk compared to the expected risk when each of the phytoplankton groups are evaluated individually.