WorldWideScience

Sample records for risk reduction mid-term

  1. Effectiveness of a combination prevention strategy for HIV risk reduction with men who have sex with men in Central America: a mid-term evaluation.

    Science.gov (United States)

    Firestone, Rebecca; Rivas, Jorge; Lungo, Susana; Cabrera, Alejandra; Ruether, Susan; Wheeler, Jennifer; Vu, Lung

    2014-12-04

    Despite over a decade of research and programming, little evidence is available on effective strategies to reduce HIV risks among Central American men who have sex with men (MSM). The Pan-American Social Marketing Organization (PASMO) and partners are implementing a HIV Combination Prevention Program to provide key populations with an essential package of prevention interventions and services: 1) behavioral, including interpersonal communications, and online outreach; 2) biomedical services including HIV testing and counseling and screening for STIs; and 3) complementary support, including legal support and treatment for substance abuse. Two years into implementation, we evaluated this program's effectiveness for MSM by testing whether exposure to any or a combination of program components could reduce HIV risks. PASMO surveyed MSM in 10 cities across Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama in 2012 using respondent-driven sampling. We used coarsened exact matching to create statistically equivalent groups of men exposed and non-exposed to the program, matching on education, measures of social interaction, and exposure to other HIV prevention programs. We estimated average treatment effects of each component and all combined to assess HIV testing and condom use outcomes, using multivariable logistic regression. We also linked survey data to routine service data to assess program coverage. Exposure to any program component was 32% in the study area (n = 3531). Only 2.8% of men received all components. Men exposed to both behavioral and biomedical components were more likely to use condoms and lubricant at last sex (AOR 3.05, 95% CI 1.08, 8.64), and those exposed to behavioral interventions were more likely to have tested for HIV in the past year (AOR 1.76, 95% CI 1.01, 3.10). PASMO's strategies to reach MSM with HIV prevention programming are still achieving low levels of population coverage, and few men are receiving the complete essential

  2. Land-Based Mitigation Strategies under the Mid-Term Carbon Reduction Targets in Indonesia

    Directory of Open Access Journals (Sweden)

    Tomoko Hasegawa

    2016-12-01

    Full Text Available We investigated the key mitigation options for achieving the mid-term target for carbon emission reduction in Indonesia. A computable general equilibrium model coupled with a land-based mitigation technology model was used to evaluate specific mitigation options within the whole economic framework. The results revealed three primary findings: (1 If no climate policy were implemented, Indonesia’s total greenhouse gas emissions would reach 3.0 GtCO2eq by 2030; (2 To reduce carbon emissions to meet the latest Intended Nationally-Determined Contributions (INDC target, ~58% of total reductions should come from the agriculture, forestry and other land use sectors by implementing forest protection, afforestation and plantation efforts; (3 A higher carbon price in 2020 suggests that meeting the 2020 target would be economically challenging, whereas the INDC target for 2030 would be more economically realistic in Indonesia.

  3. Density prediction and dimensionality reduction of mid-term electricity demand in China: A new semiparametric-based additive model

    International Nuclear Information System (INIS)

    Shao, Zhen; Yang, Shan-Lin; Gao, Fei

    2014-01-01

    Highlights: • A new stationary time series smoothing-based semiparametric model is established. • A novel semiparametric additive model based on piecewise smooth is proposed. • We model the uncertainty of data distribution for mid-term electricity forecasting. • We provide efficient long horizon simulation and extraction for external variables. • We provide stable and accurate density predictions for mid-term electricity demand. - Abstract: Accurate mid-term electricity demand forecasting is critical for efficient electric planning, budgeting and operating decisions. Mid-term electricity demand forecasting is notoriously complicated, since the demand is subject to a range of external drivers, such as climate change, economic development, which will exhibit monthly, seasonal, and annual complex variations. Conventional models are based on the assumption that original data is stable and normally distributed, which is generally insignificant in explaining actual demand pattern. This paper proposes a new semiparametric additive model that, in addition to considering the uncertainty of the data distribution, includes practical discussions covering the applications of the external variables. To effectively detach the multi-dimensional volatility of mid-term demand, a novel piecewise smooth method which allows reduction of the data dimensionality is developed. Besides, a semi-parametric procedure that makes use of bootstrap algorithm for density forecast and model estimation is presented. Two typical cases in China are presented to verify the effectiveness of the proposed methodology. The results suggest that both meteorological and economic variables play a critical role in mid-term electricity consumption prediction in China, while the extracted economic factor is adequate to reveal the potentially complex relationship between electricity consumption and economic fluctuation. Overall, the proposed model can be easily applied to mid-term demand forecasting, and

  4. Perception of Radiation Risk as a Predictor of Mid-Term Mental Health after a Nuclear Disaster: The Fukushima Health Management Survey.

    Science.gov (United States)

    Miura, Itaru; Nagai, Masato; Maeda, Masaharu; Harigane, Mayumi; Fujii, Senta; Oe, Misari; Yabe, Hirooki; Suzuki, Yuriko; Takahashi, Hideto; Ohira, Tetsuya; Yasumura, Seiji; Abe, Masafumi

    2017-09-15

    Predictive factors including risk perception for mid-term mental health after a nuclear disaster remain unknown. The purpose of this study was to examine the association between perceived radiation risk and other factors at baseline and mid-term mental health after the Fukushima Daiichi nuclear disaster of 2011 in Japan. A mail-based questionnaire survey was conducted in January 2012 and January 2013. Mental health status was assessed using the K6 scale. Psychological distress over the 2-year period was categorized into the following four groups: chronic, recovered, resistant, or worsened. Most participants (80.3%) were resistant to the disaster. A positive association was found between the radiation risk perception regarding immediate effects and the worsened group in women. Baseline post-traumatic stress disorder (PTSD) or a history of psychiatric disease predicted being in the chronic or worsened group in mid-term course. These results suggest that evacuees who believed that their health was substantially affected by the nuclear disaster were at an increased risk of having poor mid-term mental health in women. Careful assessment of risk perception after a nuclear disaster, including the presence of PTSD or a history of psychiatric disease, is needed for appropriate interventions.

  5. Mid-term results of zone 0 thoracic endovascular aneurysm repair after ascending aorta wrapping and supra-aortic debranching in high-risk patients.

    Science.gov (United States)

    Pecoraro, Felice; Lachat, Mario; Hofmann, Michael; Cayne, Neal S; Chaykovska, Lyubov; Rancic, Zoran; Puippe, Gilbert; Pfammatter, Thomas; Mangialardi, Nicola; Veith, Frank J; Bettex, Dominique; Maisano, Francesco; Neff, Thomas A

    2017-06-01

    with complex thoracic aorta disease is safe and shows promising mid-term results at 3 years. The combination of these techniques could represent an alternative to the standard open surgical repair, especially in older patients or in patients unfit for cardiopulmonary bypass. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. QUIESST: mid-term progress report

    NARCIS (Netherlands)

    Clairbois, J.-P.; Roo, F. de; Garai, M.; Conter, M.; Defrance, J.; Oltean-Dumbrava, C.; Fusco, I.

    2011-01-01

    The research QUIESST (QUIetening the Environment of Sustainable Surface Transport) successfully started in November 2009 for 36 months, its objectives and work schedule have already been presented at the INTERNOISE 2010 Congress. This paper will present the progress report at mid-term (18 months):

  7. Second mid-term business plan results

    International Nuclear Information System (INIS)

    Kusakabe, Masashi; Matsushita, Satoru; Miyahara, Nobuyuki

    2011-01-01

    This feature presented the second mid-term business plan results of National Institute of Radiological Sciences (NIRS). NIRS started its second five-year-term project in 2006, focusing on radiation life science research, and radiation protection and emergency medicine. The radiation life science research had been conducted at research centers on heavy charged particle therapy for cancer treatment, assessment of radiation effects for radiotherapy, and molecular imaging for early diagnosis and treatment planning. NIRS also provided international open laboratory for experts of many fields to collaborate to enhance the levels of radiological sciences. Fundamental technology center had supported research centers through technology development. (T. Tanaka)

  8. Mid term report for IDEAL project

    DEFF Research Database (Denmark)

    Bellini, Anna

    2004-01-01

    The main objective of this report is to describe the progresses in the WP4 achived at the mid term of the IDEAL project. The main objective of work package 4 is threefold: Firstly, obtaining a reliable forecast of the residual stresses and strains directly from the casting simulation. For this pu...... of the casting simulation, the heat treatment simulation as well as a possible subsequent load analysis together and thereby addressing the entire CAE-chain........ For this purpose the process simulation must include a thorough thermomechanical analysis itself. This is already possible in the FV-based process optimisation tool MAGMAsoft, although it is further being developed in the work package with respect to the constitutive description of the aluminium parts at high...... temperatures. Secondly, establishing a reliable model for the thermomechanical conditions during the subsequent heat treatment of the cast aluminium parts. In this process, several approaches involving both simple visco-plastic models as well as more complex unified models are taken. Thirdly, coupling...

  9. CCAA Mid Term Review | CRDI - Centre de recherches pour le ...

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

    7 janv. 2011 ... ... been prepared by four scientists tasked with evaluating, measuring and reporting on the performance of the Programme to date, suggesting adjustments and commenting on the appropriateness of the current time frame. Download the File: Mid-Term Review of CCAA programme Executive Summary.doc ...

  10. Subintimal angioplasty in femoropopliteal region-Mid-term results

    International Nuclear Information System (INIS)

    Koecher, Martin; Cerna, Marie; Utikal, Petr; Kozak, Jiri; Sisola, Ivan; Thomas, Rohit P.; Bachleda, Petr; Drac, Petr; Sekanina, Zdenek; Langova, Katerina

    2010-01-01

    Purpose: Subintimal angioplasty is becoming more frequently used treatment option for patients with long arterial occlusions or diffuse atherosclerotic changes as an alternative to surgical treatment in claudicants especially in patients with critical limb ischemia. The aim of our article is to retrospectively assess mid-term outcomes of subintimal angioplasty of chronic arterial occlusions in femoropopliteal region followed clinically and by Doppler ultrasonography. Materials and methods: From May 2002 to December 2007, 133 femoropopliteal artery occlusions in 123 patients were indicated for subintimal recanalisation. The indications for treatment were intermittent claudications in 84 patients (63.15%) and critical limb ischemia in 49 patients (36.85%). The median length of lesions was 11.4 cm, range 2-30 cm. Except doppler ultrasonographic examination done 24 h after the procedure and clinical examination before discharge, both clinical and ultrasonographic examinations were performed 6 and 12 months after the procedure and yearly thereafter. Statistical analysis of our cohort was performed by Kaplan-Meier analysis, log-rank test and Cox regression. Results: Technical success was achieved in 86.46%. Primary patency rate was 83.1% (SE: 3.9%), 67.5% (SE: 5%), 58% (SE: 5.9%) a 48.4% (SE: 7.1%) at 6, 12, 24 and 36 months respectively. No statistically significant difference of primary patency was found between the group of claudicants and the group of patient with critical limb ischemia. Statistically significant prediction factors for primary patency were only the quality of the run off and the length of the occlusion. Limb salvage rate in our group of patients with critical limb ischemia was 80.8% at 12 months. Conclusion: Subintimal recanalisation is a simple and safe procedure for treatment of chronic peripheral arterial occlusions with high primary technical success rate, acceptable primary patency rate, low percentage of complications and mortality is as low as

  11. Mid-term evaluation of ten National Research schools

    DEFF Research Database (Denmark)

    Gustafsson, Göran; Dahl, Hanne Marlene; Gustafsson, Christina

    the scheme was launched, the Research Council has issued three calls for proposals and allocated grants to a total of 22 national research schools. Five were started up in 2009, ten in 2013 and seven in 2015. A Nordic scientific programme committee was appointed in 2013, with responsibility for assessing...... grant applications, monitoring the progress of the FORSKERSKOLER scheme and serving as the evaluation panel for the mid-term evaluation in 2013 and in 2016/2017. The task of the evaluation panel has been to: 1) evaluate the quality of and progress achieved by the ten research schools which were awarded...... funding in 2012 and launched in 2013; and 2) to provide recommendations as to whether funding should be continued to cover the full eight-year period or terminated after five years. Continued funding is recommended for all ten schools to cover the full eight-year period, according to the proposed budget...

  12. Virtual power plant mid-term dispatch optimization

    International Nuclear Information System (INIS)

    Pandžić, Hrvoje; Kuzle, Igor; Capuder, Tomislav

    2013-01-01

    Highlights: ► Mid-term virtual power plant dispatching. ► Linear modeling. ► Mixed-integer linear programming applied to mid-term dispatch scheduling. ► Operation profit maximization combining bilateral contracts and the day-ahead market. -- Abstract: Wind power plants incur practically zero marginal costs during their operation. However, variable and uncertain nature of wind results in significant problems when trying to satisfy the contracted quantities of delivered electricity. For this reason, wind power plants and other non-dispatchable power sources are combined with dispatchable power sources forming a virtual power plant. This paper considers a weekly self-scheduling of a virtual power plant composed of intermittent renewable sources, storage system and a conventional power plant. On the one hand, the virtual power plant needs to fulfill its long-term bilateral contracts, while, on the other hand, it acts in the market trying to maximize its overall profit. The optimal dispatch problem is formulated as a mixed-integer linear programming model which maximizes the weekly virtual power plant profit subject to the long-term bilateral contracts and technical constraints. The self-scheduling procedure is based on stochastic programming. The uncertainty of the wind power and solar power generation is settled by using pumped hydro storage in order to provide flexible operation, as well as by having a conventional power plant as a backup. The efficiency of the proposed model is rendered through a realistic case study and analysis of the results is provided. Additionally, the impact of different storage capacities and turbine/pump capacities of pumped storage are analyzed.

  13. Software for Probabilistic Risk Reduction

    Science.gov (United States)

    Hensley, Scott; Michel, Thierry; Madsen, Soren; Chapin, Elaine; Rodriguez, Ernesto

    2004-01-01

    A computer program implements a methodology, denoted probabilistic risk reduction, that is intended to aid in planning the development of complex software and/or hardware systems. This methodology integrates two complementary prior methodologies: (1) that of probabilistic risk assessment and (2) a risk-based planning methodology, implemented in a prior computer program known as Defect Detection and Prevention (DDP), in which multiple requirements and the beneficial effects of risk-mitigation actions are taken into account. The present methodology and the software are able to accommodate both process knowledge (notably of the efficacy of development practices) and product knowledge (notably of the logical structure of a system, the development of which one seeks to plan). Estimates of the costs and benefits of a planned development can be derived. Functional and non-functional aspects of software can be taken into account, and trades made among them. It becomes possible to optimize the planning process in the sense that it becomes possible to select the best suite of process steps and design choices to maximize the expectation of success while remaining within budget.

  14. Absolute risk, absolute risk reduction and relative risk

    Directory of Open Access Journals (Sweden)

    Jose Andres Calvache

    2012-12-01

    Full Text Available This article illustrates the epidemiological concepts of absolute risk, absolute risk reduction and relative risk through a clinical example. In addition, it emphasizes the usefulness of these concepts in clinical practice, clinical research and health decision-making process.

  15. A mid-term report for LS1

    CERN Multimedia

    2014-01-01

    As the LHC’s first long shutdown, LS1, enters its second calendar year, it’s a good time for a mid-term report on how things are progressing.    Towards the end of last year, I had the pleasure to go down to the LHC tunnel to witness the closure of the first of the machine’s sectors to be completed. As I write, three sectors are now closed up, with a fourth not far behind. These are important milestones, and you can follow progress in detail in the regular LS1 reports in the Bulletin. They show that we’re on schedule for physics to resume in about a year from now, but more than that, they are an important reminder of the LS1 motto: safety, quality, schedule. It is fantastic news that we are on schedule, and testimony to the rigour that went into the detailed and complex planning of all the work that had to be undertaken in LS1. But more important than the schedule is the fact that we’ve carried out the work safely and that the qualit...

  16. An efficient approach to the evaluation of mid-term dynamic processes in power systems

    Energy Technology Data Exchange (ETDEWEB)

    Zivanovic, R M [Pretoria Technikon (South Africa); Popovic, D P [Nikola Tesla Inst., Belgrade (Yugoslavia). Power System Dept.

    1993-01-01

    This paper presents some improvements in the methodology for analysing mid-term dynamic processes in power systems. These improvements are: an efficient application of the hierarchical clustering algorithm to adaptive identification of coherent generator groups and a significant reduction of the mathematical model, on the basis of monitoring the state of only one generator in one of the established coherent groups. This enables a flexible, simple and fast transformation from the full to the reduced model and vice versa, a significant acceleration of the simulation while keeping the desired accuracy and the automatic use in continual dynamic analysis. Verification of the above mentioned contributions was performed on examples of the dynamic analysis of New England and Yugoslav power systems. (author)

  17. Treatment of Developmental Dysplasia of the Hip: Short and Mid-term Outcome

    Directory of Open Access Journals (Sweden)

    Asim AM

    2011-03-01

    Full Text Available OBJECTIVE: To review the presentation and outcome of developmental dysplasia of the hip (DDH cases in the last 6 years. METHODOLOGY: We retrospectively reviewed the presentation as well as short and mid-term outcome of 17 children (18 hips with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness, closed or open reduction depending on age at presentation and the individual needs of each patient. RESULTS: The average age at presentation was 31.1 months, and the male to female ratio was 1:4.6. Six patients (35% presented early (less than 6 months old while 7 patients (41% presented between 6 -24 months. In these 2 groups splinting or closed reduction under anaesthesia was initially utilized for treatment depending on age, and open reduction was used after failure of closed reduction and for those presented late. Average age at the time of closed reduction was 11 months, and 6 years for those underwent open reduction. The average period of follow up for all patients was 29.4 months. The final outcome was successful in 12 hips (66% in 11 patients. Ten of these presented at less than 2 years old, in the other 6 hips in which there was failure, 50% presented after 3 years of age. CONCLUSION: Late presentation of DDH is still common in Malaysia, which necessitates more complex management and more frequent occurrences of unfavourable results.

  18. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    Smoking is a well-known risk factor for perioperative complications. Smokers experience an increased incidence of respiratory complications during anaesthesia and an increased risk of postoperative cardiopulmonary complications, infections and impaired wound healing. Smokers have a greater risk...... of postoperative intensive care admission. Even passive smoking is associated with increased risk at operation. Preoperative smoking intervention 6-8 weeks before surgery can reduce the complications risk significantly. Four weeks of abstinence from smoking seems to improve wound healing. An intensive, individual...... approach to smoking intervention results in a significantly better postoperative outcome. Future research should focus upon the effect of a shorter period of preoperative smoking cessation. All smokers admitted for surgery should be informed of the increased risk, recommended preoperative smoking cessation...

  19. Introduction of an interdisciplinary heart team-based transcatheter aortic valve implantation programme: short and mid-term outcomes.

    Science.gov (United States)

    Martínez, G J; Seco, M; Jaijee, S K; Adams, M R; Cartwright, B L; Forrest, P; Celermajer, D S; Vallely, M P; Wilson, M K; Ng, M K C

    2014-09-01

    Transcatheter aortic valve implantation (TAVI) has been developed to treat symptomatic aortic stenosis in patients deemed too high risk for open-heart surgery. To address this complex population, an interdisciplinary heart team approach was proposed. Present the short- and mid-term outcomes of the first 100 patients in the Royal Prince Alfred Hospital multidisciplinary TAVI programme. Single-centre registry. Baseline and procedural data were prospectively recorded. Outcomes were recorded according to Valve Academic Research Consortium - version 2 guidelines. All patients underwent a comprehensive interdisciplinary pre-procedural evaluation. Sixty-eight transfemoral and 32 transapical implantations were performed. Mean age was 82 (±8.9) years old with an average logistic EuroSCORE of 33. Although 13 procedures had major complications, there was no intraprocedural mortality. During the first month, 9% of patients were re-admitted due to heart failure and 13% had a permanent pacemaker implanted. A 3% 30-day and 8% follow-up (mean 17 months) mortalities were recorded. While no significant differences in the rate of complications were found between the first and second half of the experience, all cases of mortality within 30 days (n = 3) occurred in the initial half. Sustained haemodynamic results were obtained with TAVI (immediate mean aortic valve gradient reduction from 47 to 9 mmHg; 1-year echocardiographic gradient 9.9 mmHg, with no moderate or severe aortic regurgitation). Excellent results can be achieved with TAVI in very high-risk patients at an Australian institution. A comprehensive evaluation based on a heart team can overcome most of the difficulties imposed by this challenging population. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  20. Sound transit climate risk reduction project.

    Science.gov (United States)

    2013-09-01

    The Climate Risk Reduction Project assessed how climate change may affect Sound Transit commuter rail, light rail, and express bus : services. The project identified potential climate change impacts on agency operations, assets, and long-term plannin...

  1. Mid-term financial impact of animal welfare improvements

    NARCIS (Netherlands)

    Gocsik, E.; Oude Lansink, A.G.J.M.; Saatkamp, H.W.

    2013-01-01

    This study used a stochastic bioeconomic simulation model to simulate the business and financial risk of different broiler production systems over a 5-yr period. Simulation analysis was conducted using the @Risk add-in in MS Excel. To compare the impact of different production systems on economic

  2. Mid-term outcomes of patients undergoing adjustable pulmonary artery banding

    Directory of Open Access Journals (Sweden)

    Sachin Talwar

    2016-01-01

    Conclusions: Patients undergoing APAB fulfilled the desired objectives of the pulmonary artery banding (PAB with minimum PA complications in the mid-term. This added to the early postoperative benefits, makes the APAB an attractive alternative to the CPAB.

  3. RISK TRANSFER AND RISK REDUCTION OF ATHLETES

    Directory of Open Access Journals (Sweden)

    Željko Vojinović

    2011-09-01

    Full Text Available One of the indispensable factors in sports is insurance. The accidents influence not only the health, permanently or temporarily,they also influence the financial resources, more or less, depending on the recovery time of the injuries. Insurer in this case pay the agreed amount (the agreed compensation to the insured. Each participant in the sporting competition should have personal insurance. The reasons for the theme are to find ways to explain how athletes can reduce the risks they are exposed to in doing their activities, training and competition, and other moments in life. Every man has a need for certainty in the future, regardless of the category in which he works, the values and skills available. The only difference is in absolute values and everyone has his own need. Athletes ,those from less successful to the most successful ones, whose transfers or fees are in millions, all think about the future and of course how to save and invest funds that are earned. They can find a solution in insurance, as an institution that takes over their risks, taking care of the invested money and benefits of those stakes. When there is uncertainty in our lives we seek security and see it as a basic need. Insurers claim that insurance offers just that - the security of property and life

  4. Outage risk reduction at Diablo Canyon

    International Nuclear Information System (INIS)

    Burnett, Tobias W.T.; Eugene Newman, C.

    2004-01-01

    A formal risk reduction program was conducted at the Diablo Canyon Nuclear Generating plant as part of EPRI's Outage Risk Assessment and Management Program. The program began with a probabilistic and deterministic assessment of the frequency of core coolant boiling and core uncovery during shutdown operations. This step identified important contributors to risk, periods of high vulnerability, and potential mechanisms for reducing risk. Next, recovery strategies were evaluated and procedures, training, and outage schedules modified. Twelve risk reduction enhancements were developed and implemented. These enhancements and their impact are described in this paper. These enhancements reduced the calculated risk of core uncovery by about a factor of four for a refueling outage without lengthening the outage schedule; increased the outage efficiency, contributing to completing 11 days ahead of schedule; and helped to earn the highest achievable SALP rating from the NRC. (author)

  5. The mid-term efficacy and safety of a permanent nitinol IVC filter (TrapEase)

    International Nuclear Information System (INIS)

    Liu, Wei Chiang; Do, Young Soo; Choo, Sung Wook; Kim, Dong Ik; Kim, Young Wook; Kim, Duk Kyung; Shin, Sung Wook; Park, Kwang Bo; Jeon, Yong Hwan; Choo, In Wook

    2005-01-01

    1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion. A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE). Indications for filter placement were: 1) deep vein thrombosis with recurrent thromboembolism; 2) and/or free-floating thrombus with contraindication to anticoagulation; and 3) complications in achieving adequate anticoagulation. Follow-up evaluations (mean: 15.4 months, range: 2 to 28 months) were performed at 6- and 12-month intervals after the procedure and included clinical histories, chart reviews, plain film, Doppler ultrasounds, and contrasted abdominal CT scans. In follow-up evaluations, the data analysis revealed no cases of symptomatic PE. There were no cases of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study, there was one case of filter thrombosis; early symptomatic thrombosis that was successfully treated in the hospital. Of the 42 subjects, eight dead. These deaths were not related to the filter device or the implantation procedure, but to the underlying disease. This study demonstrates that the TrapEase permanent IVC filter is a safe and an effective device with low complication rates and is best used in patients with thromboembolic disease with a high risk of PE

  6. Mid-term evaluation of the Climate Change Action Fund: Technology Early Action Measures (TEAM) block

    International Nuclear Information System (INIS)

    2001-11-01

    To assist Canada in meeting its commitments under the Kyoto Protocol for the reduction of greenhouse gas emissions, the Government of Canada established the Climate Change Action Fund (CCAF) in 1998. Under the CCAF umbrella, the Technology Early Action Measures (TEAM) Block was initially allocated 60 million dollars over a three-year period for the provision of cost-shared support to speed up the development and deployment of cost-effective near market-ready greenhouse gases emission reducing technologies. The main avenues adopted by TEAM in its mandate were: supporting technology development and deployment, overcoming obstacles to technology development and deployment, and piloting technology transfer to developing countries and countries in transition. A mid-term evaluation of its performance to date was conducted. It proved to be too early for an adequate assessment of the extent to which the projects sponsored by TEAM demonstrated technical success in reducing greenhouse gases emissions, considering the time-consuming tasks required for the development and negotiation of technology projects. Most projects to date have not moved beyond the early stages benchmark. It was determined that the expected outcomes will be achieved. The innovative approach selected by TEAM, building on existing programs, appeared to be very effective. Findings and recommendations were discussed in this report

  7. Disaster risk reduction and sustainable development

    International Nuclear Information System (INIS)

    Khurshedi, N.

    2005-01-01

    During the past four decades, natural hazards such as earthquakes, volcanic activity, and slides, tsunami tropical cyclones and other severe storms, tornadoes and high winds, river floods and coastal flooding, wildfire and associated haze drought, sand/dust storms, and insect infestations have caused major loss of human lives and livelihoods, the destruction of economic and social infrastructure, as well as environmental damages. Economic losses have increased almost ten times during this period. As it happen in recent Asia Tsunami, in which over 2, 00,000 people reportedly killed, estimated five million homeless, and resulted in massive displacement of population and extensive damage to infrastructure. The escalation of severe disaster events triggered by natural hazards and related technological and environment disasters is increasingly threatening both sustainable development and poverty-reduction initiatives. The loss of human lives and the rise in the cost of reconstruction efforts and loss of development assets has forced the issue of disaster reduction and risk management higher on the policy agenda of affected governments as well a multilateral and bilateral agencies and NGOs. For this Disaster risk reduction-.strategies are aimed at enabling societies at risk to become engaged in the conscious management of risk and the reduction of vulnerability. The adoption of appropriate development policies can reduce disaster risk. These policies should be gender sensitive and need the necessary political commitment. They involve the adoption of suitable regulatory and other legal measures, institutional reform, improved analytical and methodological capabilities, financial planning, education and awareness. (author)

  8. Early and mid-term outcomes of combined aortic valve replacement and coronary artery bypass grafting in elderly patients.

    Science.gov (United States)

    Fukui, Toshihiro; Bando, Ko; Tanaka, Sachiko; Uchimuro, Tomoya; Tabata, Minoru; Takanashi, Shuichiro

    2014-02-01

    Although the number of elderly patients undergoing combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) is increasing, the early and mid-term outcomes of this combined procedure remain to be determined. We sought to elucidate the early and mid-term outcomes of elderly (≥75 years) vs non-elderly (non-elderly patients (40.2%; Non-elderly group) with a mean age of 67.3±5.8 years. Early and mid-term outcomes were compared, and multivariate analyses were performed to determine the risk factors for morbidity and mortality. The mean follow-up times were 33.1±21.7 and 37.4±22.2 months in the Elderly and Non-elderly groups, respectively. The mean number of anastomoses and the frequency of use of the internal thoracic artery were similar between the two groups. The use of a mechanical valve was less frequent in the Elderly group than in the Non-elderly group (11.6 vs 60.6%, PNon-elderly groups had similar rates of operative death (1.9 vs 1.0%, P=0.651), early stroke (2.6 vs 1.0%, P=0.651), 5-year overall survival (83.1±4.8 vs 87.2±5.2%, P=0.358), 5-year freedom from cardiac death (92.3±2.7 vs 94.8±3.4%, P=0.570) and 5-year freedom from stroke (94.0±2.6 vs 99.0±1.0%, P=0.097). Cox proportional hazards analyses identified diabetes, creatinine level and EuroSCORE II, but not age, as independent predictors of overall mortality rate. Early and mid-term outcomes of combined AVR and CABG were similar between elderly and non-elderly patients. Older age was not a risk factor for mortality in patients undergoing combined AVR plus CABG, and this procedure should be recommended in properly selected elderly patients.

  9. Endovascular treatment of type B dissection in patients with Marfan syndrome: mid-term outcomes and aortic remodeling.

    Science.gov (United States)

    Eid-Lidt, Guering; Gaspar, Jorge; Meléndez-Ramírez, Gabriela; Cervantes S, Jorge; González-Pacheco, Hector; Dámas de Los Santos, Félix; Meave-González, Aloha; Ramírez Marroquín, Samuel

    2013-12-01

    To evaluate the mid-term outcomes, and the aortic remodeling in Marfan syndrome (MFS) patients with type B dissection that were treated with endovascular repair. MFS is a relative contraindication to thoracic endovascular aortic repair (TEVAR). Mid-term aortic outcomes data in MFS after TEVAR are limited, and the occurrence of late events remains unclear. Of 89 patients that underwent TEVAR between September 2002 and February 2011, 10 patients with mid-term follow-up fulfilled the Ghent criteria for MFS and complicated type B dissection. High risk for open surgery was documented in 90%. The mean age was 35.1 ± 9.4 years and all patients presented with acute aortic syndrome complicating a chronic type B dissection (DeBakey type IIIb). Five patients underwent a Bentall surgical procedure previous to endovascular repair, and in four patients initial TEVAR was followed by surgery of the ascending aorta. Treatment was limited to endovascular repair in only one patient. In-hospital mortality was 10%. At a mean follow-up of 59.6 ± 38.9 months, the cumulated mortality was of 20% and late mortality 11.1%. The rate of secondary endoleak was 44.4%, and late reintervention of 33.3%. Survival freedom from cardiovascular death at 8 years was 80.0%, and positive remodeling was documented in 37.5% of patients. Our results suggest that TEVAR is feasible, safe, and associated with a high reintervention rate and reduced rate of positive aortic remodeling in patients with Marfan syndrome. Survival at 8 years was comparable to contemporary series of open repair. Copyright © 2013 Wiley Periodicals, Inc.

  10. Evaluating a Health Risk Reduction Program.

    Science.gov (United States)

    Nagelberg, Daniel B.

    1981-01-01

    A health risk reduction program at Bowling Green State University (Ohio) tested the efficacy of peer education against the efficacy of returning (by mail) health questionnaire results. A peer health education program did not appear to be effective in changing student attitudes or lifestyles; however, the research methodology may not have been…

  11. [Distal fixation prosthesis for unstable intertrochanteric fractures in elderly patients: a mid-term follow-up study].

    Science.gov (United States)

    Zhang, Zhan-feng; Min, Ji-kang; Zhong, Jian-ming; Wang, Dan

    2016-06-01

    To explore mid-term follow up results of distal fixation prosthesis in treating unstable intertrochanteric fractures in elderly patients. From May 2008 to March 2014,58 elderly patients with unstable intertrochanteric were treated with distal fixation prosthesis, among them, there were 15 males and 43 females aged from 75 to 87 years old with an average of 83.2 years old. Fracture were classified according to Evans classification, 39 cases were type I c and 19 cases were type I d. Surgical risk was evaluated before operation, 9 patients were performed total hip arthroplasty and 49 patients were performed prosthetic replacement hip joint function of patients with different age period, Evans classificaton, prothesis type, fixation method were evaluated respectively by using Harris score. Fifty-six patients were followed up from 13 to 36 months with an average of 21.6 months. Harris score was 83.51 ± 6.40, 5 cases got excellent results, 38 cases good and 13 cases moderate. Harris score of patients aged from 75 to 80 years old was 88.64 ± 2.35, 81.64 ± 6.40 in patients aged more than 80 years old, and had significant differences between two groups; Harris score in patients with type Evans I c was 83.64 ± 6.53, and 83.11 ± 6.08 in type Evans I d, while there was no significant differences between two groups. There was no obvious meaning in Harris score between patients with tension band (83.63 ± 6.15) and without tension band (82.41 ± 6.57). There was no significant meaning in Harris score between patients with normal distal fixation prosthesis (83.34 ± 6.43) and femoral moment reconstruction distal fixation prosthesis (83.92 ± 6.51). There was 1 patient occurred hip joint dislocation on the operative side and re-dislocation after manual reduction, then received open reduction. Two patients occurred femoral osteolysis without clinical symptoms, and treated conservative treatment. Artificial joint replacement for unstable intertrochanteric fractures in elderly

  12. Ecosystem Approach To Flood Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    RK Kamble

    2013-12-01

    Full Text Available India is one of the ten worst disaster prone countries of the world. The country is prone to disasters due to number of factors; both natural and anthropogenic, including adverse geo-climatic conditions, topographical features, environmental degradation, population growth, urbanisation, industrlisation, non-scientific development practices etc. The factors either in original or by accelerating the intensity and frequency of disasters are responsible for heavy toll of human lives and disrupting the life support systems in the country. India has 40 million hectares of the flood-prone area, on an average, flood affect an area of around 7.5 million hectares per year. Knowledge of environmental systems and processes are key factors in the management of disasters, particularly the hydro-metrological ones. Management of flood risk and disaster is a multi-dimensional affair that calls for interdisciplinary approach. Ecosystem based disaster risk reduction builds on ecosystem management principles, strategies and tools in order to maximise ecosystem services for risk reduction. This perspective takes into account the integration of social and ecological systems, placing people at the centre of decision making. The present paper has been attempted to demonstrate how ecosystem-based approach can help in flood disaster risk reduction. International Journal of Environment, Volume-2, Issue-1, Sep-Nov 2013, Pages 70-82 DOI: http://dx.doi.org/10.3126/ije.v2i1.9209

  13. Failure detection system risk reduction assessment

    Science.gov (United States)

    Aguilar, Robert B. (Inventor); Huang, Zhaofeng (Inventor)

    2012-01-01

    A process includes determining a probability of a failure mode of a system being analyzed reaching a failure limit as a function of time to failure limit, determining a probability of a mitigation of the failure mode as a function of a time to failure limit, and quantifying a risk reduction based on the probability of the failure mode reaching the failure limit and the probability of the mitigation.

  14. Mid-term follow-up of aortic root remodelling compared to Bentall operation.

    Science.gov (United States)

    Bassano, C; De Matteis, G M; Nardi, P; Buratta, M M; Zeitani, J; De Paulis, R; Chiariello, L

    2001-05-01

    Aortic valve sparing with root remodelling has proven useful in cases of aortic regurgitation secondary to ascending aorta disease. An excessive rate of re-operation for recurrent aortic regurgitation after this conservative approach might compensate the prosthesis-related risk of the Bentall operation. From January 1995 to September 2000, 69 consecutive patients with aortic expansive aneurysm and concomitant aortic valve disease, were submitted to the Bentall operation (group A, n=37) in the presence of an abnormal valve, or to root remodelling (group B, n=32) in cases of secondary aortic incompetence. One patient in group A and four in group B had Marfan syndrome. The follow-up was 1021 patient-months (range, 1-68 months) in group A and 926 in group B (1-64 months). The event-free survival was calculated using the Kaplan-Meier method, and the difference between curves was evaluated using the Mantel-Cox log-rank test. The operative mortality was 5% in group A and 0% in group B. One patient died at follow-up in group A and none in group B. Four patients (three Marfan) in group B were re-operated on because of recurrent aortic regurgitation. The 5-year event-free survival was 88+/-7% in group A and 82+/-8% in group B (P=0.58). Early residual aortic regurgitation remained stable over time only in patients with good early results. Mid-term follow-up failed to reveal statistically significant differences in the clinical outcome between remodelling and the Bentall operation. Our results support the widespread use of root remodelling, provided that an indication to this conservative approach is achieved after careful, case-by-case evaluation. A good early operative result is likely to remain stable over time.

  15. Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Kobayashi Hideo

    2012-10-01

    Full Text Available Abstract Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ, and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group and patients with rheumatoid arthritis (RA group. Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern.

  16. Mid-term outcomes of the Absorb BVS versus second-generation DES: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Cordula M Felix

    Full Text Available Bioresorbable Vascular Scaffolds (BVS were introduced to overcome some of the limitations of drug-eluting stent (DES for PCI. Data regarding the clinical outcomes of the BVS versus DES beyond 2 years are emerging.To study mid-term outcomes.We searched online databases (PubMed/Medline, Embase, CENTRAL, several websites, meeting presentations and scientific session abstracts until August 8th, 2017 for studies comparing Absorb BVS with second-generation DES. The primary outcome was target lesion failure (TLF. Secondary outcomes were all-cause mortality, myocardial infarction, target lesion revascularization (TLR and definite/probable device thrombosis. Odds ratios (ORs with 95% confidence intervals (CIs were derived using a random effects model.Ten studies, seven randomized controlled trials and three propensity-matched observational studies, with a total of 7320 patients (BVS n = 4007; DES n = 3313 and a median follow-up duration of 30.5 months, were included. Risk of TLF was increased for BVS-treated patients (OR 1.34 [95% CI: 1.12-1.60], p = 0.001, I2 = 0%. This was also the case for all myocardial infarction (1.58 [95% CI: 1.27-1.96], p1 year device thrombosis was 6.10 [95% CI: 1.40-26.65], p = 0.02.At mid-term follow-up, BVS was associated with an increased risk of TLF, MI, TLR and definite/probable device thrombosis, but this did not result in an increased risk of all-cause mortality.

  17. Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

    Science.gov (United States)

    Bronner, Anne; Morignat, Eric; Hénaux, Viviane; Madouasse, Aurélien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR) was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI) taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division) during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8) in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24) and 71% (n = 39) of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9%) when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5%) when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions.

  18. Devising an indicator to detect mid-term abortions in dairy cattle: a first step towards syndromic surveillance of abortive diseases.

    Directory of Open Access Journals (Sweden)

    Anne Bronner

    Full Text Available Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy cattle herds in France. A mid-term abortion incidence rate (MAIR was computed as the ratio of the number of mid-term abortions to the number of female-weeks at risk. A mid-term abortion was defined as a return-to-service (i.e., a new AI taking place 90 to 180 days after the previous AI. Weekly variations in the MAIR in heifers and parous cows were modeled with a time-dependent Poisson model at the département level (French administrative division during the period of 2004 to 2010. The usefulness of monitoring this indicator to detect a disease-related increase in mid-term abortions was evaluated using data from the 2007-2008 episode of bluetongue serotype 8 (BT8 in France. An increase in the MAIR was identified in heifers and parous cows in 47% (n = 24 and 71% (n = 39 of the departements. On average, the weekly MAIR among heifers increased by 3.8% (min-max: 0.02-57.9% when the mean number of BT8 cases that occurred in the previous 8 to 13 weeks increased by one. The weekly MAIR among parous cows increased by 1.4% (0.01-8.5% when the mean number of BT8 cases occurring in the previous 6 to 12 weeks increased by one. These results underline the potential of the MAIR to identify an increase in mid-term abortions and suggest that it is a good candidate for the implementation of a syndromic surveillance system for bovine abortions.

  19. Percutaneous pulmonary valve implantation in patients with dysfunction of a "native" right ventricular outflow tract - Mid-term results.

    Science.gov (United States)

    Georgiev, Stanimir; Tanase, Daniel; Ewert, Peter; Meierhofer, Christian; Hager, Alfred; von Ohain, Jelena Pabst; Eicken, Andreas

    2018-05-01

    To investigate the feasibility and mid-term results of percutaneous pulmonary valve implantation (PPVI) in patients with conduit free or "native" right ventricular outflow tracts (RVOT). We identified all 18 patients with conduit free or "native" right ventricular outflow tract, who were treated with percutaneous pulmonary valve implantation (PPVI) in our institution. They were divided into two groups - these in whom the central pulmonary artery was used as an anchoring point for the preparation of the landing zone (n=10) for PPVI and these, in whom a pulmonary artery branch was used for this purpose (n=8). PPVI was performed successfully in all patients with significant immediate RVOT gradient and pulmonary regurgitation grade reduction. Four patients had insignificant paravalvular regurgitation. In one patient the valve was explanted after 4months because of bacterial endocarditis. A follow-up of 19 (4-60) months showed sustained good function of the other implanted valves. The MRI indexed right ventricular end diastolic volume significantly decreased from 108(54-174) ml/m 2 before the procedure to 76(60-126) ml/m 2 six months after PPVI, p=0.01. PPVI is feasible with good mid-term results in selected patients with a "native" RVOT without a previously implanted conduit. Creating a stable landing zone with a diameter less than the largest available valve (currently 29mm) is crucial for the technical success of the procedure. Further studies and the development of new devices could widen the indications for this novel treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

    Science.gov (United States)

    The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

  1. Adaptation of an HIV behavioural disinhibition risk reduction ...

    African Journals Online (AJOL)

    Adaptation of an HIV behavioural disinhibition risk reduction intervention for ... disinhibition risk reduction interventions for recently circumcised men for use in clinic ... medicine HIV prevention technologies into the male circumcision contexts.

  2. Mid-term results of correction of Tetralogy of Fallot with absent pulmonary valve

    Directory of Open Access Journals (Sweden)

    Sachin Talwar

    2017-11-01

    Conclusions: In contrast to children and adults with TOF/APV, infants carry significant early mortality. But the mid-term outcome for patients who survive the initial repair of TOF/APV is acceptable. However, these patients require constant surveillance and irrespective of the methods of RVOT management, the reoperation rates are expected to be high as more of these patients survive into adulthood.

  3. Mid-term results of total knee arthroplasty with a porous tantalum monoblock tibial component.

    Science.gov (United States)

    Hayakawa, Kazue; Date, Hideki; Tsujimura, Shunzo; Nojiri, Sho; Yamada, Harumoto; Nakagawa, Kenji

    2014-01-01

    The objectives of the present study were to assess the mid-term results of cementless total knee arthroplasty (TKA) with the porous tantalum monoblock tibial component and to examine the time course of bone changes on plain radiographs. The subjects were 32 patients, 29 patients were available for follow-up. We investigated the mid-term results of TKA after a mean follow-up period of 7 years and 8 months. We also examined changes of the bone over time on plain radiographs. The Knee Society Clinical Rating scores showed significant improvement. Bone changes around the tibial component were as follows: new bone formation and longitudinal trabecular thickening in 41.4% (Type A), only longitudinal trabecular thickening in 41.4% (Type B), and no changes in 17.2% (Type C). Type A and B changes were more frequent in patients with osteoarthritis, whereas Type C was only seen in patients with rheumatoid arthritis. Three knees had an initial gap, but this disappeared in all cases, and no new radiolucent lines were detected. Stress shielding was observed in seven knees (21.9%), but there was no implant loosening related to it. When we examined the relationship between the mechanical axis and the locations of the tips of the tibial pegs in patients with or without stress shielding, no significant differences were found. The results of mid-term follow-up have demonstrated favorable bone ingrowth, suggesting that porous tantalum is a promising material for cementless TKA. © 2013.

  4. Valve-sparing root replacement in children with aortic root aneurysm: mid-term results.

    Science.gov (United States)

    Lange, Rüdiger; Badiu, Catalin C; Vogt, Manfred; Voss, Bernhard; Hörer, Jürgen; Prodan, Zsolt; Schreiber, Christian; Mazzitelli, Domenico

    2013-05-01

    We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR). Thirteen patients (mean age 9.7 ± 6.5 years, 10 months-18 years) underwent AVSRR for ARA between 2002 and 2011. Six of the 13 patients had Marfan syndrome, 3 Loeys-Dietz syndrome (LDS), 2 bicuspid aortic valve syndrome and 2 an unspecified connective tissue disorder. AVR was graded as none/trace, mild and severe in 5, 7 and 1 patient, respectively. The mean pre-operative root diameter was 45 ± 10 mm (mean Z-score 10.3 ± 2.0). Remodelling of the aortic root was performed in 4 patients, reimplantation of the aortic valve in 9 and a concomitant cusp repair in 4. The diameter of the prostheses used for root replacement varied from 22 to 30 mm (mean Z-score = 2.3 ± 3). The follow-up was 100% complete with a mean follow-up time of 3.7 years. There was no operative mortality. One patient with LDS died 2.5 years after the operation due to spontaneous rupture of the descending aorta. Root re-replacement with mechanical conduit was necessary in 1 patient for severe recurrent AVR 8 days after remodelling of the aortic root. At final follow-up, AVR was graded as none/trace and mild in all patients. Eleven patients presented in New York Heart Association functional Class I and 1 in Class II. In paediatric patients with ARA, valve-sparing root replacement can be performed with low operative risk and excellent mid-term valve durability. Hence, prosthetic valve-related morbidity may be avoided. Due to the large diameters of the aortic root and the ascending aorta, the size of the implanted root prostheses will not limit later growth of the native aorta.

  5. Mid-Term Direction of JAEA Nuclear Fuel Cycle Engineering Laboratories

    International Nuclear Information System (INIS)

    Ojima, H.; Sugiyama, T.; Tanaka, K.; Takeda, S.; Nomura, S.

    2009-01-01

    1. Introduction Nuclear Fuel Cycle Engineering Laboratories (NCL) of Japan Atomic Energy Agency (JAEA) has sufficient experience and ability through its 50 year operation to establish the next generation closed cycle. It strives to become a world-class Center Of Excellence. 2. Current activity in NCL: 1) - Recycling of MOX fuel: The Tokai Reprocessing Plant has reprocessed 29 tons of MOX fuel from the ATR Fugenh as a part of 1140 tons of cumulative spent fuel reprocessed. JAEA has supported the pre-operation of the Rokkasho Reprocessing Plant. An innovative MOX pellet fabrication process has been developed in the Plutonium Fuel Development Center, and a part of products obtained by the development are used as a fuel for core confirmation test for re-startup of the FBR Monjuh. Characterization of MOX containing Am and Np has been studied and a new data such as melting point and thermal conductivity were reported. In the Chemical Processing Facility, a hot lab., an advanced aqueous reprocessing technology has been tested for TRU recovery, economical improvement, etc., using irradiated MOX fuel from the FR Joyoh. 2) - Supporting Activity: JAEA has improved the effectiveness and efficiency of existing safeguards activities. The Integrated Safeguards approach for all facilities in NCL has been implemented since August, 2008, as a pioneer and a good example in the world. To reduce anxiety among local residents, NCL has explained its operation plans and exchanged information and opinions with them concerning potential risks to health and environment. Recently, stake-holder participation in the management of NCL was started from the view point of Corporate Social Responsibility. In April, 2008, the agreement was signed with Idaho National Laboratory for cooperation of personnel training in fuel cycle area. 3. Mid-Term Direction: In Japan, feasibility and direction of the transition period from the LWR era to the FBR era should be discussed for the next several years. Study

  6. Mid-Term Direction of JAEA Nuclear Fuel Cycle Engineering Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Ojima, H.; Sugiyama, T.; Tanaka, K.; Takeda, S.; Nomura, S. [Tokai-mura, Ibaraki-ken 319-1194 (Japan)

    2009-06-15

    1. Introduction Nuclear Fuel Cycle Engineering Laboratories (NCL) of Japan Atomic Energy Agency (JAEA) has sufficient experience and ability through its 50 year operation to establish the next generation closed cycle. It strives to become a world-class Center Of Excellence. 2. Current activity in NCL: 1) - Recycling of MOX fuel: The Tokai Reprocessing Plant has reprocessed 29 tons of MOX fuel from the ATR Fugenh as a part of 1140 tons of cumulative spent fuel reprocessed. JAEA has supported the pre-operation of the Rokkasho Reprocessing Plant. An innovative MOX pellet fabrication process has been developed in the Plutonium Fuel Development Center, and a part of products obtained by the development are used as a fuel for core confirmation test for re-startup of the FBR Monjuh. Characterization of MOX containing Am and Np has been studied and a new data such as melting point and thermal conductivity were reported. In the Chemical Processing Facility, a hot lab., an advanced aqueous reprocessing technology has been tested for TRU recovery, economical improvement, etc., using irradiated MOX fuel from the FR Joyoh. 2) - Supporting Activity: JAEA has improved the effectiveness and efficiency of existing safeguards activities. The Integrated Safeguards approach for all facilities in NCL has been implemented since August, 2008, as a pioneer and a good example in the world. To reduce anxiety among local residents, NCL has explained its operation plans and exchanged information and opinions with them concerning potential risks to health and environment. Recently, stake-holder participation in the management of NCL was started from the view point of Corporate Social Responsibility. In April, 2008, the agreement was signed with Idaho National Laboratory for cooperation of personnel training in fuel cycle area. 3. Mid-Term Direction: In Japan, feasibility and direction of the transition period from the LWR era to the FBR era should be discussed for the next several years. Study

  7. Optimising risk reduction: An expected utility approach for marginal risk reduction during regulatory decision making

    International Nuclear Information System (INIS)

    Li Jiawei; Pollard, Simon; Kendall, Graham; Soane, Emma; Davies, Gareth

    2009-01-01

    In practice, risk and uncertainty are essentially unavoidable in many regulation processes. Regulators frequently face a risk-benefit trade-off since zero risk is neither practicable nor affordable. Although it is accepted that cost-benefit analysis is important in many scenarios of risk management, what role it should play in a decision process is still controversial. One criticism of cost-benefit analysis is that decision makers should consider marginal benefits and costs, not present ones, in their decision making. In this paper, we investigate the problem of regulatory decision making under risk by applying expected utility theory and present a new approach of cost-benefit analysis. Directly taking into consideration the reduction of the risks, this approach achieves marginal cost-benefit analysis. By applying this approach, the optimal regulatory decision that maximizes the marginal benefit of risk reduction can be considered. This provides a transparent and reasonable criterion for stakeholders involved in the regulatory activity. An example of evaluating seismic retrofitting alternatives is provided to demonstrate the potential of the proposed approach.

  8. Short- and Mid-term Effects of Irreversible Electroporation on Normal Renal Tissue: An Animal Model

    International Nuclear Information System (INIS)

    Wendler, J. J.; Porsch, M.; Hühne, S.; Baumunk, D.; Buhtz, P.; Fischbach, F.; Pech, M.; Mahnkopf, D.; Kropf, S.; Roessner, A.; Ricke, J.; Schostak, M.; Liehr, U.-B.

    2013-01-01

    Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting. Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days. A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney. This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.

  9. Short- and Mid-term Effects of Irreversible Electroporation on Normal Renal Tissue: An Animal Model

    Energy Technology Data Exchange (ETDEWEB)

    Wendler, J. J., E-mail: johann.wendler@med.ovgu.de; Porsch, M.; Huehne, S.; Baumunk, D. [University of Magdeburg, Department of Urology (Germany); Buhtz, P. [Institute of Pathology, University of Magdeburg (Germany); Fischbach, F.; Pech, M. [University of Magdeburg, Department of Radiology (Germany); Mahnkopf, D. [Institute of Medical Technology and Research (Germany); Kropf, S. [Institute of Biometry, University of Magdeburg (Germany); Roessner, A. [Institute of Pathology, University of Magdeburg (Germany); Ricke, J. [University of Magdeburg, Department of Radiology (Germany); Schostak, M.; Liehr, U.-B. [University of Magdeburg, Department of Urology (Germany)

    2013-04-15

    Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting. Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days. A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney. This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.

  10. Critical mid-term uncertainties in long-term decarbonisation pathways

    International Nuclear Information System (INIS)

    Usher, Will; Strachan, Neil

    2012-01-01

    Over the next decade, large energy investments are required in the UK to meet growing energy service demands and legally binding emission targets under a pioneering policy agenda. These are necessary despite deep mid-term (2025–2030) uncertainties over which national policy makers have little control. We investigate the effect of two critical mid-term uncertainties on optimal near-term investment decisions using a two-stage stochastic energy system model. The results show that where future fossil fuel prices are uncertain: (i) the near term hedging strategy to 2030 differs from any one deterministic fuel price scenario and is structurally dissimilar to a simple ‘average’ of the deterministic scenarios, and (ii) multiple recourse strategies from 2030 are perturbed by path dependencies caused by hedging investments. Evaluating the uncertainty under a decarbonisation agenda shows that fossil fuel price uncertainty is very expensive at around £20 billion. The addition of novel mitigation options reduces the value of fossil fuel price uncertainty to £11 billion. Uncertain biomass import availability shows a much lower value of uncertainty at £300 million. This paper reveals the complex relationship between the flexibility of the energy system and mitigating the costs of uncertainty due to the path-dependencies caused by the long-life times of both infrastructures and generation technologies. - Highlights: ► Critical mid-term uncertainties affect near-term investments in UK energy system. ► Deterministic scenarios give conflicting near-term actions. ► Stochastic scenarios give one near-term hedging strategy. ► Technologies exhibit path dependency or flexibility. ► Fossil fuel price uncertainty is very expensive, biomass availability uncertainty is not.

  11. Tape functionality: position, change in shape, and outcome after TVT procedure--mid-term results.

    Science.gov (United States)

    Kociszewski, Jacek; Rautenberg, Oliver; Kolben, Sebastian; Eberhard, Jakob; Hilgers, Reinhard; Viereck, Volker

    2010-07-01

    This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

  12. Risk factors in limb reduction defects.

    Science.gov (United States)

    Stoll, C; Alembik, Y; Dott, B; Roth, M P

    1992-07-01

    Risk factors were studied in 123 children with limb reduction defects (LRD) from 118,265 consecutive births of known outcome during the period from 1979 to 1987 in the area which is covered by our registry of congenital malformations. For each case a control was studied. The LRD was localised and classified according to the EUROCAT guide for the description and classification of limb defects. The prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0% were late spontaneous abortion or stillborn and termination was performed in 4.0% of the cases. The proportion of males was 0.55. The most common malformations in the 51.2% of children who had at least one other anomaly than LRD were associated cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was more often complicated by oligohydramnios, polyhydramnios and threatened abortion but there were no differences in parental characteristics. However, 9.7% of marriages were consanguineous (P less than 0.01) and the incidence of LRD in first-degree relatives of the children with LRD was high. First-degree relatives also had more non-limb malformations than did those of controls.

  13. Mid-term effect of direct intrahepatic portosystemic shunt for the treatment of portal hypertension

    International Nuclear Information System (INIS)

    Luo Jianjun; Yan Zhiping; Wang Jianhua; Liu Qingxin; Qu Xudong

    2009-01-01

    Objective: To retrospectively analyze the mid-term clinical results of direct intrahepatic portosystemic shunt (DIPS) in treating patients with portal hypertension. Methods: DIPS were created in 23 patients with portal hypertension. Both preoperative and postoperative portal systemic pressure gradient (PPG), liver function and clinical symptoms were recorded and compared. Shunt patency was checked by color Doppler ultrasonography and the data were statistically analyzed by Kaplan-Meier method. Results DIPS creation was successfully accomplished in all 23 patients. No serious complications occurred after DIPS except for hemorrhagic ascites (n = 1) and mild hepatic encephalopathy (n = 3). Mean PPG significantly decreased from preoperative (32.6 ± 5.3) mmHg with a range of (23 - 43) mmHg to postoperative (10.1 ± 2.7) mmHg with a range of (5-14) mmHg (P < 0.001). After the procedure, the albumin level also markedly decreased while the bilirubin level distinctly increased. Obvious improvement of the clinical symptoms was observed. The cumulated primary patency rate of the shunt one and two years after treatment was 77.4% and 50.2% respectively. Conclusion: The mid-term clinical results indicate that DIPS is an effective and safe procedure for treating patients with portal hypertension. (authors)

  14. Mid-term fire danger index based on satellite imagery and ancillary geographic data

    Science.gov (United States)

    Stefanidou, A.; Dragozi, E.; Tompoulidou, M.; Stepanidou, L.; Grigoriadis, D.; Katagis, T.; Stavrakoudis, D.; Gitas, I.

    2017-09-01

    Fire danger forecast constitutes one of the most important components of integrated fire management since it provides crucial information for efficient pre-fire planning, alertness and timely response to a possible fire event. The aim of this work is to develop an index that has the capability of predicting accurately fire danger on a mid-term basis. The methodology that is currently under development is based on an innovative approach that employs dry fuel spatial connectivity as well as biophysical and topological variables for the reliable prediction of fire danger. More specifically, the estimation of the dry fuel connectivity is based on a previously proposed automated procedure implemented in R software that uses Moderate Resolution Imaging Spectrometer (MODIS) time series data. Dry fuel connectivity estimates are then combined with other ancillary data such as fuel type and proximity to roads in order to result in the generation of the proposed mid-term fire danger index. The innovation of the proposed index—which will be evaluated by comparison to historical fire data—lies in the fact that its calculation is almost solely affected by the availability of satellite data. Finally, it should be noted that the index is developed within the framework of the National Observatory of Forest Fires (NOFFi) project.

  15. Mid term results of Furlong LOL uncemented hip hemiarthroplasty for fractures of the femoral neck.

    Science.gov (United States)

    Chandran, Prakash; Azzabi, Mohammed; Burton, Dave J C; Andrews, Mark; Bradley, John G

    2006-08-01

    We report the mid-term results of hemiarthroplasty with the Furlong hydroxyapatite coated bipolar prosthesis for displaced (Garden type III and IV) intracapsular hip fracture in 480 patients operated between 1989 and 2000. Three hundred sixty eight (77%) patients were lost to follow-up due to death, dementia or movement away from the area. In the patients followed up there was an 8% reoperation rate for infection, aseptic loosening, periprosthetic fracture and acetabular erosion. One hundred and twelve patients with a mean follow-up of 4 years (3-14) were studied. Eighty eight percent had no or slight pain, 77% could mobilise outdoors and 89% needed either no aid or a single walking stick to mobilise. Radiographic assessment revealed a stable implant with visible osseointegration in 91%. We conclude that hemiarthroplasty with the hydroxyapatite coated bipolar Furlong LOL prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term results in elderly patients for return to mobility, use of mobility aids and freedom from pain. It avoids the need for cement and provides satisfactory incorporation into the host bone. The use of a modular head makes revision to total hip replacement easier.

  16. Mid-term load forecasting of power systems by a new prediction method

    International Nuclear Information System (INIS)

    Amjady, Nima; Keynia, Farshid

    2008-01-01

    Mid-term load forecasting (MTLF) becomes an essential tool for today power systems, mainly in those countries whose power systems operate in a deregulated environment. Among different kinds of MTLF, this paper focuses on the prediction of daily peak load for one month ahead. This kind of load forecast has many applications like maintenance scheduling, mid-term hydro thermal coordination, adequacy assessment, management of limited energy units, negotiation of forward contracts, and development of cost efficient fuel purchasing strategies. However, daily peak load is a nonlinear, volatile, and nonstationary signal. Besides, lack of sufficient data usually further complicates this problem. The paper proposes a new methodology to solve it, composed of an efficient data model, preforecast mechanism and combination of neural network and evolutionary algorithm as the hybrid forecast technique. The proposed methodology is examined on the EUropean Network on Intelligent TEchnologies (EUNITE) test data and Iran's power system. We will also compare our strategy with the other MTLF methods revealing its capability to solve this load forecast problem

  17. [Neoadjuvant Chemotherapy Using S-1 for Pancreatic Cancer - Mid-Term Results].

    Science.gov (United States)

    Homma, Yuki; Honda, Goro; Sakamoto, Katsunori; Kurata, Masanao; Honjo, Masahiko; Hirata, Yoshihiro; Shinya, Satoshi

    2016-10-01

    Although surgical resection is the only curative strategy for pancreatic cancer, the prognosis of patients with pancreatic cancer remains poor. Recently, neoadjuvant treatment has been frequently employed as a promising treatment. Here, the mid-term results of neoadjuvant chemoradiotherapy(NACRT)using S-1, which has been performed in our hospital since 2008, are reported. Seventy-nine patients with resectable or borderline resectable pancreatic ductal adenocarcinoma, who had been intended to undergo NACRT treatment using S-1, were enrolled. The NACRT comprised radiotherapy( 1.8 Gy×28 days)and full-dose twice-daily oral S-1 given on the same days as the radiotherapy. The results of the NACRT and pancreatectomy and the patients' prognoses were evaluated. Fifty-five patients(69.6%)underwent pancreatectomy, with no case of mortality. The curative resection rate was 94.5%. Postoperative adjuvant chemotherapy was administered in 46 patients(83.6%). The 3-year survival rates of all 79 patients and 55 pancreatectomy patients were 40.1% and 50.4%, respectively. NACRT using S-1 was found to be feasible, and good mid-term outcomes were obtained. However, analysis of the long-term outcomes and comparisons with other novel anti-cancer drugs are still required.

  18. Percutaneous angioplasty of portal vein stenosis that complicated liver transplantation: the mid-term therapeutic results

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kwang Bo; Choo, Sung Wook; Do, Young Soo; Shin, Sung Wook; Cho, Sung Gi; Choo, In Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-09-15

    We wanted to valuate the mid-term therapeutic results of percutaneous transhepatic balloon angioplasty for portal vein stenosis after liver transplantation. From May 1996 to Feb 2005, 420 patients underwent liver transplantation. Percutaneous transhepatic angioplasty of the portal vein was attempted in six patients. The patients presented with the clinical signs and symptoms of portal venous hypertension or they were identified by surveillance doppler ultrasonography. The preangioplasty and postangioplasty pressure gradients were recorded. The therapeutic results were monitored by the follow up of the clinical symptoms, the laboratory values, CT and ultrasonography. The overall technical success rate was 100%. The clinical success rate was 83% (5/6). A total of eight sessions of balloon angioplasty were performed in six patients. The mean pressure gradient decreased from 14.5 mmHg to 2.8 mmHg before and after treatment, respectively. The follow up periods ranged from three months to 64 months (mean period; 32 months). Portal venous patency was maintained in all six patients until the final follow up. Combined hepatic venous stenosis was seen in one patient who was treated with stent placement. One patient showed puncture tract bleeding, and this patient was treated with coil embolization of the right portal puncture tract via the left transhepatic portal venous approach. Percutaneous transhepatic balloon angioplasty is an effective treatment for the portal vein stenosis that occurs after liver transplantation, and our results showed good mid-term patency with using this technique.

  19. Forging process design for risk reduction

    Science.gov (United States)

    Mao, Yongning

    In this dissertation, forging process design has been investigated with the primary concern on risk reduction. Different forged components have been studied, especially those ones that could cause catastrophic loss if failure occurs. As an effective modeling methodology, finite element analysis is applied extensively in this work. Three examples, titanium compressor disk, superalloy turbine disk, and titanium hip prosthesis, have been discussed to demonstrate this approach. Discrete defects such as hard alpha anomalies are known to cause disastrous failure if they are present in those stress critical components. In this research, hard-alpha inclusion movement during forging of titanium compressor disk is studied by finite element analysis. By combining the results from Finite Element Method (FEM), regression modeling and Monte Carlo simulation, it is shown that changing the forging path is able to mitigate the failure risk of the components during the service. The second example goes with a turbine disk made of superalloy IN 718. The effect of forging on microstructure is the main consideration in this study. Microstructure defines the as-forged disk properties. Considering specific forging conditions, preform has its own effect on the microstructure. Through a sensitivity study it is found that forging temperature and speed have significant influence on the microstructure. In order to choose the processing parameters to optimize the microstructure, the dependence of microstructure on die speed and temperature is thoroughly studied using design of numerical experiments. For various desired goals, optimal solutions are determined. The narrow processing window of titanium alloy makes the isothermal forging a preferred way to produce forged parts without forging defects. However, the cost of isothermal forging (dies at the same temperature as the workpiece) limits its wide application. In this research, it has been demonstrated that with proper process design, the die

  20. Mid-term migration analysis of a femoral short-stem prosthesis: a five-year EBRA-FCA-study.

    Science.gov (United States)

    Freitag, Tobias; Fuchs, Michael; Woelfle-Roos, Julia V; Reichel, Heiko; Bieger, Ralf

    2018-05-01

    The objective of this study was to evaluate the mid-term migration pattern of a femoral short stem. Implant migration of 73 femoral short-stems was assessed by Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis (EBRA-FCA) 5 years after surgery. Migration pattern of the whole group was analysed and compared to the migration pattern of implants "at risk" with a subsidence of more than 1.5 mm 2 years postoperative. Mean axial subsidence was 1.1 mm (-5.0 mm to 1.5 mm) after 60 months. There was a statistical significant axial migration until 2 years postoperative with settling thereafter. 2 years after surgery 18 of 73 Implants were classified "at risk." Nevertheless, all stems showed secondary stabilisation in the following period with no implant failure neither in the group of implants with early stabilisation nor the group with extensive early onset migration. In summary, even in the group of stems with more pronounced early subsidence, delayed settling occurred in all cases. The determination of a threshold of critical early femoral short stem subsidence is necessary because of the differing migration pattern described in this study with delayed settling of the Fitmore stem 2 years postoperatively compared to early settling within the first postoperative year described for conventional stems.

  1. Disaster Risks Reduction for Extreme Natural Hazards

    Science.gov (United States)

    Plag, H.; Jules-Plag, S.

    2013-12-01

    Mega disasters associated with extreme natural hazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Floods and droughts are major threats that potentially could reach planetary extent, particularly through secondary economic and social impacts. Earthquakes and tsunamis frequently cause disasters that eventually could exceed the immediate coping capacity of the global economy, particularly since we have built mega cities in hazardous areas that are now ready to be harvested by natural hazards. Unfortunately, the more we learn to cope with the relatively frequent hazards (50 to 100 years events), the less we are worried about the low-probability, high-impact events (a few hundred and more years events). As a consequence, threats from the 500 years flood, drought, volcano eruption are not appropriately accounted for in disaster risk reduction (DRR) discussions. Extreme geohazards have occurred regularly throughout the past, but mostly did not cause major disasters because exposure of human assets to hazards was much lower in the past. The most extreme events that occurred during the last 2,000 years would today cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. Recent extreme earthquakes have illustrated the destruction they can inflict, both directly and indirectly through tsunamis. Large volcano eruptions have the potential to impact climate, anthropogenic infrastructure and resource supplies on global scale. During the last 2,000 years several large volcano eruptions occurred, which under today's conditions are associated with extreme disaster risk. The comparison of earthquakes and volcano eruptions indicates that large volcano eruptions are the low-probability geohazards with potentially the highest impact on our civilization

  2. Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry.

    Science.gov (United States)

    Sánchez-Santos, Raquel; Masdevall, Carlos; Baltasar, Aniceto; Martínez-Blázquez, Candido; García Ruiz de Gordejuela, Amador; Ponsi, Enric; Sánchez-Pernaute, Andres; Vesperinas, Gregorio; Del Castillo, Daniel; Bombuy, Ernest; Durán-Escribano, Carlos; Ortega, Luis; Ruiz de Adana, Juan Carlos; Baltar, Javier; Maruri, Ignacio; García-Blázquez, Emilio; Torres, Antonio

    2009-09-01

    Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and long-term results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric procedure. Data were obtained from 17 centers and collected in a database. Technical issues, preoperative comorbid conditions, hospital stay, early and late complications, and short- and mid-term weight loss were analyzed. Five hundred forty patients were included; 76% were women. Mean BMI was 48.1 +/- 10. Mean age was 44.1 +/- 11.8. Morbidity rate was 5.2% and mortality rate 0.36%. Complications presented more frequently in superobese patients (OR, 2.8 (1.18-6.65)), male (OR, 2.98 (1.26-7.0)), and patients >55 years old (OR, 2.8 (1.14-6.8)). Staple-line reinforcement was related to a lower complication rate (3.7 vs 8.8%; p = 0.039). Mean hospital stay was 4.8 +/- 8.2 days. Mean follow-up was 16.5 +/- 10.6 months (1-73). Mean percent excess BMI loss (EBL) at 3 months was 38.8 +/- 22, 55.6 +/- 8 at 6 months, 68.1 +/- 28 at 12 months, and 72.4 +/- 31 at 24 months. %EBL was superior in patients with lower initial BMI and lower age. Bougie caliber was an inverse predictive factor of %EBL at 12 and 24 months (RR, 23.3 (11.4-35.2)). DM is remitted in 81% of the patients and HTA improved in 63.2% of them. A second-stage surgery was performed in 18 patients (3.2%). LSG provides good short- and mid-term results with a low morbid-mortality rate. Better results are obtained in younger patients with lowest BMI. Staple-line reinforcement and a thinner bougie are recommended to improve outcome.

  3. The current situation and mid-term prospects for European electricity markets

    International Nuclear Information System (INIS)

    Helm, Dieter

    2013-01-01

    This analysis of the current situation and mid-term prospects for European electricity markets presents: the objectives of energy policy, the historical legacy, the attempts at European integration and the Internal Energy Market (IEM), the coming of the Climate Change Package, the impact of the world economic and Euro-zone crises, the impact of shale gas and the new world of fossil fuel abundance, the impact of renewables on emissions, the impact of renewables on electricity markets, the EU emissions trading system (EU ETS) and the renewables and the electricity markets, the coming of capacity crunch in some cases, the capacity markets, the return of central buyers and national energy policies, and what is to be done for the world electricity markets

  4. Near-term electric-vehicle program. Phase II. Mid-term review summary report

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-27

    The general objective of the Near-Term Electric Vehicle Program is to confirm that, in fact, the complete spectrum of requirements placed on the automobile (e.g., safety, producibility, utility, etc.) can still be satisfied if electric power train concepts are incorporated in lieu of contemporary power train concepts, and that the resultant set of vehicle characteristics are mutually compatible, technologically achievable, and economically achievable. The focus of the approach to meeting this general objective involves the design, development, and fabrication of complete electric vehicles incorporating, where necessary, extensive technological advancements. A mid-term summary is presented of Phase II which is a continuation of the preliminary design study conducted in Phase I of the program. Information is included on vehicle performance and performance simulation models; battery subsystems; control equipment; power systems; vehicle design and components for suspension, steering, and braking; scale model testing; structural analysis; and vehicle dynamics analysis. (LCL)

  5. Near-Term Electric Vehicle Program. Phase II: Mid-Term Summary Report.

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-08-01

    The Near Term Electric Vehicle (NTEV) Program is a constituent elements of the overall national Electric and Hybrid Vehicle Program that is being implemented by the Department of Energy in accordance with the requirements of the Electric and Hybrid Vehicle Research, Development, and Demonstration Act of 1976. Phase II of the NTEV Program is focused on the detailed design and development, of complete electric integrated test vehicles that incorporate current and near-term technology, and meet specified DOE objectives. The activities described in this Mid-Term Summary Report are being carried out by two contractor teams. The prime contractors for these contractor teams are the General Electric Company and the Garrett Corporation. This report is divided into two discrete parts. Part 1 describes the progress of the General Electric team and Part 2 describes the progress of the Garrett team.

  6. Early and mid-term results of lung transplantation with donors 60 years and older.

    Science.gov (United States)

    López, Iker; Zapata, Ricardo; Solé, Juan; Jaúregui, Alberto; Deu, María; Romero, Laura; Pérez, Javier; Bello, Irene; Wong, Manuel; Ribas, Montse; Masnou, Nuria; Rello, Jordi; Roman, Antonio; Canela, Mercedes

    2015-01-01

    There are doubts about the age limit for lung donors and the ideal donor has traditionally been considered to be one younger than 55 years. The objective of this study was to compare the outcomes in lung transplantation between organs from donors older and younger than 60 years. We performed a retrospective observational study comparing the group of patients receiving organs from donors 60 years or older (Group A) or younger than 60 years (Group B) between January 2007 and December 2011. Postoperative evolution and mortality rates, short-term and mid-term postoperative complications, and global survival rate were evaluated. We analysed a total of 230 lung transplants, of which 53 (23%) involved lungs from donors 60 years of age or older (Group A), and 177 (77%) were from donors younger than 60 years (Group B). Three (5.7%) patients from Group A and 14 patients (7.9%) from Group B died within 30 days (P = 0.58). The percentage of patients free from chronic lung allograft dysfunction at 1-3 years was 95.5, 74.3 and 69.3% for Group A, and 94.5, 84.8 and 73.3% for Group B, respectively (P = 0.47). There were no statistically significant differences between Groups A and B in terms of survival at 3 years, (69.4 vs 68.8%; P = 0.28). Our results support the idea that lungs from donors aged 60-70 years can be used safely for lung transplantation with comparable results to lungs from younger donors in terms of postoperative mortality and mid-term survival. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. A mid-term, market-based power systems planning model

    International Nuclear Information System (INIS)

    Koltsaklis, Nikolaos E.; Dagoumas, Athanasios S.; Georgiadis, Michael C.; Papaioannou, George; Dikaiakos, Christos

    2016-01-01

    Highlights: • A mid-term Energy Planning along with a Unit Commitment model is developed. • The model identifies the optimum interconnection capacity. • Electricity interconnections affect the power mix and the day-ahead spot price. • Renewables’ penetration has impacts on the power reserves and the CO_2 emissions. • Energy policy and fuel pricing can have significant impacts on the power mix. - Abstract: This paper presents a generic Mixed Integer Linear Programming (MILP) model that integrates a Mid-term Energy Planning (MEP) model, which implements generation and transmission system planning at a yearly level, with a Unit Commitment (UC) model, which performs the simulation of the Day-Ahead Electricity Market. The applicability of the proposed model is illustrated in a case study of the Greek interconnected power system. The aim is to evaluate a critical project in the Ten Year Network Development Plan (TYNDP) of the Independent Power Transmission System Operator S.A. (ADMIE), namely the electric interconnection of the Crete Island with the mainland electric system. The proposed modeling framework identifies the implementation (or not) of the interconnection of the Crete Island with the mainland electric system, as well as the optimum interconnection capacity. It also quantifies the effects on the Day-Ahead electricity market and on the energy mix. The paper demonstrates that the model can provide useful insights into the strategic and challenging decisions to be determined by investors and/or policy makers at a national and/or regional level, by providing the optimal energy roadmap and management, as well as clear price signals on critical energy projects under real operating and design constraints.

  8. Building Capacity for Disaster Risk Reduction

    Science.gov (United States)

    McAdoo, B. G.; Bryner, V.

    2013-05-01

    Disaster risk is acutely high in many emerging economies due to a combination of geophysical hazards and social and ecological vulnerabilities. The risk associated with natural hazards can be a critical component of a nation's wealth, hence knowledge of these hazards will affect foreign investment in these emergent economies. On the hazard side of the risk profile, geophysicists research the frequency and magnitude of the extant hazards. These geophysicists, both local and foreign, have a responsibility to communicate these risks in the public sphere - whether they are through the mass media, or in personal conversations. Because of this implicit responsibility, it is incumbent upon geophysicists to understand the overall risk, not just the hazards. When it comes to communicating these risks, local scientists are often more effective because they speak the language, understand the social context, and are often connected to various modes of communication unavailable to foreign researchers. Investment in multidisciplinary undergraduate education is critical, as is training of established local scientists in understanding the complexities of risk assessment as well as communicating these risks effectively to broad audiences. Onagawa, Japan. 2011.

  9. Risk Reduction Education: Voices from the Field

    Science.gov (United States)

    Lamorey, Suzanne

    2010-01-01

    Teens with disabilities need information about risk topics such as addiction, abuse, sex, and delinquency to make healthy choices as they participate in mainstream society. This article presents questionnaire-based information provided by special educators in secondary schools about their efforts, limitations, and needs in providing risk reduction…

  10. Social intervention and risk reduction - indirect countermeasures

    International Nuclear Information System (INIS)

    Higgins, N.A.; Morrey, M.

    1996-01-01

    An indirect countermeasure (IC) is an action which is intended to mitigate detrimental effects experienced by individuals or the community after an accident. Indirect countermeasures (ICs) achieve this, both by averting radiation risks arising from the accident, but by removing or reducing other risks and sources of stress or harm to which the community may be subject. ICs naturally fall into two categories: social action ICs, which range from introducing compensation payments to providing information centres; and risk reducing ICs which mitigate risks to which the population might be exposed, such as radon. By including a consideration of ICs in an assessment of the optimal response, it is likely that a decision maker will become aware of a greater range of harms and benefits that might result from the application of a countermeasure. The decision maker will then be in a better position to judge the appropriateness of any action. (author)

  11. Mission Risk Reduction Regulatory Change Management

    Science.gov (United States)

    Scroggins, Sharon

    2007-01-01

    NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated

  12. Climate change, uncertainty and investment in flood risk reduction

    NARCIS (Netherlands)

    Pol, van der T.D.

    2015-01-01

    Economic analysis of flood risk management strategies has become more complex due to climate change. This thesis investigates the impact of climate change on investment in flood risk reduction, and applies optimisation methods to support identification of optimal flood risk management strategies.

  13. Disaster management and risk reduction in South Africa

    CSIR Research Space (South Africa)

    Bruwer, A

    2017-12-01

    Full Text Available The 2015 Global Assessment Report on Disaster Risk Reduction concludes that the mortality and economic loss associated with extensive risks (minor but recurrent disaster risks) in low- and middle-income countries are trending up. In the last decade...

  14. 75 FR 76345 - Risk Reduction Program

    Science.gov (United States)

    2010-12-08

    ... application of engineering and management principles, criteria, and techniques to optimize safety. Like risk.../deficiencies, using statistical models that compare the railroad's performance to the industry average or an... and implementation of its RRP utilizing valid mathematical tests or methods that conform to the...

  15. [Day clinic, a gateway towards risk reduction].

    Science.gov (United States)

    Ben Nifla, Viviane; Celli, Philippe; Samba, Hélène; Vincent, Cécile

    2018-01-01

    The addictology day clinic at Fernand-Widal hospital in Paris caters mainly for patients suffering from alcohol dependence. The aim is to consolidate the withdrawal which has taken place, to help reduce risks and harm and to support people waiting for follow-up care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. [Mid-term effectiveness of total hip arthroplasty with collum femoris preserving prosthesis].

    Science.gov (United States)

    Li, Mingqing; Hu, Yihe; Li, Kanghua; Liao, Qiande; Wen, Ting; Zhong, Da

    2012-08-01

    To discuss the clinical application of total hip arthroplasty (THA) with collum femoris preserving (CFP) prosthesis and to analyze the mid-term effectiveness. Between January 2004 and February 2007, 45 patients (48 hips) underwent THA with CFP prosthesis. There were 29 males (31 hips) and 16 females (17 hips) with an average age of 48.8 years (range, 38-60 years), including 20 left hips, 22 right hips, and 3 bilateral hips. The causes of hip replacement were osteoarthritis (20 cases), avascular necrosis of femoral head (13 cases), dysplasia (4 cases), rheumatoid arthritis (3 cases), posttraumatic osteoarthritis (2 cases), ankylosing spondylitis (2 cases), and Perths disease (1 case). The average disease duration was 6.1 years (range, 2-13 years). Harris scores, visual analogue scale (VAS) score, and the hip range of motion (ROM) were recorded at pre- and post-operation. The X-ray films were taken at pre- and post-operation to observe the position, loosening of the prosthesis, and ectopic ossification. The gait of patients were also evaluated during follow-up. Short-form 36 health survey scale (SF-36) was used to evaluate the life quality of patients. All 45 patients were followed up 5-8 years with an average of 6.4 years. All the incisions healed by first intention. No infection, hip dislocation, nerve injury, or deep vein thrombosis occurred. Six cleavage fractures (13.3%) of the lateral femoral diaphysis at the distal prosthesis occurred during operation, which healed at 8 months postoperatively without any treatment. Mild ectopic ossification occurred in 4 patients (8.9%) who had no discomfort. Five patients (11.1%) had bone mineral density loss in the region of the proximal femur. The survival rates of the cups and stems were all 100% at last follow-up. The results of Harris score, VAS score, and ROM of the hip joint at 1 year postoperatively and last follow-up were significantly better than preoperative ones (P 0.05) except the Harris score (P fair in 6 hips

  17. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, B.; Vikhrov, Dmytro; Kelman, I.; Stojanov, R.; Jakubínský, J.

    2015-01-01

    Roč. 20, č. 4 (2015), s. 499-504 ISSN 1381-2386 Institutional support: PRVOUK-P23 Keywords : flood risk reduction * household adaptation * Czech Republic Subject RIV: AH - Economics Impact factor: 3.085, year: 2015

  18. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, B.; Vikhrov, Dmytro; Kelman, I.; Stojanov, R.; Jakubínský, J.

    2015-01-01

    Roč. 20, č. 4 (2015), s. 499-504 ISSN 1381-2386 Institutional support: RVO:67985998 Keywords : flood risk reduction * household adaptation * Czech Republic Subject RIV: AH - Economics Impact factor: 3.085, year: 2015

  19. Climate change, uncertainty and investment in flood risk reduction

    OpenAIRE

    Pol, van der, T.D.

    2015-01-01

    Economic analysis of flood risk management strategies has become more complex due to climate change. This thesis investigates the impact of climate change on investment in flood risk reduction, and applies optimisation methods to support identification of optimal flood risk management strategies. Chapter 2 provides an overview of cost-benefit analysis (CBA) of flood risk management strategies under climate change uncertainty and new information. CBA is applied to determine optimal dike height...

  20. Life satisfaction in patients with and without spinal cord ischemia after advanced endovascular therapy for extensive aortic disease at mid-term follow-up.

    Science.gov (United States)

    Mehmedagic, Irma; Santén, Stefan; Jörgensen, Sophie; Acosta, Stefan

    2016-11-11

    Advanced endovascular aortic repair can be used to treat patients with extensive and complex aortic disease who are at risk of spinal cord ischaemia. The aim of this study was to compare whether life satisfaction differs between patients with and without spinal cord ischaemia at mid-term follow-up. Nested case-control study. Among patients undergoing advanced endovascular aortic repair between 2009 and 2012, 18 patients with spinal cord ischaemia and 33 without were interviewed at home. The Life Satisfaction Questionnaire (LiSat-11) and the Satisfaction With Life Scale (SWLS) were used. LiSat-11 found that patients with spinal cord ischaemia were more dissatisfied with their activities of daily living than were patients without spinal cord ischaemia (p=0.012). Both groups had similar, very low, scores in the sexual life domain; median 2.0 (interquartile range (IQR) 1.5-3.0) and 3.0 (IQR 2.0-4.0), respectively. There was no difference in SWLS between the groups. This study cohort of patients who underwent advanced endovascular aortic repair was rather homo-genous in their rating of life satisfaction and there was little difference between mid-term survivors who had spinal cord ischaemia and those who did not.

  1. Aerosols in Danish air (AIDA). Mid-term report 2000-2002

    Energy Technology Data Exchange (ETDEWEB)

    Palmgren, F; Waehlin, P; Berkowicz, R; Ketzel, M; Illerup, J B; Nielsen, M; Winther, M; Glasius, M; Jensen, B

    2003-10-01

    In year 2000 the Danish Parliament decided to fund a four-year particle research programme, which should include characterization of physical and chemical properties of the particles in Denmark and their sources and also assess the adverse health effects and the socio-economic impact in the Danish society. The overall objective of the particle programme is to provide new and broader knowledge in Denmark on the health effect of atmospheric particles with the aim to develop strategies to reduce the adverse health effect of man-made and natural sources. The activities should be closely related to other activities in Denmark and internationally. Specifically National Environmental Research Institute (NERI) shall investigate emissions, size distributions, chemical composition, transformation and dispersion of particles. The present report is the mid-term report on the activities at NERI, and is a summary oef the experimental results, analysis of particle in relation to sources - especially road traffic - and the papers published in connection with the programme. (au)

  2. Progress and Achievements at the Mid Term Stage of the Dragon 3 Programme

    Science.gov (United States)

    Desnos, Yves-Louis; Li, Zengyuan; Zmuda, Andy; Gao, Zhihai

    2014-11-01

    The Dragon Programme is a joint undertaking between ESA and the Ministry of Science and Technology (MOST) of China and the National Remote Sensing Center of China (NRSCC). Its purpose is to encourage increased exploitation of ESA and Chinese space resources within China as well as stimulate increased scientific cooperation in the field of Earth Observation (EO) science and applications between China and Europe. Since 2004, this pioneering programme has become a model for scientific and technological cooperation between China and Europe. By successfully encouraging joint research using ESA, Third Party Missions and Chinese EO data across a range of thematic areas, Dragon continues to deliver outstanding scientific results. The programme has successfully completed two phases, Dragon 1 from 2004 to 2008, Dragon 2 from 2008 to 2012. The third phase of Dragon was started in 2012 and will be completed in 2016. The Dragon 3 project teams are led by leading EO scientists and young scientists are also engaged on the projects. Advanced training in land, ocean and atmospheric applications is a feature of the programme and a course on land and one course on ocean applications have been successfully held in 2012 and 2013 in China. Here-in provided is an overview of the results, reporting and training activities at the mid-term stage of the programme.

  3. Progress and Achievements At the Mid Term Stage of the Dragon 2 Programme

    Science.gov (United States)

    Desnos, Yves-Louis; Li, Zhengyuan; Zmuda, Andy; Gao, Zhihai

    2010-10-01

    The cooperation between ESA and National Remote Sensing Center of China (NRSCC) / Ministry Of Science and Technology of China (MOST) in the development of Earth Observation (EO) applications started 15 years ago. In 2004, a new phase in cooperation began with the start of the Dragon Programme which focused on science and application using ESA satellite data. The programme was completed in 2008. Following on, the cooperation took on greater momentum with the start of a four-year EO science and exploitation programme called 'Dragon 2'. This programme brings together joint Sino-European teams to investigate land, ocean and atmospheric applications in P.R. China using data from ESA, Third Party Mission and Chinese Earth Observation satellites. The teams are led by leading EO scientists and young scientists are also engaged on the projects. Advanced training in land, ocean and atmospheric applications is a feature of the programme and after 2 years, two courses on land and one course on atmospheric applications have been successfully held in 2008, 2009 and 2010 in China. Here-in provided is an overview of the results, reporting and training activities at the mid term stage of the programme. The Sino-European teams continue to deliver world-class scientific results across a wide range of disciplines. The programme provides a platform for the joint exploitation of ESA, TPM and Chinese EO data from optical, infrared, thermal and microwave sensors for science and application development.

  4. Progress and Achievements at the Mid Term of the Dragon 3 Programme

    Science.gov (United States)

    Desnos, Yves-Louis; Li, Zengyuan; Zmuda, Andy; Gao, Zhihai

    2014-11-01

    The Dragon Programme is a joint undertaking between ESA and the Ministry of Science and Technology (MOST) of China and the National Remote Sensing Center of China (NRSCC). Its purpose is to encourage increased exploitation of ESA and Chinese space resources within China as well as stimulate increased scientific cooperation in the field of Earth Observation (EO) science and applications between China and Europe. Since 2004, this pioneering programme has become a model for scientific and technological cooperation between China and Europe. By successfully encouraging joint research using ESA, Third Party Missions and Chinese EO data across a range of thematic areas, Dragon continues to deliver outstanding scientific results. The programme has successfully completed two phases, Dragon 1 from 2004 to 2008, Dragon 2 from 2008 to 2012. The third phase of Dragon was started in 2012 and will be completed in 2016. The Dragon 3 project teams are led by leading EO scientists and young scientists are also engaged on the projects. Advanced training in land, ocean and atmospheric applications is a feature of the programme and a course on land and one course on ocean applications have been successfully held in 2012 and 2013 in China. Here-in provided is an overview of the results, reporting and training activities at the mid-term stage of the programme.

  5. Mid-term evaluation of the Climate Change Action Fund: Science, Impacts and Adaptation (SIA) block

    International Nuclear Information System (INIS)

    2001-11-01

    In 1998, the Climate Change Action Fund was established by the Government of Canada. Its budget represented 150 million dollars over a three year period, and was an additional 625 million dollars in the federal budget of February 2000 was allocated for climate change initiatives, of which 150 million dollars were earmarked over a three year period to the Climate Change Action Fund. To provide input for Treasury Board Submissions looking for funding approval in the future, it was necessary to conduct a mid-term evaluation focused on program performance to date. The period covered by the evaluation was September 2000 to the end of January 2001. This report examined the performance of the Science, Impact and Adaptation Block (SIA). Based on a series of interviews with representatives of Block managers, Technical and Executive Policy Committees, successful applicants, unsuccessful applicants and peer reviewers, as well as a review of the documentation maintained by SIA, it addressed the following issues: Block relevance, progress/success to date, and effectiveness in meeting the objectives. It was determined that the objectives displayed relevance to the climate change agenda of the federal government, progress to date was considered satisfactory, and most of the objectives should be met in a timely fashion. A summary of the findings was included in this document along with recommendations pertaining to the findings. 3 tabs., 1 fig

  6. Hydrogen risk reduction in Nuclear power plant

    International Nuclear Information System (INIS)

    Movahed, M.A.; Travis, J.R.

    1999-01-01

    In case of a severe accident in a nuclear power plant with core melt and hydrogen production, the hydrogen risk is one of the main concerns. It may jeopardize the containment integrity due to violent deflagration that can lead to DDT (Deflagration Detonation Transient) or even detonation of proper hydrogen mitigation means are not available. The design of the EPR (European Pressurized water Reactor) Hydrogen mitigation and control system is based on the lumped parameter code WAVCO and the 3D code GASFLOW. The concept consists of recombiners and igniters to cope with all scenarios including those without steam. The system has been checked to avoid DDT by the 7λ criteria that's implemented in GASFLOW. Future analysis could deal with determining dynamic pressure loads, if appropriate, and some sensitivity studies to check the hydrogen control measures with respect to different source locations and mass flow rates. Also a conditional criterion for determining the likelihood of fast deflagration should be developed. (author)

  7. The CAP Mid Term Review and the WTO Doha Round; Analyses for the Netherlands, EU and accession countries

    NARCIS (Netherlands)

    Lips, M.

    2004-01-01

    This report analyses the potential impact of the EU CAP reforms that follow the Mid Term Review and the Harbinson Proposal for negotiation modalities in the WTO Doha Round on the Netherlands, EU14 and the accession countries. In welfare terms, the MTR has a rela-tively small impact on the

  8. [Enteral nutrition: reduction in the contamination risk].

    Science.gov (United States)

    Montemerlo, H; Menéndez, A M; Marcenac, F; Floridia, J; Esteban, L; Barbaricca, M

    1996-01-01

    Enteral nutrition is used as a routine therapy in patients with caloric-protein malnutrition, severe dysphagia, major burns, intestinal resection, and enterocutaneous fistulae, as long as a portion of the digestive tract still has an active absorptive function. The administration takes place by means of surgical (ostomies) or non-surgical (nasogastric) tubes. In our country, a significant number of hospitalized patients with various diseases receive this type of nutrition. Given that the colonization of the digestive tract by hospital flora is the first step towards developing intra-hospital infections, the contamination implies serious risks. The objective of this study was to study the most appropriate conditions for the manufacturing, storage and administration of the mixture of nutrients of enteral nutrition, to guarantee nutrition with a lower contamination risk. This study was conducted by the Unit of Nutritional Assistance of the Mater Dei Clinic, by means of bacteriological controls, from January 1991 to December 1992, and in 1993 in which the work systematics were reviewed. The study was prospective, and those solutions whose bacteriological counts were lower than 100.000 colony forming units (CFU), and which showed an absence of enteropathological micro-organisms, were considered acceptable, and those solutions which had a bacteriological count greater than or equal to 100.000 CFU and or the presence of enteropathological micro-organisms, were considered unacceptable. During the first period, "usual working conditions", we analyzed the infra-structure, the personnel, the constituents, and the apparatus used in the manufacturing, for which 36 samples were studied at t0 (moment of preparation). Afterwards, in the second period "special working conditions", we analyzed the manufacturing procedures, the storage and the administration of 103 solutions, corresponding to 36 patients, taking samples at t0 and t24 (after 24 hours of preparing). In the first phase

  9. Mid-term results of lateral unicondylar mobile bearing knee arthroplasty: a multicentre study of 363 cases.

    Science.gov (United States)

    Walker, T; Zahn, N; Bruckner, T; Streit, M R; Mohr, G; Aldinger, P R; Clarius, M; Gotterbarm, T

    2018-01-01

    The aim of this independent multicentre study was to assess the mid-term results of mobile bearing unicondylar knee arthroplasty (UKA) for isolated lateral osteoarthritis of the knee joint. We retrospectively evaluated 363 consecutive, lateral UKAs (346 patients) performed using the Oxford domed lateral prosthesis undertaken in three high-volume knee arthroplasty centres between 2006 and 2014. Mean age of the patients at surgery was 65 years (36 to 88) with a mean final follow-up of 37 months (12 to 93) RESULTS: A total of 36 (10.5%) patients underwent revision surgery, giving a survival rate of 90.1% at three years (95% confidence intervals (CI) 86.1 to 93.1; number at risk: 155) and 85.0% at five years (95% CI 77.9 to 89.9; number at risk: 43). Dislocation of the mobile bearing occurred in 18 patients (5.6%) at three years (95% CI 1.0 to 16.4; number at risk: 154) and in 20 patients (8.5%) at five years (95% CI 1.0 to 27.0; number at risk: 42). There were no significant differences in the dislocation rate between the participating centres or the surgeons. We were not able to identify an effect of each surgeon's learning curve on the dislocation rate of the mobile bearing. The clinical outcome in patients without revision surgery at final follow-up was good to excellent, with a mean Oxford knee score of 40.3 (95% CI 39.4 to 41.2), a mean Tegner activity score of 3.2 (95% CI 3.1 to 3.3) and a mean University of California, Los Angeles score of 5.7 (95% CI 5.5 to 5.9). Our data, which consists of a high number of patients treated with mobile bearing UKA in the lateral compartment, indicates a high revision rate of 15% at five years with dislocation of the mobile bearing being the main reason for implant failure. Despite the good functional and clinical results and the high patient satisfaction in our study group, we therefore discontinued using mobile-bearing lateral UKA in favour of a fixed-bearing component. Cite this article: Bone Joint J 2018;100-B:42-9. ©2018

  10. Existential risks: exploring a robust risk reduction strategy.

    Science.gov (United States)

    Jebari, Karim

    2015-06-01

    A small but growing number of studies have aimed to understand, assess and reduce existential risks, or risks that threaten the continued existence of mankind. However, most attention has been focused on known and tangible risks. This paper proposes a heuristic for reducing the risk of black swan extinction events. These events are, as the name suggests, stochastic and unforeseen when they happen. Decision theory based on a fixed model of possible outcomes cannot properly deal with this kind of event. Neither can probabilistic risk analysis. This paper will argue that the approach that is referred to as engineering safety could be applied to reducing the risk from black swan extinction events. It will also propose a conceptual sketch of how such a strategy may be implemented: isolated, self-sufficient, and continuously manned underground refuges. Some characteristics of such refuges are also described, in particular the psychosocial aspects. Furthermore, it is argued that this implementation of the engineering safety strategy safety barriers would be effective and plausible and could reduce the risk of an extinction event in a wide range of possible (known and unknown) scenarios. Considering the staggering opportunity cost of an existential catastrophe, such strategies ought to be explored more vigorously.

  11. Communication about melanoma and risk reduction after melanoma diagnosis.

    Science.gov (United States)

    Rodríguez, Vivian M; Berwick, Marianne; Hay, Jennifer L

    2017-12-01

    Melanoma patients are advised to perform regular risk-reduction practices, including sun protection as well as skin self-examinations (SSEs) and physician-led examinations. Melanoma-specific communication regarding family risk and screening may promote such behaviors. To this end, associations between patients' melanoma-specific communication and risk reduction were examined. Melanoma patients (N = 169) drawn from a population-based cancer registry reported their current risk-reduction practices, perceived risk of future melanoma, and communication with physicians and relatives about melanoma risk and screening. Patients were, on average, 56 years old and 6.7 years' post diagnosis; 51% were male, 93% reported "fair/very fair" skin color, 75% completed at least some college, and 22% reported a family history of melanoma. Patients reported varying levels of regular (always/nearly always) sun protection: sunscreen use (79%), shade seeking (60%), hat use (54%), and long-sleeve shirt use (30%). Only 28% performed thorough SSE regularly, whereas 92% reported undergoing physician-led skin examinations within the past year. Participants who were female, younger, and had a higher perceived risk of future melanoma were more likely to report past communication. In adjusted analyses, communication remained uniquely associated with increased sunscreen use and SSE. Encouraging melanoma patients to have a more active role in discussions concerning melanoma risk and screening with relatives and physicians alike may be a useful strategy to promote 2 key risk-reduction practices post melanoma diagnosis and treatment. Future research is needed to identify additional strategies to improve comprehensive risk reduction in long-term melanoma patients. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Percutaneous Transluminal Angioplasty of Renal Artery Fibromuscular Dysplasia: Mid-term Results

    International Nuclear Information System (INIS)

    Kim, Hyo Jin; Do, Young Soo; Shin, Sung Wook; Park, Kwang Bo; Cho, Sung Ki; Choe, Yeon Hyeon; Choo, Sung Wook; Choo, In Wook; Kim, Duk Kyung

    2008-01-01

    To evaluate mid-term imaging, clinical follow-up, and restenosis rates from patients that had undergone percutaneous transluminal renal artery angioplasty (PTRA) for symptomatic renal artery fibromuscular dysplasia (FMD). Between March 1999 and July 2006, 16 consecutive renal artery FMD patients underwent PTRA for poorly controlled hypertension. The patients were enrolled into this retrospective study after receiving 19 primary and four secondary PTRAs in 19 renal artery segments. Follow-up monitoring of blood pressure, use of antihypertensive medication, and the serum creatinine level after PTRA were assessed at 1, 3, 6, 9, 12 months, and each following year. The degree of restenosis was evaluated with computed tomographic angiography (CTA) after PTRA at 6, 12 months, and every year if possible. Technical and clinical success rates for the treatment of FMD, and restenosis rates for the renal artery were evaluated. The technical success rate for primary PTRA was 79% (15/19) and the complication rate was 16% (3/19). Hypertension improved in 80% (12/15) of the patients after four weeks follow-up, and was finally cured or improved in 93% (14/15) during the mean follow-up period of 23.6 months. There was a cumulative 22% (4/18) restenosis rate during the follow-up period. All of the patients were treated with a second PTRA without complications and all of the patients were cured of hypertension after the second PTRA. Percutaneous transluminal renal artery angioplasty for clinically symptomatic renal FMD is technically and clinically successful and safe to perform. For all patients with restenosis, there was a good response after undergoing a second PTRA

  13. Mid-term outcomes of endovascular aortic aneurysm repair with carbon dioxide-guided angiography.

    Science.gov (United States)

    Takeuchi, Yuriko; Morikage, Noriyasu; Matsuno, Yutaro; Nakamura, Tamami; Samura, Makoto; Ueda, Koshiro; Harada, Takasuke; Ikeda, Yoshitaka; Suehiro, Kotaro; Ito, Hiroshi; Sakata, Kensuke; Hamano, Kimikazu

    2018-05-14

    Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO 2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO 2 -guided angiography. Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO 2 -EVAR group (n=30). Subjects in the CO 2 -EVAR group had severe renal dysfunction (n=27) and IC allergy (n=4). Intraoperative, postoperative, and follow-up variables were compared. Compared to the IC-EVAR group, preoperative serum creatinine level was significantly higher (2.0 vs. 0.92 mg/dL, P < .0001) and mean IC dose significantly lower (18 vs. 55 mL P < .0001) in the CO 2 -EVAR group. The fluoroscopy time, operative time, number of stent grafts placed, and technical success rates of the groups were similar; no type I and/or type III endoleaks were detected on completion angiography. There was no acute kidney injury and one case of intestinal necrosis in the CO 2 -EVAR group, potentially due to cholesterol embolism. Postoperative endoleak, enlargement of aneurysms, survival, freedom from secondary intervention, and renal function change up to 3 months postoperatively were similar between groups. CO 2 -EVAR is technically feasible and exhibits prominent renal protection. However, consideration of the aortic lumen status remains an important challenge. Copyright © 2018. Published by Elsevier Inc.

  14. Mid-Term Vascular Safety of Renal Denervation Assessed by Follow-up MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de; Schmieder, Raphael; Lell, Michael; Janka, Rolf [Friedrich-Alexander University Erlangen-Nuremberg, Department of Radiology (Germany); Veelken, Roland; Schmieder, Roland E. [Friedrich-Alexander University Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Uder, Michael [Friedrich-Alexander University Erlangen-Nuremberg, Department of Radiology (Germany); Ott, Christian [Friedrich-Alexander University Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany)

    2016-03-15

    Background/AimsRenal denervation (RDN) emerged as a treatment option for reducing blood pressure (BP) in patients with treatment-resistant hypertension (TRH). However, concerns have been raised regarding the incidence of late renal artery stenosis or thromboembolism after RDN. The goal of the current study was, therefore, to conduct a prospective clinical trial on the mid-term vascular integrity of the renal arteries and the perfusion of the renal parenchyma assessed by magnetic resonance imaging (MRI) in the follow-up after catheter-based RDN.MethodsIn our single-centre investigator initiated study, 51 patients with true TRH underwent catheter-based RDN using the Symplicity Flex{sup TM} catheter (Medtronic Inc., Palo Alto, CA). Follow-up MRI was performed at a median of 11 months (interquartile range 6–18 months) after RDN on a 1.5T MR unit. High-resolution MR angiography (MRA) and MRI results were compared to the baseline digital angiography of renal arteries obtained at time of RDN. In case of uncertainties (N = 2) catheter angiography was repeated.ResultsBoth office and 24-h ambulatory BP were significantly reduced 6 and 12 months after RDN. Renal function remained unchanged 6 and 12 months after RDN. In all patients, MRA excluded new or progression of pre-existing low grade renal artery stenosis as well as focal aneurysms at the sites of radiofrequency ablation. In none of the patients new segmental perfusion deficits in either kidney were detected on MRI.ConclusionsNo vascular or parenchymal complications after radiofrequency-based RDN were detected in 51 patients followed up by MRI.

  15. Waiting for Disasters: A Risk Reduction Assessment of Technological Disasters

    Science.gov (United States)

    Rovins, Jane; Winningham, Sam

    2010-05-01

    This session provides a risk reduction/mitigation assessment of natural hazards causation of technological disasters and possible solution. People use technology in an attempt to not only control their environment but nature itself in order to make them feel safe and productive. Most strategies for managing hazards followed a traditional planning model i.e. study the problem, identify and implement a solution, and move on to the next problem. This approach is often viewed as static model and risk reduction is more of an upward, positive, linear trend. However, technological disasters do not allow risk reduction action to neatly fit this upward, positive, linear trend with actual or potential threats to the environment and society. There are different types of technological disasters, including industrial accidents; pipeline ruptures; accidents at power, water and heat supply systems and other lines of communication; sudden collapse of buildings and mines; air crashes; shipwrecks; automobile and railway accidents to name a few. Natural factors can play an essential role in triggering or magnifying technological disasters. They can result from the direct destruction of given technical objects by a hazardous natural process such as the destruction of an atomic power plant or chemical plant due to an earthquake. Other examples would include the destruction of communications or infrastructure systems by heavy snowfalls, strong winds, avalanches. Events in the past ten years clearly demonstrate that natural disasters and the technological disasters that accompany them are not problems that can be solved in isolation and risk reduction can play an important part. Risk reduction was designed to head off the continuing rising financial and structural tolls from disasters. All Hazard Risk Reduction planning was supposed to include not only natural, but technological, and human-made disasters as well. The subsequent disaster risk reduction (DRR) indicators were to provide the

  16. Microenterprise development interventions for sexual risk reduction: a systematic review.

    Science.gov (United States)

    Cui, Rosa R; Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E; Tucker, Joseph D

    2013-11-01

    Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

  17. Children capacity in disaster risk reduction: A call for action

    Directory of Open Access Journals (Sweden)

    Leila Mohammadinia

    2017-01-01

    Full Text Available Disasters have various physical, psychological, social and economical effects on all age group, particularly children who are more vulnerable than adults. In the aftermath of disasters, children like pregnant women, elderly and handicaps are special group with special needs. This is because they are at greater risk based on their specific physiological and psychological characteristics. Moreover,, according to the Sendai document, children need more attention in Disaster Risk Reduction (DRRprograms design, policies implementation with a proactive approach in Disaster Risk Reduction (1. In the Sendai document it is emphasized that policies regarding disaster risk reduction, cognition and risk perception about the risk property should be considered based upon the hazards and the environment in terms of vulnerability, capacity and exposure (2.Hyogo framework for action was also already have been focused on child priority on the legislation program (3. Accordingly, it is necessary to involve children in disaster risk reduction programs actively in order to overcome their needs and their problems (4. As children are more affected groups in various aspects of disasters in most countries, their potential utilization, the conditions and space should be provided based on laws, national policies, training and capacity. Although after disaster children required particular needs and attention(5-6, they should be considered as an active group who could participate in DRR program and help their family and also the community.(4, 7 Some evidences suggest on value of children team working for community preparedness. Iran had a successful experience for using adolescence capacity as a pillar in activation of early warning; including notification announced while observing the rising sea levels for local community in order to reduce the risk of flood disaster at a local area in the North of Iran. According to the Hyogo and the Sendai documents, it seems that using

  18. Effect of smoking reduction on lung cancer risk

    DEFF Research Database (Denmark)

    Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

    2005-01-01

    Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases.......Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

  19. Short-term and mid-term results with the Sorin Freedom Solo aortic valve.

    Science.gov (United States)

    Ustunsoy, Hasim; Yasim, Alptekin; Deniz, Hayati; Gokaslan, Gokhan; Ozcaliskan, Ozerdem

    2013-03-01

    The study aim was to present the short- and mid-term results for patients who underwent aortic valve replacement (AVR) with the Sorin Freedom Solo third-generation stentless prosthetic valve. AVR with a Sorin Freedom Solo valve was performed in 14 patients between March 2006 and March 2011. Patients aged > or = 60 years (male:female ratio 6:8; mean age 73.28 +/- 5.42 years) who required AVR with the Sorin Freedom Solo valve according to the surgeon's choice were included in the study. The valvular prosthesis was implanted in the supra-annular position, using a single suture line. Eight patients underwent an isolated AVR; combined interventions were carried out in the other patients due to concomitant cardiac disease. One patient died during the immediate perioperative period, and two more during the follow up, from non-cardiac causes. The mean maximum transvalvular gradient of patients with aortic stenosis was 88.1 +/- 20.2 mmHg, and this fell to 26.4 +/- 7.6 mmHg during the early postoperative period. The mean gradient at one year of follow up was further decreased to 19.4 +/- 5.3 mmHg. The left ventricular end-diastolic and end-systolic diameters were also significantly reduced, from 4.8 +/- 0.9 to 4.3 +/- 0.6 cm and from 3.2 +/- 0.6 to 2.8 +/- 5.3 cm, respectively. The average left ventricular ejection fraction was 60.2 +/- 4.9% preoperatively, and 63.2 +/- 2.1% at one year after surgery (p = NS). No paravalvular leakage, endocarditis, prosthesis failure or neurologic events were reported among patients. The Sorin Freedom Solo stentless valve has provided good early and intermediate-term results. Implantation of the prosthesis is straightforward, with low rates of morbidity and mortality. However, these data require further support from larger patient series and long-term follow up.

  20. Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Lee, Y K; Ha, Y C; Yoo, J-I; Jo, W L; Kim, K-C; Koo, K H

    2017-06-01

    We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  1. The efficacy of serostatus disclosure for HIV Transmission risk reduction.

    Science.gov (United States)

    O'Connell, Ann A; Reed, Sandra J; Serovich, Julianne A

    2015-02-01

    Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698-705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed.

  2. The Global Earthquake Model and Disaster Risk Reduction

    Science.gov (United States)

    Smolka, A. J.

    2015-12-01

    Advanced, reliable and transparent tools and data to assess earthquake risk are inaccessible to most, especially in less developed regions of the world while few, if any, globally accepted standards currently allow a meaningful comparison of risk between places. The Global Earthquake Model (GEM) is a collaborative effort that aims to provide models, datasets and state-of-the-art tools for transparent assessment of earthquake hazard and risk. As part of this goal, GEM and its global network of collaborators have developed the OpenQuake engine (an open-source software for hazard and risk calculations), the OpenQuake platform (a web-based portal making GEM's resources and datasets freely available to all potential users), and a suite of tools to support modelers and other experts in the development of hazard, exposure and vulnerability models. These resources are being used extensively across the world in hazard and risk assessment, from individual practitioners to local and national institutions, and in regional projects to inform disaster risk reduction. Practical examples for how GEM is bridging the gap between science and disaster risk reduction are: - Several countries including Switzerland, Turkey, Italy, Ecuador, Papua-New Guinea and Taiwan (with more to follow) are computing national seismic hazard using the OpenQuake-engine. In some cases these results are used for the definition of actions in building codes. - Technical support, tools and data for the development of hazard, exposure, vulnerability and risk models for regional projects in South America and Sub-Saharan Africa. - Going beyond physical risk, GEM's scorecard approach evaluates local resilience by bringing together neighborhood/community leaders and the risk reduction community as a basis for designing risk reduction programs at various levels of geography. Actual case studies are Lalitpur in the Kathmandu Valley in Nepal and Quito/Ecuador. In agreement with GEM's collaborative approach, all

  3. Mid-Term Results of Surgical Treatment of Atrial Fibrillation in Valvular Heart Disease Assesed by Speckle Tracking Echocardiography.

    Science.gov (United States)

    Lorenzo, Natalia; Mendez, Irene; Taibo, Mikel; Martinis, Gianfranco; Badia, Sara; Reyes, Guillermo; Aguilar, Rio

    2018-03-19

    Atrial fibrillation frequently affects patients with valvular heart disease. Ablation of atrial fibrillation during valvular surgery is an alternative for restoring sinus rhythm. This study aimed to evaluate mid-term results of successful atrial fibrillation surgical ablation during valvular heart disease surgery, to explore left atrium post-ablation mechanics and to identify predictors of recurrence. Fifty-three consecutive candidates were included. Eligibility criteria for ablation included persistent atrial fibrillation valvular heart disease surgery.

  4. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    Science.gov (United States)

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  5. Effect of smoking reduction on lung cancer risk

    DEFF Research Database (Denmark)

    Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

    2005-01-01

    Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

  6. Measuring the Value of Mortality Risk Reductions in Turkey

    Science.gov (United States)

    Tekeşin, Cem; Ara, Shihomi

    2014-01-01

    The willingness to pay (WTP) for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident) are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical life (VSL) estimated for Afsin-Elbistan, Kutahya-Tavsanli, Ankara and the pooled case are found as 0.56, 0.35, 0.46 and 0.49 million Purchasing Power Parity (PPP) adjusted 2012 US dollars (USD). Different types of risk cause different VSL estimates and we found the lung cancer premium of 213% against traffic accident. The effects of one-year-delayed provision of risk-reduction service are the reduction of WTP by 482 TL ($318 in PPP adjusted USD) per person on average, and the disutility from status-quo (zero risk reduction) against alternative is found to be 891 TL ($589 in PPP adjusted USD) per person on average. Senior discounts of VSL are partially determined by status-quo preference and the amount of discount decreases once the status-quo bias is removed. The peak VSL is found to be for the age group 30–39 and the average VSL for the age group is 0.8 million PPP adjusted USD). Turkey’s compliance to European Union (EU) air quality standard will cause welfare gains of total 373 million PPP adjusted USD for our study areas in terms of reduced number of premature mortality. PMID:25000150

  7. Measuring the Value of Mortality Risk Reductions in Turkey

    Directory of Open Access Journals (Sweden)

    Cem Tekeşin

    2014-07-01

    Full Text Available The willingness to pay (WTP for mortality risk reduction from four causes (lung cancer, other type of cancer, respiratory disease, traffic accident are estimated using random parameter logit model with data from choice experiment for three regions in Turkey. The value of statistical life (VSL estimated for Afsin-Elbistan, Kutahya-Tavsanli, Ankara and the pooled case are found as 0.56, 0.35, 0.46 and 0.49 million Purchasing Power Parity (PPP adjusted 2012 US dollars (USD. Different types of risk cause different VSL estimates and we found the lung cancer premium of 213% against traffic accident. The effects of one-year-delayed provision of risk-reduction service are the reduction of WTP by 482 TL ($318 in PPP adjusted USD per person on average, and the disutility from status-quo (zero risk reduction against alternative is found to be 891 TL ($589 in PPP adjusted USD per person on average. Senior discounts of VSL are partially determined by status-quo preference and the amount of discount decreases once the status-quo bias is removed. The peak VSL is found to be for the age group 30–39 and the average VSL for the age group is 0.8 million PPP adjusted USD. Turkey’s compliance to European Union (EU air quality standard will cause welfare gains of total 373 million PPP adjusted USD for our study areas in terms of reduced number of premature mortality.

  8. Investigating the risk reduction potential of disaster insurance across Europe

    NARCIS (Netherlands)

    Surminski, Swenja; Hudson, Paul

    2017-01-01

    The notion that insurance can play a significant role in risk reduction has recently gained increasing attention in the wake of rising losses from natural disasters. While this notion is accepted in theory, we notice that, in practice, little is known about if and how insurance promotes efforts to

  9. Sexual risk reduction among Zambian couples | Jones | SAHARA-J ...

    African Journals Online (AJOL)

    Zambia has over 1 million HIV infections nationwide and an urban prevalence rate of 23%. This study compared the impact of male involvement in multiple and single session risk reduction interventions among inconsistent condom users in Zambia and the role of serostatus among HIV-seropositive and serodiscordant ...

  10. Endovascular therapy of abdominal aortic aneurysm: results of a mid-term follow-up

    International Nuclear Information System (INIS)

    Pitton, M.B.; Schweitzer, H.; Herber, S.; Thelen, M.; Schmiedt, W.; Neufang, A.; Dueber, C.

    2003-01-01

    Prospective study to evaluate clinical results and complications of endovascular abdominal aortic aneurysm treatment in a mid-term follow-up. Materials and methods: A total of 122 patients (9 females, 113 males, average age 70.0±7,9 years) with abdominal aortic aneurysms were treated with stent grafts (53 Vanguard or Stentor endografts, 69 Talent endografts). Group I consisted of 40 patients who had all aortic tributaries of the aneurysm sac occluded prior to endovalscular grafting, either spontaneously by parietal thrombosis or by selective coil embolization of the respective ostia preserving collateral circulation distal to the vessel occlusion. Group II consisted of 82 patients and included all cases without or with incomplete coil embolization with at least one patent vessel. Stent grafting was performed in general anesthesia in the first 21 patients, followed by peridural anesthesia in 15 cases, and local anesthesia with conscious sedation in 86 cases. The results were evaluated with Spiral-CT, MRI and radiographs of the endovascular graft, with follow-up examinations obtained at 3, 6, 12 months, and every year - Implantation was successfully completed in all cases without primary conversion surgery, laparotomy or any significant complication. Mean follow-up was 29±21 months (maximum 82 months). The 30-day mortality was 0,8% due to a myocardial infarction 3 days after discharge from the hospital. A total of 47 re-interventions were performed in 29 patients (23.8%), with 35 re-interventions in 18 cases with Vanguard or Stentor endografts and 12 re-interventions in 11 patients with Talent endografts. 23 percutaneous re-interventions included distal graft extension (n=11), Wallstent for kinking and limb stenosis (n=3), and secondary coil embolization of collateral vessels (n=9). 24 surgical re-interventions included proximal graft extension (n=6), new endovascular grafts (n=3), surgical clipping of lumbar and mesenteric artery branches for type-II endoleaks

  11. Long-Term International Space Station (ISS) Risk Reduction Activities

    Science.gov (United States)

    Fodroci, M. P.; Gafka, G. K.; Lutomski, M. G.; Maher, J. S.

    2012-01-01

    As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the initial ISS requirements and design were intended to provide the best practicable levels of safety, it is always possible to further reduce risk - given the determination, commitment, and resources to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS, and to reduce risk to all crewmembers. While years of work went into the development of ISS requirements, there are many things associated with risk reduction in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity Hazard Level- 4 [THL] materials, emergency procedures, emergency equipment, control of drag-throughs) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards) Due to the hard work and cooperation of many parties working together across the span of more than a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery for years

  12. Constructing a holistic approach to disaster risk reduction: the significance of focusing on vulnerability reduction.

    Science.gov (United States)

    Palliyaguru, Roshani; Amaratunga, Dilanthi; Baldry, David

    2014-01-01

    As a result of the increase in natural disaster losses, policy-makers, practitioners, and members of the research community around the world are seeking effective and efficient means of overcoming or minimising them. Although various theoretical constructs are beneficial to understanding the disaster phenomenon and the means of minimising losses, the disaster risk management process becomes less effective if theory and practice are set apart from one another. Consequently, this paper seeks to establish a relationship between two theoretical constructs, 'disaster risk reduction (DRR)' and 'vulnerability reduction', and to develop a holistic approach to DRR with particular reference to improving its applicability in practical settings. It is based on a literature review and on an overall understanding gained through two case studies of post-disaster infrastructure reconstruction projects in Sri Lanka and three expert interviews in Sri Lanka and the United Kingdom. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  13. Assessment of aircraft risk reduction at Pantex Plant

    International Nuclear Information System (INIS)

    Lin, Y.T.; Hedtke, R.; Fike, D.; Diniz, J.

    1996-01-01

    The possibility of an aircraft crashing into the Department of Energy's (DOE) Pantex plant facility has been of concern in risk assessments. In response to public concerns, and in an effort to reduce risks associated with overflights of Pantex, several changes to navigational aids at Amarillo International Airport have been implemented. For over one year, a radar airspace monitor and recording system has been connected to the airport surveillance radar at Amarillo to record the flight paths, aircraft types, and traffic density of aircraft in the vicinity of the Pantex plant. The data has provided a better understanding of the overflight risk at Pantex as well as a means to measure the effectiveness of risk reduction efforts

  14. Levelized cost-risk reduction prioritization of waste disposal options

    International Nuclear Information System (INIS)

    Wilkinson, V.K.; Young, J.M.

    1992-01-01

    The prioritization of solid waste disposal options in terms of reduced risk to workers, the public, and the environment has recently generated considerable governmental and public interest. In this paper we address the development of a methodology to establish priorities for waste disposal options, such as incineration, landfills, long-term storage, waste minimization, etc. The study is one result of an overall project to develop methodologies for Probabilistic Risk Assessments (PRAs) of non-reactor nuclear facilities for the US Department of Energy. Option preferences are based on a levelized cost-risk reduction analysis. Option rankings are developed as functions of disposal option cost and timing, relative long- and short-term risks, and possible accident scenarios. We examine the annual costs and risks for each option over a large number of years. Risk, in this paper, is defined in terms of annual fatalities (both prompt and long-term) and environmental restoration costs that might result from either an accidental release or long-term exposure to both plant workers and the public near the site or facility. We use event timing to weigh both costs and risks; near-term costs and risks are discounted less than future expenditures and fatalities. This technique levels the timing of cash flows and benefits by converting future costs and benefits to present value costs and benefits. We give an example Levelized Cost-Benefit Analysis of incinerator location options to demonstrate the methodology and required data

  15. Eighteenth annual risk reduction engineering laboratory research symposium

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The Eighteenth Annual Risk Reduction Engineering Laboratory Research Symposium was held in Cincinnati, Ohio, April 14-16, 1992. The purpose of this Symposium was to present the latest significant research findings from ongoing and recently completed projects funded by the Risk Reduction Engineering Laboratory (RREL). These Proceedings are organized into two sections. Sessions A and B, which contain extended abstracts of the paper presentations. A list of poster displays is also included. Subjects include remedial action, treatment, and control technologies for waste disposal, landfill liner and cover systems, underground storage tanks, and demonstration and development of innovative/alternative treatment technologies for hazardous waste. Alternative technology subjects include thermal destruction of hazardous wastes, field evaluations, existing treatment options, emerging treatment processes, waste minimization, and biosystems for hazardous waste destruction

  16. Social Geology and Landslide Disaster Risk Reduction in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Jayasingha P

    2017-03-01

    Full Text Available AbstractLandslide disaster risk reduction is presently a challenging task facing by Sri Lankangeologists. Increasing trend of population growth in Sri Lanka has adversely affected thestability of central highland due to various human activities. Among them establishment ofhuman settlements and change in land use pattern have become a serious issue in triggeringland instabilities in central highland of the country. National Building Research Oragnisationwhich is the main focal point in land slide disaster risk reduction in Sri Lanka has takenvaluable and timely needed actions including preparation of landslide hazard zonation maps,early warnings and mitigations. Though the landslide is a geological phenomenon, it is highlyinteracted with human societies. Hence managing the issues arising with the landslideoccurrence should be addressed with a sociological approach. This new approach is known asSocio Geological approach which is discussed here.Key words: Landslide, Geology, Socio Geology, Social Geologist

  17. Baseline risk and marginal willingness to pay for health risk reduction.

    Science.gov (United States)

    Gerking, Shelby; Adamowicz, Wiktor; Dickie, Mark; Veronesi, Marcella

    2017-01-01

    Empirical results presented in this paper suggest that parents' marginal willingness to pay (MWTP) for a reduction in morbidity risk from heart disease is inversely related to baseline risk (i.e., the amount of risk initially faced) both for themselves and for their children. For instance, a 40% reduction from the mean of baseline risk results in an increase in MWTP by 70% or more. Thus, estimates of monetary benefits of public programs to reduce heart disease risk would be understated if the standard practice is followed of evaluating MWTP at initial risk levels and then multiplying this value by the number of cases avoided. Estimates are supported by: (1) unique quantitative information on perceptions of the risk of getting heart disease that allow baseline risk to be defined at an individual level and (2) improved econometric procedures to control for well-known difficulties associated with stated preference data.

  18. Household flood risk reduction in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Duží, Barbora; Vikhrov, Dmytro; Kelman, I.; Stojanov, Robert; Jakubínský, Jiří

    2015-01-01

    Roč. 18, č. 8 (2015), s. 1-6 ISSN 1381-2386 R&D Projects: GA MŠk(CZ) EE2.4.31.0056; GA MŠk(CZ) LD13032; GA MŠk(CZ) LD13033 Institutional support: RVO:67179843 Keywords : Bečva River Basin * Czech Republic * flood risk reduction * floods * household adaptation * household coping Subject RIV: AO - Sociology, Demography Impact factor: 3.085, year: 2015

  19. Workplace injuries and risk reduction practices in Malaysia.

    Science.gov (United States)

    Ali, Roslinah; Shaharudin, Rafiza; Omar, Azahadi; Yusoff, Fadhli

    2012-01-01

    This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006. This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire. Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers. Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.

  20. Indigenous knowledge for disaster risk reduction: An African perspective

    Directory of Open Access Journals (Sweden)

    Nnamdi G. Iloka

    2016-07-01

    Full Text Available Indigenous knowledge is valuable knowledge that has helped local communities all over the world survive for generations. This knowledge originates from the interaction between members of the community and the environment in which they live. Although much has been written about indigenous knowledge, its documentation in the area of disaster risk reduction and climate change in Africa has been very limited. The wealth of this knowledge has not been well-recognised in the disaster risk reduction field, as policy-makers still rely on mitigation strategies based on scientific knowledge. Colonialism and lack of proper documentation of indigenous knowledge are some of the contributing factors to this. Ignoring the importance of understanding adaptive strategies of the local people has led to failed projects. Understanding how local people in Africa have managed to survive and adapt for generations, before the arrival of Western education, may be the key to developing sustainable policies to mitigate future challenges. Literature used in this article, obtained from the books, papers and publications of various experts in the fields of disaster risk reduction, climate change, indigenous knowledge and adaptation, highlight the need for more interest to be shown in indigenous knowledge, especially in the developing country context. This would lead to better strategies which originate from the community level but would aim for overall sustainable development in Africa.

  1. Mid term monitoring of heavy metals content in soils of Mediterranean coastal wetlands. La Albufera de Valencia Natural Park, Spain

    Science.gov (United States)

    Pascual-Aguilar, Juan Antonio; Andreu, Vicente; Gimeno-García, Eugenia

    2014-05-01

    Coastal wetlands, in general, and Mediterranean ones, in particular, suffer from differente anthropogenic pressures that may affect their intrinsic environmental and ecological functions. Most, if not all, Mediterranean wetlands are not natural spaces were preservation of habitat and wildlife is the only management policy achieved, bur rather their terriroty is a combination of land units with different activities and influences, such as farming, environmental protection and connectivities with urban and industrial areas. Therefore, the need of periodical monitoring is required whenever pressures and environmental health of wetlands is assessed, particularly of those processes that affect the interconnection of environmental compartiments involving water, soils and biota. In agro-ecological protected wetlands soils play and important role because they are potential sources of pollutants due to farming practices. In this case, presence of heavy metals in soils is and indicator of both environmental health and anthtopogenic direct (farming activities) and indirect (neighbour urban areas) pressures. In this work a mid term (17 year) monitoring of seven heavy metals (Cd, Co, Cr, Cu, Pb, Ni and Zn) in soils of coastal Mediterranean wetlands (La Albufera Natural Park, Spain) are analyzed. Two monitoring campaings were achieved in 1991 and 2008. In both cases the same 20 points were visited which were distributed in the natural park according two four different sectors of potential anthropogenic pressure and land use. At each point two soil samples were collected at differente depths (0 to 20 cm and 20 to 40 cm). The selected metals were analyzed to determine its total and extractable fractions by treatment with EDTA. Atomic Absorption Spectrometry, using graphite furnace when necessary, was used for the determination of metals. In general, there is a reduction of metal contents in the study area in both dates. The trend of metals according to average concentration (mg

  2. Mid-term evaluation of the NRECA (National Rural Electric Cooperative Association) Central America Rural Electrification Support Program (CARES)

    Energy Technology Data Exchange (ETDEWEB)

    Perlack, R.D. (Oak Ridge National Lab., TN (USA)); Jones, H.G. (Oak Ridge Associated Universities, Inc., TN (USA)); Garcia, A. III (Texas A and M Univ., College Station, TX (USA). Dept. of Agricultural Engineering); Flores, E. (Flores (Edgar), Guatemala City (Guatemala))

    1990-09-01

    Oak Ridge National Laboratory was requested by the Regional Office for Central America and Panama to conduct a mid-term evaluation of the Cares Project, which is being implemented by the National Rural Electric Cooperative Association. This evaluation was conducted over a three week period by a four person team. Overall, the project has had numerous successes and is highly valued by local counterpart utilities and USAID Missions. Notwithstanding the significant results of the project, changes can be made in certain operating procedures and in the direction of some programmatic activities that can lead to an even more effective project.

  3. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C. [Brower & Company, Andover, MA (United States); Bell, K. [Convergence Research, Seattle, WA (United States); Bernow, S.; Duckworth, M. [Tellus Inst., Boston, MA (United States); Spinney P. [Charles River Associates, Boston, MA (United States)

    1996-12-31

    This paper presents preliminary results of a study to evaluate the risk-reduction benefits of wind power for a case study utility system using decision analysis techniques. The costs and risks of two alternative decisions-whether to build a 400 MW gas-fired combined cycle plant or a 1600 MW wind plant in 2003-were compared through computer simulations as fuel prices, environmental regulatory costs, wind and conventional power plant availability, and load growth were allowed to vary. Three different market scenarios were examined: traditional regulation, a short-term power pool, and fixed-price contracts of varying duration. The study concludes that, from the perspective of ratepayers, wind energy provides a net levelized risk-reduction benefit of $3.4 to $7.8/MWh under traditional regulation, and less in the other scenarios. From the perspective of the utility plant owners, wind provides a significant risk benefit in the unregulated market scenarios but none in a regulated market. The methodology and findings should help inform utility resource planning and industry restructuring efforts. 2 figs., 3 tabs.

  4. Cancer risk in aluminum reduction plant workers (Canada)

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, J.J.; Demers, P.A.; Le, N.D.; Friesen, M.D.; Lorenzi, M.F.; Fang, R.; Gallagher, R.P. [British Columbia Cancer Agency, Vancouver, BC (Canada)

    2006-09-15

    A 14-year update to a previously published historical cohort study of aluminum reduction plant workers was conducted. All men with three or more years at an aluminum reduction plant in British Columbia (BC), Canada between the years 1954 and 1997 were included; a total of 6,423 workers. A total of 662 men were diagnosed with cancer, representing a 400% increase from the original study. Standardized mortality and incidence ratios were used to compare the cancer mortality and incidence of the cohort to that of the BC population. Poisson regression was used to examine risk by cumulative exposure to coal tar pitch volatiles (CTPV) measured as benzene soluble materials (BSM) and benzo(a)pyrene (BaP). The risk for bladder cancer was related to cumulative exposure to CTPV measured as BSM and BaP (p trends < 0.001), and the risk for stomach cancer was related to exposure measured by BaP (p trend BaP < 0.05). The risks for lung cancer (p trend < 0.001), non-Hodgkin lymphoma (p trend < 0.001), and kidney cancer (p trend < 0.01) also increased with increasing exposure, although the overall rates were similar to that of the general population. Analysis of the joint effect of smoking and CTPV exposure on cancer showed the observed dose-response relationships to be independent of smoking.

  5. Merging Cultural Heritage Assessments with Risk Reduction and Disaster Recovery

    DEFF Research Database (Denmark)

    Bojsen, Ann Kristina Mikkelsen

    heritage. These limitations serve as motivation for the introduction of the ACTOR framework (Assessing Cultural Threats, Obstacles and Resilience) ACTOR aims at merging cultural heritage assessments with risk reduction and disaster recovery, and provide disaster management students with a learning......Abstract There is a general professional consensus that vulnerability and risk assessments are crucial tasks in any serious attempt to substantially reduce disaster losses and enhance the reconciliation or recovery in the post event phase. However, cultural heritage is often considered...... as an overarching element that should be assessed, rather than a permanent key component of the assessments. Research in disaster management noticeably illustrates how cultural heritage is increasingly at risk from disasters caused by natural and human-made hazards, as well as the effects of climate change. Still...

  6. Assessment of reduction in perception of nuclear risk related to perception of environmental risk

    International Nuclear Information System (INIS)

    Boemer, Veronica Araujo; Aquino, Afonso Rodrigues de

    2009-01-01

    This work presents a bibliographic research accomplished to evaluate the matter of reduction in risk perception, on people in general, that nuclear energy can show, for generation of electric power, face to perception of risk associated to environmental questions, as the global warming, from greenhouse effect, addressing the matter to the relevance of public acceptance for the development of new technologies. (author)

  7. Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

    OpenAIRE

    Nikolić, Marko; Kruljac, Ivan; Kirigin, Lora; Mirošević, Gorana; Ljubičić, Neven; Nikolić, Borka Pezo; Bekavac-Bešlin, Miroslav; Budimir, Ivan; Vrkljan, Milan

    2015-01-01

    Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. ----- Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB),...

  8. Mid-Term Electricity Market Clearing Price Forecasting with Sparse Data: A Case in Newly-Reformed Yunnan Electricity Market

    Directory of Open Access Journals (Sweden)

    Chuntian Cheng

    2016-10-01

    Full Text Available For the power systems, for which few data are available for mid-term electricity market clearing price (MCP forecasting at the early stage of market reform, a novel grey prediction model (defined as interval GM(0, N model is proposed in this paper. Over the traditional GM(0, N model, three major improvements of the proposed model are: (i the lower and upper bounds are firstly identified to give an interval estimation of the forecasting value; (ii a novel whitenization method is then established to determine the definite forecasting value from the forecasting interval; and (iii the model parameters are identified by an improved particle swarm optimization (PSO instead of the least square method (LSM for the limitation of LSM. Finally, a newly-reformed electricity market in Yunnan province of China is studied, and input variables are contrapuntally selected. The accuracy of the proposed model is validated by observed data. Compared with the multiple linear regression (MLR model, the traditional GM(0, N model and the artificial neural network (ANN model, the proposed model gives a better performance and its superiority is further ensured by the use of the modified Diebold–Mariano (MDM test, suggesting that it is suitable for mid-term electricity MCP forecasting in a data-sparse electricity market.

  9. 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

  10. Breast Cancer Incidence and Risk Reduction in the Hispanic Population.

    Science.gov (United States)

    Power, Eric J; Chin, Megan L; Haq, Mohamed M

    2018-02-26

    Breast cancer is the most common non-skin cancer amongst women worldwide and is the fifth leading cause of cancer-related mortality overall. It is also the foremost reason for cancer-related mortality in Hispanic females in the United States (US). Although the current incidence of breast cancer is significantly lower in Hispanics compared to that of non-Hispanic Whites (NHW) and Blacks, (91.9, 128.1, and 124.3 per 100,000, respectively, annually), this may increase if Hispanics develop similar lifestyle behaviors to other American women, in categories such as weight management, age at first birth, number of children, and breastfeeding habits. Stage-for-stage mortality for Hispanics is similar to NHWs, but the mortality rate is not declining as rapidly in this ethnic group. Hispanic women share many of the same risk factors for developing breast cancer as NHWs and Blacks. This suggests that many of the risk reduction strategies used in other racial populations may also benefit this group. Providing education about breast cancer and implementing risk reduction strategies in culturally-aware environments could help keep incidence low and reduce cancer-related mortality. Since Hispanics are the largest minority group in the US, this could have a significant impact on the incidence and mortality nationally.

  11. Earth observation for disaster risk reduction in Pakistan

    International Nuclear Information System (INIS)

    Rafiq, L.

    2012-01-01

    This thesis investigates the role of Earth Observation (EO) for disaster risk reduction for Pakistan. It demonstrates that significant improvements are possible through the utilization of EO data for natural disaster risk reduction activities in Pakistan. In this thesis, a multi hazard approach is proposed in order to identify vulnerability and risk at district level in Pakistan. In particular, a methodology for ranking hazards, vulnerabilities and risks based on Delphi methods is developed. This method is implemented and the results are mapped for four selected hazards i.e., earthquakes, floods, cyclones and droughts. Based on the final risk rankings, the potential of EO is explored with a focus on vulnerability assessment through detailed analysis of two case studies i.e.; Flood and Cyclone/Tsunami. The study also reviews and evaluates the institutional framework of the National Disaster Management Authority of Pakistan in order to identify existing gaps and address them in view of modern technology being used globally. Results reveal that these gaps are mainly related to policies, coordination and communication of different stakeholders at the national level. The work also reviews the available Early Warning System (EWS) in Pakistan and particularly its usage during disasters. Within the context of EWS, multi-sensor satellite data have been utilized for the analysis of structure of an Arabian Sea tropical Cyclone. Results of this focal study provide useful information for operational analysis and forecasting as well as for designing disaster mitigation measures. This information may also play a major role in the development of cyclone warning strategies in the future. (author)

  12. Reduction of Systemic Risk by Means of Pigouvian Taxation.

    Science.gov (United States)

    Zlatić, Vinko; Gabbi, Giampaolo; Abraham, Hrvoje

    2015-01-01

    We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI) are direct and certain, an overall positive effect on risk adjusted return on investments (ROIRA) is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund.

  13. Reduction of Systemic Risk by Means of Pigouvian Taxation.

    Directory of Open Access Journals (Sweden)

    Vinko Zlatić

    Full Text Available We analyze the possibility of reduction of systemic risk in financial markets through Pigouvian taxation of financial institutions, which is used to support the rescue fund. We introduce the concept of the cascade risk with a clear operational definition as a subclass and a network related measure of the systemic risk. Using financial networks constructed from real Italian money market data and using realistic parameters, we show that the cascade risk can be substantially reduced by a small rate of taxation and by means of a simple strategy of the money transfer from the rescue fund to interbanking market subjects. Furthermore, we show that while negative effects on the return on investment (ROI are direct and certain, an overall positive effect on risk adjusted return on investments (ROIRA is visible. Please note that the taxation is introduced as a monetary/regulatory, not as a _scal measure, as the term could suggest. The rescue fund is implemented in a form of a common reserve fund.

  14. Valuing Drinking Water Risk Reductions Using the Contingent Valuation Method: A Methodological Study of Risks from THM and Giardia (1986)

    Science.gov (United States)

    This study develops contingent valuation methods for measuring the benefits of mortality and morbidity drinking water risk reductions. The major effort was devoted to developing and testing a survey instrument to value low-level risk reductions.

  15. HIV Risk Reduction Among Young Adult Chronic Psychiatric Patients

    Science.gov (United States)

    1990-08-28

    emotional language to convey information on risk reduction. Common myths concerning transmission are presented and the audience is specifically told that...current study include: ’Can contact with semen (cum) from the penis result In AIDS?’,’ Can a person get AIDS from vaginal fluids in a woman’s vagina ? Can...hands. It doesn’t like being exposed to sunlight or air. Female: The AIDS virus lives inside the human body, in the blood, in a woman’s vagina and

  16. Mid-term financial impact of animal welfare improvements in Dutch broiler production.

    Science.gov (United States)

    Gocsik, E; Lansink, A G J M Oude; Saatkamp, H W

    2013-12-01

    This study used a stochastic bioeconomic simulation model to simulate the business and financial risk of different broiler production systems over a 5-yr period. Simulation analysis was conducted using the @Risk add-in in MS Excel. To compare the impact of different production systems on economic feasibility, 2 cases were considered. The first case focused on the economic feasibility of a completely new system, whereas the second examined economic feasibilities when a farm switches from a conventional to an animal welfare-improving production system. A sensitivity analysis was conducted to assess the key drivers of economic feasibility and to reveal systematic differences across production systems. The study shows that economic feasibility of systems with improved animal welfare predominantly depends on the price that farmers receive. Moreover, the study demonstrates the importance of the level and variation of the price premium for improved welfare, particularly in the first 5 yr after conversion. The economic feasibility of the production system increases with the level of welfare improvements for a sufficiently high price level for broiler meat and low volatility in producer prices. If this is not the case, however, risk attitudes of farmers become important as well as the use of potential risk management instruments.

  17. Risk reduction for nonmelanoma skin cancer with childhood sunscreen use

    International Nuclear Information System (INIS)

    Stern, R.S.; Weinstein, M.C.; Baker, S.G.

    1986-01-01

    Exposure to ultraviolet radiation is the principle cause of basal and squamous cell carcinomas of the skin, which are the most frequent tumors occurring in white residents of the United States. Using a mathematical model based on epidemiologic data, we quantified the potential benefits of using a sunscreen with a sun protective factor of 15 and estimate that regular use of such a sunscreen during the first 18 years of life would reduce the lifetime incidence of these tumors by 78%. Additional benefits of sunscreen use during childhood include reduced risk of sunburn, retarding the pace of skin aging, and possible reduction in melanoma risk. We recommend that pediatricians encourage sunscreen use and sun avoidance as a regular part of pediatric preventive health care

  18. Mid-term evaluation of the Climate Change Action Fund : Public education and outreach (PEO) Block

    International Nuclear Information System (INIS)

    2001-11-01

    In February 1998, the Government of Canada established the Climate Change Action Fund (CCAF) to assist Canada in meeting its commitments under the Kyoto Protocol for the reduction of greenhouse gas emissions. The CCAF managed a budget of 150 million dollars over three years, and the Public Education and Outreach (PEO) Block was allocated 30 million dollars of that total for its operations. Its mandate was to increase public awareness and understanding on the topic of climate change, as well as providing the required information to effect reductions in the emissions of greenhouse gases and adapt to climate change. An evaluation into this program was conducted, and it covered the period September 2000 to January 20, 2001. To date, 152 projects have been approved, which represents an investment of approximately 17.5 million dollars. Approximately 6 million dollars have been spent on the awareness component, while government communication activities used approximately 3.1 million dollars. Staff and project management fees in support of the program account for the remaining funds. This report addressed the performance to date in meeting the objectives, and also included recommendations for improved effectiveness. PEO files and records, a report entitled Interim review of the Climate Change Action Fund PEO Program, interviews with Departmental representatives, and interviews with external stakeholder groups formed the basis for the findings and recommendations. It was determined that future direction represents the most critical issue facing the PEO block. 1 tab

  19. Disaster risk reduction in developing countries: costs, benefits and institutions.

    Science.gov (United States)

    Kenny, Charles

    2012-10-01

    Some 60,000 people worldwide die annually in natural disasters, mostly due to the collapse of buildings in earthquakes, and primarily in the developing world. This is despite the fact that engineering solutions exist that can eliminate almost completely the risk of such deaths. Why is this? The solutions are expensive and technically demanding, so their cost-benefit ratio often is unfavourable as compared to other interventions. Nonetheless, there are various public disaster risk reduction interventions that are highly cost-effective. That such interventions frequently remain unimplemented or ineffectively executed points to a role for issues of political economy. Building regulations in developing countries appear to have limited impact in many cases, perhaps because of inadequate capacity and corruption. Public construction often is of low quality, perhaps for similar reasons. This suggests the need for approaches that emphasise simple and limited disaster risk regulation covering only the most at-risk structures-and that, preferably, non-experts can monitor-as well as numerous transparency and oversight mechanisms for public construction projects. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  20. Ibrutinib-associated bleeding: pathogenesis, management and risk reduction strategies.

    Science.gov (United States)

    Shatzel, J J; Olson, S R; Tao, D L; McCarty, O J T; Danilov, A V; DeLoughery, T G

    2017-05-01

    Ibrutinib is an irreversible inhibitor of Bruton's tyrosine kinase (Btk) that has proven to be an effective therapeutic agent for multiple B-cell-mediated lymphoproliferative disorders. Ibrutinib, however, carries an increased bleeding risk compared with standard chemotherapy. Bleeding events range from minor mucocutaneous bleeding to life-threatening hemorrhage, due in large part to the effects of ibrutinib on several distinct platelet signaling pathways. There is currently a minimal amount of data to guide clinicians regarding the use of ibrutinib in patients at high risk of bleeding or on anticoagulant or antiplatelet therapy. In addition, the potential cardiovascular protective effects of ibrutinib monotherapy in patients at risk of vascular disease are unknown. Patients should be cautioned against using non-steroidal anti-inflammatory drugs, fish oils, vitamin E and aspirin-containing products, and consider replacing ibrutinib with a different agent if dual antiplatelet therapy is indicated. Patients should not take vitamin K antagonists concurrently with ibrutinib; direct oral anticoagulants should be used if extended anticoagulation is strongly indicated. In this review, we describe the pathophysiology of ibrutinib-mediated bleeding and suggest risk reduction strategies for common clinical scenarios associated with ibrutinib. © 2017 International Society on Thrombosis and Haemostasis.

  1. Patterns of NPS Use and Risk Reduction in Slovenia.

    Science.gov (United States)

    Sande, Matej; Paš, Mina; Nahtigal, Klara; Šabić, Simona

    2018-01-15

    The following study presents factors influencing the decision to use/not to use new psychoactive substances (NPS), various patterns of NPS use, the problems experienced by users, and the methods for reducing the risks associated with NPS use. The study seeks to provide an in-depth look into the characteristics of NPS use and support the planning of targeted interventions in the field of NPS. The study involved 19 in-depth interviews carried out with 25 individuals divided into three subsamples in order to gain insight into the various experiences of NPS users. The interviews were conducted in Slovenia between December 2013 and October 2014. The sample was obtained by using the convenience sampling and snowball sampling methods. The main pattern of NPS use determined by the study concerned synthetic cathinones, specifically 3-MMC, with binge use spanning several days being a prominent feature. The main risks involving NPS use were: mixing various drugs, inappropriate dosing, lack of information prior to use, and the use of unknown substances. Several users spoke about effective strategies for reducing risks, such as obtaining information beforehand, using one's own implements and using only small quantities of unknown substances. Conclusions/Importance: The study revealed various factors based on which users decide to use NPS. Furthermore, users reported a number of problems resulting from NPS use, while risk reduction strategies are employed to a much lesser extent. Based on the results obtained, specific intervention efforts concerning NPS use and targeting specific groups of younger users were designed.

  2. The Mid-Term Changes of Pulmonary Function Tests After Phrenic Nerve Transfer.

    Science.gov (United States)

    Yavari, Masoud; Hassanpour, Seyed Esmail; Khodayari, Mohammad

    2016-03-01

    In the restoration of elbow flexion, the phrenic nerve has proven to be a good donor, but considering the role of the phrenic nerve in respiratory function, we cannot disregard the potential dangers of this method. In the current study, we reviewed the results of pulmonary function tests (PFT) in four patients who underwent phrenic nerve transfer. We reviewed the results of serial spirometry tests, which were performed before and after phrenic nerve transfer surgery. All patients regained Biceps power to M3 strength or above. None of our patients experienced pulmonary problems or respiratory complaints, but a significant reduction of spirometric parameters occurred after surgery. This study highlights the close link between the role of the phrenic nerve and pulmonary function, such that the use of this nerve as a transfer donor leads to spirometric impairments.

  3. Percutaneous vertebroplasty in the management of vertebral osteoporotic fractures. Short-term, mid-term and long-term follow-up of 285 patients

    International Nuclear Information System (INIS)

    Masala, Salvatore; Mammucari, Matteo; Angelopoulos, Georgios; Fiori, Roberto; Massari, Francesco; Simonetti, Giovanni; Faria, Skerdilajd

    2009-01-01

    To evaluate the short-term, mid-term and long-term follow-up of 285 patients who had undergone percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (VCF) in our department from 2003 to 2006, and, particularly, to analyse our data on the safety and the usefulness of PVP for durable pain reduction, mobility improvement and the need for analgesic drugs. Follow-up analysis was made through a questionnaire completed by the patients before and after PVP (1 week, 1 year and 3 years). The results are reported by subdivision of patients into groups (by gender, age and number of treated vertebrae), with special reference to pain management, drug administration and quality of life. All patients (285) were followed up for 1 week, 186 for 12 months, and 68 patients were followed up for 3 years. One week after PVP all patients reported normal ambulation (with or without pain), and more than 95% were able to perform activities of daily living (ADL) either without pain or with mild pain. There was no difference in pain relief between the genders after 1 week's follow up, but after 3 years better analgesia results were observed in women. There was no statistically significant difference in the visual analogue scale (VAS) values before PVP between age groups (P = 0.7) and gender (P = 0.4); Patients younger than 75 years had better outcomes than did older ones (>75 years) at 1 week and 1 year follow up. Patients also reported significant reduction in drug therapy for pain. PVP is a safe and useful procedure for the treatment of vertebral osteoporotic fractures. It produces enduring pain reduction, improves patients' mobility and decreases the need for analgesic drugs. (orig.)

  4. Risk reduction and TQM: A corporate culture of continuous improvement

    International Nuclear Information System (INIS)

    Nau, D.C.

    1992-01-01

    A company supplying products and services to the nuclear industry that implements a cultural commitment to continuous improvement, in addition to providing higher quality products and services, also represents a significant reduction in operational risk to that industry. The implementation of a culture of total quality management (TQM), initiated by Sorrento Electronics (SE) in 1989, involves total commitment to the basic TQM principles: continuous improvement, people performing the work are the best sources of how to do it better, and employees must be empowered to make the improvements. What this means to the nuclear industry is a significant reduction in operational risk through: (1) products based on simpler, standardized, proven designs with established operational track records, enhancing confidence that they will perform as expected; (2) the highest confidence that products and supporting documentation are delivered with zero defects; (3) critical power plant schedules can be supported through the shortest possible equipment delivery times; (4) highly motivated employees with extremely positive attitudes, working together in cross-functional teams, virtually eliminate the possibility of deliberate product tampering or sabotage

  5. Disaster Risk Reduction through school learners’ awareness and preparedness

    Directory of Open Access Journals (Sweden)

    Takalani S. Rambau

    2012-11-01

    Full Text Available In 2006, the ISDR (International Strategy for Disaster Reduction (2007 initiated a campaign called Disaster Risk Reduction Begins at School to encourage the integration of disaster risk education into school curricula in countries vulnerable to disasters. A study was initiated to determine how education, in particular curriculum development and teaching, contributes to South African learners’ hazard awareness and disaster preparedness. Mixed method research (consisting of questionnaires, interviews and document reviews was done to collect data. 150 educators from Gauteng, the Western Cape, KwaZulu-Natal, North West and the Eastern Cape completed questionnaires. Five curriculum coordinators, three disaster specialists and two disaster lecturers were interviewed to record their perspectives. The first finding of the study was that the majority of educators, disaster specialists and curriculum coordinators identified floods, fire, droughts, epidemics, road accidents and storms as the most prevalent disasters in the country. The second finding from the literature and empirical data collection revealed that South African communities, particularly people residing in informal settlements and other poor areas, are more vulnerable to disasters than their counterparts in more affluent areas. The third finding of the study was that teaching learners about hazards and disasters is vital and must be expanded.

  6. Resilience and disaster risk reduction: an etymological journey

    Science.gov (United States)

    Alexander, D. E.

    2013-04-01

    This paper examines the development over historical time of the meaning and uses of the term resilience. The objective is to deepen our understanding of how the term came to be adopted in disaster risk reduction and resolve some of the conflicts and controversies that have arisen when it has been used. The paper traces the development of resilience through the sciences, humanities, and legal and political spheres. It considers how mechanics passed the word to ecology and psychology, and how from there it was adopted by social research and sustainability science. As other authors have noted, as a concept, resilience involves some potentially serious conflicts or contradictions, for example between stability and dynamism, or between dynamic equilibrium (homeostasis) and evolution. Moreover, although the resilience concept works quite well within the confines of General Systems Theory, in situations in which a systems formulation inhibits rather than fosters explanation, a different interpretation of the term is warranted. This may be the case for disaster risk reduction, which involves transformation rather than preservation of the ''state of the system''. The article concludes that the modern conception of resilience derives benefit from a rich history of meanings and applications, but that it is dangerous - or at least potentially disappointing - to read to much into the term as a model and a paradigm. Sagitta in lapidem numquam figitur, interdum resiliens percutit dirigentem. ("An arrow never lodges in a stone: often it recoils upon its sender.") St. John Chrysostom (c. 347-407), Archbishop of Constantinople.

  7. Smartphone Delivery of Mobile HIV Risk Reduction Education.

    Science.gov (United States)

    Phillips, Karran A; Epstein, David H; Mezghanni, Mustapha; Vahabzadeh, Massoud; Reamer, David; Agage, Daniel; Preston, Kenzie L

    2013-01-01

    We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability "as is" in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings.

  8. Smartphone Delivery of Mobile HIV Risk Reduction Education

    Directory of Open Access Journals (Sweden)

    Karran A. Phillips

    2013-01-01

    Full Text Available We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability “as is” in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P<0.05. Additionally, all of our video modules met our a priori criteria for feasibility: ≤20% of data were missing due to participant noncompliance and ≤20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings.

  9. Resilience and disaster risk reduction: an etymological journey

    Science.gov (United States)

    Alexander, D. E.

    2013-11-01

    This paper examines the development over historical time of the meaning and uses of the term resilience. The objective is to deepen our understanding of how the term came to be adopted in disaster risk reduction and resolve some of the conflicts and controversies that have arisen when it has been used. The paper traces the development of resilience through the sciences, humanities, and legal and political spheres. It considers how mechanics passed the word to ecology and psychology, and how from there it was adopted by social research and sustainability science. As other authors have noted, as a concept, resilience involves some potentially serious conflicts or contradictions, for example between stability and dynamism, or between dynamic equilibrium (homeostasis) and evolution. Moreover, although the resilience concept works quite well within the confines of general systems theory, in situations in which a systems formulation inhibits rather than fosters explanation, a different interpretation of the term is warranted. This may be the case for disaster risk reduction, which involves transformation rather than preservation of the "state of the system". The article concludes that the modern conception of resilience derives benefit from a rich history of meanings and applications, but that it is dangerous - or at least potentially disappointing - to read to much into the term as a model and a paradigm.

  10. Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes.

    Science.gov (United States)

    Chew, Nicholas; Hon, Jimmy Kim Fatt; Yip, Wei Luen James; Chan, Siew Pang; Poh, Kian-Keong; Kong, William Kok-Fai; Teoh, Kristine Leok Kheng; Yeo, Tiong Cheng; Tan, Huay Cheem; Tay, Edgar Lik Wui

    2017-09-01

    Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperative patients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. We evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions. This prospective study recruited 59 patients from a major academic medical centre in Singapore. The main outcomes were two-year survival rates, peri-procedural complications, symptom improvement, valvular function and assessment of learning curve. Mean age was 76.8 years (61.0% male), mean body surface area 1.6 m 2 and mean logistic EuroSCORE 18.7%. Survival was 93.2%, 86.0% and 79.1% at 30 days, one year and two years, respectively. At 30 days post TAVI, the rate of stroke was 1.7%, life-threatening bleeding 5.1%, acute kidney injury 25.0%, major vascular complication 5.1%, and new permanent pacemaker implantation 6.8%. 29.3% of TAVI patients were rehospitalised (47.1% cardiovascular-related) within one year. These composite outcomes were measured: device success (93.2%); early safety (79.7%); clinical efficacy (66.1%); and time-related valve safety (84.7%). Univariate analysis found these predictors of two-year all-cause mortality: logistic EuroSCORE (hazard ratio [HR] 1.07; p < 0.001); baseline estimated glomerular filtration rate (HR 0.97; p = 0.048); and acute kidney injury (HR 5.33; p = 0.022). Multivariate analysis identified non-transfemoral TAVI as a predictor of cardiovascular-related two-year mortality (HR 14.64; p = 0.008). Despite the unique clinical differences in Asian populations, this registry demonstrated favourable mid-term clinical and safety outcomes in Asians undergoing TAVI. Copyright: © Singapore Medical Association

  11. Landslide risk reduction strategies: an inventory for the Global South

    Science.gov (United States)

    Maes, Jan; Kervyn, Matthieu; Vranken, Liesbet; Dewitte, Olivier; Vanmaercke, Matthias; Mertens, Kewan; Jacobs, Liesbet; Poesen, Jean

    2015-04-01

    Landslides constitute a serious problem globally. Moreover, landslide impact remains underestimated especially in the Global South. It is precisely there where the largest impact is experienced. An overview of measures taken to reduce risk of landslides in the Global South is however still lacking. Because in many countries of the Global South disaster risk reduction (DRR) is at an emerging stage, it is crucial to monitor the ongoing efforts (e.g. discussions on the Post-2015 Framework for DRR). The first objective of this study is to make an inventory of techniques and strategies that are applied to reduce risk from landslides in tropical countries. The second objective is to investigate what are the main bottlenecks for implementation of DRR strategies. In order to achieve these objectives, a review of both scientific and grey literature was conducted, supplemented with expert knowledge. The compilation of recommended and implemented DRR measures from landslide-prone tropical countries is based on an adapted classification proposed by the SafeLand project. According to Vaciago (2013), landslide risk can be reduced by either reducing the hazard, the vulnerability, the number or value of elements at risk or by sharing the residual risk. In addition, these measures can be combined with education and/or awareness raising and are influenced by governance structures and cultural beliefs. Global landslide datasets have been used to identify landslide-prone countries, augmented with region-specific datasets. Countries located in the tropics were selected in order to include landslide-prone countries with a different Human Development Index (HDI) but with a similar climate. Preliminary results support the statement made by Anderson (2013) that although the importance of shifting from post-disaster emergency actions to pre-disaster mitigation is acknowledged, in practice this paradigm shift seems rather limited. It is expected that this is especially the case in countries

  12. Risk avoidance versus risk reduction: a framework and segmentation profile for understanding adolescent sexual activity.

    Science.gov (United States)

    Hopkins, Christopher D; Tanner, John F; Raymond, Mary Anne

    2004-01-01

    The teen birthrate in the United States is twice that of other industrialized nations. Adolescents in the U.S. are among high-risk groups for HIV/AIDS and other sexually transmitted diseases. As a result, the Department of Health and Human Services changed its policy on the promotion of abstinence to teenagers from a focus on a risk reduction strategy to a focus on a risk avoidance strategy. In order to create more effective risk avoidance as well as risk reduction campaigns, this study proposes a framework to illustrate the distinction that teens make between spontaneous sexual activity and planned sexual activity, as well as those teens that make a commitment to abstinence versus abstinence by default. Furthermore, this study classifies teens into three behavior segments (abstemious, promiscuous and monogamous) and then assesses specific differences that exist within these groups relative to their attitudes and perceptions concerning abstinence, sexual activity, contraception, fear and norms. This change in focus from a risk reduction to a risk avoidance strategy has important implications for social marketing, public policy and marketing theory.

  13. The Eurobulker oil spill: mid-term changes of some ecosystem indicators

    International Nuclear Information System (INIS)

    Zenetos, A.; Hatzianestis, J.; Lantzouni, M.; Simboura, M.; Sklivagou, E.; Arvanitakis, G.

    2004-01-01

    The sinking of the tanker Eurobulker in Southern Evoikos gulf (Aegean Sea, Greece) in September 2000 resulted in a spill of 700 tons of crude oil. The environmental impact of the spill was studied by the National Centre for Marine Research. The hydrocarbon concentrations in water, sediment and coastal benthic organisms were measured and the response of the benthic communities to the disturbance caused by the oil spill was studied along the direction to the coast and over three sampling seasons. The most severe and direct effects were evidenced on the muddy benthic communities of the accident site and the stations in the close vicinity sampled shortly after the spill. The effects included reduction of the species richness and community diversity, but the communities reached full recovery 8 months later. The impact of the spill was more indirect and delayed in the coastal stations, where as the hydrocarbon measurements indicated, the pollutants were transported later and induced their effects on the benthic communities 6 months after the accident. (author)

  14. Mid-term evaluation of the Climate Change Action Fund : foundation analysis block

    International Nuclear Information System (INIS)

    2001-11-01

    From September 2000 to January 20, 2001, an evaluation was conducted into the Climate Change Action Fund (CCAF). Established in February 1998 by the Government of Canada, the CCAF was intended to help Canada meet its commitments under the Kyoto Protocol for the reduction of greenhouse gas (GHG) emissions. Over three years, the CCAF Program provided 150 million dollars, and the Foundation Block received 34 million dollars from these funds. In order to lay the groundwork for a National Implementation Strategy along with the provinces, industry and shareholders, the Foundation Analysis Block supported several initiatives such as the Issue Tables process, the development of analysis and modelling tools to be used for options, examination of cross-cutting options, and the required mechanisms within the department and with other stakeholders. The performance to date was evaluated and the results described in this report. It was concluded that the objectives were met, that progress was made and was well managed overall. Funding was deemed sufficient. Some of the recommendations made included: setting realistic time targets that take into account the complexity of deriving common sectoral/cross-sectoral modelling results, performance targets and ways for monitoring the progress must be established in the case of all major activities. 4 tabs., 1 fig

  15. Breast and Ovarian Cancer Risk and Risk Reduction in Jewish BRCA1/2 Mutation Carriers

    Science.gov (United States)

    Finkelman, Brian S.; Rubinstein, Wendy S.; Friedman, Sue; Friebel, Tara M.; Dubitsky, Shera; Schonberger, Niecee Singer; Shoretz, Rochelle; Singer, Christian F.; Blum, Joanne L.; Tung, Nadine; Olopade, Olufunmilayo I.; Weitzel, Jeffrey N.; Lynch, Henry T.; Snyder, Carrie; Garber, Judy E.; Schildkraut, Joellen; Daly, Mary B.; Isaacs, Claudine; Pichert, Gabrielle; Neuhausen, Susan L.; Couch, Fergus J.; van't Veer, Laura; Eeles, Rosalind; Bancroft, Elizabeth; Evans, D. Gareth; Ganz, Patricia A.; Tomlinson, Gail E.; Narod, Steven A.; Matloff, Ellen; Domchek, Susan; Rebbeck, Timothy R.

    2012-01-01

    Purpose Mutations in BRCA1/2 dramatically increase the risk of both breast and ovarian cancers. Three mutations in these genes (185delAG, 5382insC, and 6174delT) occur at high frequency in Ashkenazi Jews. We evaluated how these common Jewish mutations (CJMs) affect cancer risks and risk reduction. Methods Our cohort comprised 4,649 women with disease-associated BRCA1/2 mutations from 22 centers in the Prevention and Observation of Surgical End Points Consortium. Of these women, 969 were self-identified Jewish women. Cox proportional hazards models were used to estimate breast and ovarian cancer risks, as well as risk reduction from risk-reducing salpingo-oophorectomy (RRSO), by CJM and self-identified Jewish status. Results Ninety-one percent of Jewish BRCA1/2-positive women carried a CJM. Jewish women were significantly more likely to undergo RRSO than non-Jewish women (54% v 41%, respectively; odds ratio, 1.87; 95% CI, 1.44 to 2.42). Relative risks of cancer varied by CJM, with the relative risk of breast cancer being significantly lower in 6174delT mutation carriers than in non-CJM BRCA2 carriers (hazard ratio, 0.35; 95% CI, 0.18 to 0.69). No significant difference was seen in cancer risk reduction after RRSO among subgroups. Conclusion Consistent with previous results, risks for breast and ovarian cancer varied by CJM in BRCA1/2 carriers. In particular, 6174delT carriers had a lower risk of breast cancer. This finding requires additional confirmation in larger prospective and population-based cohort studies before being integrated into clinical care. PMID:22430266

  16. Optimal Risk Reduction in the Railway Industry by Using Dynamic Programming

    OpenAIRE

    Michael Todinov; Eberechi Weli

    2013-01-01

    The paper suggests for the first time the use of dynamic programming techniques for optimal risk reduction in the railway industry. It is shown that by using the concept ‘amount of removed risk by a risk reduction option’, the problem related to optimal allocation of a fixed budget to achieve a maximum risk reduction in the railway industry can be reduced to an optimisation problem from dynamic programming. For n risk reduction options and size of the available risk reduction budget B (expres...

  17. Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene.

    Science.gov (United States)

    Petis, Stephen M; Vasarhelyi, Edward M; Lanting, Brent A; Howard, James L; Naudie, Douglas D R; Somerville, Lyndsay E; McCalden, Richard W

    2016-02-01

    The choice of bearing articulation for total hip arthroplasty in younger patients is amenable to debate. We compared mid-term patient-reported outcomes and survivorship across 2 different bearing articulations in a young patient cohort. We reviewed patients with cobalt-chrome or oxidized zirconium on highly crosslinked polyethylene who were followed prospectively between 2004 and 2012. Kaplan-Meier analysis was used to determine predicted cumulative survivorship at 5 years with all-cause and aseptic revisions as the outcome. We compared patient-reported outcomes, including the Harris hip score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short-form 12 (SF-12) scores. A total of 622 patients were followed during the study period. Mean follow-up was 8.2 (range 2.0-10.6) years for cobalt-chrome and 7.8 (range 2.1-10.7) years for oxidized zirconium. Mean age was 54.9 ± 10.6 years for cobalt-chrome and 54.8 ± 10.7 years for oxidized zirconium. Implant survivorship was 96.0% (95% confidence interval [CI] 94.9%-97.1%) for cobalt-chrome and 98.7% (95% CI 98.0%-99.4%) for oxidized zirconium on highly crosslinked polyethylene for all-cause revisions, and 97.2% (95% CI 96.2%-98.2%) for cobalt-chrome and 99.0% (95% CI 98.4%-99.6%) for oxidized zirconium for aseptic revisions. An age-, sex- and diagnosis-matched comparison of the HHS, WOMAC and SF-12 scores demonstrated no significant changes in clinical outcomes across the groups. Both bearing surface couples demonstrated excellent mid-term survivorship and outcomes in young patient cohorts. Future analyses on wear and costs are warranted to elicit differences between the groups at long-term follow-up.

  18. [In hospital and mid-term outcome of patients with NIR stent implantation: multicenter ESPORT-NIR registry].

    Science.gov (United States)

    Iñiguez, A; García, E; Seabra, R; Bordes, P; Bethencourt, A; Rigla, J

    2001-05-01

    Despite improvements in the results and techniques of catheter-based revascularization, few studies have evaluated the clinical results of the application of new stent designs. We describe the in-hospital and mid-term outcome of patients undergoing a stent NIR implantation. At least 1 Stent NIR was implanted in 1.004 patients (1.136 lesions) recruited from 50 centers in an international, multicenter, prospective, registry (Spain and Portugal NIR stent registry). Inclusion criteria were objective coronary ischemia related to a severe de novo lesion or first restenosis in native vessels with a reference diameter >= 2.75 mm. The primary end-point was the incidence of major adverse cardiac events within the first 7 months of follow-up. The mean age of the patients was 60 years and 82% were male. Angioplasty was indicated due to unstable angina in 61% of the cases. Stent implantation was successfully achieved in 99.6%. Clinical success (angiographic success without in-hospital major events) was achieved in 98.6% of patients. The rate of angiographic restenosis (> 50% stenosis narrowing) was 16% (CI 95%; 11.7-21.2). The accumulated major cardiac adverse event rate at seven months of follow-up was 8.7%: death (0.9%), acute myocardial infarction (1.2%) and target lesion revascularization (6.6%). In the wide setting of the population included in the ESPORT-NIR registry, stent NIR implantation was a highly effective therapy with a good mid-term clinical and angiographic outcome.

  19. Early- and Mid-term Results of the Chimney Technique in the Repair of Aortic Arch Pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Junjie; Jiao, Yuanyong, E-mail: wishlucky@163.com, E-mail: johemail@163.com; Zhang, Xiwei; Jiang, Jun; Yang, Hongyu; Ma, Hao [First Affiliated Hospital of Nanjing Medical University, Division of Vascular Surgery, Department of General Surgery (China)

    2016-11-15

    PurposeTo examine the safety, feasibility, and mid-term efficacy of the chimney technique for aortic arch pathologies.MethodsFrom February 2011 to December 2014, a total of 35 patients (30 men; mean age 54.3 ± 14.1 years) with aortic arch pathologies underwent thoracic endovascular aortic repair combined with chimney stents. The indication was a proximal landing zone <1.5 cm. Follow-up was performed at 3, 6, and 12 months and then yearly thereafter.ResultsA total of 36 chimney stents were deployed (innominate artery, n = 1; left common carotid artery, n = 9; right subclavian artery, n = 1; left subclavian artery, n = 25). The technical success rate was 94.3 % (33/35). Immediate type Ia endoleaks (ELIa) were observed in two patients (8.6 %, 2/35). Twenty-five patients were successfully followed-up for a median period of 29.3 months (range, 6–48 months). One patient died due to aortic dissection aneurysm rupture at 36 months (mortality rate of 4 %, 1/25). Three late ELIa were observed and no reinterventions were performed. The overall incidence of ELIa was 20 % (5/25). During follow-up, the patency rate for chimney stents was 92 % (23/25).ConclusionOur limited experience demonstrates that the chimney technique is a viable and relatively safe treatment for patients with challenging thoracic aortic pathologies at least in the mid-term follow-up period.

  20. Mid-term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes.

    Science.gov (United States)

    Uno, Kohei; Seki, Yosuke; Kasama, Kazunori; Wakamatsu, Kotaro; Hashimoto, Kenkichi; Umezawa, Akiko; Yanaga, Katsuhiko; Kurokawa, Yoshimochi

    2017-12-11

    Bariatric surgery is recognized as an effective treatment for type 2 diabetes mellitus, but data on its efficacy for type 1 diabetes mellitus, especially slowly progressive insulin-dependent diabetes mellitus, are limited. We investigated five Japanese patients with slowly progressive insulin-dependent diabetes mellitus who underwent bariatric surgery at our center. Five morbidly obese glutamic acid decarboxylase antibody-positive diabetic patients underwent two different types of bariatric surgery. The mean titer of anti-glutamic acid decarboxylase antibody was 4.6 U/mL, and the mean preoperative bodyweight and BMI were 113 kg and 39.6 kg/m 2 , respectively. The mean hemoglobin A1c was 8.4%. The mean fasting serum C-peptide was 5.0 ng/mL. Laparoscopic sleeve gastrectomy was performed in two patients, while laparoscopic sleeve gastrectomy with duodenojejunal bypass was performed in three patients. At one year after surgery, the mean bodyweight and BMI significantly dropped, and the mean percentage of excess weight loss was 96.4%. The mean hemoglobin A1c was 5.7%. This favorable trend was maintained at mid-term. Bariatric surgery for morbidly obese patients with anti-glutamic acid decarboxylase antibody-positive type 1 diabetes mellitus, especially slow progressive autoimmune diabetes, seemed effective in achieving mid-term glycemic control. Longer follow-up with a larger number of patients, as well as validation with more advanced patients with slowly progressive insulin-dependent diabetes mellitus, will be needed. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  1. Early- and Mid-term Results of the Chimney Technique in the Repair of Aortic Arch Pathologies

    International Nuclear Information System (INIS)

    Zou, Junjie; Jiao, Yuanyong; Zhang, Xiwei; Jiang, Jun; Yang, Hongyu; Ma, Hao

    2016-01-01

    PurposeTo examine the safety, feasibility, and mid-term efficacy of the chimney technique for aortic arch pathologies.MethodsFrom February 2011 to December 2014, a total of 35 patients (30 men; mean age 54.3 ± 14.1 years) with aortic arch pathologies underwent thoracic endovascular aortic repair combined with chimney stents. The indication was a proximal landing zone <1.5 cm. Follow-up was performed at 3, 6, and 12 months and then yearly thereafter.ResultsA total of 36 chimney stents were deployed (innominate artery, n = 1; left common carotid artery, n = 9; right subclavian artery, n = 1; left subclavian artery, n = 25). The technical success rate was 94.3 % (33/35). Immediate type Ia endoleaks (ELIa) were observed in two patients (8.6 %, 2/35). Twenty-five patients were successfully followed-up for a median period of 29.3 months (range, 6–48 months). One patient died due to aortic dissection aneurysm rupture at 36 months (mortality rate of 4 %, 1/25). Three late ELIa were observed and no reinterventions were performed. The overall incidence of ELIa was 20 % (5/25). During follow-up, the patency rate for chimney stents was 92 % (23/25).ConclusionOur limited experience demonstrates that the chimney technique is a viable and relatively safe treatment for patients with challenging thoracic aortic pathologies at least in the mid-term follow-up period.

  2. Risk reduction and the privatization option: First principles

    International Nuclear Information System (INIS)

    Bjornstad, D.J.; Jones, D.W.; Russell, M.; Cummings, R.C.; Valdez, G.; Duemmer, C.L.

    1997-01-01

    The Department of Energy's Office of Environmental Restoration and Waste Management (EM) faces a challenging mission. To increase efficiency, EM is undertaking a number of highly innovative initiatives--two of which are of particular importance to the present study. One is the 2006 Plan, a planning and budgeting process that seeks to convert the clean-up program from a temporally and fiscally open-ended endeavor to a strictly bounded one, with firm commitments over a decade-long horizon. The second is a major overhauling of the management and contracting practices that define the relationship between the Department and the private sector, aimed at cost reduction by increasing firms' responsibilities and profit opportunities and reducing DOE's direct participation in management practices and decisions. The goal of this paper is to provide an independent perspective on how EM should create new management practices to deal with private sector partners that are motivated by financial incentives. It seeks to ground this perspective in real world concerns--the background of the clean-up effort, the very difficult technical challenges it faces, the very real threats to environment, health and safety that have now been juxtaposed with financial drivers, and the constraints imposed by government's unique business practices and public responsibilities. The approach is to raise issues through application of first principles. The paper is targeted at the EM policy officer who must implement the joint visions of the 2006 plan and privatization within the context of the tradeoff between terminal risk reduction and interim risk management

  3. Risk reduction and the privatization option: First principles

    Energy Technology Data Exchange (ETDEWEB)

    Bjornstad, D.J.; Jones, D.W.; Russell, M. [Joint Inst. for Energy and Environment, Knoxville, TN (United States); Cummings, R.C.; Valdez, G. [Georgia State Univ., Atlanta, GA (United States); Duemmer, C.L. [Hull, Duemmer and Garland (United States)

    1997-06-25

    The Department of Energy`s Office of Environmental Restoration and Waste Management (EM) faces a challenging mission. To increase efficiency, EM is undertaking a number of highly innovative initiatives--two of which are of particular importance to the present study. One is the 2006 Plan, a planning and budgeting process that seeks to convert the clean-up program from a temporally and fiscally open-ended endeavor to a strictly bounded one, with firm commitments over a decade-long horizon. The second is a major overhauling of the management and contracting practices that define the relationship between the Department and the private sector, aimed at cost reduction by increasing firms` responsibilities and profit opportunities and reducing DOE`s direct participation in management practices and decisions. The goal of this paper is to provide an independent perspective on how EM should create new management practices to deal with private sector partners that are motivated by financial incentives. It seeks to ground this perspective in real world concerns--the background of the clean-up effort, the very difficult technical challenges it faces, the very real threats to environment, health and safety that have now been juxtaposed with financial drivers, and the constraints imposed by government`s unique business practices and public responsibilities. The approach is to raise issues through application of first principles. The paper is targeted at the EM policy officer who must implement the joint visions of the 2006 plan and privatization within the context of the tradeoff between terminal risk reduction and interim risk management.

  4. The Good, The Bad and The Ugly: Disaster Risk Reduction (DRR) Versus Disaster Risk Creation (DRC)

    Science.gov (United States)

    Lewis, James

    2012-01-01

    In understanding and trying to reduce the risk from disasters, connections are often articulated amongst poverty, vulnerability, risk, and disasters. These are welcome steps, but the approach taken in top-down international documents is rarely to articulate explicitly that vulnerability accrues from a wide variety of dynamic and long-term processes. Neglecting these processes—and failing to explore their links with poverty, risk, and disasters—tends to encourage disaster risk creation. This paper identifies seven examples of on-the-ground realities of long-term vulnerability within two clusters: Endangerment: 1 Environmental degradation. 2 Discrimination. 3 Displacement. Impoverishment: 4 Self-seeking public expenditure. 5 Denial of access to resources. 6 Corruption. 7 Siphoning of public money. Examples are presented as vignettes, many contemporary and many rooted in historical contexts, to demonstrate the extent to which “vulnerability drivers” emanate from greed, the misuse of political and commercial power, mismanagement and incompetence amongst other behaviours. Moving forward to the tackling of disaster risk creation, instead of simply seeking disaster risk reduction, requires detailed investigation into these contemporary and historical realities of the causes of vulnerability. That would support the integration of disaster risk reduction within the many wider contexts that foment and perpetuate vulnerability. PMID:22919564

  5. The Good, The Bad and The Ugly: Disaster Risk Reduction (DRR) Versus Disaster Risk Creation (DRC).

    Science.gov (United States)

    Lewis, James

    2012-06-21

    In understanding and trying to reduce the risk from disasters, connections are often articulated amongst poverty, vulnerability, risk, and disasters. These are welcome steps, but the approach taken in top-down international documents is rarely to articulate explicitly that vulnerability accrues from a wide variety of dynamic and long-term processes. Neglecting these processes-and failing to explore their links with poverty, risk, and disasters-tends to encourage disaster risk creation. This paper identifies seven examples of on-the-ground realities of long-term vulnerability within two clusters: Endangerment: 1 Environmental degradation. 2 Discrimination. 3 Displacement. Impoverishment: 4 Self-seeking public expenditure. 5 Denial of access to resources. 6 Corruption. 7 Siphoning of public money. Examples are presented as vignettes, many contemporary and many rooted in historical contexts, to demonstrate the extent to which "vulnerability drivers" emanate from greed, the misuse of political and commercial power, mismanagement and incompetence amongst other behaviours. Moving forward to the tackling of disaster risk creation, instead of simply seeking disaster risk reduction, requires detailed investigation into these contemporary and historical realities of the causes of vulnerability. That would support the integration of disaster risk reduction within the many wider contexts that foment and perpetuate vulnerability.

  6. Therapeutical approach to plasma homocysteine and cardiovascular risk reduction

    Directory of Open Access Journals (Sweden)

    Marcello Ciaccio

    2008-03-01

    Full Text Available Marcello Ciaccio, Giulia Bivona, Chiara BelliaDepartment of Medical Biotechnologies and Forensic Medicine, Faculty of Medicine, University of Palermo, ItalyAbstract: Homocysteine is a sulfur-containing aminoacid produced during metabolism of methionine. Since 1969 the relationship between altered homocysteine metabolism and both coronary and peripheral atherotrombosis is known; in recent years experimental evidences have shown that elevated plasma levels of homocysteine are associated with an increased risk of atherosclerosis and cardiovascular ischemic events. Several mechanisms by which elevated homocysteine impairs vascular function have been proposed, including impairment of endothelial function, production of reactive oxygen species (ROS and consequent oxidation of low-density lipids. Endothelial function is altered in subjects with hyperhomocysteinemia, and endothelial dysfunction is correlated with plasma levels of homocysteine. Folic acid and B vitamins, required for remethylation of homocysteine to methionine, are the most important dietary determinants of homocysteine and daily supplementation typically lowers plasma homocysteine levels; it is still unclear whether the decreased plasma levels of homocysteine through diet or drugs may be paralleled by a reduction in cardiovascular risk.Keywords: homocysteine, MTHFR, cardiovascular disease, folate, B vitamin

  7. Risk reduction by combining nature values with flood protection?

    Directory of Open Access Journals (Sweden)

    Van Loon-Steensma Jantsje M.

    2016-01-01

    foreland into the dike design does not automatically mean that nature values and flood protection are well integrated. Flood protection imposes rather different requirements on the extent and features of marshes than nature conservation and development. Wave damping is most effective with a high and stable marsh, while nature thrives with dynamic processes and differences in elevation. Therefore, only a design that allows natural marsh dynamics and includes different marsh zones could combine nature values with flood protection. In practice, this means a dike design with an uncertain foreland, that offers space for natural processes. The uncertainty in foreland development reduces the possible flood risk reduction. In our paper we describe the critical points of interest concerning risk reduction in this system.

  8. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    Robert S. Balch; Ron Broadhead

    2005-03-01

    Incomplete or sparse data such as geologic or formation characteristics introduce a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results when working with sparse data. State-of-the-art expert exploration tools, relying on a database, and computer maps generated by neural networks and user inputs, have been developed through the use of ''fuzzy'' logic, a mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk has been reduced with the use of these properly verified and validated ''Fuzzy Expert Exploration (FEE) Tools.'' Through the course of this project, FEE Tools and supporting software were developed for two producing formations in southeast New Mexico. Tools of this type can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In today's oil industry environment, many smaller exploration companies lack the resources of a pool of expert exploration personnel. Downsizing, volatile oil prices, and scarcity of domestic exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tools benefit a diverse group in the U.S., allowing a more efficient use of scarce funds, and potentially reducing dependence on foreign oil and providing lower product prices for consumers.

  9. ASTARTE: Assessment Strategy and Risk Reduction for Tsunamis in Europe

    Science.gov (United States)

    Baptista, M. A.; Yalciner, A. C.; Canals, M.

    2014-12-01

    enhancement of the Tsunami Warning System in the NEAM region in terms of monitoring, early warning and forecast, governance and resilience. This work is funded by project ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe. Grant 603839, 7th FP (ENV.2013.6.4-3 ENV.2013.6.4-3)

  10. Binomial Distribution Sample Confidence Intervals Estimation 7. Absolute Risk Reduction and ARR-like Expressions

    Directory of Open Access Journals (Sweden)

    Andrei ACHIMAŞ CADARIU

    2004-08-01

    Full Text Available Assessments of a controlled clinical trial suppose to interpret some key parameters as the controlled event rate, experimental event date, relative risk, absolute risk reduction, relative risk reduction, number needed to treat when the effect of the treatment are dichotomous variables. Defined as the difference in the event rate between treatment and control groups, the absolute risk reduction is the parameter that allowed computing the number needed to treat. The absolute risk reduction is compute when the experimental treatment reduces the risk for an undesirable outcome/event. In medical literature when the absolute risk reduction is report with its confidence intervals, the method used is the asymptotic one, even if it is well know that may be inadequate. The aim of this paper is to introduce and assess nine methods of computing confidence intervals for absolute risk reduction and absolute risk reduction – like function.Computer implementations of the methods use the PHP language. Methods comparison uses the experimental errors, the standard deviations, and the deviation relative to the imposed significance level for specified sample sizes. Six methods of computing confidence intervals for absolute risk reduction and absolute risk reduction-like functions were assessed using random binomial variables and random sample sizes.The experiments shows that the ADAC, and ADAC1 methods obtains the best overall performance of computing confidence intervals for absolute risk reduction.

  11. Early and mid-term results of autograft rescue by Ross reversal: A one-valve disease need not become a two-valve disease.

    Science.gov (United States)

    Hussain, Syed T; Majdalany, David S; Dunn, Aaron; Stewart, Robert D; Najm, Hani K; Svensson, Lars G; Houghtaling, Penny L; Blackstone, Eugene H; Pettersson, Gösta B

    2018-02-01

    Risk of reoperation and loss of a second native valve are major drawbacks of the Ross operation. Rather than discarding the failed autograft, it can be placed back into the native pulmonary position by "Ross reversal." We review our early and mid-term results with this operation. From 2006 to 2017, 39 patients underwent reoperation for autograft dysfunction. The autograft was successfully rescued in 35 patients: by Ross reversal in 30, David procedure in 4, and autograft repair in 1. Medical records were reviewed for patient characteristics (mean age was 46 ± 13 years, range 18-67 years, and 23 were male), previous operations, indications for reoperation, hospital outcomes, and echocardiographic findings for the 30 patients undergoing successful Ross reversal. Follow-up was 4.1 ± 3.5 years (range 7 months-11 years). Median interval between the original Ross procedure and Ross reversal was 12 years (range 5-19 years). Eight patients also had absolute indications for replacement of the pulmonary allograft. There was no operative mortality. One patient required reoperation for bleeding. Another had an abdominal aorta injury from use of an endoballoon clamp. There was no other major postoperative morbidity, and median postoperative hospital stay was 7.2 days (range 4-41 days). No patient required reoperation during follow-up. Twenty-four patients had acceptable pulmonary valve function, and 6 had clinically well-tolerated moderate or severe pulmonary regurgitation. Ross reversal can be performed with low morbidity and acceptable pulmonary valve function, reducing patient risk of losing 2 native valves when the autograft fails in the aortic position. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  12. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Jin; Park, Byung Kwan; Park, Jung Jae; Kim, Chan Kyo [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351 (Korea, Republic of)

    2016-11-01

    To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m{sup 2} (14.2–142.7 mL/min/1.73 m{sup 2}) and 72.0 mL/min/1.73 m{sup 2} (7.2–112.6 mL/min/1.73 m{sup 2}), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes.

  13. CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

    International Nuclear Information System (INIS)

    Kim, Hae Jin; Park, Byung Kwan; Park, Jung Jae; Kim, Chan Kyo

    2016-01-01

    To evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) treatment in patients with small (< 4 cm) renal cell carcinoma (RCC) in Korea. Between 2010 and 2015, 51 patients (40 men and 11 women; median age, 57 years) with biopsyproven 51 RCC were treated using CT-guided RFA. All patients were clinically staged T1aN0M0 prior to RFA. The median tumor size and follow-up period were 2.1 cm (range, 1.0–3.9 cm) and 26 months (4–60 months), respectively. Local tumor progression, distant metastasis, primary and secondary effectiveness rates, and major complication rates were recorded. Estimated glomerular filtration rates (GFRs) between pre-RFA and last follow-up were compared using paired t tests. The 2-year recurrence-free survival rate was calculated using Kaplan-Meier survival analysis. Of the 51 patients, 2 (3.9%) experienced local tumor progression, and 1 (2.0%) had lymph node metastasis after the first RFA session. Primary and secondary effectiveness rates were 96.1% (49/51) and 100% (1/1), respectively. Only 1 patient experienced a major complication (uretero-pelvic stricture) after the second RFA session for treating a local tumor progression, and the major complication rate was 1.9% (1/52). The median pre-RFA and last follow-up GFRs were 87.1 mL/ min/1.73 m 2 (14.2–142.7 mL/min/1.73 m 2 ) and 72.0 mL/min/1.73 m 2 (7.2–112.6 mL/min/1.73 m 2 ), respectively (p < 0.0001). The 2-year recurrence-free survival rate was 96.0%. CT-guided RFA is a safe and effective treatment in Korean patients with T1a RCC because of excellent mid-term outcomes

  14. Mid-term Report

    DEFF Research Database (Denmark)

    Badger, Merete; Monaco, Lucio; Farinetti, Laura

    2012-01-01

    This report represents the deliverable D1.1 of project Virtual Campus Hub. The project runs from October 2011 to September 2013. The report is the core of the project’s 1st periodic report, which was submitted to the European Commission on November 26, 2012. In addition, this report contains...

  15. A procedure for seismic risk reduction in Campania Region

    Science.gov (United States)

    Zuccaro, G.; Palmieri, M.; Maggiò, F.; Cicalese, S.; Grassi, V.; Rauci, M.

    2008-07-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  16. A procedure for seismic risk reduction in Campania Region

    International Nuclear Information System (INIS)

    Zuccaro, G.; Palmieri, M.; Cicalese, S.; Grassi, V.; Rauci, M.; Maggio, F.

    2008-01-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  17. The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Ross, Stephanie L.; Jones, Lucile M.

    2013-01-01

    The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey (CGS), the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

  18. Transhepatic Balloon Dilatation of Early Biliary Strictures in Pediatric Liver Transplantation: Successful Initial and Mid-Term Outcome

    International Nuclear Information System (INIS)

    Belenky, Alexander; Mor, Eytan; Bartal, Gabriel; Atar, Eli; Shapiro, Riki; Bar-Nathan, Nathan; Bachar, Gil N.

    2004-01-01

    Purpose: To evaluate the initial and mid-term outcomes of transhepatic balloon dilatation for the treatment of early biliary strictures in lateral left-segment liver transplants in young children.Methods: Between April 1997 and May 2001, seven children aged 9 months to 6 years with nine benign strictures in left-segment liver grafts were treated percutaneously. Sessions of two or three dilations were performed three or four times at average intervals of 10-20 days. In each session, the biliary stenoses were gradually dilated using balloons of 3-7 mm. Follow-up ranged from 12 to 54 months (mean 27 months, median 12 months). Clinical success was defined as resolution of the stenosis, normalization of liver enzymes and lack of clinical symptoms. Results: Technical success was achieved in all nine strictures. Hemobilia occurred in one patient and was successfully treated. On follow-up, all patients had complete clinical recovery with normalization of liver function and imaging of patent bile ducts. Conclusion: Balloon dilatation is an effective and relatively safe method for the treatment of early biliary strictures in left-segment liver transplantation in young children. We recommend this approach as the initial treatment for early strictures. Metal stents or surgery should be reserved for patients with late appearance of strictures or failure of balloon dilatation

  19. Development of low cost systems for co-utilisation of biomass in large power plant. Mid term review report

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, W.R.

    2003-07-01

    Interest in the cofiring of biomass materials with coal in large coal-fired power stations in the UK has increased significantly in recent years in response to the potential additional income from Renewables Obligation Certificates (ROCs). It is anticipated that most coal-fired power stations in the UK will have the capability to cofire biomass materials by the end of 2003. This mid-term review report examines the various stages in the route to fully commercial operation of biomass cofiring at coal-fired power stations, the availability of suitable biomass materials in the UK and the technical options for cofiring. The factors affecting the economics of biomass cofiring in large coal-fired boilers are discussed including the delivered price of biofuels, the future value of ROCs, the development costs of cofiring projects, the 25% ceiling on cofiring imposed by the Renewables Obligation Order 2002 and the use of preblending. An overview of the current status of cofiring in the UK is presented, which includes a summary of the results of trials already carried out by operators of coal-fired power stations and a discussion of the future prospects for biomass cofiring in the UK.

  20. Mid-term follow-up of whiplash with Bournemouth Questionnaire: the significance of the initial depression to pain ratio.

    Science.gov (United States)

    Griggs, R K L; Cook, J; Gargan, M; Bannister, G; Amirfeyz, R

    2015-01-01

    The Bournemouth Questionnaire (BQ) was used to report the short to mid-term outcome of a prospective cohort of patients who had sustained Whiplash Associated Disorder (WAD), and establish whether outcome could be predicted on initial assessment. One hundred patients with WAD grades I-III on the Quebec Task Force Classification were referred for physiotherapy (neck posture advice, initially practised under the direct supervision of a therapist). BQ scores were recorded on the first visit, at six weeks, then at final follow-up. Seventy-six percent of patients were available at final follow-up, 58% women. The mean age was 43.2 years old and follow-up time 38 months (28-48). Symptoms plateaued after six weeks in the majority and improved gradually thereafter. When the individual BQ components on initial presentation were reassessed, patients who score disproportionately highly in BQ Question 5 (Depression) had a worse outcome. To quantify this, the ratio of BQ Questions 5 (Depression)/1 (Pain) was calculated. BQ5/1 ratio greater than 1 on initial presentation had an odds ratio of 2 for poor outcome (p= 0.02). The BQ can therefore be used to identify patients with a disproportionately high depression score (BQ5) who are highly likely to clinically deteriorate in the medium term.

  1. THE MID - TERM EFFECT OF KINESIO TAPING ON PEAK POWER OF QUADRICEPS AND HAMSTRING MUSCLES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Amel Khabazan Mahdi

    2017-01-01

    Full Text Available Purpose: The aim of this study was to assess mid- term effect of Kinesio tape on peak power of quadriceps and hamstrings muscles after ACL reconstruction 24 hours after taping. Material: Thirty six men who had undergone ACL reconstruction and completed physiotherapy periods (6 months were assigned to no taping, placebo and taping groups. Peak power was tested before and 24 hours after taping by Isokinetic dynamometry. Data was analyzed by SPSS software 19. ANOVA and post hoc test (LSD were used for interpretive analysis. Results: The results showed that the effect of Kinesio tape on peak power of quadriceps muscles at velocities of 180°/s and 300°/s was significant. In the hamstring muscles, significant effects were obtained at velocities of 60°/s, 180°/s & 300°/s. Conclusion: Positive impacts of Kinesio tape on muscular peak power among athletes who had ACL reconstruction were observed. Regardless of psychological effect and reducing re - injury fear, Kinesio - tape causes to stabilize and increase effective range of motion of the knee, so it is recommended that in the explosive training, athletes who have ACL reconstruction should use tape to reduce the probability of re-injury and increase muscle power.

  2. Impact of growing costs on the profitability of crop production in Poland in the mid-term perspective

    Directory of Open Access Journals (Sweden)

    Aldona SKARŻYŃSKA

    2016-02-01

    Full Text Available Main aim of this paper was to demonstrate the impact of cultivation intensity on economic of selected activities of crop production in Poland. The projection of income of these activities in mid-term perspective, i.e. in 2016, has also been developed. Studies have shown that for cultivation technology of low intensity, as compared to high, the economic results of examined activities were more favourable. The profitability of production, expressed as a ratio of the value of production to economic costs, was higher by 10.0 to 52.7%. According to the projection results, in the highly intensive cultivation, high costs and dynamics of growth, stronger than growth of income, had a negative impact on the level of income. It is expected, even with an exceptionally high yield, income level will be lower than in the cultivation of low intensity. The results show that the use of technological progress can reduce a negative impact of chemicals on the environment while maintaining the high economic efficiency of production.

  3. Mid-term Clinical Results and Patient Satisfaction After Uterine Artery Embolization in Women with Symptomatic Uterine Fibroids

    International Nuclear Information System (INIS)

    Smeets, Albert J.; Lohle, Paul N. M.; Vervest, Harry A. M.; Boekkooi, P. Focco; Lampmann, Leo E.H.

    2006-01-01

    Purpose. To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids. Methods. Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire. Questions were aimed at changes in bleeding, pain, and bulk-related symptoms. Symptoms after UAE were scored as disappeared, improved, unchanged or worsened. Adverse events were noted, such as vaginal dryness and discharge, menopausal complaints or fibroid expulsion. Patient satisfaction after UAE was assessed. Patient satisfaction of women embolized with polyvinyl alcohol (PVA) particles was compared with satisfaction of women embolized with calibrated microspheres. Results. The questionnaire was returned by 110 of 135 women (81%) at a median time interval of 14 months following UAE. In 10 women additional embolization or hysterectomy had been performed. Of the 110 responders, 86 (78%) were satisfied with the result of UAE. The proportion of satisfied women was higher in the group embolized with calibrated microspheres than in women embolized with PVA, although this difference was not statistically significant (p = 0.053). Conclusion. UAE in women with symptomatic uterine fibroids leads to improvement of symptoms and patient satisfaction is good in the vast majority after a median follow-up period of 14 months

  4. [Mid-Term Clinical Results after Open Rotator Cuff Reconstruction in Double-Row Technique with Titanium Anchor Screws].

    Science.gov (United States)

    Geyer, S; Schoch, C; Nelitz, M; Geyer, M

    2015-08-01

    The double-row rotator cuff repair is discussed controversially. Despite improved biomechanical properties, reduced re-tear rates and higher costs, no significant difference compared to single-row fixation in the clinical results is found. Mid-term results of an open double-row fixation with titanium anchor screws are presented. 237 patients (m = 142, f = 95, median age: 56.3 years) were operated in 2007 with this technique by the senior author (M. G.). Preoperatively, 2 years and 4,5 years postoperatively a subjective shoulder score (SSG) with follow-up rates of 86, 87 and 83 %, was evaluated. 5.1 years postoperatively an objective evaluation of 131 patients using the Constant-Murley scores (CS), the simple shoulder tests (SST), Gerber's shoulder value and the evaluation with school grades followed. The integrity of the cuff was checked with ultrasound. The absolute (re-tears and partial re-tears) and the relative (re-tears, partial re-tears, thinning and thickening of the cuff) re-tear rates were evaluated. In SSG a highly significant improvement from 51 to 83 points was found (p row cuff repair with titanium screws is a safe and cost effective technique with a low re-tear rate with comparable clinical results regarding open and arthroscopic procedures. Georg Thieme Verlag KG Stuttgart · New York.

  5. Endovascular implantation of stent-grafts in the thoracic aorta - mid-term results of a prospective controlled study

    International Nuclear Information System (INIS)

    Duda, S.H.; Pusich, B.; Tepe, G.; Pereira, P.; Feuls, R.; Claussen, C.D.; Raygrotzki, S.; Aebert, H.; Ziemer, G.; Uckmann, F.P.

    2002-01-01

    Purpose: To evaluate the effectiveness and safety of endovascular treatment of various descending thoracic aortic pathologies with covered stent-grafts as an alternative to open surgery. Methods: Among 16 patients (5 type B dissections, 5 contained ruptures, 3 aneurysms of the descending aorta, 1 thoraco-abdominal aneurysm, 1 mural thrombosis, 1 patch aneurysm) treated between November 1997 and November 2000, eight patients received Talent TM stent-grafts and another 8 patients underwent a Gore-TAG TM stent-graft implantation. A clinical follow-up and control CT scans were obtained after the procedure and then at six-month intervals. Results: Deployment of the stent-grafts was technically successful in all cases. Sufficient aortic reconstruction was achieved in all but one patient who needed surgical treatment. One patient died two days after the procedure from aortic rupture due to retrograde type A dissection. Another patient died 19 months after the procedure from an unknown cause. There was no occurrence of distal embolization, paralysis or infection. During follow-up, all patients remained free from recurrence or late complications of their disease. Conclusion: Endoluminal treatment of thoracic aortic pathologies with covered stent-grafts appears to be a safe and feasible method with at least mid-term efficacy. (orig.) [de

  6. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

    Directory of Open Access Journals (Sweden)

    Tiren Davut

    2012-01-01

    Full Text Available Abstract Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%. Nine patients (32% developed impingement symptoms and in 7 patients (25% subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14% developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11% had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.

  7. Mid-term results of off-pump coronary artery bypass grafting assessed by multi-slice computed tomography

    International Nuclear Information System (INIS)

    Yoshida, Seijiro; Nitta, Yoshio; Oda, Katsuhiko

    2004-01-01

    Off-pump coronary artery bypass (OPCAB) has recently increased in popularity, but the long-term results are still unknown. We evaluated the mid-term results of OPCAB surgery using multi-slice computed tomography (MSCT), which is a non-invasive postoperative evaluation method. Thirty-one consecutive patients who underwent OPCAB surgery at least 2 years prior to the study were selected. The age was 50 to 79 years (66.9±6.5) and the ratio of men to women was 26:5. Coronary angiography was performed in all patients at 2 weeks postoperatively. The follow-up was complete, and mean follow-up was 30.9 months. There were no hospital deaths and 1 non-cardiac late death. The graft patency rate in coronary angiography was left internal thoracic artery (LITA) 30/30 (100%), right internal thoracic artery (RITA) 2/2 (100%), radial artery (RA) 14/15 (93%), saphenous vein graft (SVG) 15/17 (88%). No graft became occluded on MSCT study and all patients have been angina-free during the follow-up period. We suggest that OPCAB is feasible in most patients with good patency and low mortality. MSCT is an effective follow up method for the morphological findings and noninvasive quantitative evaluation of the bypass grafts. (author)

  8. Mid-term periodicities and heliospheric modulation of coronal index and solar flare index during solar cycles 22-23

    Science.gov (United States)

    Singh, Prithvi Raj; Saxena, A. K.; Tiwari, C. M.

    2018-04-01

    We applied fast Fourier transform techniques and Morlet wavelet transform on the time series data of coronal index, solar flare index, and galactic cosmic ray, for the period 1986-2008, in order to investigate the long- and mid-term periodicities including the Rieger ({˜ }130 to {˜ }190 days), quasi-period ({˜ }200 to {˜ }374 days), and quasi-biennial periodicities ({˜ }1.20 to {˜ }3.27 years) during the combined solar cycles 22-23. We emphasize the fact that a lesser number of periodicities are found in the range of low frequencies, while the higher frequencies show a greater number of periodicities. The rotation rates at the base of convection zone have periods for coronal index of {˜ }1.43 years and for solar flare index of {˜ }1.41 year, and galactic cosmic ray, {˜ }1.35 year, during combined solar cycles 22-23. In relation to these two solar parameters (coronal index and solar flare index), for the solar cycles 22-23, we found that galactic cosmic ray modulation at mid cut-off rigidity (Rc = 2.43GV) is anti-correlated with time-lag of few months.

  9. Mid-term effects of reduced-impact logging on the regeneration of seven tree commercial species in the Eastern Amazon

    NARCIS (Netherlands)

    Schwartz, G.; Peña-Claros, M.; Lopes, J.C.A.; Mohren, G.M.J.; Kanashiro, M.

    2012-01-01

    Reduced-impact logging (RIL) is a set of techniques aimed to maintain forest structure and functions of the harvested forest as similar as possible to pre-logging status, while reducing adverse impacts from logging activity on the remaining forest. We analysed the mid-term effects of RIL on the

  10. Advances in volcano monitoring and risk reduction in Latin America

    Science.gov (United States)

    McCausland, W. A.; White, R. A.; Lockhart, A. B.; Marso, J. N.; Assitance Program, V. D.; Volcano Observatories, L. A.

    2014-12-01

    We describe results of cooperative work that advanced volcanic monitoring and risk reduction. The USGS-USAID Volcano Disaster Assistance Program (VDAP) was initiated in 1986 after disastrous lahars during the 1985 eruption of Nevado del Ruiz dramatizedthe need to advance international capabilities in volcanic monitoring, eruption forecasting and hazard communication. For the past 28 years, VDAP has worked with our partners to improve observatories, strengthen monitoring networks, and train observatory personnel. We highlight a few of the many accomplishments by Latin American volcano observatories. Advances in monitoring, assessment and communication, and lessons learned from the lahars of the 1985 Nevado del Ruiz eruption and the 1994 Paez earthquake enabled the Servicio Geológico Colombiano to issue timely, life-saving warnings for 3 large syn-eruptive lahars at Nevado del Huila in 2007 and 2008. In Chile, the 2008 eruption of Chaitén prompted SERNAGEOMIN to complete a national volcanic vulnerability assessment that led to a major increase in volcano monitoring. Throughout Latin America improved seismic networks now telemeter data to observatories where the decades-long background rates and types of seismicity have been characterized at over 50 volcanoes. Standardization of the Earthworm data acquisition system has enabled data sharing across international boundaries, of paramount importance during both regional tectonic earthquakes and during volcanic crises when vulnerabilities cross international borders. Sharing of seismic forecasting methods led to the formation of the international organization of Latin American Volcano Seismologists (LAVAS). LAVAS courses and other VDAP training sessions have led to international sharing of methods to forecast eruptions through recognition of precursors and to reduce vulnerabilities from all volcano hazards (flows, falls, surges, gas) through hazard assessment, mapping and modeling. Satellite remote sensing data

  11. New GOES-R Risk Reduction Activities at CIRA

    Science.gov (United States)

    Rogers, M. A.; Miller, S. D.; Grasso, L. D.; Haynes, J. M.; NOH, Y. J.; Forsythe, J.; Zupanski, M.; Lindsey, D. T.

    2017-12-01

    A team of atmospheric scientists at the Cooperative Institute for Research in the Atmosphere (CIRA) at the Colorado State University has been selected by the National Oceanic and Atmospheric Administration's (NOAA) GOES-R Risk Reduction (GOES-R3) science program to develop applications to enhance the utilization of the GOES-R sensors, including the Advanced Baseline Imager (ABI) and the Geostationary Lightning Mapper (GLM). The selected project topics follow NOAA's Research and Development Objectives listed in its 5-year Strategic Plan. The projects will be carried out over a three-year period which started on 1 July 2017 and will end on 30 June 2019. CIRA is working on five GOES-R3 application developments: 1) Developing an Environmental Awareness Repertoire of ABI Imagery (`DEAR-ABII') to Advise the Operational Weather Forecaster. DEAR-ABII maximizes the vast potential of the new GOES-R/GOES-16 sensor technology. 2) GOES-R ABI channel differencing used to reveal cloud-free zones of `precursors of convective initiation'. This product identifies where convective initiation may occur in cloud free skies. 3) Improving the ABI Cloud Layers Product for Multiple Layer Cloud Systems and Aviation Forecast Applications. This project aims to improve the GOES-16 cloud layer product by providing information on the boundaries of cloud layers even when one layer overlies another. 4) Using the New Capabilities of GOES-R to Improve Blended, Multisensor Water Vapor Products for Forecasters. GOES-R TPW retrievals will be merged with TPW derived from polar orbiter and surface data to improve the operational NOAA blended TPW product. 5) Data assimilation of GLM observations in HWRF/GSI system. Assimilation of GOES-R GLM observations for the NOAA operational hurricane model with the goal to improve operational hurricane forecasting. Examples for each of these applications will be presented.

  12. Pengaruh Brand Credibility Terhadap Information Efficiency Dan Risk Reduction, Serta Dampaknya Atas Repurchase Intention

    OpenAIRE

    Faisal, Aekram

    2015-01-01

    This research conducted to know the influence of Brand Credibility to Information efficiency and Risk reduction, also the influence of Information efficiency and Risk reduction to Repurchase intention. This research aimed to know the influence of Brand Credibility to Repurchase intention that mediated by Information efficiency and Risk reduction. The methodology of this research is testing hypothesis research. The sample collecting by questionnaire of 150 respondents from Starb...

  13. Relationships among Trust in Messages, Risk Perception, and Risk Reduction Preferences Based upon Avian Influenza in Taiwan

    Science.gov (United States)

    Fang, David; Fang, Chen-Ling; Tsai, Bi-Kun; Lan, Li-Chi; Hsu, Wen-Shan

    2012-01-01

    Improvements in communications technology enable consumers to receive information through diverse channels. In the case of avian influenza, information repeated by the mass media socially amplifies the consumer awareness of risks. Facing indeterminate risks, consumers may feel anxious and increase their risk perception. When consumers trust the information published by the media, their uncertainty toward avian influenza may decrease. Consumers might take some actions to reduce risk. Therefore, this study focuses on relationships among trust in messages, risk perception and risk reduction preferences. This study administered 525 random samples and consumer survey questionnaires in different city of Taiwan in 2007. Through statistical analysis, the results demonstrate: (1) the higher the trust consumers have in messages about avian influenza, the lower their risk perceptions are; (2) the higher the consumers’ risk perceptions are and, therefore, the higher their desired level of risk reductive, the more likely they are to accept risk reduction strategies; (3) consumer attributes such as age, education level, and marital status correlate with significant differences in risk perception and risk reduction preferences acceptance. Gender has significant differences only in risk reduction preferences and not in risk perception. PMID:23066394

  14. Relationships among Trust in Messages, Risk Perception, and Risk Reduction Preferences Based upon Avian Influenza in Taiwan

    Directory of Open Access Journals (Sweden)

    Wen-Shan Hsu

    2012-08-01

    Full Text Available Improvements in communications technology enable consumers to receive information through diverse channels. In the case of avian influenza, information repeated by the mass media socially amplifies the consumer awareness of risks. Facing indeterminate risks, consumers may feel anxious and increase their risk perception. When consumers trust the information published by the media, their uncertainty toward avian influenza may decrease. Consumers might take some actions to reduce risk. Therefore, this study focuses on relationships among trust in messages, risk perception and risk reduction preferences. This study administered 525 random samples and consumer survey questionnaires in different city of Taiwan in 2007. Through statistical analysis, the results demonstrate: (1 the higher the trust consumers have in messages about avian influenza, the lower their risk perceptions are; (2 the higher the consumers’ risk perceptions are and, therefore, the higher their desired level of risk reductive, the more likely they are to accept risk reduction strategies; (3 consumer attributes such as age, education level, and marital status correlate with significant differences in risk perception and risk reduction preferences acceptance. Gender has significant differences only in risk reduction preferences and not in risk perception.

  15. The challenge of pelvic discontinuity: cup-cage reconstruction does better than conventional cages in mid-term.

    Science.gov (United States)

    Abolghasemian, M; Tangsaraporn, S; Drexler, M; Barbuto, R; Backstein, D; Safir, O; Kuzyk, P; Gross, A

    2014-02-01

    The use of ilioischial cage reconstruction for pelvic discontinuity has been replaced by the Trabecular Metal (Zimmer, Warsaw, Indiana) cup-cage technique in our institution, due to the unsatisfactory outcome of using a cage alone in this situation. We report the outcome of 26 pelvic discontinuities in 24 patients (20 women and four men, mean age 65 years (44 to 84)) treated by the cup-cage technique at a mean follow-up of 82 months (12 to 113) and compared them with a series of 19 pelvic discontinuities in 19 patients (18 women and one man, mean age 70 years (42 to 86)) treated with a cage at a mean follow-up of 69 months (1 to 170). The clinical and radiological outcomes as well as the survivorship of the groups were compared. In all, four of the cup-cage group (15%) and 13 (68%) of the cage group failed due to septic or aseptic loosening. The seven-year survivorship was 87.2% (95% confidence interval (CI) 71 to 103) for the cup-cage group and 49.9% (95% CI 15 to 84) for the cage-alone group (p = 0.009). There were four major complications in the cup-cage group and nine in the cage group. Radiological union of the discontinuity was found in all successful cases in the cup-cage group and three of the successful cage cases. Three hips in the cup-cage group developed early radiological migration of the components, which stabilised with a successful outcome. Cup-cage reconstruction is a reliable technique for treating pelvic discontinuity in mid-term follow-up and is preferred to ilioischial cage reconstruction. If the continuity of the bone graft at the discontinuity site is not disrupted, early migration of the components does not necessarily result in failure.

  16. Does Donor Age of Nonirradiated Achilles Tendon Allograft Influence Mid-Term Results of Revision ACL Reconstruction?

    Science.gov (United States)

    Zaffagnini, Stefano; Roberti di Sarsina, Tommaso; Bonanzinga, Tommaso; Nitri, Marco; Macchiarola, Luca; Stefanelli, Federico; Lucidi, Gianandrea; Grassi, Alberto

    2018-01-01

    Purpose  The purpose of the present study was to investigate if the donor age of nonirradiated Achilles tendon allograft could influence the clinical results of revision anterior cruciate ligament (ACL) reconstruction. Methods  All patients that underwent ACL revision between 2004 and 2008 with at least 4 years of follow-up were included. For all the patients that met the inclusion criteria, the age of the graft donor was obtained from the tissue bank. Lysholm score was administered to patients that met inclusion criteria. In addition, patients were divided in two groups based on the donor age (<45 years vs. ≥45 years), and the baseline characteristics and outcomes were compared. Results  Fifty-two patients were evaluated at a mean 4.8 ± 0.8 years follow-up with Lysholm score. The Lysholm significantly improved from 62.3 ± 6.6 at preoperative status to 84.4 ± 12.3 at final follow-up. The mean donor age was 48.7 ± 8.4 years; a significant difference in Lysholm score was noted between patients that received an allograft with a donor age <45 years (14 patients; 27%) and those receiving an allograft with a donor age ≥45 years (38; 73%) (89.5 ± 3.2 vs. 80.1 ± 11.1, respectively; p  = 0.0469). The multiple regression model showed the donor age, the final follow-up, and the preoperative Lysholm score as significant predictors of postoperative Lysholm score ( p  < 0.0002). Conclusion  Donor age of nonirradiated Achilles tendon allograft influenced the mid-term results of revision ACL reconstruction, thus advising the use of grafts from young donors. Level of Evidence  Level III, retrospective comparative study. PMID:29675501

  17. A practical approach to assess depression risk and to guide risk reduction strategies in later life.

    Science.gov (United States)

    Almeida, Osvaldo P; Alfonso, Helman; Pirkis, Jane; Kerse, Ngaire; Sim, Moira; Flicker, Leon; Snowdon, John; Draper, Brian; Byrne, Gerard; Goldney, Robert; Lautenschlager, Nicola T; Stocks, Nigel; Scazufca, Marcia; Huisman, Martijn; Araya, Ricardo; Pfaff, Jon

    2011-03-01

    Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies. A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer. The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors. Our

  18. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities

    International Nuclear Information System (INIS)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included

  19. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

    Energy Technology Data Exchange (ETDEWEB)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

  20. Effect of preoperatively continued aspirin use on early and mid-term outcomes in off-pump coronary bypass surgery: a propensity score-matched study of 1418 patients.

    Directory of Open Access Journals (Sweden)

    Fucheng Xiao

    Full Text Available To date, effect of preoperatively continued aspirin administration in off-pump coronary artery bypass grafting (CABG is less known. We aimed to assess the effect of preoperatively continued aspirin use on early and mid-term outcomes in patients receiving off-pump CABG.From October 2009 to September 2013 at the Fuwai Hospital, 709 preoperative aspirin users were matched with unique 709 nonaspirin users using propensity score matching to obtain risk-adjusted outcome comparisons between the two groups. Early outcomes were in-hospital death, stroke, intra- and post-operative blood loss, reoperation for bleeding and blood product transfusion. Major adverse cardiac events (death, myocardial infarction or repeat revascularization, angina recurrence and cardiogenic readmission were considered as mid-term endpoints.There were no significant differences among the groups in baseline characteristics after propensity score matching. The median intraoperative blood loss (600 ml versus 450 ml, P = 0.56, median postoperative blood loss (800 ml versus 790 ml, P = 0.60, blood transfusion requirements (25.1% versus 24.4%, P = 0.76 and composite outcome of in-hospital death, stroke and reoperation for bleeding (2.8% versus 1.6%, P = 0.10 were similar in aspirin and nonaspirin use group. At about 4 years follow-up, no significant difference was observed among the aspirin and nonaspirin use group in major adverse cardiac events free survival estimates (95.7% versus 91.5%, P = 0.23 and freedom from cardiogenic readmission (88.5% versus 85.3%, P = 0.77 whereas the angina recurrence free survival rates was 83.7% and 73.9% in the aspirin and nonaspirin use group respectively (P = 0.02, with odd ratio for preoperative aspirin estimated at 0.71 (95% confidence interval, 0.49-1.04, P = 0.08.Preoperatively continued aspirin use was not associated with increased risk of intra- and post-operative blood loss, blood transfusion requirements and composite outcome of in

  1. Mitigating fall risk: A community fall reduction program.

    Science.gov (United States)

    Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

    One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Reduction of regulatory risk: a network economic approach

    OpenAIRE

    Knieps, Günter; Weiß, Hans-Jörg

    2007-01-01

    Several definitions of regulatory risk are known from the literature. From the perspective of regulatory reform it is important to differentiate between the impact of a given regulatory scheme on the firm's risk exposure and the risk arising from discretionary behavior of regulatory agencies. Whereas the conse-quences of effective regulation in principle are known and accepted, excessive regulatory discretion may cause a strong need for regulatory reform. Regulatory reform focussing on the re...

  3. Mid-term outcomes of orbital atherectomy combined with drug-coated balloon angioplasty for treatment of femoropopliteal disease.

    Science.gov (United States)

    Foley, T Raymond; Cotter, Ryan P; Kokkinidis, Damianos G; Nguyen, Daniel D; Waldo, Stephen W; Armstrong, Ehrin J

    2017-05-01

    To assess the intraprocedural and mid-term outcomes of orbital atherectomy (OA) combined with drug-coated balloon (DCB) angioplasty for the treatment of calcified femoropopliteal disease. In this single-center cohort, 89 patients (139 lesions) were treated with DCB angioplasty for claudication or critical limb ischemia (CLI). Angiographic characteristics and procedural outcomes were reviewed for patients treated with or without adjunctive OA. Lesion calcification was graded using two previously published scoring systems, the angiographic calcium score (ACS) and the peripheral artery calcification scoring system (PACSS). Among 139 lesions, 40 (29%) were treated with OA + DCB. Mean lesion length was 135 ± 100 mm for lesions treated with OA + DCB and 139 ± 100 mm for DCB alone (P = 0.9). Moderate to severe calcification was present in 83% of patients treated with OA, compared to 42% of patients treated with DCB alone (P < 0.001). Lesions treated with OA + DCB were less likely to require bailout stenting (18% vs. 39%, P =0.01). Rates of embolization (0% in OA + DCB vs. 2% in DCB only, P = 0.4), dissection (13% vs. 14%, P = 0.8), and perforation (0%) did not differ significantly between groups. The freedom from TLR at 1 year was 82% in both groups (P = 0.6) while primary patency was 81% in-patients treated with DCB alone and 77% in-patients treated with DCB with concomitant OA (P = 0.8). In this single-center analysis of patients undergoing DCB angioplasty for claudication or CLI, OA was most often used for the treatment of severely calcified lesions. These lesions were more likely to be treated with scoring balloons and less likely to require bailout stenting. At 1 year, target lesion revascularization and primary patency was similar in patients treated with and without adjunctive OA, despite the higher lesion complexity among those receiving the combination procedure. © 2017 Wiley Periodicals, Inc. © 2017 Wiley

  4. Mid-term cost-effectiveness analysis of open and endovascular repair for ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Rollins, K E; Shak, J; Ambler, G K; Tang, T Y; Hayes, P D; Boyle, J R

    2014-02-01

    Emergency endovascular repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) may have lower operative mortality rates than open surgical repair. Concerns remain that the early survival benefit after EVAR for rAAA may be offset by late reinterventions. The aim of this study was to compare reintervention rates and cost-effectiveness of EVAR and open repair for rAAA. A retrospective analysis was undertaken of patients with rAAA undergoing EVAR or open repair over 6 years. A health economic model developed for the cost-effectiveness of elective EVAR was used in the emergency setting. Sixty-two patients (mean age 77·9 years) underwent EVAR and 85 (mean age 75·9 years) had open repair of rAAA. Median follow-up was 42 and 39 months respectively. There was no significant difference in 30-day mortality rates after EVAR and open repair (18 and 26 per cent respectively; P = 0·243). Reintervention rates were also similar (32 and 31 per cent; P = 0·701). The mean cost per patient was €26,725 for EVAR and €30,297 for open repair, and the cost per life-year gained was €7906 and €9933 respectively (P = 0·561). Open repair had greater initial costs: longer procedural times (217 versus 178·5 min; P < 0·001) and intensive care stay (5·0 versus 1·0 days; P = 0·015). Conversely, EVAR had greater reintervention (€156,939 versus €35,335; P = 0·001) and surveillance (P < 0·001) costs. There was no significant difference in reintervention rates after EVAR or open repair for rAAA. EVAR was as cost-effective at mid-term follow-up. The increased procedural costs of open repair are not outweighed by greater surveillance and reintervention costs after EVAR. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  5. A mid-term assessment of progress towards the immunization coverage goal of the Global Immunization Vision and Strategy (GIVS

    Directory of Open Access Journals (Sweden)

    Karimov Rouslan I

    2011-10-01

    Full Text Available Abstract Background The Global Immunization Vision and Strategy (GIVS (2006-2015 aims to reach and sustain high levels of vaccine coverage, provide immunization services to age groups beyond infancy and to those currently not reached, and to ensure that immunization activities are linked with other health interventions and contribute to the overall development of the health sector. Objective To examine mid-term progress (through 2010 of the immunization coverage goal of the GIVS for 194 countries or territories with special attention to data from 68 countries which account for more than 95% of all maternal and child deaths. Methods We present national immunization coverage estimates for the third dose of diphtheria and tetanus toxoid with pertussis (DTP3 vaccine and the first dose of measles containing vaccine (MCV during 2000, 2005 and 2010 and report the average annual relative percent change during 2000-2005 and 2005-2010. Data are taken from the WHO and UNICEF estimates of national immunization coverage, which refer to immunizations given during routine immunization services to children less than 12 months of age where immunization services are recorded. Results Globally DTP3 coverage increased from 74% during 2000 to 85% during 2010, and MCV coverage increased from 72% during 2000 to 85% during 2010. A total of 149 countries attained or were on track to achieve the 90% coverage goal for DTP3 (147 countries for MCV coverage. DTP3 coverage ≥ 90% was sustained between 2005 and 2010 by 99 countries (98 countries for MCV. Among 68 priority countries, 28 countries were identified as having made either insufficient or no progress towards reaching the GIVS goal of 90% coverage by 2015 for DTP3 or MCV. DTP3 and MCV coverage remained Conclusion Progress towards GIVS goals highlights improvements in routine immunization coverage, yet it is troubling to observe priority countries with little or no progress during the past five years. These results

  6. Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

    Science.gov (United States)

    Di Miceli, Riccardo; Marambio, Carlotta Bustos; Zati, Alessandro; Monesi, Roberta; Benedetti, Maria Grazia

    2017-12-01

    Purpose  The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods  We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups. Subjective IKDC score was obtained at follow-up. Statistical analysis was performed to compare the two groups for IKDC score. Subgroup analysis was performed to assess the effect of postoperative regimen (knee bracing and weight bearing) on functional outcomes. Results  The mean age of patients was 30.8 ± 10.6 years. Mean IKDC score was 87.4 ± 13.9. The mean follow-up was 3.5 ± 1.8 years. Twenty-two (53.7%) patients underwent ACLR only, while 19 (46.3%) also received other interventions, such as meniscal repair and/or collateral ligament suture. Analysis of overall data showed no differences between the groups for IKDC score. Patients in the ACLR group exhibited a significantly better IKDC score when no brace and full weight bearing after 4 weeks from surgery was prescribed in comparison with patients who worn a brace and had delayed full weight bearing. No differences were found with respect to the use of brace and postoperative weight bearing regimen in the ACLR-OI group. Conclusion  Brace and delayed weight bearing after ACLR have a negative influence on long-term functional outcomes. Further research is required to explore possible differences in the patients operated on ACLR and other intervention with respect to the use of a brace and the timing of full weight bearing to identify optimal recovery strategies. Level of Evidence  Level III, retrospective observational

  7. Incentivising flood risk adaptation through ris based insurance premiums: trade-offs between affordability and risk reduction

    NARCIS (Netherlands)

    Hudson, P.G.M.B.; Botzen, W.J.W.; Feyen, L.; Aerts, J.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

  8. Citizen science for hydrological risk reduction and resilience building

    NARCIS (Netherlands)

    Paul, Jonathan D.; Buytaert, Wouter; Allen, Simon; Ballesteros‐Cánovas, Juan A.; Bhusal, Jagat K.; Cieslik, Katarzyna; Clark, Julian; Dugar, Sumit; Hannah, David M.; Stoffel, M.; Dewulf, A.R.P.J.; Dhital, Megh R.; Liu, Wei; Nayaval, Janak Lal; Neupane, Bhanu; Schiller, Arnulf; Smith, P.J.; Supper, Robert

    2017-01-01

    In disaster risk management (DRM), an emerging shift has been noted from broad-scale, top-down assessments toward more participatory, community-based, bottom-up approaches. Arguably, nonscientist local stakeholders have always played an important role in knowledge risk management and resilience

  9. Risk reduction by use of a buffer zone

    NARCIS (Netherlands)

    Wijnant-Timmerman, S.L.; Wiersma, T.

    2008-01-01

    In situations where chemical industries and residential areas are situated close to each other, the population runs a safety risk associated with the accidental release of toxic gases. TNO has investigated the possibilities to reduce this risk by integrating safety measures in the area between the

  10. Valuation of morbidity and mortality risk reductions. Does context matter?

    DEFF Research Database (Denmark)

    Seested Nielsen, Jytte; Gyrd-Hansen, Dorte; Kjær, Trine

    2012-01-01

    targeting risks of death or risks of ill health should not necessarily be valued equally across sectors. From a welfare economic perspective, the use of the same estimates across contexts – and especially across sectors – could be misleading and in worst case lead to inefficient resource allocations....

  11. The possibility of drought risk reduction in corn production

    Directory of Open Access Journals (Sweden)

    Pajić Nemanja

    2016-01-01

    Full Text Available Weather derivatives are contemporary instruments for insurance risk of drought in agricultural production. Corn production is particularly sensitive to this risk, and the amount of the yield of this crop is in significant correlation with the July-August rainfall amount. Oscillations of production output, caused by the risk of drought, are reflected directly on the fluctuations of the financial result. The application of weather derivatives may decrease the variability of the mentioned economic parameter in corn production. In the investigated example of corn production, simulating the application of the weather option the coefficient of variation of realized financial results decreased by 9.64% compared to the version without the insured risk. At the same time, using the analysed insurance instrument, the risk of achieving a negative financial result is eliminated.

  12. Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

    Science.gov (United States)

    Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

    2018-04-01

    In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  13. Devising an Indicator to Detect Mid-Term Abortions in Dairy Cattle: A First Step Towards Syndromic Surveillance of Abortive Diseases

    OpenAIRE

    Bronner, Anne; Morignat, Eric; H?naux, Viviane; Madouasse, Aur?lien; Gay, Emilie; Calavas, Didier

    2015-01-01

    Bovine abortion surveillance is essential for human and animal health because it plays an important role in the early warning of several diseases. Due to the limited sensitivity of traditional surveillance systems, there is a growing interest for the development of syndromic surveillance. Our objective was to assess whether, routinely collected, artificial insemination (AI) data could be used, as part of a syndromic surveillance system, to devise an indicator of mid-term abortions in dairy ca...

  14. Semantic Mediation Tool for Risk Reduction, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This project focuses on providing an infrastructure to aid the building of ontologies from existing NASA applications, in a manner that leads to long-term risk...

  15. Mid-term haemodynamic and clinical results after aortic valve replacement using the Freedom Solo stentless bioprosthesis versus the Carpentier Edwards Perimount stented bioprosthesis.

    Science.gov (United States)

    van der Straaten, Ellen P J; Rademakers, Leonard M; van Straten, Albert H M; Houterman, Saskia; Tan, M Erwin S H; Soliman Hamad, Mohamed A

    2016-04-01

    The aim of this study was to investigate the mid-term haemodynamic and clinical results after aortic valve replacement (AVR) using the Sorin Freedom Solo (SFS) stentless bioprosthesis, compared with the standard Carpentier Edwards Perimount (CEP) stented bioprosthesis. In this retrospective cohort study of prospectively collected data, 116 patients were included in the SFS group (53 males; median age 74 years, range 56-85 years), and 122 patients in the CEP group (85 males; median age 73 years, range 43-88 years) between July 2007 and January 2013. Echocardiography was performed at 6 weeks after surgery in our centre, and the most recent echocardiography (in our centre or in referring cardiology departments) was requested. Between September 2013 and April 2014, all patients were called by the same researcher to gain clinical follow-up data. Mid-term mortality was 16.4% in the SFS group (19 patients) and 21.3% in the CEP group (26 patients); (P = 0.3). The mean transvalvular gradient was 7.4 ± 3.1 mmHg in the SFS group, and 11.6 ± 3.2 mmHg in the CEP group at 6 weeks postoperatively (P Solo stentless bioprosthesis is as safe as the Carpentier Edwards bioprosthesis, and provides better short- and mid-term haemodynamic performance than the Carpentier Edwards bioprosthesis. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  16. Single-center mid-term experience with chimney-graft technique for the preservation of flow to the supra-aortic branches.

    Science.gov (United States)

    Shahverdyan, Robert; Mylonas, Spyridon; Gawenda, Michael; Brunkwall, Jan

    2018-04-01

    Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate. Results A total of 30 patients (80% male, median age 70.0 years) were treated using the chimney-graft technique for the supra-aortic branches. The indication was a degenerative aneurysm in nine patients (32%) and a type B Stanford aortic dissection and a penetrating aortic ulcer in the descending aorta in seven patients (23%), respectively. In six patients (20.0%), the indication was an type Ia endoleak after previous endovascular thoracic repair, whereas a pseudoaneurysm after previous open repair of the descending aorta was the indication in one patient (3%). Twenty-three patients (77%) were treated electively, five (17%) emergently and two (7%) urgently because of free rupture. Technical success was achieved in 90% of patients. The 30-day/in-hospital mortality was 17% (5/30). A retrograde dissection was presented in five patients. Four patients experienced a cerebrovascular event. Eight patients had type Ia endoleak and 10 had type II. During the median follow-up of 16 months (range: 0-56), four further patients died: one in respiratory insufficiency, one due to a ruptured abdominal aortic aneurysm, one in meningitis and the last one for unknown reason. The chimney-graft patency was 100%. According to the Kaplan-Meier curve, the estimated survival at one year was 66 ± 9%. Conclusions The chimney-graft technique, despite a technically demanding strategy, is a useful tool as bailout procedure in our armamentarium for high-risk patients

  17. Risk reduction of international mining projects by means of investor consortia and diversification of external financing

    International Nuclear Information System (INIS)

    Kirchner, C.

    1982-01-01

    Investors and creditors of international mining projects bear specific risks which may be reduced by means of forming investor and financing consortia. Risk is defined for each actor separately. Project risk and investor risk respectively credit risk are useful categories in order to analyze risk reduction. In each case formation of consortia has a positive influence on the economic viability of the project, and thus reduces the project risk. Furthermore, formation of consortia leads to better compliance of the host country of the mining project with the project and financing agreements. Thus, investor and credit risk may be reduced. (orig.) [de

  18. Integrated risk reduction framework to improve railway hazardous materials transportation safety

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xiang, E-mail: liu94@illinois.edu; Saat, M. Rapik, E-mail: mohdsaat@illinois.edu; Barkan, Christopher P.L., E-mail: cbarkan@illinois.edu

    2013-09-15

    Highlights: • An integrated framework is developed to optimize risk reduction. • A negative binomial regression model is developed to analyze accident-cause-specific railcar derailment probability. • A Pareto-optimality technique is applied to determine the lowest risk given any level of resource. • A multi-attribute decision model is developed to determine the optimal amount of investment for risk reduction. • The models could aid the government and rail industry in developing cost-efficient risk reduction policy and practice. -- Abstract: Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation.

  19. Harnessing farmers' knowledge and perceptions for health-risk reduction in wastewater-irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, Pay; Seidu, Razak

    2009-01-01

    This chapter addresses the importance of understanding farmers' knowledge and perceptions on health-risk and risk-reduction measures for the development of mutually acceptable risk-management strategies. Drawing on studies from different countries, the chapter shows that it is not realistic to ex...

  20. Harnessing Farmers' knowledge and perceptions for health-risk reduction in wastewater-irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernhard; Drechsel, Pay; Seidu, Razak

    2010-01-01

    This chapter addresses the importance of understanding farmers’ knowledge and perceptions on health-risk and risk-reduction measures for the development of mutually acceptable risk-management strategies. Drawing on studies from different countries, the chapter shows that it is not realistic to ex...

  1. Treatment options for hypertriglyceridemia: from risk reduction to pancreatitis

    Science.gov (United States)

    Berglund, Lars; Brunzell, John D.; Goldberg, Anne C.; Goldberg, Ira J.; Stalenhoef, Anton

    2013-01-01

    While there has been considerable focus on the role and treatment of LDL cholesterol levels, a definitive role of triglycerides in the management of cardiovascular disease has been uncertain. Notably, with increasing triglyceride levels, there is a parallel increase in cholesterol levels carried by triglyceride-rich lipoproteins, which has prompted interest in the use of non-HDL cholesterol levels as a tool guiding interventions. Recent studies have provided evidence for an independent role of triglyceride levels as a cardiovascular risk factor, and recently, an Endocrine Society guideline was published for treatment of hypertriglyceridemia. In contrast to the relative uncertainty regarding triglycerides and cardiovascular disease, a role of very high triglyceride levels as a risk factor for pancreatitis has been well known. The present paper summarizes the underlying evidence for a risk role for triglyceride levels in cardiovascular disease and pancreatitis, current treatment recommendations and areas of future research. PMID:24840268

  2. Non-smooth optimization methods for large-scale problems: applications to mid-term power generation planning

    International Nuclear Information System (INIS)

    Emiel, G.

    2008-01-01

    evaluated only a subset of the dual local sub-functions, instead of all of them. This type of incremental approach has already been applied for sub-gradient algorithms and the reported computational results are promising. In chapter 4, we use instead a specialized variant of bundle methods known by their stability and precision. We give numerical illustrations for the EDF's mid-term generation planning problem. In chapter 5, we focus on this specific problem. The French power mix includes hydraulic, nuclear, and classical thermal power plants, with each generation unit having its own technical constraints. For an horizon of one to three years, the generation planning problem is a large scale stochastic program, un-tractable with a direct frontal approach. We will present a software using Lagrangian decomposition on a scenario tree to tackle this problem. The dual function is maximized using a proximal bundle method. As a byproduct of our work we proposed some improvements of the algorithms to fasten and stabilize the resolution process and extract useful informations regarding the primal solutions. We also developed a heuristical valuation of water and nuclear resources. (author)

  3. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C.; Bell, K.; Spinney, P. [and others

    1997-05-01

    The question of uncertainty and risk in electric utility resource planning has received considerable attention in recent years. During the 1980s, many utilities suffered financial losses because of unexpectedly high plant construction costs and low growth in electricity demand. In addition, the introduction of competition to the electric industry is creating new risks for power companies. No longer will utilities be able to count on regulatory protections and a base of captive consumers to provide a stable market and adequate return on their investments. Alternative risk management strategies will have to be considered instead. One approach to managing risk is for a utility company to invest in diverse power sources such as wind power plants. Since wind plants consume no fuel, can be built in relatively small increments with short construction lead times, and generate no pollutants, it is often said that they offer significant protection from risks associated with conventional fossil-fuel power plants. So far there have been few efforts to quantify these benefits, however. The study compares the costs and risks of two competing resource options, a gas-fired combined cycle plant and a wind plant, both utility-owned, through decision analysis. The case study utility is Texas Utilities Electric, a very large investor-owned company serving an area with substantial, high-quality wind resources. The authors chose a specific moment in the future - the year 2003 - when the utility currently plans to build a large fossil-fueled power plant, and examined the implications for the utility`s expected revenues, costs, and profits if a wind plant were to be built instead.

  4. Biodiesel from Specified Risk Material Tallow: An Appraisal of TSE Risks and their Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Baribeau, A.; Bradley, R.; Brown, P.; Goodwin, J.; Kihm, U.; Lotero, E.; O' Connor, D.; Schuppers, M.; Taylor, D.

    2007-03-15

    potential to inactivate TSE infectivity, for example, exposure to strong acids or bases and, depending on the process, exposure to high temperature or purification by chromatography or precipitation. However, the two-phase aqueouslipidic nature of transesterification introduces an element of uncertainty about the effect of these procedures on infectivity. Biodiesel use. Combustion temperatures, even at millisecond exposures, might partially inactivate contaminated biodiesel. But experimental data have so far been limited to saline tissue suspensions of infected tissues and several minute exposure times in static rather than dynamic combustion processes. A substantial body of epidemiological and laboratory evidence indicates that TSE is not transmitted by aerosol inhalation. Overall conclusion. Biodiesel produced from animals infected with TSE poses a negligible risk to animal and public health. This conclusion extends even to the use of SRM as a source of tallow, based on experimental evidence showing that rendered tallow from infected animal tissues does not transmit disease to inoculated susceptible animals. Although infectivity reductions during biodiesel manufacturing steps should therefore be redundant, any such reduction would still be desirable as an added measure of safety. At present, the potential for infectivity reduction through biodiesel manufacturing and combustion can only be estimated from analogy to methods known to inactivate infectivity in saline suspensions of infected tissue. Studies of the actual biodiesel process, using experimentally contaminated input tallow, are recommended as the only means by which a scientifically-based conclusion can be made about the capacity of these processes to reduce or eliminate TSE infectivity.

  5. Biodiesel from Specified Risk Material Tallow: An Appraisal of TSE Risks and their Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Baribeau, A; Bradley, R; Brown, P; Goodwin, J; Kihm, U; Lotero, E; O' Connor, D; Schuppers, M; Taylor, D

    2007-03-15

    inactivate TSE infectivity, for example, exposure to strong acids or bases and, depending on the process, exposure to high temperature or purification by chromatography or precipitation. However, the two-phase aqueouslipidic nature of transesterification introduces an element of uncertainty about the effect of these procedures on infectivity. Biodiesel use. Combustion temperatures, even at millisecond exposures, might partially inactivate contaminated biodiesel. But experimental data have so far been limited to saline tissue suspensions of infected tissues and several minute exposure times in static rather than dynamic combustion processes. A substantial body of epidemiological and laboratory evidence indicates that TSE is not transmitted by aerosol inhalation. Overall conclusion. Biodiesel produced from animals infected with TSE poses a negligible risk to animal and public health. This conclusion extends even to the use of SRM as a source of tallow, based on experimental evidence showing that rendered tallow from infected animal tissues does not transmit disease to inoculated susceptible animals. Although infectivity reductions during biodiesel manufacturing steps should therefore be redundant, any such reduction would still be desirable as an added measure of safety. At present, the potential for infectivity reduction through biodiesel manufacturing and combustion can only be estimated from analogy to methods known to inactivate infectivity in saline suspensions of infected tissue. Studies of the actual biodiesel process, using experimentally contaminated input tallow, are recommended as the only means by which a scientifically-based conclusion can be made about the capacity of these processes to reduce or eliminate TSE infectivity.

  6. Osteoporosis: Implications for Risk Reduction in the College Setting.

    Science.gov (United States)

    Leslie, Maryann; St. Pierre, Richard W.

    1999-01-01

    Examines risk factors for osteoporosis that are especially relevant to the college health setting, focusing on bone development, inadequate calcium and vitamin D intake, cigarette smoking and alcohol use, steroid use and high protein diets, and physical inactivity and excessive exercise. Also presents intervention strategies for college health…

  7. 76 FR 41278 - Cargo Security Risk Reduction; Public Listening Sessions

    Science.gov (United States)

    2011-07-13

    ....mil/hq/cg5/cg544/cdc.asp or the Federal Docket Management System at http://www.Regulations.gov . For... important for the Coast Guard, in concert with stakeholders, to implement a holistic strategy to mitigate... risk management and shared responsibility between public and private sector stakeholders, across the...

  8. Risk Reduction with a Fuzzy Expert Exploration Tool

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, William W.; Broadhead, Ron; Sung, Andrew

    2000-10-24

    This project developed an Artificial Intelligence system that drew up on a wide variety of information in providing realistic estimates of risk. ''Fuzzy logic,'' a system of integrating large amounts of inexact, incomplete information with modern computational methods derived usable conclusions, were demonstrated as a cost-effective computational technology in many industrial applications.

  9. [Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

    Science.gov (United States)

    Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

    2014-01-01

    Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

  10. The social value of mortality risk reduction: VSL versus the social welfare function approach.

    Science.gov (United States)

    Adler, Matthew D; Hammitt, James K; Treich, Nicolas

    2014-05-01

    We examine how different welfarist frameworks evaluate the social value of mortality risk reduction. These frameworks include classical, distributively unweighted cost-benefit analysis--i.e., the "value per statistical life" (VSL) approach-and various social welfare functions (SWFs). The SWFs are either utilitarian or prioritarian, applied to policy choice under risk in either an "ex post" or "ex ante" manner. We examine the conditions on individual utility and on the SWF under which these frameworks display sensitivity to wealth and to baseline risk. Moreover, we discuss whether these frameworks satisfy related properties that have received some attention in the literature, namely equal value of risk reduction, preference for risk equity, and catastrophe aversion. We show that the particular manner in which VSL ranks risk-reduction measures is not necessarily shared by other welfarist frameworks. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Evolution of surgical techniques for a progressive risk reduction.

    Science.gov (United States)

    Amato, Bruno; Santoro, Mario; Izzo, Raffaele; Servillo, Giuseppe; Compagna, Rita; Di Domenico, Lorenza; Di Nardo, Veronica; Giugliano, Giuseppe

    2017-07-18

    Advanced age is a strong predictor of high perioperative mortality in surgical patients and patients aged 75 years and older have an elevated surgical risk, much higher than that of younger patients. Progressive advances in surgical techniques now make it possible to treat high-risk surgical patients with minimally invasive procedures. Endovascular techniques have revolutionized the treatment of several vascular diseases, in particular carotid stenosis, aortic pathologies, and severely incapacitating intermittent claudication or critical limb ischemia. The main advantages of the endovascular approach are the low complication rate, high rate of technical success and a good clinical outcome. Biliary stenting has improved the clinical status of severely ill patients with bile duct stricture before major surgery, and represents a good palliative therapy in the case of malignant biliary obstruction.

  12. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  13. A Dutch Perspective on Coastal Louisiana Flood Risk Reduction and Landscape Stabilization

    National Research Council Canada - National Science Library

    Dijkman, Jos

    2007-01-01

    .... The project was aimed at identifying options for the long-term reduction of flood risks and landscape stabilization in Planning Areas I and 2 in Louisiana, in the framework of the Louisiana Coastal...

  14. The Effect of Risk Reduction Intervention on Earthquake Disaster Preparedness of the Elderly People

    Directory of Open Access Journals (Sweden)

    Kian Nourozi

    2016-01-01

    Conclusion: Preparedness programs for disaster risk reduction has a positive effect on the elders’ preparedness. Thus, similar multimodal preparedness programs should be used more frequently for this vulnerable community citizens.

  15. Case Study of Cardiovascular Risk Reduction in the Northwest Region and TRICARE Region 11

    National Research Council Canada - National Science Library

    Murphy, Rosemary

    2003-01-01

    ... and TRICARE Lead Agent Region 11. The outcomes management team developed a cardiovascular risk reduction scorecard and metrics in which to evaluate the care being given to the TRICARE prime enrollees with a cardiovascular disease diagnosis...

  16. Farmers prone to drought risk : why some farmers undertake farm-level risk-reduction measures while others not?

    NARCIS (Netherlands)

    Gidey, T.G.; van der Veen, A.

    2015-01-01

    This research investigates farmers’ cognitive perceptions of risk and the behavioral intentions to undertake farm-level risk-reduction measures. It has been observed that people who are susceptible to natural hazards often fail to act, or do very little, to protect their assets or lives. To answer

  17. Low-cost risk reduction strategy for small workplaces: how can we spread good practices?

    Science.gov (United States)

    Kogi, K

    2006-01-01

    Recent advances in health risk reduction approaches are examined based on inter-country networking experiences. A noteworthy progress is the wider application of low-cost improvements to risk reduction particularly in small enterprises and agriculture in both industrially developing and developed countries. This is helped by the readiness of managers and workers to implement these improvements despite many constraints. Typical improvements include mobile racks, simple workstation changes, screening hazards, better welfare facilities and teamwork arrangements. In view of the complex circumstances of work-related health risks, it is important to know whether a low-cost strategy can advance risk reduction practices effectively and what support measures are necessary. It is confirmed that the strategy can overcome related constraints through its advantages. Main advantages lie in (a) the facilitation of improved practices in multiple technical areas, (b) the strengthening of realistic stepwise risk reduction, and (c) the enhanced multiplier effects through training of local trainers. Action-oriented risk assessment tools, such as action checklists and low-cost improvement guides, can encourage risk-reducing measures adjusted to each local situation. It is suggested to spread the low-cost risk reduction strategy for improving small workplaces in diversified settings with the support of these locally tailored tools.

  18. Risk reduction strategies in laparoscopic donor nephrectomy: A comparative study

    Directory of Open Access Journals (Sweden)

    T Manohar

    2006-01-01

    Full Text Available OBJECTIVES: As the advancements, modifications and standardization of laparoscopy are taking place, there is a need for the reduction in morbidity associated with laparoscopic live donor nephrectomy. This study was performed to determine and reconfirm the advantages of laparoscopic donor nephrectomy over its open counterpart. MATERIALS AND METHODS: Two hundred open live donor nephrectomy (ODN cases were compared to 264 cases of laparoscopic live donor nephrectomy (LDN. Pretransplant functional and radiological evaluation was done routinely by excretory urogram and renal arteriography. In case of vascular variations, CT angiography was preferred. Open cases were done by conventional method and laparoscopic group underwent certain technical and surgical modifications, including meticulous planning for the port placement. Operative time, analgesia requirement, start of the orals, hospital stay, blood loss, late allograft function, incidence of rejection, complications and technical problems were analyzed. RESULTS: Operative time was 135.8 ± 43 and 165 ± 44.4 min ( P < 0.0001, requirement of analgesia was 60.5 ± 40 and 320 ± 120 mg ( P < 0.0001, hospital stay was 4 ± 0.04 and 5.7 ± 2.03 days ( P < 0.0001, warm ischemia time was 6.1 ± 2.0 and 4.1 ± 0.80 min ( P < 0.0001 and time taken for the serum creatinine to stabilize in the recipient was 4.1 ± 1.6 and 4.32 ± 1.40 days ( P =0.06 for LDN and ODN groups respectively. There was a significant reduction in the blood loss in LDN group ( P =0.0005. Overall complications were 6.81 and 14.5% and ureteric injury was seen in 0.37 and 1% in LDN and ODN respectively. CONCLUSION: Laparoscopic live donor nephrectomy can now be performed with low morbidity and mortality to both donors and recipients and is proving to be the preferred operation to open donor nephrectomy. Our continued innovations in technical modifications have made this novel operation successful.

  19. Selection of risk reduction portfolios under interval-valued probabilities

    International Nuclear Information System (INIS)

    Toppila, Antti; Salo, Ahti

    2017-01-01

    A central problem in risk management is that of identifying the optimal combination (or portfolio) of improvements that enhance the reliability of the system most through reducing failure event probabilities, subject to the availability of resources. This optimal portfolio can be sensitive with regard to epistemic uncertainties about the failure events' probabilities. In this paper, we develop an optimization model to support the allocation of resources to improvements that mitigate risks in coherent systems in which interval-valued probabilities defined by lower and upper bounds are employed to capture epistemic uncertainties. Decision recommendations are based on portfolio dominance: a resource allocation portfolio is dominated if there exists another portfolio that improves system reliability (i) at least as much for all feasible failure probabilities and (ii) strictly more for some feasible probabilities. Based on non-dominated portfolios, recommendations about improvements to implement are derived by inspecting in how many non-dominated portfolios a given improvement is contained. We present an exact method for computing the non-dominated portfolios. We also present an approximate method that simplifies the reliability function using total order interactions so that larger problem instances can be solved with reasonable computational effort. - Highlights: • Reliability allocation under epistemic uncertainty about probabilities. • Comparison of alternatives using dominance. • Computational methods for generating the non-dominated alternatives. • Deriving decision recommendations that are robust with respect to epistemic uncertainty.

  20. Risk reduction by filtered venting in PWR large dry-containments

    International Nuclear Information System (INIS)

    Gazzillo, F.; Kastenberg, W.E.

    1984-01-01

    The potential risk reduction associated with a Filtered-Vented Containment System is evaluated. A low-volume venting strategy has been considered and data referring to the Zion power plant, along with the results of the Zion Probabilistic Safety Study, have been used. An estimate of the reduction factor is first made for a single core melt accident sequence whose containment failure mode is late overpressure. The result, interpreted as a reduction factor applicable to the release category associated with containment late overpressure is then used for the estimation of the overall risk reduction factor. In particular, the case of internal and external risk for the Zion power plant are considered. Because the contribution from seismic events dominates the overall risk, the importance of different assumptions for seismic fragility is also assessed. Finally an uncertainty analysis of the risk reduction factor for a single accident sequence is performed. An estimate is also obtained on the level of confidence with which certain required values of risk reduction can be achieved. (orig.)

  1. Consideration on risk reduction of future breeder reactors

    International Nuclear Information System (INIS)

    Vossebrecker, H.

    1990-09-01

    An overall concept of risk minimization of future sodium-cooled fast breeder reactors is presented in this report. Since shutdown reliability is of vital importance for the breeder safety, a so-called third shutdown level is proposed in addition to the two independent fast shutdown systems. It is basically a group of passive and active measures, which are capable to bring the reactor to safe conditions in all conceivable accident-initiating events and in case of total failure of the two actual shutdown systems. Core disruptions as a result of shutdown failure are therefore beyond the scope of technical imagination. Measures are also foreseen to combat other conceivable causes of core disruption, in particular to achieve residual heat removal with essentially passive systems by making use of the good natural circulation capacity of sodium. On top of that, since absolute safety can never be claimed, damage-limiting containment measures are discussed

  2. A business perspective on environmental risk and cost reduction

    International Nuclear Information System (INIS)

    Roper, U.V.

    1998-01-01

    The ways in which the petrochemical industry can enjoy successful business partnerships with environmental service companies was discussed. The petrochemical industry has traditionally viewed environmental service companies as an inherent cost in the context of risk management, and not in the context of business opportunity. Today, as environmental issues are integrated into business operations, there is a new potential for creating business opportunities in a number of operational areas, among them : (1) energy efficiency, (2) process efficiency, (3) waste minimization, (4) waste recycling, and (5) operational pooling. As environmental service companies became more competitive, they have become more attractive business partners. They are providing more diversified services and are better aligned with core competencies required to exploit business opportunities that are too small for major players in the oil,natural gas and petro-chemical industry. They also offer public recognition and financial upside for industry. Some examples of successful business partnerships along these lines are briefly described

  3. Flooding risk reduction for the ASCO NPP PSA

    International Nuclear Information System (INIS)

    Nos Llorens, V.; Faig Sureda, J.

    1993-01-01

    Developed within the framework of the UTE (INITEC-INYPSA-Empresarios Agrupados), the Probabilistic Safety Analysis (PSA) of the Asco Nuclear Power Plant has served both as a basic tool in reducing the risk of potential internal flooding at the plant, and as a guideline for studying the optimization and feasibility of necessary plant design modifications and changes to procedures. During execution of the work, and in view of the results, a series of improvements were proposed which gave rise to design modification studies. The paper seeks to describe the effect of these modifications on reducing core damage frequency, it also includes a general description of the methodology used. Finally, it compares the results obtained in the context of similar studies performed in other PSAs. (author)

  4. Ethical questions in landslide management and risk reduction in Norway

    Science.gov (United States)

    Taurisano, A.; Lyche, E.; Thakur, V.; Wiig, T.; Øvrelid, K.; Devoli, G.

    2012-04-01

    The loss of lives caused by landslides in Norway is smaller than in other countries due to the low population density in exposed areas. However, annual economic losses from damage to properties and infrastructures are vast. Yet nationally coordinated efforts to manage and reduce landslide and snow avalanche risk are a recent challenge, having started only in the last decade. Since 2009, this has been a task of the Norwegian Water Resources and Energy Directorate (NVE) under the Ministry of Petroleum and Energy. Ongoing work includes collection of landslide data, production of susceptibility and hazard maps, planning of mitigation measures along with monitoring and early warning systems, assistance to areal planning, providing expertise in emergencies and disseminating information to the public. These activities are realized in collaboration with the Norwegian Geological Survey (NGU), the Meteorological Institute, the Road and Railway authorities, universities and private consultant companies. As the total need for risk mitigating initiatives is by far larger than the annual budget, priority assessment is crucial. This brings about a number of ethical questions. 1. Susceptibility maps have been produced for the whole country and provide a first indication of areas with potential landslide or snow avalanche hazard, i.e. areas where special attention and expert assessments are needed before development. Areas where no potential hazard is shown can in practice be developed without further studies, which call for relatively conservative susceptibility maps. However, conservative maps are problematic as they too often increase both cost and duration of building projects beyond the reasonable. 2. Areas where hazard maps or risk mitigation initiatives will be funded are chosen by means of cost-benefits analyses which are often uncertain. How to estimate the benefits if the real probability for damage can only be judged on a very subjective level but not really calculated

  5. Structuring Cooperative Nuclear RIsk Reduction Initiatives with China.

    Energy Technology Data Exchange (ETDEWEB)

    Brandt, Larry [Stanford Univ., CA (United States); Reinhardt, Jason Christian [Stanford Univ., CA (United States); Hecker, Siegfried [Stanford Univ., CA (United States)

    2017-03-01

    The Stanford Center for International Security and Cooperation engaged several Chinese nuclear organizations in cooperative research that focused on responses to radiological and nuclear terrorism. The objective was to identify joint research initiatives to reduce the global dangers of such threats and to pursue initial technical collaborations in several high priority areas. Initiatives were identified in three primary research areas: 1) detection and interdiction of smuggled nuclear materials; 2) nuclear forensics; and 3) radiological (“dirty bomb”) threats and countermeasures. Initial work emphasized the application of systems and risk analysis tools, which proved effective in structuring the collaborations. The extensive engagements between national security nuclear experts in China and the U.S. during the research strengthened professional relationships between these important communities.

  6. Integrated risk reduction framework to improve railway hazardous materials transportation safety.

    Science.gov (United States)

    Liu, Xiang; Saat, M Rapik; Barkan, Christopher P L

    2013-09-15

    Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Miles McQueen; Wayne Boyer; Mark Flynn; Sam Alessi

    2006-03-01

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

  8. The assessment of treated wastewater quality and the effects of mid-term irrigation on soil physical and chemical properties (case study: Bandargaz-treated wastewater)

    Science.gov (United States)

    Kaboosi, Kami

    2017-09-01

    This study was conducted to investigate the characteristics of inflow and outflow wastewater of the Bandargaz wastewater treatment plant on the basis of the data collection of operation period and the samples taken during the study. Also the effects of mid-term use of the wastewater for irrigation (from 2005 to 2013) on soil physical and chemical characteristics were studied. For this purpose, 4 samples were taken from the inflow and outflow wastewater and 25 quality parameters were measured. Also, the four soil samples from a depth of 0-30 cm of two rice field irrigated with wastewater in the beginning and middle of the planting season and two samples from one adjacent rice field irrigated with fresh water were collected and their chemical and physical characteristics were determined. Average of electrical conductivity, total dissolved solids, sodium adsorption ratio, chemical oxygen demand and 5 days biochemical oxygen demand in treated wastewater were 1.35 dS/m, 707 ppm, 0.93, 80 ppm and 40 ppm, respectively. Results showed that although some restrictions exist about chlorine and bicarbonate, the treated wastewater is suitable for irrigation based on national and international standards and criteria. In comparison with fresh water, the mid-term use of wastewater caused a little increase of soil salinity. However, it did not lead to increase of soil salinity beyond rice salinity threshold. Also, there were no restrictions on soil in the aspect of salinity and sodium hazard on the basis of many irrigated soil classifications. In comparison with fresh water, the mid-term use of wastewater caused the increase of total N, absorbable P and absorbable K in soil due to high concentration of those elements in treated wastewater.

  9. Beyond the Sendai Framework for Disaster Risk Reduction: Vulnerability Reduction as a Challenge Involving Historical and Traditional Buildings

    Directory of Open Access Journals (Sweden)

    Valentina Pica

    2018-03-01

    Full Text Available In observance of the international procedures on disaster risk management, and in particular the Sendai Framework (2015, this research focuses on how more specific procedures related to it can be made effective in the treatment of historic areas worldwide. Disaster risk management is now viewed as being important in the context of historic buildings, as they are strongly related to cultural identity as well as to resilient communities, and can have a large impact on local economies. The study points out that cultural heritage might be the core field of action for capacity building in less vulnerable places, and that its protection is one of the main tasks to attend to in order to achieve the goal of vulnerability reduction. The paper also aims to answer questions such as: which actions could allow better protection of cultural heritage? Is it correct to involve local communities in reconstruction plans by capacity building and self-managed projects? How have reconstruction plans been managed recently worldwide? By further developing the applicability of the priority areas of action of the Sendai Framework, the research illustrates critical points and best practices that will hopefully support disaster risk reduction based on strategic management and remote monitoring, involving technologies and social participation.

  10. Social media in disaster risk reduction and crisis management.

    Science.gov (United States)

    Alexander, David E

    2014-09-01

    This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

  11. The critical role of volcano monitoring in risk reduction

    Directory of Open Access Journals (Sweden)

    R. I. Tilling

    2008-01-01

    Full Text Available Data from volcano-monitoring studies constitute the only scientifically valid basis for short-term forecasts of a future eruption, or of possible changes during an ongoing eruption. Thus, in any effective hazards-mitigation program, a basic strategy in reducing volcano risk is the initiation or augmentation of volcano monitoring at historically active volcanoes and also at geologically young, but presently dormant, volcanoes with potential for reactivation. Beginning with the 1980s, substantial progress in volcano-monitoring techniques and networks – ground-based as well space-based – has been achieved. Although some geochemical monitoring techniques (e.g., remote measurement of volcanic gas emissions are being increasingly applied and show considerable promise, seismic and geodetic methods to date remain the techniques of choice and are the most widely used. Availability of comprehensive volcano-monitoring data was a decisive factor in the successful scientific and governmental responses to the reawakening of Mount St. elens (Washington, USA in 1980 and, more recently, to the powerful explosive eruptions at Mount Pinatubo (Luzon, Philippines in 1991. However, even with the ever-improving state-of-the-art in volcano monitoring and predictive capability, the Mount St. Helens and Pinatubo case histories unfortunately still represent the exceptions, rather than the rule, in successfully forecasting the most likely outcome of volcano unrest.

  12. "How can the Elections Help us Quell Hunger?" Mid-Term Review of Norwegian Support to UNDP's Trust Fund for Civic Education

    OpenAIRE

    Orre, Aslak; Larssen, Christian; Sánchez, Manolo

    2008-01-01

    This report is the mid-term review of UNDPs trust fund for civic education in Angola. The trust fund was set up in late 2006, with support from the embassies of Norway, Sweden and USAid, topped up with UNDP’s own funds. By late 2007, 22 CSOs or umbrella organisations had been selected and supported with grants to carry out civic education activities throughout the country. The most common activity is civic education sessions, where a specially trained promoter talks to a popular gathering. ...

  13. High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis

    DEFF Research Database (Denmark)

    Laursen, Jens Ole

    2017-01-01

    PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant...... pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients...

  14. Children?s oral health-related quality of life and associated factors: Mid-term changes after dental treatment under general anesthesia

    OpenAIRE

    Baghdadi, Ziad D.

    2015-01-01

    Objectives: This study aimed to document the mid-term effects of comprehensive dental treatment under general anesthesia (DTGA) on parent-assessed children?s oral health-related quality of life (COHRQoL). A second aim was to examine some epidemiological factors associated with COHRQoL and treatment outcome. Study Design: A pretest-posttest design was followed in which parents were surveyed using the Child Oral Health Quality of Life Questionnaire before and 6-9 months after their children (ag...

  15. Mid-term follow-up outcomes of 2-staged hybrid coronary revascularization compared with off-pump coronary artery bypass for patients with multivessel coronary artery disease.

    Science.gov (United States)

    Wu, Song; Ling, Yunpeng; Fu, Yuanhao; Zhang, Lufeng; Yang, Hang; Guo, Lijun; Gao, Wei; Wan, Feng

    2017-06-01

    Two-staged hybrid coronary revascularization (HCR) is a novel procedure in selected patients with multivessel coronary artery disease. However, few studies are available on the mid-term or long-term outcomes of this 2-staged procedure as compared to off-pump coronary artery bypass (OPCAB). To compare in-hospital and mid-term follow-up outcomes of 2-staged HCR with OPCAB in patients with multivessel coronary artery disease. The present retrospective study analyzed the data from 73 patients who underwent the 2-staged HCR (HCR group) during 2012-2014 at the heart center. Three hundred and eighty-three patients who underwent conventional OPCAB by the same surgeon were selected for the comparative analysis performed on in-hospital and mid-term follow-up outcomes between the two groups. No significant difference was observed in the preoperative outcome between the two groups. The HCR group had a shorter operation duration (152.9 ±43.8 vs. 262.6 ±51.8 min, p < 0.05), less bleeding (558.6 ±441.3 vs. 1035.5 ±613.3 ml, p < 0.05), shorter mechanical ventilation (9.4 ±7.4 vs. 19.0 ±18.3 h, p < 0.05), and less blood transfusion (12 (16.4%) vs. 200 (52.2%), p < 0.05). The mean follow-up duration was 25.0 ±9.6 months in the HCR group and 22.8 ±10.6 months in the OPCAB group. The incidence of major adverse cardiac or cerebrovascular events (MACCE) was similar in both groups (4 (5.5%) vs. 10 (2.8%), p = 0.408). The estimated 3-year survival was similar in both groups (log-rank χ 2 = 1.041, p = 0.308). The 2-staged HCR is a safe and effective surgical procedure and may offer similar mid-term follow-up outcomes to OPCAB.

  16. Comparative effectiveness of personalized lifestyle management strategies for cardiovascular disease risk reduction

    NARCIS (Netherlands)

    P. Chu (Paula); A. Pandya; J.A. Salomon (Joshua A); S.J. Goldie (Sue J); Hunink, M.G.M. (M.G. Myriam)

    2015-01-01

    textabstractBackground-Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year

  17. Cost-effectiveness analysis of risk reduction at nuclear power plants

    International Nuclear Information System (INIS)

    Lochard, J.; Maccia, C.; Pages, P.

    1985-01-01

    Cost-effectiveness analysis of risk reduction is now widely accepted as a rational analytical framework to consistently address the resource allocation problem underlying any risk management process. This paper presents how this technique can be usefully applied to complex systems such as the management of radioactive releases from nuclear power plants into the environment. (orig.) [de

  18. Evaluation of an HIV-risk reduction programme for first-year ...

    African Journals Online (AJOL)

    Results indicated that HIV-related knowledge; condom knowledge and risk perception were enhanced by the HIV- related risk reduction programme. However, there is a need for improvement, especially with regard to attitudes towards condoms since some students still had negative attitudes even after the intervention ...

  19. Estimating mortality risk reduction and economic benefits from controlling ozone air pollution

    National Research Council Canada - National Science Library

    Committee on Estimating Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure

    2008-01-01

    ... in life expectancy, and to assess methods for estimating the monetary value of the reduced risk of premature death and increased life expectancy in the context of health-benefits analysis. Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution details the committee's findings and posits several recommendations to address these issues.

  20. COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar:" ongoing research activities and mid-term results

    Science.gov (United States)

    Pajewski, Lara; Benedetto, Andrea; Loizos, Andreas; Slob, Evert; Tosti, Fabio

    2015-04-01

    This work aims at presenting the ongoing activities and mid-term results of the COST (European COoperation in Science and Technology) Action TU1208 'Civil Engineering Applications of Ground Penetrating Radar.' Almost three hundreds experts are participating to the Action, from 28 COST Countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Malta, Macedonia, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom), and from Albania, Armenia, Australia, Egypt, Hong Kong, Jordan, Israel, Philippines, Russia, Rwanda, Ukraine, and United States of America. In September 2014, TU1208 has been praised among the running Actions as 'COST Success Story' ('The Cities of Tomorrow: The Challenges of Horizon 2020,' September 17-19, 2014, Torino, IT - A COST strategic workshop on the development and needs of the European cities). The principal goal of the COST Action TU1208 is to exchange and increase scientific-technical knowledge and experience of GPR techniques in civil engineering, whilst simultaneously promoting throughout Europe the effective use of this safe and non-destructive technique in the monitoring of infrastructures and structures. Moreover, the Action is oriented to the following specific objectives and expected deliverables: (i) coordinating European scientists to highlight problems, merits and limits of current GPR systems; (ii) developing innovative protocols and guidelines, which will be published in a handbook and constitute a basis for European standards, for an effective GPR application in civil- engineering tasks; safety, economic and financial criteria will be integrated within the protocols; (iii) integrating competences for the improvement and merging of electromagnetic scattering techniques and of data- processing techniques; this will lead to a novel freeware tool for the localization of buried objects

  1. RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

    Energy Technology Data Exchange (ETDEWEB)

    William W. Weiss

    2000-06-30

    Incomplete or sparse information on geologic or formation characteristics introduces a high level of risk for oil exploration and development projects. Expert systems have been developed and used in several disciplines and industries, including medical diagnostics, with favorable results. A state-of-the-art exploration ''expert'' tool, relying on a computerized data base and computer maps generated by neural networks, is proposed through the use of ''fuzzy'' logic, a relatively new mathematical treatment of imprecise or non-explicit parameters and values. This project will develop an Artificial Intelligence system that will draw upon a wide variety of information to provide realistic estimates of risk. ''Fuzzy logic,'' a system of integrating large amounts of inexact, incomplete information with modern computational methods to derive usable conclusions, has been demonstrated as a cost-effective computational technology in many industrial applications. During project year 1, 90% of geologic, geophysical, production and price data were assimilated for installation into the database. Logs provided geologic data consisting of formation tops of the Brushy Canyon, Lower Brushy Canyon, and Bone Springs zones of 700 wells used to construct regional cross sections. Regional structure and isopach maps were constructed using kriging to interpolate between the measured points. One of the structure derivative maps (azimuth of curvature) visually correlates with Brushy Canyon fields on the maximum change contours. Derivatives of the regional geophysical data also visually correlate with the location of the fields. The azimuth of maximum dip approximately locates fields on the maximum change contours. In a similar manner the second derivative in the x-direction of the gravity map visually correlates with the alignment of the known fields. The visual correlations strongly suggest that neural network architectures will be

  2. Governance of disaster risk reduction in Cameroon: The need to empower local government

    Directory of Open Access Journals (Sweden)

    Henry N. Bang

    2013-02-01

    Full Text Available The impact of natural hazards and/or disasters in Cameroon continues to hit local communities hardest, but local government lacks the ability to manage disaster risks adequately. This is partly due to the fact that the necessity to mainstream disaster risk reduction into local governance and development practices is not yet an underlying principle of Cameroon’s disaster management framework. Using empirical and secondary data, this paper analyses the governance of disaster risks in Cameroon with particular focus on the challenges local government faces in implementing disaster risk reduction strategies. The hypothesis is that the governance of disaster risks is too centralised at the national level, with huge implications for the effective governance of disaster risks at the local level. Although Cameroon has reinvigorated efforts to address growing disaster risks in a proactive way, it is argued that the practical actions are more reactive than proactive in nature. The overall aim is to explore the challenges and opportunities that local government has in the governance of disaster risks. Based on the findings from this research, policy recommendations are suggested on ways to mainstream disaster risk reduction strategies into local governance, and advance understanding and practice in the local governance of disaster risks in the country.

  3. Moderate alcohol consumption and cardiovascular risk reduction: open issues

    Directory of Open Access Journals (Sweden)

    Simona Costanzo

    2006-06-01

    Full Text Available

    Background: The inverse relationship between low to moderate alcohol consumption and several favorable health outcomes has been well established in many epidemiological studies and meta-analyses. However, several questions still remain controversial.

    Aims: To discuss a number of open questions relating to the healthy effect of a moderate intake of alcohol (especially wine on cardiovascular disease and total mortality. This will be based on findings from the literature, with a particular emphasis on meta-analyses.

    Results and Conclusion: The role of different alcoholic beverages, age and sex, confounding, former drinkers and study design has been discussed. Whether wine is better than beer or spirits, though suggestive, remains to be established. Cardiovascular morbidity and total mortality is significantly reduced both in men and women who are regular drinkers of low amounts of alcohol; however, the predicted protection in women disappears at lower doses than in men. The primary protection of alcohol decreases after adjustment for known variables, thus confirming the importance of confounding in assessing drinking effects, but it remains significant and of undoubted public health value. As the cardiovascular protection by moderate alcohol consumption might have been unduly overestimated by inclusion in control groups of former drinkers, we compared studies that used as a reference group the category of no alcohol intake and/or formally excluded former drinkers with studies which did not: the protection was indeed somewhat lower in the former than in the latter studies, but was still statistically significant. We conclude that the dose-response relationship between alcohol intake and cardiovascular risk or total mortality, consistently described by J-shaped curves, can be reasonably attributed to a combination of both real beneficial (at lower doses and harmful (at higher doses

  4. Farmers Prone to Drought Risk: Why Some Farmers Undertake Farm-Level Risk-Reduction Measures While Others Not?

    Science.gov (United States)

    Gebrehiwot, Tagel; van der Veen, Anne

    2015-03-01

    This research investigates farmers' cognitive perceptions of risk and the behavioral intentions to undertake farm-level risk-reduction measures. It has been observed that people who are susceptible to natural hazards often fail to act, or do very little, to protect their assets or lives. To answer the question of why some people show adaptive behavior while others do not, a socio-psychological model of precautionary adaptation based on protection motivation theory and trans-theoretical stage model has been applied for the first time to areas of drought risk in the developing countries cultural context. The applicability of the integrated model is explored by means of a representative sample survey of smallholder farmers in northern Ethiopia. The result of the study showed that there is a statistically significant association between farmer's behavioral intention to undertake farm-level risk-reduction measures and the main important protection motivation model variables. High perceived vulnerability, severity of consequences, self-efficacy, and response efficacy lead to higher levels of behavioral intentions to undertake farm-level risk-reduction measures. For farmers in the action stage, self-efficacy and response efficacy were the main motivators of behavioral intention. For farmers in the contemplative stage, self-efficacy and cost appear to be the main motivators for them to act upon risk reduction, while perceived severity of consequences and cost of response actions were found to be important for farmers in the pre-contemplative stage.

  5. Health risk reduction programs in employer-sponsored health plans: Part II-law and ethics.

    Science.gov (United States)

    Rothstein, Mark A; Harrell, Heather L

    2009-08-01

    We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests.

  6. Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

    Science.gov (United States)

    Rothstein, Mark A.; Harrell, Heather L.

    2011-01-01

    Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

  7. US-Soviet cooperation in countering nuclear terrorism: the role of risk reduction centers

    International Nuclear Information System (INIS)

    Nunn, S.; Warner, J.W.

    1987-01-01

    Preventing nuclear terrorism should be high on the agenda of US-Soviet relations. Indeed, the specter of nuclear terrorism, more than any other factor originally prompted and has subsequently sustained the author's deep interest in US-Soviet agreements on establishment of US-Soviet Nuclear Risk Reduction Centers and other important risk-reduction measures. Such centers can play an invaluable role in facilitating discussions aimed at forestalling possible contingencies and in providing a mechanism for dampening escalatory dangers that might otherwise result from any future nuclear terrorism incident. In addition to these crucial substantive functions, the centers could serve to reassure anxious publics that the governments they have entrusted with command authority over tens of thousands of nuclear devices are giving the highest priority to reducing the risk that any of them will ever be used, whether by design or by accident. Nuclear risk Reduction Centers are an idea whose time has come

  8. Disaster Risk Reduction through Innovative Uses of Crowd Sourcing (Invited)

    Science.gov (United States)

    Berger, J.; Greene, M.

    2010-12-01

    Crowd sourcing can be described as a method of distributed problem-solving. It takes advantage of the power of the crowd, which can in some cases be a community of experts and in other cases the collective insight of a broader range of contributors with varying degrees of domain knowledge. The term crowd sourcing was first used by Jeff Howe in a June 2006 Wired magazine article “The Rise of Crowdsourcing,” and is a combination of the terms “crowd” and “outsourcing.” Some commonly known examples of crowd sourcing, in its broadest sense, include Wikepedia, distributed participatory design projects, and consumer websites such as Yelp and Angie’s List. The popularity and success of early large-scale crowd sourcing activities is made possible through leveraging Web 2.0 technologies that allow for mass participation from distributed individuals. The Earthquake Engineering Research Institute (EERI) in Oakland, California recently participated in two crowd sourcing projects. One was initiated and coordinated by EERI, while in the second case EERI was invited to contribute once the crowd sourcing activity was underway. In both projects there was: 1) the determination of a problem or set of tasks that could benefit immediately from the engagement of an informed volunteer group of professionals; 2) a segmenting of the problem into discrete pieces that could be completed in a short period of time (from ten minutes to four hours); 3) a call to action, where an interested community was made aware of the project; and 4) the collection, aggregation, vetting and ultimately distribution of the results in a relatively short period of time. The first EERI crowd sourcing example was the use of practicing engineers and engineering students in California to help estimate the number of pre-1980 concrete buildings in the high seismic risk counties in the state. This building type is known to perform poorly in earthquakes, and state officials were interested in understanding

  9. Perceptions of farmers on health risks and risk reduction measures in wastewater-irrigated urban vegetable farming in Ghana

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, Pay; Konradsen, Flemming

    2008-01-01

    , authorities and the general public, especially if they had some incentives. These findings demonstrate the need to involve farmers as early as possible in intervention projects especially in informal farming practices, like urban agriculture, where restrictions are difficult to implement. This will ensure......Most irrigation water used in urban vegetable farming in Ghana is contaminated with untreated wastewater. This poses health risks to farmers and consumers. As part of a study to explore options for health risk reduction, this paper summarizes farmers' perceptions on health risks and possible risk...

  10. Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction.

    Science.gov (United States)

    Chu, Paula; Pandya, Ankur; Salomon, Joshua A; Goldie, Sue J; Hunink, M G Myriam

    2016-03-29

    Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  11. Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

    Science.gov (United States)

    Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

    2015-02-12

    Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the

  12. POTENTIAL HEALTH RISK REDUCTION ARISING FROM REDUCED MERCURY EMISSIONS FROM COAL FIRED POWER PLANTS.

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, T. M.; Lipfert, F. W.; Morris, S. C.; Moskowitz, P. D.

    2001-09-01

    The U.S. Environmental Protection Agency (EPA) has announced plans to regulate mercury (Hg) emissions from coal-fired power plants. EPA has not prepared a quantitative assessment of the reduction in risk that could be achieved through reduction in coal plant emissions of Hg. To address this issue, Brookhaven National Laboratory (BNL) with support from the U.S. Department of Energy Office of Fossil Energy (DOE FE) prepared a quantitative assessment of the reduction in human health risk that could be achieved through reduction in coal plant emissions of Hg. The primary pathway for Hg exposure is through consumption of fish. The most susceptible population to Hg exposure is the fetus. Therefore the risk assessment focused on consumption of fish by women of child-bearing age. Dose response factors were generated from studies on loss of cognitive abilities (language skills, motor skills, etc.) by young children whose mothers consumed large amounts of fish with high Hg levels. Population risks were estimated for the general population in three regions of the country, (the Midwest, Northeast, and Southeast) that were identified by EPA as being heavily impacted by coal emissions. Three scenarios for reducing Hg emissions from coal plants were considered: (1) A base case using current conditions; (2) A 50% reduction; and, (3) A 90% reduction. These reductions in emissions were assumed to translate linearly into a reduction in fish Hg levels of 8.6% and 15.5%, respectively. Population risk estimates were also calculated for two subsistence fisher populations. These groups of people consume substantially more fish than the general public and, depending on location, the fish may contain higher Hg levels than average. Risk estimates for these groups were calculated for the three Hg levels used for the general population analyses. Analysis shows that the general population risks for exposure of the fetus to Hg are small. Estimated risks under current conditions (i.e., no

  13. Parallel structures for disaster risk reduction and climate change adaptation in Southern Africa

    Directory of Open Access Journals (Sweden)

    Per Becker

    2013-01-01

    Full Text Available During the last decade, the interest of the international community in the concepts of disaster risk reduction and climate change adaptation has been growing immensely. Even though an increasing number of scholars seem to view these concepts as two sides of the same coin (at least when not considering the potentially positive effects of climate change, in practice the two concepts have developed in parallel rather than in an integrated manner when it comes to policy, rhetoric and funding opportunities amongst international organisations and donors. This study investigates the extent of the creation of parallel structures for disaster risk reduction and climate change adaptation in the Southern African Development Community (SADC region. The chosen methodology for the study is a comparative case study and the data are collected through focus groups and content analysis of documentary sources, as well as interviews with key informants. The results indicate that parallel structures for disaster risk reduction and climate change adaptation have been established in all but one of the studied countries. The qualitative interviews performed in some of the countries indicate that stakeholders in disaster risk reduction view this duplication of structures as unfortunate, inefficient and a fertile setup for conflict over resources for the implementation of similar activities. Additional research is called for in order to study the concrete effects of having these parallel structures as a foundation for advocacy for more efficient future disaster risk reduction and climate change adaptation.

  14. Estimating the Value of Price Risk Reduction in Energy Efficiency Investments in Buildings

    Directory of Open Access Journals (Sweden)

    Pekka Tuominen

    2017-10-01

    Full Text Available This paper presents a method for calculating the value of price risk reduction to a consumer that can be achieved with investments in energy efficiency. The value of price risk reduction is discussed to some length in general terms in the literature reviewed but, so far, no methodology for calculating the value has been presented. Here we suggest such a method. The problem of valuating price risk reduction is approached using a variation of the Black–Scholes model by considering a hypothetical financial instrument that a consumer would purchase to insure herself against unexpected price hikes. This hypothetical instrument is then compared with an actual energy efficiency investment that reaches the same level of price risk reduction. To demonstrate the usability of the method, case examples are calculated for typical single-family houses in Finland. The results show that the price risk entailed in household energy consumption can be reduced by a meaningful amount with energy efficiency investments, and that the monetary value of this reduction can be calculated. It is argued that this often-overlooked benefit of energy efficiency investments merits more consideration in future studies.

  15. Evaluation of severe accident risks and the potential for risk reduction: Surry Power Station, Unit 1: Draft report for comment

    International Nuclear Information System (INIS)

    Benjamin, A.S.; Boyd, G.J.; Kunsman, D.M.; Murfin, W.B.; Williams, D.C.

    1987-02-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a particular pressurized water reactor with a subatmospheric containment (Surry, Unit 1). Emphasis was placed on determining the magnitude and character of the uncertainties, rather than focusing on a point estimate. The risk-reduction potential of a set of proposed safety option backfits was also studied, and their costs and benefits were also evaluated. It was found that the risks from internal events are generally lower than previously evaluated in the Reactor Safety Study (RSS). However, certain unresolved issues (such as direct containment heating) caused the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. None of the postulated safety options appears to be cost effective for the Surry power plant. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150

  16. Evaluation of severe accident risks and the potential for risk reduction: Surry Power Station, Unit 1: Draft report for comment

    Energy Technology Data Exchange (ETDEWEB)

    Benjamin, A.S.; Boyd, G.J.; Kunsman, D.M.; Murfin, W.B.; Williams, D.C.

    1987-02-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a particular pressurized water reactor with a subatmospheric containment (Surry, Unit 1). Emphasis was placed on determining the magnitude and character of the uncertainties, rather than focusing on a point estimate. The risk-reduction potential of a set of proposed safety option backfits was also studied, and their costs and benefits were also evaluated. It was found that the risks from internal events are generally lower than previously evaluated in the Reactor Safety Study (RSS). However, certain unresolved issues (such as direct containment heating) caused the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. None of the postulated safety options appears to be cost effective for the Surry power plant. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150.

  17. Reflections from the interface between seismological research and earthquake risk reduction

    Science.gov (United States)

    Sargeant, S.

    2012-04-01

    Scientific understanding of earthquakes and their attendant hazards is vital for the development of effective earthquake risk reduction strategies. Within the global disaster reduction policy framework (the Hyogo Framework for Action, overseen by the UN International Strategy for Disaster Reduction), the anticipated role of science and scientists is clear, with respect to risk assessment, loss estimation, space-based observation, early warning and forecasting. The importance of information sharing and cooperation, cross-disciplinary networks and developing technical and institutional capacity for effective disaster management is also highlighted. In practice, the degree to which seismological information is successfully delivered to and applied by individuals, groups or organisations working to manage or reduce the risk from earthquakes is variable. The challenge for scientists is to provide fit-for-purpose information that can be integrated simply into decision-making and risk reduction activities at all levels of governance and at different geographic scales, often by a non-technical audience (i.e. people without any seismological/earthquake engineering training). The interface between seismological research and earthquake risk reduction (defined here in terms of both the relationship between the science and its application, and the scientist and other risk stakeholders) is complex. This complexity is a function of a range issues that arise relating to communication, multidisciplinary working, politics, organisational practices, inter-organisational collaboration, working practices, sectoral cultures, individual and organisational values, worldviews and expectations. These factors can present significant obstacles to scientific information being incorporated into the decision-making process. The purpose of this paper is to present some personal reflections on the nature of the interface between the worlds of seismological research and risk reduction, and the

  18. Risk measures in practical use: risk reduction has its price, but is it known?

    International Nuclear Information System (INIS)

    Reinertsen, Rune

    1995-01-01

    Different risk measures are discussed in order to decide which to use to best express the risk workers are exposed to. A new risk measure is introduced and advantages and disadvantages are presented. The need for a new risk measure (Expected Number of Fatalities Rate ENFR), is discussed and explained with the help of an example. The example also contains a comparison with the well-known FAR-value. Also some problems and benefits of introducing a measure of the kind: ΔRISK/Δ$ are discussed and conclusions made. The question of what amount of money should be used on risk reducing activities is also addressed

  19. First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

    Science.gov (United States)

    Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

    2017-01-01

    There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 76 FR 44301 - Information Collection; Homeowner Risk Reduction Behaviors Concerning Wildfire Risks and Climate...

    Science.gov (United States)

    2011-07-25

    ... the design of more effective risk mitigation projects and improved communication strategies among.... This information will assist the Forest Service in their risk communication efforts with ``at risk... of California State University of Long Beach, Long Beach, California. The results will be made...

  1. Exploring Perceived Risk and Risk Reduction Strategies in the Pursuit of Higher Education Abroad

    Science.gov (United States)

    Lam, Jason M. S.; Tong, David Yoon Kin; Ariffin, Ahmad Azmi M.

    2017-01-01

    While past studies have merely focused on perceived risks that influence how students select the destination of international education best suited to their needs, research on perceived risk regarding post-purchase behavior remains limited. This study attempts to extend and redefine the perceived risk paradigm by uncovering the underlying elements…

  2. Copper increases reductive dehalogenation of haloacetamides by zero-valent iron in drinking water: Reduction efficiency and integrated toxicity risk.

    Science.gov (United States)

    Chu, Wenhai; Li, Xin; Bond, Tom; Gao, Naiyun; Bin, Xu; Wang, Qiongfang; Ding, Shunke

    2016-12-15

    The haloacetamides (HAcAms), an emerging class of nitrogen-containing disinfection byproducts (N-DBPs), are highly cytotoxic and genotoxic, and typically occur in treated drinking waters at low μg/L concentrations. Since many drinking distribution and storage systems contain unlined cast iron and copper pipes, reactions of HAcAms with zero-valent iron (ZVI) and metallic copper (Cu) may play a role in determining their fate. Moreover, ZVI and/or Cu are potentially effective HAcAm treatment technologies in drinking water supply and storage systems. This study reports that ZVI alone reduces trichloroacetamide (TCAcAm) to sequentially form dichloroacetamide (DCAcAm) and then monochloroacetamide (MCAcAm), whereas Cu alone does not impact HAcAm concentrations. The addition of Cu to ZVI significantly improved the removal of HAcAms, relative to ZVI alone. TCAcAm and their reduction products (DCAcAm and MCAcAm) were all decreased to below detection limits at a molar ratio of ZVI/Cu of 1:1 after 24 h reaction (ZVI/TCAcAm = 0.18 M/5.30 μM). TCAcAm reduction increased with the decreasing pH from 8.0 to 5.0, but values from an integrated toxic risk assessment were minimised at pH 7.0, due to limited removal MCAcAm under weak acid conditions (pH = 5.0 and 6.0). Higher temperatures (40 °C) promoted the reductive dehalogenation of HAcAms. Bromine was preferentially removed over chlorine, thus brominated HAcAms were more easily reduced than chlorinated HAcAms by ZVI/Cu. Although tribromoacetamide was more easily reduced than TCAcAm during ZVI/Cu reduction, treatment of tribromoacetamide resulted in a higher integrated toxicity risk than TCAcAm, due to the formation of monobromoacetamide (MBAcAm). Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Reduction of cancer risk by optimization of Computed Tomography head protocols: far eastern Cuban experience

    International Nuclear Information System (INIS)

    Miller Clemente, R.; Adame Brooks, D.; Lores Guevara, M.; Perez Diaz, M.; Arias Garlobo, M. L.; Ortega Rodriguez, O.; Nepite Haber, R.; Grinnan Hernandez, O.; Guillama Llosas, A.

    2015-01-01

    The cancer risk estimation constitutes one way for the evaluation of the public health, regarding computed tomography (CT) exposures. Starting from the hypothesis that the optimization of CT protocols would reduce significantly the added cancer risk, the purpose of this research was the application of optimization strategies regarding head CT protocols, in order to reduce the factors affecting the risk of induced cancer. The applied systemic approach included technological and human components, represented by quantitative physical factors. the volumetric kerma indexes, compared with respect to standard, optimized and reference values, were evaluated with multiple means comparison method. The added cancer risk resulted from the application of the methodology for biological effects evaluation, at low doses with low Linear Energy Transfer. Human observers in all scenarios evaluated the image quality. the reduced dose was significantly lower than for standard head protocols and reference levels, where: (1) for pediatric patients, by using an Automatic Exposure Control system, a reduction of 31% compared with standard protocol and ages range of 10-14, and (2) adults, using a Bilateral Filter for images obtained at low doses of 62% from those of standard head protocol. The risk reduction was higher than 25%. The systemic approach used allows the effective identification of factors involved on cancer risk related with exposures to CT. The combination of dose modulation and image restoration with Bilateral Filter, provide a significantly reduction of cancer risk, with acceptable diagnostic image quality. (Author)

  4. Blood Glucose Reduction by Diabetic Drugs with Minimal Hypoglycemia Risk for Cardiovascular Outcomes

    DEFF Research Database (Denmark)

    Huang, Chi-Jung; Wang, Wei-Ting; Sung, Shih-Hsien

    2018-01-01

    of antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and the Cochrane Library up to January 27, 2018. Mixed-effects meta-regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse...... concentration was 0.42% lower (median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The meta-regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, -0.39 to -0.55; P...-40%) for MACE. By contrast, the meta-regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P>0.74). CONCLUSIONS: Compared with placebo, newer T2D agents with less hypoglycemic hazard significantly reduced...

  5. Anaortic off-pump versus clampless off-pump using the PAS-Port device versus conventional coronary artery bypass grafting: mid-term results from a matched propensity score analysis of 5422 unselected patients.

    Science.gov (United States)

    Furukawa, Nobuyuki; Kuss, Oliver; Preindl, Konstantin; Renner, André; Aboud, Anas; Hakim-Meibodi, Kavous; Benzinger, Michael; Pühler, Thomas; Ensminger, Stephan; Fujita, Buntaro; Becker, Tobias; Gummert, Jan F; Börgermann, Jochen

    2017-10-01

    Meta-analyses from observational and randomized studies have demonstrated benefits of off-pump surgery for hard and surrogate endpoints. In some of them, increased re-revascularization was noted in the off-pump groups, which could impact their long-term survival. Therefore, we analyzed the course of all patients undergoing isolated coronary surgery regarding the major cardiac and cerebrovascular event (MACCE) criteria. A prospective register was taken from a high-volume off-pump center recording all anaortic off-pump (ANA), clampless off-pump (PAS-Port) and conventional (CONV) coronary artery bypass operations between July 2009 and June 2015. Propensity Score Matching was performed based on 28 preoperative risk variables. We identified 935 triplets (N = 2805). Compared with CONV, in-hospital mortality of both the ANA group (OR for ANA [95% CI] 0.25 [0.06; 0.83], P = 0.021), and the PAS-Port group was lower (OR for PAS-Port [95% CI] 0.50 [0.17; 1.32], P = 0.17). In the mid-term follow-up there were no significant differences between the groups regarding mortality (HR for ANA [95%-CI] 0.83 [0.55-1.26], P = 0.38; HR for PAS-Port [95%-CI] 1.06 [0.70-1.59], P = 0.79), incidence of stroke (HR for ANA 0.81 [0.43-1.53], P = 0.52; HR for PAS-Port 0.78 [0.41-1.50], P = 0.46), myocardial infarction (HR for ANA 0.53 [0.22-1.31], P = 0.17; HR for PAS-Port 0.78 [0.37-1.66], P = 0.52) or re-revascularization rate (HR for ANA 0.99 [0.67-1.44], P = 0.94; HR for PAS-Port 0.95 [0.65-1.38], P = 0.77). Both off-pump clampless techniques were associated with lower in-hospital mortality compared with conventional CABG. The mid-term course showed no difference with regard to the MACCE criteria between anaortic off-pump, clampless off-pump using PAS-Port and conventional CABG. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Sequential Vein Bypass Grafting is Not Associated with an Increase of Either In-hospital or Mid-term Adverse Events in Off-pump Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Fucheng Xiao

    2015-01-01

    Full Text Available Background: The impact of sequential vein bypass grafting on clinical outcomes is less known in off-pump coronary artery bypass grafting (CABG. We aimed to evaluate the effects of sequential vein bypass grafting on clinical outcomes in off-pump CABG. Methods: From October 2009 to September 2013 at the Fuwai Hospital, 127 patients with at least one sequential venous graft were matched with 127 patients of individual venous grafts only, using propensity score matching method to obtain risk-adjusted outcome comparison. In-hospital measurement was composite outcome of in-hospital death, myocardial infarction (MI, stroke, requirement for intra-aortic ballon pump (IABP assistance and prolonged ventilation. Major adverse cardiac events (MACEs: Death, MI or repeat revascularization and angina recurrence were considered as mid-term endpoints. Results: No significant difference was observed among the groups in baseline characteristics. Intraoperative mean blood flow per vein graft was 40.4 ml in individual venous grafts groups versus 59.5 ml in sequential venous grafts groups (P < 0.001. There were no differences between individual and sequential venous grafts groups with regard to composite outcome of in-hospital mortality, MI, stroke, IABP assistance and prolonged ventilation (11.0% vs. 14.2%, P = 0.45. Individual in-hospital measurement also did not differ significantly between the two groups. At about four years follow-up, the survival estimates free from MACEs (92.5% vs. 97.3%, P = 0.36 and survival rates free of angina recurrence (80.9% vs. 85.5%, P = 0.48 were similar among individual and sequential venous grafts groups with a mean follow-up of 22.5 months. In the Cox regression analysis, sequential vein bypass grafting was not identified as an independent predictor of both MACEs and angina recurrence. Conclusions: Compared to individual vein bypass grafting, sequential vein bypass grafting was not associated with an increase of either in

  7. Reduction of risk level as one of the main challenges of development in covered karst regions

    Directory of Open Access Journals (Sweden)

    Makhnatov Stanislav A.

    2013-01-01

    Full Text Available The paper describes the experience of application of the residual karst risk concept, and presents coefficients of karst risk level reduction for planning constructional karst-protection. Practical experience of design for karstified territories of Nizhny Novgorod region demonstrates that special research of the interaction between constructions and foundations is required. Numerous accidents can serve vivid examples proving the need. I2n this situation it is important to approach the issue of safety in a proper way, taking into account probable economic, environmental and social damage. The problem can be solved by introduction of the karst risk level parameter, which permits to take into consideration constructional characteristics of objects (design philosophy, service life, as well as conditions and mechanisms of interaction between the foundation and the construction (sinkholes, local subsidence, karst-suffosion deformations, etc.. The importance of risk reduction is highlighted by current Russian Federal laws. Depending on karst risk level adequate karst-protection should be performed. For building projects, reduction of karst risk to a permissible level (conventionally equal to 1 is one of the most important research challenges of the karstified territories development, and its solution permits to plan appropriate karst protection measures.

  8. Introduction to cost-effectiveness analysis of risk reduction measures in energy systems

    International Nuclear Information System (INIS)

    1986-07-01

    The aim of this report is to introduce readers to methods of cost-effectiveness analysis and their application in risk reduction, especially in connection with the energy-producing industries. The background to the assessment of risk and the problems in estimating it quantitatively are outlined. The methodology of cost-effectiveness analysis is then described, particular attention being given to the way in which results are derived and the overall use that can be made of them. This is followed by a discussion of quantitative applications and an outline of the methods that may be used to derive estimates both of risk and the cost of reducing it. The use of cost-effectiveness analysis is illustrated in an appendix, which gives as a worked example a case study on the reduction of public risk associated with radioactive releases during normal operation of a PWR. After drawing some general conclusions the report recommends that such analyses should normally be used as an aid to risk management whenever several alternative risk reduction measures are under consideration

  9. Historic Landslide Data Combined with Sentinel Satellite Data to Improve Modelling for Disaster Risk Reduction

    Science.gov (United States)

    Bye, B. L.; Kontoes, C.; Catarino, N.; De Lathouwer, B.; Concalves, P.; Meyer-Arnek, J.; Mueller, A.; Kraft, C.; Grosso, N.; Goor, E.; Voidrot, M. F.; Trypitsidis, A.

    2017-12-01

    Landslides are geohazards potentially resulting in disasters. Landslides both vary enormously in their distribution in space and time. The surface deformation varies considerably from one type of instability to another. Individual ground instabilities may have a common trigger (extreme rainfall, earthquake), and therefore occur alongside many equivalent occurrences over a large area. This means that they can have a significant regional impact demanding national and international disaster risk reduction strategies. Regional impacts require collaboration across boarders as reflected in The Sendai Framework for Disaster Risk Reduction (2015-2030). The data demands related to the SDGs are unprecedented, another factor that will require coordinated efforts at the global, regional and national levels. Data of good quality are vital for governments, international organizations, civil society, the private sector and the general public in order to make informed decisions, included for disaster risk reduction. The NextGEOSS project evolves the European vision of a user driven GEOSS data exploitation for innovation and business, relying on 3 main pillars; engaging communities of practice, delivering technological advancements, and advocating the use of GEOSS. These 3 pillars support the creation and deployment of Earth observation based innovative research activities and commercial services. In this presentation we will explain how one of the 10 NextGEOSS pilots, Disaster Risk Reduction (DRR), plan to provide an enhanced multi-hazard risk assessment framework based on statistical analysis of long time series of data. Landslide events monitoring and landslides susceptibility estimation will be emphazised. Workflows will be based on models developed in the context of the Copernicus Emergency Management Service. Data envisaged to be used are: Radar SAR data; Yearly ground deformation/velocities; Historic landslide inventory; data related to topographic, geological, hydrological

  10. [A mid-term review of the Millennium Development Goals: where are we with the goals on health?].

    Science.gov (United States)

    Kaddar, Miloud

    2009-01-01

    The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.

  11. An office-based approach to emotional and behavioral risk factor reduction for cardiovascular disease.

    Science.gov (United States)

    Hochman, Daniel M; Feinstein, Robert E; Stauter, Erinn C

    2013-01-01

    There are many psychological risk factors for cardiovascular disease, and the ability to reduce mortality depends on an ability to integrate care of these risk factors with traditional Framingham cardiovascular risk and use them both in routine practice. The aim of this article is to provide an update of all the major emotional and behavioral cardiovascular risk factors along with a practical treatment model for implementation. First, we provide a review of major emotional and behavioral cardiovascular risk factors, the associated primary effect, and proposed mechanism of action. Second, we provide an office-based approach to cardiovascular risk factor reduction and methods of reducing barriers to implementation, called Prevention Oriented Primary Care-Abridged. The approach integrates several forms of detection, assessment using the 3As (ask, assess, assist), and Stages of Change approaches, and subsequent efficient and targeted treatment with either Motivational Interviewing or further office intervention. A case example is provided to help illustrate this process.

  12. 41 CFR 102-80.55 - Are Federal agencies responsible for managing the execution of risk reduction projects?

    Science.gov (United States)

    2010-07-01

    ... Management Risks and Risk Reduction Strategies § 102-80.55 Are Federal agencies responsible for managing the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are Federal agencies responsible for managing the execution of risk reduction projects? 102-80.55 Section 102-80.55 Public...

  13. Synthesized research report in the second mid-term research phase. Mizunami Underground Research Laboratory project, Horonobe Underground Research Laboratory project and geo-stability project (Translated document)

    International Nuclear Information System (INIS)

    Hama, Katsuhiro; Sasao, Eiji; Iwatsuki, Teruki; Onoe, Hironori; Sato, Toshinori; Yasue, Kenichi; Asamori, Koichi; Niwa, Masakazu; Osawa, Hideaki; Nagae, Isako; Natsuyama, Ryoko; Fujita, Tomoo; Sasamoto, Hiroshi; Matsuoka, Toshiyuki; Takeda, Masaki; Aoyagi, Kazuhei; Nakayama, Masashi; Miyakawa, Kazuya; Ito, Hiroaki; Ohyama, Takuya; Senba, Takeshi; Amano, Kenji

    2016-08-01

    We have synthesized the research results from the Mizunami/Horonobe Underground Research Laboratories (URLs) and geo-stability projects in the second mid-term research phase. This report can be used as a technical basis for the Nuclear Waste Management Organization of Japan/Regulator at each decision point from siting to beginning of disposal (Principal Investigation to Detailed Investigation Phase). High-quality construction techniques and field investigation methods have been developed and implemented, which will be directly applicable to the National Disposal Program (together with general assessments of hazardous natural events and processes). Acquisition of technical knowledge on decisions of partial backfilling and final closure from actual field experiments in the Mizunami/Horonobe URLs will be crucial as the main theme for the next phases. (author)

  14. Synthesized research report in the second mid-term research phase. Mizunami Underground Research Laboratory project, Horonobe Underground Research Laboratory project and geo-stability project

    International Nuclear Information System (INIS)

    Hama, Katsuhiro; Sasao, Eiji; Iwatsuki, Teruki; Saegusa, Hiromitsu; Sato, Toshinori; Umeda, Koji; Yasue, Kenichi; Asamori, Koichi; Osawa, Hideaki; Koide, Kaoru; Nagae, Isako; Natsuyama, Ryoko; Mizuno, Takashi; Fujita, Tomoo; Sasamoto, Hiroshi; Matsuoka, Toshiyuki; Yokota, Hideharu; Ishii, Eiichi; Aoyagi, Kazuhei; Nakayama, Masashi; Ito, Hiroaki; Tsusaka, Kimikazu; Ohyama, Takuya; Senba, Takeshi; Amano, Kenji

    2015-08-01

    We have synthesised the research results from Mizunami/Horonobe URLs and geo-stability projects in the second mid-term research phase. It could be used as technical bases for NUMO/Regulator in each decision point from siting to beginning of disposal (Principal Investigation to Detailed Investigation Phase). High quality construction techniques and field investigation methods have been developed and implemented and these will be directly applicable to the National Disposal Program (along with general assessments of hazardous natural events and processes). It will be crucial to acquire technical knowledge on decisions of partial backfilling and final closure by actual field experiments in Mizunami/Horonobe URLs as main themes for the next phases. (author)

  15. Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke.

    Science.gov (United States)

    Goljar, Nika; Globokar, Daniel; Puzić, Nataša; Kopitar, Natalija; Vrabič, Maja; Ivanovski, Matic; Vidmar, Gaj

    2016-09-01

    To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients. A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010-2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006-2014 period to evaluate effectiveness of fall-risk reduction measures. The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55-101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014. The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention. Implications for Rehabilitation Recognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards. Assessing the fall risk is a team tasks and combines information from various sources. Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient.

  16. What if Dutch investors started worrying about flood risk? Implications for disaster risk reduction

    NARCIS (Netherlands)

    Husby, T.G.; Mechler, R.; Jongman, B.

    2016-01-01

    Increasingly, roles and responsibilities of the public sector in flood risk management are receiving attention in research and policy. Part of the debate suggests that allocating risk to the private sector increases efficiency as it promotes individual adaptation, thereby reducing the impact if a

  17. Risk reduction in road and rail LPG transportation bij passive fire protection

    NARCIS (Netherlands)

    Molag e.a., M. (Menso)

    2009-01-01

    The potential reduction of risk in LPG (Liquified Petroleum Gas) road transport due to the adoption of passive fire protectionswas investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements

  18. Disaster risk reduction capacity assessment for precarious settlements in Guatemala City.

    Science.gov (United States)

    Miles, Scott B; Green, Rebekah A; Svekla, Walter

    2012-07-01

    This study presents findings of an institutional capacity analysis of urban disaster risk reduction for informal settlements in the Guatemala Metropolitan Region. It uses a resource access perspective of vulnerability, actor-network theory, and qualitative data collection. The analysis reveals that there is interest in disaster risk reduction for the informal settlements; however, there is little in the way of direct financial or oversight relationships between informal settlement residents and all other actors. Respondents observed that informal settlements would probably remain inhabited; thus, there is a need for disaster risk reduction within these settlements. Disaster risk reduction capacity for informal settlements exists and can be further leveraged, as long as steps are taken to ensure appropriate access to and control of resources and oversight. Further, the nascent institutional arrangements should be strengthened through increased communication and coordination between actors, a decentralization of oversight and financial relationships, and mediation of identified resource conflicts. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  19. Children with Disabilities in Disability-Inclusive Disaster Risk Reduction: Focussing on School Settings

    Science.gov (United States)

    Ronoh, Steve; Gaillard, J. C.; Marlowe, Jay

    2017-01-01

    Every year, worldwide, disasters affect approximately seven million children with disabilities, highlighting their potential vulnerability. Although there is a growing move internationally to promote the rights of children with disabilities, they still receive little attention from disaster risk reduction (DRR) researchers and policy makers. They…

  20. Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming

    Science.gov (United States)

    Menning, Chadwick; Holtzman, Mellisa

    2015-01-01

    Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month…

  1. Pure meat – public perceptions of risk reduction strategies in meat production

    DEFF Research Database (Denmark)

    Korzen, Sara Marie; Sandøe, Peter; Lassen, Jesper

    2011-01-01

    generally have an aversion to risk reduction strategies. Some variation was found, however, in the rejection of the strategies. Thus, more acceptable strategies are characterised by a low degree of technological interference, and by being close to the consumer’s experience in everyday life and/or familiar...

  2. Ready for the Storm: Education for Disaster Risk Reduction and Climate Change Adaptation and Mitigation

    Science.gov (United States)

    Kagawa, Fumiyo; Selby, David

    2012-01-01

    Incidences of disaster and climate change impacts are rising globally. Disaster risk reduction and climate change education are two educational responses to present and anticipated increases in the severity and frequency of hazards. They share significant complementarities and potential synergies, the latter as yet largely unexploited. Three…

  3. Education for disaster risk reduction : linking theory with practice in Ghana´s basic schools

    NARCIS (Netherlands)

    Apronti, Priscilla; Saito, Osamu; Otsuki, K.|info:eu-repo/dai/nl/306279258; Kranjac-Berisavljevic, Gordana

    2015-01-01

    Current understanding of disaster risk reduction (DRR) concurs that, when provided the right education, children have the potential to reduce their own vulnerability and the vulnerability of others in their community. What, then, comprises the right education for DRR? Research has established the

  4. Evaluation of a Peer-Led Drug Abuse Risk Reduction Project for Runaway/Homeless Youths.

    Science.gov (United States)

    Fors, Stuart W.; Jarvis, Sara

    1995-01-01

    Evaluates the Drug Prevention in Youth risk reduction program that was implemented in shelters for runaway/homeless youths in the southeastern United States. An evaluation strategy was developed allowing for comparisons between peer-led, adult-led and nonintervention groups. Well-trained and motivated peer/near-peer leaders made particularly…

  5. Environmental Assessment: Bird Strike Risk Reduction at Laughlin Air Force Base, Texas

    Science.gov (United States)

    2008-01-01

    mglkg in rats, 291 - 609 mglkg in mice, > 1000 mglkg in sheep , > 100 mglkg in dogs and > 1000 mglkg in rabbits (Pesticide Residues in Food-1987... vineyards . Wildl. Soc. Bull. 21:47-51. LAFB Strike Risk Reduction EA - 39 Gaines, T.B. 1969. Acute toxicity of pesticides. Toxicol. Appl. Pharmacol

  6. Risk reduction in road and rail LPG transportation by passive fire protection

    NARCIS (Netherlands)

    Paltrinieri, N.; Landucci, G.; Molag, M.; Bonvicini, S.; Spadoni, G.; Cozzani, V.

    2009-01-01

    The potential reduction of risk in LPG (Liquefied Petroleum Gas) road transport due to the adoption of passive fire protections was investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements

  7. Valuing Mortality Risk Reductions for Environmental Policy: A White Paper (1999)

    Science.gov (United States)

    This white paper addresses current and recent U.S. EPA practices regarding the valuation of mortality risk reductions, focusing especially on empirical estimates of the “value of a statistical life” (VSL) from stated preference and hedonic wage studies.

  8. The Differential Effects of Social Media Sites for Promoting Cancer Risk Reduction.

    Science.gov (United States)

    Lauckner, Carolyn; Whitten, Pamela

    2016-09-01

    Social media are potentially valuable tools for disseminating cancer education messages, but the differential effects of various sites on persuasive outcomes are unknown. In an effort to inform future health promotion, this research tested the effects of Facebook, YouTube, Twitter, and blogs for delivering a cancer risk reduction message. Using an experimental design, participants were randomly placed in several conditions that delivered the same message but with different forms of social media. Effects on comprehension and attitudes were examined, as they are important variables in the behavior change process. YouTube led to higher comprehension and stronger attitudes toward cancer risk reduction than Twitter, but there were no differences between other sites. Additionally, YouTube led to stronger attitudes toward cancer risk reduction as compared to Facebook, but not any other sites. These results demonstrate that, even if the message is kept constant, the form of social media used to deliver content can have an effect on persuasive outcomes. More research is needed to determine the mechanisms behind the differences found, however. Altogether, this line of research is valuable for any individuals seeking to use social media for health promotion purposes and could have direct implications for the development of cancer risk reduction campaigns.

  9. Communicating risk using absolute risk reduction or prolongation of life formats

    DEFF Research Database (Denmark)

    Harmsen, Charlotte Gry; Kristiansen, Ivar Sønbø; Larsen, Pia Veldt

    2014-01-01

    . The COMRADE questionnaire was used to measure patients' confidence in their decision and satisfaction with the risk communication. RESULTS: Of the 240 patients included for analyses, 112 were allocated to POL information and 128 to ARR. Patients redeeming a statin prescription totalled six (5.4%) when...... informed using POL, and 32 (25.0%) when using ARR. The level of confidence in decision and satisfaction with risk communication did not differ between the risk formats. CONCLUSION: Patients redeemed statin prescriptions less often when their GP communicated treatment effectiveness using POL compared......BACKGROUND: It is important that patients are well-informed about risks and benefits of therapies to help them decide whether to accept medical therapy. Different numerical formats can be used in risk communication but It remains unclear how the different formats affect decisions made by real...

  10. Is there evidence showing that salt intake reduction reduces cardiovascular morbidity and mortality risk?

    Directory of Open Access Journals (Sweden)

    Fernando Lanas

    2012-02-01

    Full Text Available A recent systematic review of Cochrane collaboration about the effect of reducing dietary salt concluded that “there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity in normotensive or hypertensive populations”. This conclusion has generated an important debate, because the estimation that salt reduction can prevent 24% of strokes and 18% of myocardial infarctions has decided the health authorities of several nations to implement salt consumption reduction programs. The review of ecological studies and clinical trials allow to conclude that a reduction in salt consumption reduces blood pressure and methodological well conducted cohort studies has shown that cardiovascular events risk decreases progressively with lower levels of blood pressure. Combining this two finding we can assume that population should benefice from a decrease on salt consumption although there are no studies that shown a reduction in cardiovascular events in population with high sodium intake when dietary salt is reduced.

  11. The role of service learning in teaching and research for disaster-risk reduction

    Science.gov (United States)

    Suckale, J.; Saiyed, Z.; Alvisyahrin, T.; Hilley, G. E.; Muhari, A.; Zoback, M. L. C.; Truebe, S.

    2016-12-01

    An important motivation for natural-hazards research is to reduce threats posed by natural disasters to at-risk communities. Yet, we rarely teach students how research may be used to construct implementable solutions that reduce disaster risk. The goal of this contribution is to evaluate the potential of service learning to impart students with both the scientific background and the skills necessary to navigate real-world constraints of disaster risk reduction. We present results from a service-learning class taught at Stanford in the Winter quarter of 2016 in collaboration with the Indonesian Ministry of Marine Affairs and Fisheries and Syiah Kuala University, Banda Aceh. The main deliverable of the class was a final project in which students developed a specific idea of how to contribute to tsunami-risk reduction in Indonesia. A common critique of the service-learning approach posits that it may implicitly embed social and political perspectives within risk-reduction strategies that may be inappropriate within a particular culture. We attempted to avoid this problem using three strategies: First, we paired students from Stanford with students at Syiah Kuala University, Banda Aceh, to facilitate a close dialogue. Second, the Ministry of Marine Affairs and Fisheries provided a list of current risk-reduction strategies without requiring students to contribute to one specific project to minimally precondition project suggestions. Third, our community partners provided ongoing feedback on the scope and feasibility of the proposed projects and students were assessed based on their ability to integrate the feedback. Preliminary results from our class suggest significant promise for a service-learning approach to teaching disaster-risk reduction. There was substantial student interest in service learning, particularly among undergraduates. Pre-and post-assessment surveys showed that over 75% of students adjusted previous notions about disaster-risk reduction during the

  12. Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans.

    Science.gov (United States)

    Liou, Doreen; Bauer, Kathleen; Bai, Yeon

    2014-11-01

    The purpose of this research was to examine the attitudes, beliefs and behaviours related to obesity risk reduction in Chinese Americans. A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviours and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analysed for different acculturation groups. 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practised behaviour to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviours included convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviours, attitude was significant for 'western-identified' individuals. In 'Asian-identified' individuals, perceived behavioural control, self-efficacy and perceived benefits were salient. Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviours for obesity risk reduction that are socially acceptable. © Royal Society for Public Health 2013.

  13. Mid-term coral-algal dynamics and conservation status of a Gorgona Island (Tropical Eastern Pacific coral reef

    Directory of Open Access Journals (Sweden)

    Fernando A Zapata

    2010-05-01

    Full Text Available Colombian coral reefs, as other reefs worldwide, have deteriorated significantly during the last few decades due to both natural and anthropogenic disturbances. The National Monitoring System for Coral Reefs in Colombia (SIMAC was established in 1998 to provide long-term data bases to assess the changes of Colombian coral reefs against perturbations and to identify the factors responsible for their decline or recovery. On the Pacific coast, data on coral and algal cover have been collected yearly during seven consecutive years (1998-2004 from 20 permanent transects in two sites at La Azufrada reef, Gorgona Island. Overall, coral cover was high (55.1%-65.7% and algal cover low (28.8%-37.5% and both exhibited significant changes among years, most notably on shallow areas. Differences between sites in both coral and algal cover were present since the study began and may be explained by differences in sedimentation stress derived from soil runoff. Differences between depths most likely stem from the effects of low tidal sub-aerial exposures. Particularly intense sub-aerial exposures occurred repeatedly during January-March, 2001 and accounted for a decrease in coral and an increase in algal cover on shallow depths observed later that year. Additionally, the shallow area on the Northern site seems to be negatively affected by the combined effect of sedimentation and low tidal exposure. However, a decrease in coral cover and an increase of algal cover since 2001 on deep areas at both sites remain unexplained. Comparisons with previous studies suggest that the reef at La Azufrada has been more resilient than other reefs in the Tropical Eastern Pacific (TEP, recovering pre-disturbance (1979 levels of coral cover within a 10 year period after the 1982-83 El Niño, which caused 85% mortality. Furthermore, the effects of the 1997-98 El Niño, indicated by the difference in overall live coral cover between 1998 and 1999, were minor (<6% reduction. Despite

  14. Mid-term coral-algal dynamics and conservation status of a Gorgona Island (Tropical Eastern Pacific) coral reef.

    Science.gov (United States)

    Zapata, Fernando A; Rodríguez-Ramírez, Alberto; Caro-Zambrano, Carlos; Garzón-Ferreira, Jaime

    2010-05-01

    Colombian coral reefs, as other reefs worldwide, have deteriorated significantly during the last few decades due to both natural and anthropogenic disturbances. The National Monitoring System for Coral Reefs in Colombia (SIMAC) was established in 1998 to provide long-term data bases to assess the changes of Colombian coral reefs against perturbations and to identify the factors responsible for their decline or recovery. On the Pacific coast, data on coral and algal cover have been collected yearly during seven consecutive years (1998-2004) from 20 permanent transects in two sites at La Azufrada reef, Gorgona Island. Overall, coral cover was high (55.1%-65.7%) and algal cover low (28.8%-37.5%) and both exhibited significant changes among years, most notably on shallow areas. Differences between sites in both coral and algal cover were present since the study began and may be explained by differences in sedimentation stress derived from soil runoff. Differences between depths most likely stem from the effects of low tidal sub-aerial exposures. Particularly intense sub-aerial exposures occurred repeatedly during January-March, 2001 and accounted for a decrease in coral and an increase in algal cover on shallow depths observed later that year. Additionally, the shallow area on the Northern site seems to be negatively affected by the combined effect of sedimentation and low tidal exposure. However, a decrease in coral cover and an increase of algal cover since 2001 on deep areas at both sites remain unexplained. Comparisons with previous studies suggest that the reef at La Azufrada has been more resilient than other reefs in the Tropical Eastern Pacific (TEP), recovering pre-disturbance (1979) levels of coral cover within a 10 year period after the 1982-83 El Niño, which caused 85% mortality. Furthermore, the effects of the 1997-98 El Niño, indicated by the difference in overall live coral cover between 1998 and 1999, were minor (< 6% reduction). Despite recurrent

  15. Mid-term Outcome of 100 Consecutive Ross Procedures: Excellent Survival, But Yet to Be a Cure.

    Science.gov (United States)

    Zimmermann, Corina; Attenhofer Jost, Christine; Prêtre, René; Mueller, Christoph; Greutmann, Matthias; Seifert, Burkhardt; Valsangiacomo Büchel, Emanuela; Kretschmar, Oliver; Dave, Hitendu Hasmukhlal; Weber, Roland

    2018-03-01

    The Ross procedure offers excellent short-term outcome but the long-term durability is under debate. Reinterventions and follow-up of 100 consecutive patients undergoing Ross Procedure at our centre (1993-2011) were analysed. Follow-up was available for 96 patients (97%) with a median duration of 5.3 (0.1-17.1) years. Median age of the patient cohort was 15.2 (0.04-58.4) years with 76 males. 93% had underlying congenital aortic stenosis. Root replacement technique was applied in all. The most common valved conduits used for reconstruction of the right ventricular outflow tract were homografts (66 patients) and bovine jugular vein (Contegra R ) graft (31 patients). Additional procedures included Ross-Konno procedure (14%), resection of subaortic stenosis/myectomy (11%) and reduction plasty of the ascending aorta (25%). One patient died within the first 30 days (1%). Late deaths occurred in 4 patients (4%) 0.5-4.5 years postoperatively: causes included pulmonary hypertension due to endocardial fibroelastosis (2), subarachnoid haemorrhage (1) and sudden cardiac death (1). Five-year survival was 93.6 (95% CI 88.1-99.1)%. Moderate or severe aortic (autograft) regurgitation needing reoperation occurred in 8 patients with a 5-year freedom from autograft reoperation of 98.5 (95.6-100)%. Five-year freedom from reintervention (surgery or catheter based) on the right ventricular outflow tract conduit was 91.5 (85.5-96.5)%. Univariate predictors of this reinterventions were smaller graft size (p = 0.03) and use of a Contegra R graft (p = 0.04). Ross procedure can be performed with low mortality and good survival in the long term. Most of the reinterventions are related to the neo-right ventricular outflow tract and may be partly attributed to the lack of growth. While the Ross Procedure remains an invaluable option for aortic valve disease in children, new solutions for the neo-pulmonary valve as well as for the less often occurring problems on the autograft are

  16. Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary.

    Science.gov (United States)

    Phibbs, Suzanne; Kenney, Christine; Severinsen, Christina; Mitchell, Jon; Hughes, Roger

    2016-12-14

    The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the "new" agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010-2011 earthquakes in Canterbury, New Zealand.

  17. Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary

    Directory of Open Access Journals (Sweden)

    Suzanne Phibbs

    2016-12-01

    Full Text Available The Sendai Framework for Disaster Risk Reduction (2015 is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the ”new” agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010–2011 earthquakes in Canterbury, New Zealand.

  18. Risk of hospital admission for COPD following smoking cessation and reduction

    DEFF Research Database (Denmark)

    Godtfredsen, N S; Vestbo, J; Osler, M

    2002-01-01

    BACKGROUND: Little is known about the effects of changes in smoking habits on the subsequent risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between smoking cessation and reduction and admission to hospital for COPD in a general...... by at least 50% between the two initial examinations without quitting and smokers who stopped smoking during this time were compared with continuous heavy smokers using a Cox proportional hazards model. RESULTS: During the follow up period 1,260 subjects (741 men and 519 women) were admitted to hospital...... for COPD. After multivariate adjustment, quitting smoking was associated with a significant reduction in the risk of hospital admission. The relative hazard (HR) was 0.57 (95% confidence interval (CI) 0.33 to 0.99). Those who reduced smoking did not show a significantly lower risk of hospitalisation than...

  19. The effectiveness of coral reefs for coastal hazard risk reduction and adaptation

    Science.gov (United States)

    Ferrario, Filippo; Beck, Michael W.; Storlazzi, Curt D.; Micheli, Fiorenza; Shepard, Christine C.; Airoldi, Laura

    2014-01-01

    The world’s coastal zones are experiencing rapid development and an increase in storms and flooding. These hazards put coastal communities at heightened risk, which may increase with habitat loss. Here we analyse globally the role and cost effectiveness of coral reefs in risk reduction. Meta-analyses reveal that coral reefs provide substantial protection against natural hazards by reducing wave energy by an average of 97%. Reef crests alone dissipate most of this energy (86%). There are 100 million or more people who may receive risk reduction benefits from reefs or bear hazard mitigation and adaptation costs if reefs are degraded. We show that coral reefs can provide comparable wave attenuation benefits to artificial defences such as breakwaters, and reef defences can be enhanced cost effectively. Reefs face growing threats yet there is opportunity to guide adaptation and hazard mitigation investments towards reef restoration to strengthen this first line of coastal defence.

  20. Renal cell carcinoma in patients with a solitary kidney after nephrectomy treated with radiofrequency ablation: Mid term results

    International Nuclear Information System (INIS)

    Hoffmann, Ralf-Thorsten; Jakobs, Tobias F.; Kubisch, Constanze H.; Trumm, Christoph; Weber, Christof; Siebels, Michael; Helmberger, Thomas K.; Reiser, Maximilian F.

    2010-01-01

    This retrospective study aimed to evaluate the feasibility and effectiveness of radiofrequency ablation (RFA) in patients with solitary kidney for the treatment of renal cell carcinoma (RCC). Within 2 years 10 patients (seven males, three females; age 65 ± 8 years) were treated. All patients had a history of nephrectomy of the contralateral kidney. The indications for RFA were inoperability or high probability of complete renal failure after surgical enucleation of the tumor. 13 tumors with a size between 1.9 and 4.2 cm (average 2.7 cm) were treated. In patients with a tumor diameter larger than 2.5 cm a transarterial embolization was performed prior to RFA to reduce heat sink effect and risk of bleeding. Therapeutical success was defined as a lack of contrast enhancement in follow up examinations and shrinking of the treated area. Furthermore all patients' renal function was monitored. RFA of renal tumors under CT-fluoroscopy was feasible in all patients. Within the follow up (3 and 24 months) no tumor recurrence or major complication was detected. One patient developed another RCC and was successfully treated with a second RF-ablation. None of the patients developed renal failure with the need of hemodialysis. In one of the patients a hemorrhage into the surrounding tissue was noticed, which stopped spontaneously. RFA is a valuable and effective therapeutical option in patients with solitary kidney suffering from inoperable renal cell carcinoma. The complication rate is small and an excellent tumor control can be achieved without deterioration of the renal function.

  1. A qualitative descriptive study of risk reduction for coronary disease among the Hong Kong Chinese.

    Science.gov (United States)

    Chan, Choi Wan; Lopez, Violeta

    2014-01-01

    Achieving optimal control and reduction in coronary heart disease (CHD) risks in Hong Kong (HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. An interview schedule was used to guide discussions during focus group interviews. Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. © 2013 Wiley Periodicals, Inc.

  2. Evaluation of severe accident risks and the potential for risk reduction: Grand Gulf, Unit 1. Draft for comment, February 1987

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C N [Technadyne Engineering Consultants, Inc., Albuquerque, NM (United States); Benjamin, A S; Kunsman, D M; Williams, D C [Sandia National Laboratories, Albuquerque, NM (United States); Boyd, G J; Lewis, S R [Safety and Reliability Optimization Services, Inc., Knoxville, TN (United States); Smith, L N [Science Applications International Corporation, Albuquerque, NM (United States)

    1987-04-01

    The Severe Accident Risk Reduction Program (SARRP) has completed a rebaselining of the risks to the public from a boiling water reactor with a Mark III containment (Grand Gulf, Unit 1). Emphasis was placed on determining the magnitude and character of the uncertainties, rather than focusing on a point estimate. The risk-reduction potential of a set of proposed safety option backfits was also studied, and their costs and benefits were also evaluated. It was found that the risks from internal events are generally low relative to previous studies; for example, most of the uncertainty range is lower than the point estimate of risk for the Peach Bottom plant in the Reactor Safety Study (RSS). However, certain unresolved issues cause the top of the uncertainty band to appear at a level that is comparable with the RSS point estimate. These issues include the diesel generator failure rate, iodine and cesium revolatilization after vessel breach and the possibility of reactor vessel pedestal failure caused by core debris attack. Some of the postulated safety options appear to be potentially cost effective for the Grand Gulf power plant, particularly when onsite accidents costs are included in the evaluation of benefits. Principally these include procedural modifications and relatively inexpensive hardware additions to insure core cooling in the event of a station blackout. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150. (author)

  3. Promoting flood risk reduction: The role of insurance in Germany and England

    Science.gov (United States)

    Surminski, Swenja; Thieken, Annegret H.

    2017-10-01

    Improving society's ability to prepare for, respond to and recover from flooding requires integrated, anticipatory flood risk management (FRM). However, most countries still focus their efforts on responding to flooding events if and when they occur rather than addressing their current and future vulnerability to flooding. Flood insurance is one mechanism that could promote a more ex ante approach to risk by supporting risk reduction activities. This paper uses an adapted version of Easton's System Theory to investigate the role of insurance for FRM in Germany and England. We introduce an anticipatory FRM framework, which allows flood insurance to be considered as part of a broader policy field. We analyze if and how flood insurance can catalyze a change toward a more anticipatory approach to FRM. In particular we consider insurance's role in influencing five key components of anticipatory FRM: risk knowledge, prevention through better planning, property-level protection measures, structural protection and preparedness (for response). We find that in both countries FRM is still a reactive, event-driven process, while anticipatory FRM remains underdeveloped. Collaboration between insurers and FRM decision-makers has already been successful, for example in improving risk knowledge and awareness, while in other areas insurance acts as a disincentive for more risk reduction action. In both countries there is evidence that insurance can play a significant role in encouraging anticipatory FRM, but this remains underutilized. Effective collaboration between insurers and government should not be seen as a cost, but as an investment to secure future insurability through flood resilience.

  4. Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction

    Directory of Open Access Journals (Sweden)

    Dai Hongying

    2013-01-01

    Full Text Available Abstract Background Multifactor Dimensionality Reduction (MDR has been widely applied to detect gene-gene (GxG interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. Results We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. Conclusions The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi are proposed to detect multiple GxG interactions.

  5. Preoperative risk assessment among women undergoing bilateral prophylactic mastectomy for cancer risk reduction.

    Science.gov (United States)

    Rueth, Natasha M; McMahon, Melissa; Arrington, Amanda K; Swenson, Karen; Leach, Joseph; Tuttle, Todd M

    2011-09-01

    Cancer risk assessment is an important decision-making tool for women considering irreversible risk-reducing surgery. Our objective was to determine the prevalence of BRCA testing among women undergoing bilateral prophylactic mastectomy (BPM) and to review the characteristics of women who choose BPM within a metropolitan setting. We retrospectively reviewed records of women who underwent BPM in the absence of cancer within 2 health care systems that included 5 metropolitan hospitals. Women with invasive carcinoma or ductal carcinoma in situ (DCIS) were excluded; neither lobular carcinoma in situ (LCIS) nor atypical hyperplasia (AH) were exclusion criteria. We collected demographic information and preoperative screening and risk assessment, BRCA testing, reconstruction, and associated cancer risk-reducing surgery data. We compared women who underwent BRCA testing to those not tested. From January 2002 to July 2009, a total of 71 BPMs were performed. Only 25 women (35.2%) had preoperative BRCA testing; 88% had a BRCA mutation. Compared with tested women, BRCA nontested women were significantly older (39.1 vs. 49.2 years, P < 0.001), had significantly more preoperative biopsies and mammograms and had fewer previous or simultaneous cancer risk-reducing surgery (oophorectomy). Among BRCA nontested women, common indications for BPM were family history of breast cancer (n = 21, 45.6%) or LCIS or AH (n = 16, 34.8%); 9 nontested women (19.6%) chose BPM based on exclusively on cancer-risk anxiety or personal preference. Most women who underwent BPM did not receive preoperative genetic testing. Further studies are needed to corroborate our findings in other geographic regions and practice settings.

  6. Development of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction Scale

    Directory of Open Access Journals (Sweden)

    Sarang Kim

    2014-06-01

    Full Text Available Background and Aims: It is not yet understood how attitudes concerning dementia risk may affect motivation to change health behaviours and lifestyle. This study was designed to develop a reliable and valid theory-based measure to understand beliefs underpinning the lifestyle and health behavioural changes needed for dementia risk reduction. Methods: 617 participants aged ≥50 years completed a theory-based questionnaire, namely, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR scale. The MCLHB-DRR consists of 53 items, reflecting seven subscales of the Health Belief Model. Results: Confirmatory factor analysis was performed and revealed that a seven-factor solution with 27 items fitted the data (comparative fit index = 0.920, root-mean-square error of approximation = 0.047 better than the original 53 items. Internal reliability (α = 0.608-0.864 and test-retest reliability (α = 0.552-0.776 were moderate to high. Measurement of invariance across gender and age was also demonstrated. Conclusions: These results propose that the MCLHB-DRR is a useful tool in assessing the beliefs and attitudes of males and females aged ≥50 years towards dementia risk reduction. This measure can be used in the development and evaluation of interventions aimed at dementia prevention.

  7. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction

    Directory of Open Access Journals (Sweden)

    Cochrane Thomas

    2012-11-01

    Full Text Available Abstract Background The global burden of the major vascular diseases is projected to rise and to remain the dominant non-communicable disease cluster well into the twenty first century. The Department of Health in England has developed the NHS Health Check service as a policy initiative to reduce population vascular disease risk. The aims of this study were to monitor population changes in cardiovascular disease (CVD risk factors over the first year of the new service and to assess the value of tailored lifestyle support, including motivational interview with ongoing support and referral to other services. Methods Randomised trial comparing NHS Health Check service only with NHS Health Check service plus additional lifestyle support in Stoke on Trent, England. Thirty eight general practices and 601 (365 usual care, 236 additional lifestyle support patients were recruited and randomised independently between September 2009 and February 2010. Changes in population CVD risk between baseline and one year follow-up were compared, using intention-to-treat analysis. The primary outcome was the Framingham 10 year CVD risk score. Secondary outcomes included individual modifiable risk measures and prevalence of individual risk categories. Additional lifestyle support included referral to a lifestyle coach and free sessions as needed for: weight management, physical activity, cook and eat and positive thinking. Results Average population CVD risk decreased from 32.9% to 29.4% (p Conclusions The NHS Health Check service in Stoke on Trent resulted in significant reduction in estimated population CVD risk. There was no evidence of further benefit of the additional lifestyle support services in terms of absolute CVD risk reduction.

  8. Risk prediction and risk reduction in patients with manifest arterial disease

    NARCIS (Netherlands)

    Goessens, B.M.B.; Goessens, B.M.B.

    2006-01-01

    Risicovoorspelling en risicoverlaging bij patienten met manifest vaatlijden Engelstalig abstract The number of patients with clinical manifest arterial disease is increasing because of the aging of the population. Patients with manifest arterial disease have an increased risk of a new vascular event

  9. Schizophrenia--A High-Risk Factor for Suicides: Clues to Risk Reduction.

    Science.gov (United States)

    Caldwell, Constance B.; Gottesman, Irving I.

    1992-01-01

    Notes that suicide is chief cause of premature death among schizophrenic persons, with lifetime incidence of suicide for patients with schizophrenia at 10-13% compared to general population estimate of 1%. Discusses salient risk factors for suicide in schizophrenics and types of especially vulnerable patients identified by research. Notes that…

  10. A practical approach to assess depression risk and to guide risk reduction strategies in later life

    NARCIS (Netherlands)

    Almeida, O.P.; Alfonso, H.; Pirkis, J; Kerse, N.; Sim, M.; Flicker, L.; Snowdon, J.; Draper, B.; Byrne, G.; Goldney, R.; Lautenschlager, N.T.; Stocks, N.; Scazufca, M.; Huisman, M.; Araya, R.; Pfaff, J.

    2011-01-01

    Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors

  11. The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes.

    Science.gov (United States)

    Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Koci, Veronica; Lunn, Sonja

    2014-12-01

    Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2,564 grade 10 students and their parents in the Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention that should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs.

  12. Theoretical framework to study exercise motivation for breast cancer risk reduction.

    Science.gov (United States)

    Wood, Maureen E

    2008-01-01

    To identify an appropriate theoretical framework to study exercise motivation for breast cancer risk reduction among high-risk women. An extensive review of the literature was conducted to gather relevant information pertaining to the Health Promotion Model, self-determination theory, social cognitive theory, Health Belief Model, Transtheoretical Model, theory of planned behavior, and protection motivation theory. An iterative approach was used to summarize the literature related to exercise motivation within each theoretical framework. Protection motivation theory could be used to examine the effects of perceived risk and self-efficacy in motivating women to exercise to facilitate health-related behavioral change. Evidence-based research within a chosen theoretical model can aid practitioners when making practical recommendations to reduce breast cancer risk.

  13. Communication products for the Science Application for Risk Reduction (SAFRR) tsunami scenario: Chapter K in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Perry, Suzanne C.

    2013-01-01

    Science Application for Risk Reduction (SAFRR), like its predecessor the Multi-Hazards Demonstration Project, has a mission to increase the use of science by decision-makers of all kinds. Thus, an important part of any SAFRR scenario is development of products that enhance usability of the science. In this tsunami scenario, the focus has been on development of three kinds of products: products that augment typical outputs of scientific studies, such as reports, to make the results of the scenario more relevant and usable to nonscientists; products that distill local impacts and allow users in specific locales to identify which aspects of the broad regional study apply to their local area; and

  14. REDUCTION OF SYSTEMIC RISK IN SERBIA THROUGH INTELLIGENT RISK MANAGEMENT IN STATE-OWNED ENTERPRISES

    OpenAIRE

    Dragan Đuričin; Iva Vuksanović

    2012-01-01

    These days, the effects of the combined crisis in Serbia have been larger than ever. Serbia was already in a transitional recession when it entered global economic crisis of 2008. The global double dip recession and this domestic recession, caused by structural imbalances before and during the transition, exacerbate each other's negative effects. Consequently, companies find themselves exposed to systemic (or external) risk that is beyond their control, and is continually increasing. The curr...

  15. Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip.

    Science.gov (United States)

    Schur, Mathew D; Lee, Christopher; Arkader, Alexandre; Catalano, Anthony; Choi, Paul D

    2016-06-01

    The purpose of this study was to identify and evaluate risk factors of avascular necrosis (AVN) after closed treatment for developmental dysplasia of the hip (DDH). A retrospective review of children diagnosed with DDH at a tertiary-care children's hospital between 1986 and 2009 was performed. The presence of AVN was assessed according to Salter's classification system. Eighty-two affected hips in 70 children with an average age of 10 months at closed reduction (range 1-31 months) and 5 years (range 2-19 years) of follow-up met the inclusion criteria. Twenty-nine (of 82, 35 %) affected hips developed AVN. The use of pre-reduction traction (p = 0.019) increased the risk of AVN, while preoperative Pavlik harness or brace trial (p = 0.28), presence of ossific nucleus at the time of closed reduction (p = 0.16), and adductor tenotomy (p = 0.37) were not significant factors. Laterality (right vs. left) was also not a significant risk factor (p = 0.75), but patients who underwent closed reduction for bilateral DDH were less likely to develop AVN (p = 0.027). Overall, the degree of abduction did not affect the rate of AVN (p = 0.87). However, in patients treated with closed reduction younger than 6 months of age, the rate of AVN was increased with abduction ≥50° (9/15, 60 %) compared to abduction AVN were more likely to require subsequent surgery (p = 0.034) and more likely to report a fair/poor clinical outcome (p = 0.049). The risk of AVN (35 %) following closed reduction and spica casting for DDH is high. The degree of abduction in spica casts appears to be a risk factor in patients ≤6 months old. The authors recommend that abduction in spica casts should be limited to <50° in children younger than 6 months of age. IV.

  16. Designing a Physical Security System for Risk Reduction in a Hypothetical Nuclear Facility

    International Nuclear Information System (INIS)

    Saleh, A.A.; Abd Elaziz, M.

    2017-01-01

    Physical security in a nuclear facility means detection, prevention and response to threat, the ft, sabotage, unauthorized access and illegal transfer involving radioactive and nuclear material. This paper proposes a physical security system designing concepts to reduce the risk associated with variant threats to a nuclear facility. This paper presents a study of the unauthorized removal and sabotage in a hypothetical nuclear facility considering deter, delay and response layers. More over, the study involves performing any required upgrading to the security system by investigating the nuclear facility layout and considering all physical security layers design to enhance the weakness for risk reduction

  17. Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

    The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting ...

  18. Public risk-reduction measures: cost-effectiveness from a global point-of-view

    International Nuclear Information System (INIS)

    Oliveira, L.F.S. de; Motta Barros, E.B. da; Fleming, P.V.; Rosa, L.P.

    1985-05-01

    A review of systemic or global approach to cost-effectiveness analysis of risk-reduction measures is presented, and its advantages and limitations are discussed. The method is applied for problem of the cost-effectiveness of increasing the Angra 3 reactor containment wall thickness from 60cm to 180cm thick, in case of a direct commercial aircraft crash on it. (Author) [pt

  19. Improving End-To-End Tsunami Warning for Risk Reduction on Canada’s West Coast

    Science.gov (United States)

    2015-01-01

    in 2014, up from 455 cals in 2013 (Chamber of Shipping, 2014). Even the more traditional forms of marine tourism such as sports fishing have been...some of the most noteworthy areas of new economic activity to emerge have been aquaculture, recreation and tourism , research and oil, gas and other...Risk Reduction on Canada’s West Coast (CSSP-2013-TI-1033) 3   annual value of output over $590 milion (Fisheries and Oceans Canada, 2013). Tourism

  20. Ethical Responsibility of Governance for Integrating Disaster Risk Reduction with Development

    Science.gov (United States)

    Parkash Gupta, Surya

    2015-04-01

    The development in the public as well as the private sectors is controlled and regulated, directly or indirectly by the governments at federal, provincial and local levels. If this development goes haphazard and unplanned, without due considerations to environmental constraints and potential hazards; it is likely to cause disasters or may get affected by disasters. Therefore, it becomes an ethical responsibility of the people involved in governance sector to integrate disaster risk reduction with development in their administrative territories through enforcement of appropriate policies, guidelines and regulatory mechanisms. Such mechanisms should address the social, scientific, economic, environmental, and legal requirements that play significant role in planning, implementation of developmental activities as well as disaster management. The paper focuses on defining the ethical responsibilities for the governance sector for integrating disaster risk reduction with development. It highlights the ethical issues with examples from two case studies, one from the Uttarakhand state and the other Odhisa state in India. The case studies illustrates how does it make a difference in disaster risk reduction if the governments own or do not own ethical responsibilities. The paper considers two major disaster events, flash floods in Uttarakhand state and Cyclone Phailin in Odhisa state, that happened during the year 2013. The study points out that it makes a great difference in terms of consequences and response to disasters when ethical responsibilities are owned by the governance sector. The papers attempts to define these ethical responsibilities for integrating disaster risk reduction with development so that the governments can be held accountable for their acts or non-actions.

  1. Social Media Use and Sexual Risk Reduction Behavior Among Minority Youth: Seeking Safe Sex Information.

    Science.gov (United States)

    Stevens, Robin; Gilliard-Matthews, Stacia; Dunaev, Jamie; Todhunter-Reid, Abigail; Brawner, Bridgette; Stewart, Jennifer

    Sexual health is an important area of study-particularly for minority youth and youth living in disadvantaged neighborhoods. The purpose of the research was to examine the sources of sexual health information associated with youth adopting sexual risk reduction behaviors. Data collection took place in a small city in the Northeastern United States using cross-sectional behavioral surveys and modified venue-based sampling. Participants included 249 African American and Latino youth aged 13-24. Participants reported their sources of information about contraception and human immunodeficiency virus/sexually transmitted disease, such as TV/movies, parents, social media; their intentions to have sex; and condom and contraception use during their last sexual activity. Social media use, past pregnancy experience, past sexual history, age, and gender were also measured. Standard tests of bivariate association (chi-square and F tests) were used to examine initial associations between sexual risk reduction behavior and exposure to sexual risk reduction information on social media. Logistic regression models were used to test multivariate relationships between information sources and sexual risk reduction behavior. Youth who were exposed to sexual health messages on social media were 2.69 times (p < .05) and 2.49 times (p < .08) more likely to have used contraception or a condom at last intercourse, respectively. Parents, schools, or traditional media as information sources were not significantly associated with contractive use or condom use at last intercourse. Youth sexual behavior is increasingly informed by social media messages. Health practitioners should utilize social media as an important health promotion tool.

  2. Participatory three dimensional mapping for the preparation of landslide disaster risk reduction program

    Science.gov (United States)

    Kusratmoko, Eko; Wibowo, Adi; Cholid, Sofyan; Pin, Tjiong Giok

    2017-07-01

    This paper presents the results of applications of participatory three dimensional mapping (P3DM) method for fqcilitating the people of Cibanteng' village to compile a landslide disaster risk reduction program. Physical factors, as high rainfall, topography, geology and land use, and coupled with the condition of demographic and social-economic factors, make up the Cibanteng region highly susceptible to landslides. During the years 2013-2014 has happened 2 times landslides which caused economic losses, as a result of damage to homes and farmland. Participatory mapping is one part of the activities of community-based disaster risk reduction (CBDRR)), because of the involvement of local communities is a prerequisite for sustainable disaster risk reduction. In this activity, participatory mapping method are done in two ways, namely participatory two-dimensional mapping (P2DM) with a focus on mapping of disaster areas and participatory three-dimensional mapping (P3DM) with a focus on the entire territory of the village. Based on the results P3DM, the ability of the communities in understanding the village environment spatially well-tested and honed, so as to facilitate the preparation of the CBDRR programs. Furthermore, the P3DM method can be applied to another disaster areas, due to it becomes a medium of effective dialogue between all levels of involved communities.

  3. Takotsubo Cardiomyopathy: A Long Term Follow-up Shows Benefit with Risk Factor Reduction

    Directory of Open Access Journals (Sweden)

    Koroush Khalighi

    2015-11-01

    Full Text Available Only sparse data was available on long-term of Takotusbo Cardiomyopathy (TC. Previous studies suggested prognosis is not necessarily benign. We report the long-term follow-up of 12 TC patients actively managed with risk factor reduction. Retrospective analysis of all patients diagnosed with TC at our hospital between 1998 and 2010. We identified 12 patients with TC among 1651 cases of emergent left heart catheterization over 12 years. Mean follow-up time was 8.3 ± 3.6 years. All were female, 87% had hypertension, 25% had history of Coronary Artery Disease (CAD, 67% had hyperlipidemia, 44% had some preceding emotional trauma, and 44% had some physical/physiological stress. Previous studies have shown that over 50% of TC patients experience future cardiac events, and 10% have a recurrence of TC. Patients were prescribed therapeutic lifestyle changes (TLC and guideline directed medical therapy (GDMT for aggressive risk factor reduction. TLC included diet, exercise, and cardiac rehabilitation. GDMT often included aspirin, beta-blockers, ACE-inhibitors, and statins. Follow-up echocardiograms showed recovery and maintenance of the ejection fraction. There was no cardiac mortality and no recurrences of TC. Aggressive risk factor reduction with TLC and GDMT may be effective in improving the long term outcomes of patients with TC.

  4. Social Participation and Disaster Risk Reduction Behaviors in Tsunami Prone Areas

    Science.gov (United States)

    Witvorapong, Nopphol; Muttarak, Raya; Pothisiri, Wiraporn

    2015-01-01

    This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1) following disaster-related news closely, (2) preparing emergency kits and/or having a family emergency plan, and (3) having an intention to migrate) and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation. PMID:26153891

  5. Alcoholism Risk Reduction in France: A Modernised Approach Related to Alcohol Misuse Disorders

    Directory of Open Access Journals (Sweden)

    Georges Brousse

    2014-11-01

    Full Text Available During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption.

  6. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Tracy L. Schumacher

    2016-09-01

    Full Text Available Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18–70 years, 47% male, five with CVD diagnosis. Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived “need” to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family “ringleader” to influence involvement and capitalising on personal accountability to other family members.

  7. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease.

    Science.gov (United States)

    Schumacher, Tracy L; Burrows, Tracy L; Thompson, Deborah I; Callister, Robin; Spratt, Neil J; Collins, Clare E

    2016-09-30

    Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.

  8. A text message intervention for alcohol risk reduction among community college students: TMAP.

    Science.gov (United States)

    Bock, Beth C; Barnett, Nancy P; Thind, Herpreet; Rosen, Rochelle; Walaska, Kristen; Traficante, Regina; Foster, Robert; Deutsch, Chris; Fava, Joseph L; Scott-Sheldon, Lori A J

    2016-12-01

    Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population. To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students. Heavy drinking adult CC students (N=60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up). Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD=1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up. The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy. Copyright © 2016. Published by Elsevier Ltd.

  9. Meditation and Cardiovascular Risk Reduction: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Levine, Glenn N; Lange, Richard A; Bairey-Merz, C Noel; Davidson, Richard J; Jamerson, Kenneth; Mehta, Puja K; Michos, Erin D; Norris, Keith; Ray, Indranill Basu; Saban, Karen L; Shah, Tina; Stein, Richard; Smith, Sidney C

    2017-09-28

    Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long

  10. Living with risk. A global review of disaster reduction initiatives. Preliminary version

    International Nuclear Information System (INIS)

    2002-01-01

    In recent years the world has witnessed an interminable succession of disasters - floods, storms, earthquakes, landslides, volcanic eruptions and wildfires that have claimed many thousands of lives, caused material losses in the tens of billions of dollars, and inflicted a terrible toll on developing countries in particular, where disasters divert attention and resources needed desperately to escape poverty. Communities will always face natural hazards, but today's disasters are often generated by, or at least exacerbated by, human activities. At the most dramatic level, human activities are changing the natural balance of the earth, interfering as never before with the atmosphere, the oceans, the polar ice caps, the forest cover and the natural pillars that make our world a livable home. But we are also putting ourselves in harm's way in less visible ways. At no time in human history have so many people lived in cities clustered around seismically active areas. Destitution and demographic pressure have led more people than ever before to live in flood plains or in areas prone to landslides. Poor land-use planning; environmental mismanagement; and a lack of regulatory mechanisms both increase the risk and exacerbate the effects of disasters. Living with risk: a global review of disaster reduction is the first comprehensive effort by the United Nations system to take stock of disaster reduction initiatives throughout the world. Coordinated by the secretariat of the International Strategy for Disaster Reduction (ISDR), the report discusses current disaster trends, assesses policies aimed at mitigating the impact of disasters, and offers examples of successful initiatives. It also recommends that risk reduction be integrated into sustainable development at all levels - global, national and local. Most of all, Living with risk shows that we are far from helpless in the face of natural hazards. Early warning and risk reduction measures have been important factors in

  11. GEO activities towards improved Geophysical monitoring. A key input to Disaster Risk Reduction.

    Science.gov (United States)

    Achache, J.; Rum, G.

    2007-05-01

    GEO has been established in 2005 with the main objective to put in place a Global, Coordinated, Comprehensive and Sustained System of Observing Systems (GEOSS) to serve 9 Social Benefit Areas, among which Disaster Risk Reduction. The paper will first set up the reference GEO framework, through a brief description of GEOSS key features, architectural functions and capacity building, and then will recall the value of the Geophysical observations, coming both from in situ and remote (satellite) systems, and, even more important, of their integration. GEO activities related to Geophysical monitoring and the use of related observation to foster social benefits in the Disaster Risk Reduction area will then be shortly described, together with the on-going key actions, including specific examples on key scientific/technical and data sharing aspects associated to GEOSS implementation. Special attention will be devoted on how Capacity Building strategy and activities are addressed through GEOSS development, building on infrastructure and programs under consolidation within GEO framework, such as the GEOSS Information collection and dissemination systems under development (GEONETCast, GEO Web Portal, GEO Clearinghouse) and the UN programs such as SPIDER (SPace based Information for Disaster management and Emergency Response) and UNOSAT. The paper will provide recommendations on the way forward for the implementation of Disaster Risk Management provisions as an integral part of sustainable development, also with the objective of creating within GEO a supporting framework to UNDP and World Bank activities on Risk Identification and Assessment.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

    Science.gov (United States)

    Williams, Paul T; Thompson, Paul D

    2013-05-01

    To test whether equivalent energy expenditure by moderate-intensity (eg, walking) and vigorous-intensity exercise (eg, running) provides equivalent health benefits. We used the National Runners' (n=33 060) and Walkers' (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. Baseline expenditure (metabolic equivant hours per day [METh/d]) was compared with self-reported, physician-diagnosed incident hypertension, hypercholesterolemia, diabetes mellitus, and CHD during 6.2 years follow-up. Running significantly decreased the risks for incident hypertension by 4.2% (Pdiabetes mellitus by 12.1% (Phypertension; and (3) 43.5%, 44.1%, 47.7%, and 68.2% from running, and 34.1%, 44.2% and 23.6% from walking for diabetes mellitus (walking >5.4 METh/d excluded for too few cases). The risk reductions were not significantly different for running than walking for diabetes mellitus (P=0.94), hypertension (P=0.06), or CHD (P=0.26), and only marginally greater for walking than running for hypercholesterolemia (P=0.04). Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.

  14. Teaching medical students cancer risk reduction nutrition counseling using a multimedia program.

    Science.gov (United States)

    Kolasa, K M; Jobe, A C; Miller, M G; Clay, M C

    1999-03-01

    There are many barriers to medical students receiving education about the linkage between nutrition and cancer, including the lack of role models and teachers and insufficient curricular time. We tested the use of a multimedia program as a possible solution to teaching diet-risk assessment and counseling skills. Images of Cancer Prevention, The Nutrition Link is a CD-ROM multimedia program that was developed and evaluated by 147 medical students. Pre-use and post-use surveys, computer log files, and recorded response sessions were used to determine the learner's 1) ease in using the program, 2) attitudes about the treatment of the content, 3) knowledge gain, and 4) attitudes about the role of physicians in nutrition assessment and counseling for cancer risk reduction. Students improved their knowledge of dietary guidelines for cancer risk reduction and made positive changes in their attitudes toward the role of physicians in dietary counseling. However, most students reported that they would not use the program unless it was required that they do so. The multimedia program was successful; it affected students' knowledge and attitudes concerning nutrition as a modifiable risk factor for some cancers. In addition, the design and delivery of the multimedia product was positively reviewed by the students for ease of access, message design, individualized instruction, and flexibility. Despite these favorable ratings, it was not clear that students would use the program unless required to do so.

  15. Interventional devascularization for the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension: mid-term to long-term results

    International Nuclear Information System (INIS)

    Liu Wei; Chen Hongbo; Chen Gensheng; Zhang Weiping; Zheng Qun

    2009-01-01

    Objective: To assess the mid-term to long-term results of interventional devascularization in the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension. Methods: Interventional devascularization was performed in 49 patients with upper gastrointestinal hemorrhage due to portal hypertension caused by cirrhosis. The patients were followed up for 6-36 months after the procedure. The recurrence of bleeding, postoperative complications and outcome. were observed and analyzed. Results: The technical success rate was 98.0% (48 / 49) and the mortality was 2%. The re-bleeding occurrence rate at 1, 6, 12, 24 and 36 months was 0%, 2.1%, 12.5%, 24.5% and 27.9%, respectively. The causes of re-bleeding included re-rupture of varicose vein (25%), portal hypertensive gastropathy (58.3%) and peptic ulcer (16.7%). Conclusion: The interventional devascularization is a simple, safe and effective method for the treatment of upper gastrointestinal hemorrhage due to portal hypertension. (authors)

  16. Impact of T-cell-mediated immune response on xenogeneic heart valve transplantation: short-term success and mid-term failure.

    Science.gov (United States)

    Biermann, Anna C; Marzi, Julia; Brauchle, Eva; Schneider, Maria; Kornberger, Angela; Abdelaziz, Sherif; Wichmann, Julian L; Arendt, Christophe T; Nagel, Eike; Brockbank, Kelvin G M; Seifert, Martina; Schenke-Layland, Katja; Stock, Ulrich A

    2018-04-01

    Allogeneic frozen cryopreserved heart valves (allografts or homografts) are commonly used in clinical practice. A major obstacle for their application is the limited availability in particular for paediatrics. Allogeneic large animal studies revealed that alternative ice-free cryopreservation (IFC) results in better matrix preservation and reduced immunogenicity. The objective of this study was to evaluate xenogeneic (porcine) compared with allogeneic (ovine) IFC heart valves in a large animal study. IFC xenografts and allografts were transplanted in 12 juvenile merino sheep for 1-12 weeks. Immunohistochemistry, ex vivo computed tomography scans and transforming growth factor-β release profiles were analysed to evaluate postimplantation immunopathology. In addition, near-infrared multiphoton imaging and Raman spectroscopy were employed to evaluate matrix integrity of the leaflets. Acellular leaflets were observed in both groups 1 week after implantation. Allogeneic leaflets remained acellular throughout the entire study. In contrast, xenogeneic valves were infiltrated with abundant T-cells and severely thickened over time. No collagen or elastin changes could be detected in either group using multiphoton imaging. Raman spectroscopy with principal component analysis focusing on matrix-specific peaks confirmed no significant differences for explanted allografts. However, xenografts demonstrated clear matrix changes, enabling detection of distinct inflammatory-driven changes but without variations in the level of transforming growth factor-β. Despite short-term success, mid-term failure of xenogeneic IFC grafts due to a T-cell-mediated extracellular matrix-triggered immune response was shown.

  17. NKS-R ExCoolSe mid-term report KTH severe accidents research relevant to the NKS-ExCoolSe project

    International Nuclear Information System (INIS)

    Hyun Sun Park; Truc-Nam Dinh

    2006-04-01

    The present mid-term progress report is prepared on the recent results from the KTH severe accident research program relevant to the objective of the ExCoolSe project sponsored by the NKS-R program. The previous PRE-MELT-DEL project at KTH sponsored by NKS provided an extensive assessment on the remaining issues of severe accidents in general and suggested the key issues to be resolved such as coolability and steam explosion energetics in ex-vessel which became a backbone of the ExCoolSe project in NKS. The EXCOOLSE project has been integrated with, and leveraged on, parallel research program at KTH on severe accident phenomena the MSWI project which is funded by the APRI program, SKI in Sweden and HSK in Switzerland and produced more understanding of the key remaining issues. During last year, the critical assessment of the existing knowledge and current SAMG and designs of Nordic BWRs identified the research focus and initiated the new series of research activities toward the resolution of the key remaining issues specifically pertaining to the Nordic BWRs.(au)

  18. Initial and mid-term results of a 4F compatible self-expanding low strut profile nitinol stent in the superficial femoral artery

    International Nuclear Information System (INIS)

    Muehlenbruch, G.; Brock, H.; Das, M.; Hohl, C.; Mahnken, A.H.; Wildberger, J.; Guenther, R.W.; Haage, P.

    2007-01-01

    Purpose: To evaluate the initial and mid-term results of a new self-expanding low strut profile nitinol stent for treatment of atherosclerotic lesions stenoses and occlusions in the superficial femoral artery (SFA). Materials and Methods: In 8 patients (4 male, 4 female, mean age 74.8 ± 8.8 years) with SFA lesions and non-satisfying results after PTA treatment alone, 10 self-expanding nitinol Xpert stents were deployed via a 4 F sheath. Stent characteristics and handling were graded by the interventionalist. Fontaine classification, duplex flow measurements and ankle brachial index (ABI) at rest and stress were taken prior and one day after stent placement. Patients were followed 3, 6 and 12 months after the procedure obtaining the same parameters at each appointment. Results: Initial stent treatment was successful in all patients. Stent handling and positioning were rated very good and safe. All patients improved clinically by at least one Fontaine stage (range before treatment: stage IIb to IV). The mean ABI at rest (stress) improved initially from 0.68 (0.70) to 1.07 (0.99). During a mean follow-up period of 8.3 months no case of clinically relevant in-stent stenosis was observed with stable values of ABI at rest and stress. (orig.)

  19. Value of magnetic resonance imaging in the mid-term follow-up of osteochondritis dissecans of the femoral condyle and talus

    International Nuclear Information System (INIS)

    Bachmann, G.; Rominger, M.; Rau, W.S.; Juergensen, I.

    1999-01-01

    Purpose: Definition of the prognostic value of clinical and morphological findings in the mid-term follow-up of OCD of the femoral condyle and talus. Demonstration of the consolidation of OCD on MRI depending on different therapies. Materials and Methods: 76 patients were examined before and at an average of 30 months after conservative or surgical therapy using T 1 and T 2 weighted SE and 3D-FISP sequences and contrast enhanced studies. Six clinical (age, gender, site, duration and severity of symptoms, therapy) and six morphological (size, signal intensity, fragmentation, contrast enhancement, condition of cartilage, staging) data were registered on first MRI and correlated with the degree of consolidation of OCD (partial and complete remission, no change and progression) on control MRI. Results: Patients under 17 years showed partial or complete remissions in 73%, those of 17 years or older in 33%. Conservatively treated patients had a higher remission rate (54%) than those treated with different surgical techniques (drilling 50%, refixation 43%, abrasio 38%). Small OCDs had a higher remission rate than large lesions (63% vs. 33%). OCDs covered with intact cartilage healed better than lesions with chondral defects (61% vs. 26%). Contrast enhancing fragments had a better prognosis than non-enhancing lesions (100% vs. 40%). Conclusions: Prognosis of OCD can be better estimated when size of OCD, condition of cartilage and enhancement of contrast agent is graduated with MRI and patient age is registered. The consequences for therapy planning are great. (orig.) [de

  20. Update on Risk Reduction Activities for a Liquid Advanced Booster for NASA's Space Launch System

    Science.gov (United States)

    Crocker, Andrew M.; Greene, William D.

    2017-01-01

    The stated goals of NASA's Research Announcement for the Space Launch System (SLS) Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) are to reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS and enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Dynetics, Inc. and Aerojet Rocketdyne (AR) formed a team to offer a wide-ranging set of risk reduction activities and full-scale, system-level demonstrations that support NASA's ABEDRR goals. During the ABEDRR effort, the Dynetics Team has modified flight-proven Apollo-Saturn F-1 engine components and subsystems to improve affordability and reliability (e.g., reduce parts counts, touch labor, or use lower cost manufacturing processes and materials). The team has built hardware to validate production costs and completed tests to demonstrate it can meet performance requirements. State-of-the-art manufacturing and processing techniques have been applied to the heritage F-1, resulting in a low recurring cost engine while retaining the benefits of Apollo-era experience. NASA test facilities have been used to perform low-cost risk-reduction engine testing. In early 2014, NASA and the Dynetics Team agreed to move additional large liquid oxygen/kerosene engine work under Dynetics' ABEDRR contract. Also led by AR, the objectives of this work are to demonstrate combustion stability and measure performance of a 500,000 lbf class Oxidizer-Rich Staged Combustion (ORSC) cycle main injector. A trade study was completed to investigate the feasibility, cost effectiveness, and technical maturity of a domestically-produced engine that could potentially both replace the RD-180 on Atlas V and satisfy NASA SLS payload-to-orbit requirements via an advanced booster application. Engine physical dimensions and performance parameters resulting from this study provide the system level requirements for the ORSC risk reduction test article

  1. Analysis of risk reduction methods for interfacing system LOCAs [loss-of-coolant accidents] at PWRs

    International Nuclear Information System (INIS)

    Bozoki, G.; Kohut, P.; Fitzpatrick, R.

    1988-01-01

    The Reactor Safety Study (WASH-1400) predicted that Interfacing System Loss-of-Coolant Accidents (ISL) events were significant contributors to risk even though they were calculated to be relatively low frequency events. However, there are substantial uncertainties involved in determining the probability and consequences of the ISL sequences. For example, the assumed valve failure modes, common cause contributions and the location of the break/leak are all uncertain and can significantly influence the predicted risk from ISL events. In order to provide more realistic estimates for the core damage frequencies (CDFs) and a reduction in the magnitude of the uncertainties, a reexamination of ISL scenarios at PWRs has been performed by Brookhaven National Laboratory. The objective of this study was to investigate the vulnerability of pressurized water reactor designs to ISLs and identify any improvements that could significantly reduce the frequency/risk of these events

  2. Competing risk model for reduction in life expectancy from radiogenic latent cancer

    International Nuclear Information System (INIS)

    Davis, H.T.

    1978-01-01

    Because of the large number of persons who could potentially receive low doses of radiation as a result of a nuclear reactor accident, the number of fatalities from latent cancers is generally larger than the early, or prompt, fatalities. For this reason the latent cancer fatality risk of reactor accidents is perceived as being more important than the early fatality risk. In addition, there exists the temptation to add the latent cancer fatality risk to the early fatality risk for the purpose of comparing reactor accident risks to other risks that society is exposed to, such as automobile accidents, airplane accidents, hurricanes, etc. However, the impact on the individual, and society as a whole, due to latent cancer fatalities is significantly different from the impact produced by early fatalities. Early fatalities generally result in appreciable life shortening for the affected individual while latent cancer fatalities generally result in very limited life shortening. A mathematical model was developed to express the reduction in life expectancy due to latent radiogenic cancer as a function of dose received

  3. Substance Use and Mild Traumatic Brain Injury Risk Reduction and Prevention: A Novel Model for Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer H. Olson-Madden

    2012-01-01

    Full Text Available Traumatic brain injury (TBI and substance use disorders (SUDs frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances before and after injury. Further, a growing body of literature supports the relationship between comorbid histories of mild TBI (mTBI and SUDs and negative outcomes. Alcohol and other drug use are strongly associated with risk taking. Disinhibition, impaired executive function, and/or impulsivity as a result of mTBI also contribute to an individual’s proclivity towards risk-taking. Risk-taking behavior may therefore, be a direct result of SUD and/or history of mTBI, and risky behaviors may predispose individuals for subsequent injury or continued use of substances. Based on these findings, evaluation of risk-taking behavior associated with the co-occurrence of SUD and mTBI should be a standard clinical practice. Interventions aimed at reducing risky behavior among members of this population may assist in decreasing negative outcomes. A novel intervention (Substance Use and Traumatic Brain Injury Risk Reduction and Prevention (STRRP for reducing and preventing risky behaviors among individuals with co-occurring mTBI and SUD is presented. Areas for further research are discussed.

  4. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

    Science.gov (United States)

    Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

    2002-03-01

    To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

  5. Sexual risk-reduction strategies among HIV-infected men receiving ART in Kibera, Nairobi.

    Science.gov (United States)

    Ragnarsson, Anders; Thorson, Anna; Dover, Paul; Carter, Jane; Ilako, Festus; Indalo, Dorcas; Ekstrom, Anna Mia

    2011-03-01

    This paper explores motivational factors and barriers to sexual behaviour change among men receiving antiretroviral treatment (ART). Twenty in-depth interviews were undertaken with male patients enrolled at the African Medical and Research Foundation clinic in Africa's largest urban informal settlement, Kibera in Nairobi, Kenya. All participants experienced prolonged and severe illness prior to the initiation of ART. Fear of symptom relapse was the main trigger for sexual behaviour change. Partner reduction was reported as a first option for behaviour change since this decision could be made by the individual. Condom use was perceived as more difficult as it had to be negotiated with female partners. Cultural norms regarding expectations for reproduction and marriage were not supportive of sexual risk-reduction strategies. Thus, local sociocultural contexts of HIV-infected people must be incorporated into the contextual adaptation and design of ART programmes and services as they have an over-riding influence on sexual behaviour and programme effectiveness. Also, HIV-prevention interventions need to address both personal, micro- and macro-level factors of behaviour to encourage individuals to take on sexual risk-reduction strategies. In order to achieve the anticipated preventive effect of ART, these issues are important for the donor community and policy-makers, who are the major providers of ART programme support within weak health systems in sub-Saharan Africa.

  6. Closed reduction of slipped capital femoral epiphysis: high-risk factor for avascular necrosis.

    Science.gov (United States)

    Kitano, Toshio; Nakagawa, Keisuke; Wada, Mayuko; Moriyama, Michiko

    2015-07-01

    How should we treat acute/unstable slipped capital femoral epiphysis (SCFE) without the development of avascular necrosis (AVN)? To answer this question, we investigated the risk factors of AVN development after SCFE. Seventy-six hips of 64 patients were classified using two kinds of classification systems, Loder's classification based on instability and the conventional classification based on the duration of symptom, because both classifications are related to AVN development. Of 21 unstable SCFEs, seven hips developed AVN. Of 35 hips defined as acute or acute on chronic, nine hips developed AVN. Two stable SCFEs of Loder's classification developed AVN, one was acute and the other was acute on chronic. No hips of chronic SCFE developed AVN. The factor that had influenced AVN development was only closed reduction, whether purposefully or inadvertently, in an acute or unstable SCFE. On the basis of the findings of this study, one should not embark on any modality of closed reduction for an unstable or acute form of SCFE, as there is a high risk for occurrence of AVN. For the same reason, a traction table should not be used for SCFE fixation, so as to avoid an inadvertent reduction or force that can lead to AVN.

  7. Constructing post-carbon institutions: Assessing EU carbon reduction efforts through an institutional risk governance approach

    International Nuclear Information System (INIS)

    LaBelle, Michael

    2012-01-01

    This paper examines three different governance approaches the European Union (EU) and Member States (MS) are relying on to reach a low carbon economy by 2050. Current governance literature explains the operational methods of the EU's new governance approach to reduce carbon emissions. However, the literature neglects to account for the perceived risks that inhibit the roll-out of new low carbon technology. This article, through a novel approach, uses a grounded theoretical framework to reframe traditional risk literature and provides a connection to governance literature in order to assess the ability of EU governance mechanisms to reduce carbon emissions. The empirical research is based on responses from European energy stakeholders who participated in a Delphi method discussion and in semi-structured interviews; these identified three essential requirements for carbon emissions to be reduced to near zero by 2050: (1) an integrated European energy network, (2) carbon pricing and (3) demand reduction. These features correspond to institutionalized responses by the EU and MS: the Agency for the Cooperation of Energy Regulators (ACER); European Union Emission Trading Scheme (EU ETS) and energy efficiency directives and policies integrated into existing MS institutions. The theoretical and empirical findings suggest that governance by facilitation (energy efficiency) fails to induce significant investment and new policy approaches and cannot be relied on to achieve requisite reductions in demand. Governance by negotiation (ACER) and governance by hierarchy (EU ETS) do reduce risks and may encourage the necessary technological uptake. The term ‘risk governance’ is used to explain the important role governance plays in reducing risks and advancing new technology and thereby lowering carbon emissions in the energy sector. - Highlights: ► This article assesses the role of EU institutions in reducing carbon emissions by 2050. ► Empirical research is based on Delphi

  8. Assessing urban potential flooding risk and identifying effective risk-reduction measures.

    Science.gov (United States)

    Cherqui, Frédéric; Belmeziti, Ali; Granger, Damien; Sourdril, Antoine; Le Gauffre, Pascal

    2015-05-01

    Flood protection is one of the traditional functions of any drainage system, and it remains a major issue in many cities because of economic and health impact. Heavy rain flooding has been well studied and existing simulation software can be used to predict and improve level of protection. However, simulating minor flooding remains highly complex, due to the numerous possible causes related to operational deficiencies or negligent behaviour. According to the literature, causes of blockages vary widely from one case to another: it is impossible to provide utility managers with effective recommendations on how to improve the level of protection. It is therefore vital to analyse each context in order to define an appropriate strategy. Here we propose a method to represent and assess the flooding risk, using GIS and data gathered during operation and maintenance. Our method also identifies potential management responses. The approach proposed aims to provide decision makers with clear and comprehensible information. Our method has been successfully applied to the Urban Community of Bordeaux (France) on 4895 interventions related to flooding recorded during the 2009-2011 period. Results have shown the relative importance of different issues, such as human behaviour (grease, etc.) or operational deficiencies (roots, etc.), and lead to identify corrective and proactive. This study also confirms that blockages are not always directly due to the network itself and its deterioration. Many causes depend on environmental and operating conditions on the network and often require collaboration between municipal departments in charge of roads, green spaces, etc. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Clinical utility of rosuvastatin and other statins for cardiovascular risk reduction among the elderly

    Directory of Open Access Journals (Sweden)

    Sydney B Long

    2010-12-01

    Full Text Available Sydney B Long, Michael J Blaha, Roger S Blumenthal, Erin D MichosJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USAAbstract: Age is one of the strongest predictors of cardiovascular disease (CVD risk. Treatment with statins can significantly reduce CVD events and mortality in both primary and secondary prevention. Yet despite the high CVD risk among the elderly, there is underutilization of statins in this population (ie, the treatment-risk paradox. Few studies have investigated the use of statins in the elderly, particularly for primary prevention and, as a result, guidelines for treating the elderly are limited. This is likely due to: uncertainties of risk assessment in older individuals where the predictive value of individual risk factors is decreased; the need to balance the benefits of primary prevention with the risks of polypharmacy, health care costs, and adverse medication effects in a population with decreased life expectancy; the complexity of treating patients with many other comorbidities; and increasingly difficult social and economic concerns. As life expectancy increases and the total elderly population grows, these issues become increasingly important. JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin is the largest primary prevention statin trial to date and enrolled a substantial number of elderly adults. Among the 5695 JUPITER participants ≥70 years of age, the absolute CVD risk reduction associated with rosuvastatin was actually greater than for younger participants. The implications of this JUPITER subanalysis and the broader role of statins among older adults is the subject of this review.Keywords: JUPITER, rosuvastatin, elderly, risk

  10. 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.

  11. Update on Risk Reduction Activities for a Liquid Advanced Booster for NASA's Space Launch System

    Science.gov (United States)

    Crocker, Andrew M.; Doering, Kimberly B; Meadows, Robert G.; Lariviere, Brian W.; Graham, Jerry B.

    2015-01-01

    The stated goals of NASA's Research Announcement for the Space Launch System (SLS) Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) are to reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS; and enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Dynetics, Inc. and Aerojet Rocketdyne (AR) formed a team to offer a wide-ranging set of risk reduction activities and full-scale, system-level demonstrations that support NASA's ABEDRR goals. For NASA's SLS ABEDRR procurement, Dynetics and AR formed a team to offer a series of full-scale risk mitigation hardware demonstrations for an affordable booster approach that meets the evolved capabilities of the SLS. To establish a basis for the risk reduction activities, the Dynetics Team developed a booster design that takes advantage of the flight-proven Apollo-Saturn F-1. Using NASA's vehicle assumptions for the SLS Block 2, a two-engine, F-1-based booster design delivers 150 mT (331 klbm) payload to LEO, 20 mT (44 klbm) above NASA's requirements. This enables a low-cost, robust approach to structural design. During the ABEDRR effort, the Dynetics Team has modified proven Apollo-Saturn components and subsystems to improve affordability and reliability (e.g., reduce parts counts, touch labor, or use lower cost manufacturing processes and materials). The team has built hardware to validate production costs and completed tests to demonstrate it can meet performance requirements. State-of-the-art manufacturing and processing techniques have been applied to the heritage F-1, resulting in a low recurring cost engine while retaining the benefits of Apollo-era experience. NASA test facilities have been used to perform low-cost risk-reduction engine testing. In early 2014, NASA and the Dynetics Team agreed to move additional large liquid oxygen/kerosene engine work under Dynetics' ABEDRR contract. Also led by AR, the

  12. Minority Households' Willingness-to-Pay for Public and Private Wildfire Risk Reduction in Florida

    Science.gov (United States)

    Gonzalez-Caban, A.; Sanchez, J. J.

    2017-12-01

    The purpose of this work is to estimate willingness-to-pay (WTP) for minority (African-American and Hispanic) homeowners in Florida for private and public wildfire risk reduction programs and also to test for differences in response between the two groups. A random parameter logit and latent class models allowed us to determine if there is difference in wildfire mitigation program preferences, whether WTP is higher for public or private actions for wildfire risk reduction, and whether households with personal experience and who perceive that they live in higher-risk areas have significantly higher WTP. We also compare FL minority homeowners' WTP values with Florida original homeowners' estimates. Results suggest that FL minority homeowners are willing to invest in public programs, with African-Americans WTP values at a higher rate than Hispanics. In addition, the highest priority for cost sharing funds would go to low-income homeowners, especially to cost-share private actions on their own land. These results may help fire managers optimize allocation of scarce cost-sharing funds for public versus private actions.

  13. NASA Propulsion Concept Studies and Risk Reduction Activities for Resource Prospector Lander

    Science.gov (United States)

    Trinh, Huu P.; Williams, Hunter; Burnside, Chris

    2015-01-01

    The trade study has led to the selection of propulsion concept with the lowest cost and net lowest risk -Government-owned, flight qualified components -Meet mission requirements although the configuration is not optimized. Risk reduction activities have provided an opportunity -Implement design improvements while development with the early-test approach. -Gain knowledge on the operation and identify operation limit -Data to anchor analytical models for future flight designs; The propulsion system cold flow tests series have provided valuable data for future design. -The pressure surge from the system priming and waterhammer within component operation limits. -Enable to optimize the ullage volume to reduce the propellant tank mass; RS-34 hot fire tests have successfully demonstrated of using the engines for the RP mission -No degradation of performance due to extended storage life of the hardware. -Enable to operate the engine for RP flight mission scenarios, outside of the qualification regime. -Provide extended data for the thermal and GNC designs. Significant progress has been made on NASA propulsion concept design and risk reductions for Resource Prospector lander.

  14. Cost-effectiveness analysis of risk reduction at nuclear power plants: What have we learned from experience

    International Nuclear Information System (INIS)

    Lochard, J.; Pages, P.

    1984-01-01

    Within the field of risk management techniques, cost-effectiveness analysis of risk reduction is now recognized as an adequate method for evaluating and defining the optimal allocation of protection and safety resources within large industrial systems. The paper considers some of the issues that arise in connection with cost-effectiveness analysis of risk reduction at nuclear power stations. Particular attention is called to both the interdependence between criteria that characterize risk reduction problems and the resulting aggregation and weighting procedures needed when the multidimensionality of criteria is explicitly taken into account. The discussion of these problems is illustrated with results of case studies on both public and occupational risk reduction at French PWRs during normal operation. (author)

  15. Use of GIS in the estimation and development of risk reduction technology

    International Nuclear Information System (INIS)

    Ha, Jae Joo

    1998-03-01

    The occurrence probability of a severe accident in the nuclear power plant is very small because the safety of a plant and the public is considered in the design and operation of a nuclear power plant. However, if a severe accident occurs, the establishment of a reduction strategy of damages resulting from it is essential because the effect of it on the human and the environment is very large. The important criterion which determines the severity of an accident is risk, which is defined as the product of its frequently and the consequence. The establishment of countermeasures in order to estimate and reduce risks quantitatively can be a very powerful tool to minimize the effect of an accident on the human and the environment. The research on the establishment of a framework which integrates a geographic information system (GIS), a database management system (DBMS), and decision making support system (DMSS) is considered very actively. Based on these systems, we can accomplish the estimation and display of risks and the development of reduction methodologies which are essential parts of an accident management of a nuclear power plant. The GIS plays a role to support users to systematize and comprehend spatial relationships of information which are necessary for the decision making. Through the DBMS, we can establish and manage spatial and attribute data, and use them in the query and selection. The DMSS is a computer-based information system which makes a necessary decision easily. In this study, we reviewed the fundamental concepts of a GIS and examined the methodology for the use of it in the estimation and display of risks. Also, we established the fundamental GIS platform of a Yonggwang site and the necessary database systems for the estimation of risks. (author). 17 refs., 9 tabs., 34 figs

  16. Effectiveness of Methadone in Reduction of High Risk Behaviors in Clients of MMT Center

    Directory of Open Access Journals (Sweden)

    F Ehsani

    2010-09-01

    Full Text Available Introduction: Addiction as a social, health problem with its specific complications threatens societies. High risk behaviors such as violence, self mutilation, tattooing, shared injections and unprotected sex behaviors are some of the problems in addicts that need to be treated. One of these treatments is methadone therapy. The purpose of this study was to evaluate effectiveness of methadone in prevention or reduction of high risk behaviors in clients of a MMT center of Shaheed Sadoughi University of medical sciences of Yazd. Methods: This study was done on 93 clients of a MMT center.Questionnaire for this study included items from MAP and questions about some other risky behaviors. This questionnaire was completed at onset of treatment and 6 months after. Data was analyzed with SPSS software program Results: 89.2% of participants were married and 10.8% were single. 63.5% of them were in the20-40 years age group. Most commonly abused substances were heroin and opium. Before onset of treatment, 37.6% of participants had history of imprisonment, 35.5% had shared injections, 32.3%had had unprotected sex, 22.6%had tattooing and 5.4%had mutilated their own selves. Only 36.6% didn’t have any high risk behavior. These behaviors were more common in heroin users and in the20-40 years age group. After onset of treatment and during 6 month of MMT, 86% of clients didn’t have any risky behavior. Only 14%of them continued to have unsafe sex behaviors Conclusion: Addiction can cause high risk behaviors. Data in this paper suggests that young age, heroin use, low education level and no or inadequate information about addictive substances and their consequences are effective and important factors that cause high risk behaviors. Treatment of addicts with methadone maintenance therapy plays an important role in reduction of risky behaviors. Development of appropriate and more MMT centers are recommended.

  17. Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

    Science.gov (United States)

    Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

    2018-01-01

    Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links. PMID:29670057

  18. SAFRR (Science Application for Risk Reduction) Tsunami Scenario--Executive Summary and Introduction: Chapter A in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

    Science.gov (United States)

    Ross, Stephanie L.; Jones, Lucile M.; Miller, Kevin H.; Porter, Keith A.; Wein, Anne; Wilson, Rick I.; Bahng, Bohyun; Barberopoulou, Aggeliki; Borrero, Jose C.; Brosnan, Deborah M.; Bwarie, John T.; Geist, Eric L.; Johnson, Laurie A.; Kirby, Stephen H.; Knight, William R.; Long, Kate; Lynett, Patrick; Mortensen, Carl E.; Nicolsky, Dmitry J.; Perry, Suzanne C.; Plumlee, Geoffrey S.; Real, Charles R.; Ryan, Kenneth; Suleimani, Elena; Thio, Hong Kie; Titov, Vasily V.; Whitmore, Paul M.; Wood, Nathan J.

    2013-01-01

    The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey, the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

  19. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours.

    Science.gov (United States)

    Wintemute, Garen J

    2011-12-01

    Alcohol use and firearm ownership are risk factors for violent injury and death. To determine whether firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours, the author conducted a cross-sectional study using Behavioral Risk Factor Surveillance System data for eight states in the USA from 1996 to 1997 (the most recent data available). Altogether, 15 474 respondents provided information on firearm exposure. After adjustment for demographics and state of residence, firearm owners were more likely than those with no firearms at home to have ≥5 drinks on one occasion (OR 1.32; 95% CI 1.16 to 1.50), to drink and drive (OR 1.79; 95% CI 1.34 to 2.39) and to have ≥60 drinks per month (OR 1.45; 95% CI 1.14 to 1.83). Heavy alcohol use was most common among firearm owners who also engaged in behaviours such as carrying a firearm for protection against other people and keeping a firearm at home that was both loaded and not locked away. The author concludes that firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours.

  20. Risk reduction in a changing insurance climate: examples from the US and UK

    Science.gov (United States)

    Horn, Diane; McShane, Michael

    2015-04-01

    Coastal cities face a range of increasingly severe challenges as sea level rises, and adaptation to future flood risk will require more than structural defences. Many cities will not be able to rely solely on engineering structures for protection and will need to develop a suite of policy responses to increase their resilience to impacts of rising sea level. Insurance can be used as a risk-sharing mechanism to encourage adaptation to sea level rise, using pricing or restrictions on availability of cover to discourage new development in flood risk areas or to encourage the uptake of flood resilience measures. We draw on flood insurance policy lessons learned from the United States and the United Kingdom to propose risk-sharing among private insurers/reinsurers, government, and policyholders to alleviate major issues of the current programs, while still maintaining a holistic approach to managing flood risk. The UK and the US are almost polar opposites in the way flood insurance is implemented. Flood insurance in the US is fully public and in the UK fully private; however, in both countries the participants feel that the established system is unsustainable. In the US, flood coverage is excluded from property policies provided by private insurers, and is only available through the National Flood Insurance Program (NFIP), with the federal government acting as insurer of last resort. Flood risk reduction has been part of the NFIP remit since the introduction of the program in 1968. Following massive payments for flood claims related primarily to Hurricanes Katrina and Sandy, the NFIP is approximately 26 billion in debt, prompting calls to bring private insurance back into the flood insurance business. Two major Congressional modifications to the NFIP in 2012 and 2014 have pushed the contradictory goals of fully risk-based, yet affordable premiums. The private market has not been significantly involved in a risk-bearing role, but that is changing as private insurers

  1. Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction

    Science.gov (United States)

    Gyawu, Rebecca; Quansah, Joseph E.; Fall, Souleymane; Gichuhi, Peter N.; Bovell-Benjamin, Adelia C.

    2015-01-01

    In-store measures were utilized to evaluate the availability of healthy food choices and nutrition/health promotion messages for cancer risk reduction in the selected Alabama Black Belt counties/cities. Sixty one retail food outlets (RFOs) were audited in 12 Alabama Black Belt cities. Store types included convenience stores (49.2%), restaurants (19.7%), fast food restaurants (16.4%), small supermarkets (8.2%), and large supermarket and farmers' markets (3.3 %), respectively. Although there were low numbers of farmers' markets/street stands and large supermarkets, these had significantly (p food environment had limited opportunities for healthy food choices. PMID:26844138

  2. Short and long term efficiencies of debris risk reduction measures: Application to a European LEO mission

    Science.gov (United States)

    Lang, T.; Kervarc, R.; Bertrand, S.; Carle, P.; Donath, T.; Destefanis, R.; Grassi, L.; Tiboldo, F.; Schäfer, F.; Kempf, S.; Gelhaus, J.

    2015-01-01

    Recent numerical studies indicate that the low Earth orbit (LEO) debris environment has reached a point such that even if no further space launches were conducted, the Earth satellite population would remain relatively constant for only the next 50 years or so. Beyond that, the debris population would begin to increase noticeably, due to the production of collisional debris (Liou and Johnson, 2008). Measures to be enforced play thus a major role to preserve an acceptable space mission risk and ensure sustainable space activities. The identification of such measures and the quantification of their efficiency over time for LEO missions is of prime concern in the decision-making process, as it has been investigated for the last few decades by the Inter-Agency Space Debris Coordination Committee (IADC). This paper addresses the final results of a generic methodology and the characteristics of a tool developed to assess the efficiency of the risk reduction measures identified for the Sentinel-1 (S1) mission. This work is performed as part of the 34-month P2-ROTECT project (Prediction, Protection & Reduction of OrbiTal Exposure to Collision Threats), funded by the European Union within the Seventh Framework Programme. Three ways of risk reduction have been investigated, both in short and long-term, namely: better satellite protection, better conjunction prediction, and cleaner environment. According to our assumptions, the S1 mission vulnerability evaluations in the long term (from 2093 to 2100) show that full compliance to the mitigation measures leads to a situation twice safer than that induced by an active debris removal of 5 objects per year in a MASTER2009 Business-As-Usual context. Because these measures have visible risk reduction effects in the long term, complementary measures with short response time are also studied. In the short term (from 2013 to 2020), a better prediction of the conjunctions is more efficient than protecting the satellite S1 itself. By

  3. The sexual double standard in African American adolescent women's sexual risk reduction socialization.

    Science.gov (United States)

    Fasula, Amy M; Miller, Kim S; Wiener, Jeffrey

    2007-01-01

    This study explored the sexual double standard (SDS) (in which males are afforded more freedom and power than females in heterosexual interactions) in African American mothers' sexual messages to sons and daughters. We used a convenience sample of 129 African American adolescents, aged 14 to 17 years, and their mothers who reported SDS attitudes. Qualitative analyses revealed gender differences based on an SDS in mothers' sexual risk reduction socialization. Mothers typically took a proactive approach with sons and a neutral or prohibitive approach with daughters. Findings provide directions for socially relevant programs for African American parents, schools, and communities.

  4. Triple-orifice valve repair in severe Barlow disease with multiple-jet mitral regurgitation: report of mid-term experience.

    Science.gov (United States)

    Fucci, Carlo; Faggiano, Pompilio; Nardi, Matilde; D'Aloia, Antonio; Coletti, Giuseppe; De Cicco, Giuseppe; Latini, Leonardo; Vizzardi, Enrico; Lorusso, Roberto

    2013-09-10

    Barlow disease represents a surgical challenge for mitral valve repair (MR) in the presence of mitral insufficiency (MI) with multiple regurgitant jets. We hereby present our mid-term experience using a modified edge-to-edge technique to address this peculiar MI. From March 2003 till December 2010, 25 consecutive patients (mean age 54 ± 7 years, 14 males) affected by severe Barlow disease with multiple regurgitant jets were submitted to MR. Preoperative transesophageal echo (TEE) in all the cases showed at least 2 regurgitant jets, involving one or both leaflets in more than one segment. In all the patients, a triple orifice valve (TOV) repair with annuloplasty was performed. Intra-operative TEE and postoperative transthoracic echocardiography (TTE) were carried out to evaluate results of the TOV repair. There was no in-hospital death and one late death (non-cardiac related). At intra-operative TEE, the three orifices showed a mean total valve area of 2.9 ± 0.1cm(2) (range 2.5-3.3 cm(2)) with no residual regurgitation (2 cases of trivial MI) and no sign of valve stenosis (mean transvalvular gradient 4.6 ± 1.5 mmHg). At follow up (mean 38 ± 22 months), TTE showed favourable MR and no recurrence of significant MI (6 cases of trivial and 1 of mild MI). Stress TTE was performed in 5 cases showing persistent effective valve function (2 cases of trivial MI at peak exercise). All the patients showed significant NYHA functional class improvement. This report indicates that the TOV technique is effective in correcting complex Barlow mitral valves with multiple jets. Further studies are required to confirm long-term applicability and durability in more numerous clinical cases. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Mid-term follow-up of patients with transposition of the great arteries after atrial inversion operation using two- and three-dimensional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Fogel, Mark A.; Weinberg, Paul M.; Hubbard, Anne

    2002-01-01

    Background: Older patients with transposition of the great arteries who have undergone an atrial inversion procedure (ATRIAL-INV) are difficult to image by echocardiography. The surgical baffles are spatially complex. Objective: To test the hypothesis that two- and three-dimensional MRI can elucidate the spatially complex anatomy in this patient population. Materials and methods; Twelve patients with ATRIAL-INV, ages 16±4.5 years, underwent routine T1-weighted spin-echo axial imaging to obtain a full cardiac volumetric data set. Postprocessing created three-dimensional shaded surface displays and allowed for multiplanar reconstruction. Routine transthoracic echocardiography was available on all patients. Results: Three-dimensional reconstruction enabled complete spatial conceptualization of the venous pathways, and allowed for precise localization of a narrowed region in the upper limb of the systemic venous pathway found in two patients. This was subsequently confirmed on angiography. Routine MRI was able to image the full extent of the venous pathways in all 12 patients. Routine transthoracic echocardiography was able to visualize proximal portions of the venous pathways in eight (67%), the distal upper limb in five (42%), and the distal lower limb in four (33%) patients, and it was able to visualize the outflow tracts in all patients. Conclusion: Three-dimensional reconstruction adds important spatial information, which can be especially important in stenotic regions. Routine MRI is superior to transthoracic echocardiography in delineation of the systemic and pulmonary venous pathway anatomy of ATRIAL-INV patients at mid-term follow-up. Although transesophageal echocardiography is an option, it is more invasive. (orig.)

  6. Endovascular treatment of intracranial aneurysms with the p64 flow diverter stent: mid-term results in 35 patients with 41 intracranial aneurysms.

    Science.gov (United States)

    Morais, Ricardo; Mine, Benjamin; Bruyère, Pierre Julien; Naeije, Gilles; Lubicz, Boris

    2017-03-01

    The p64 flow diverter (FD) device is a fully resheathable and detachable stent dedicated for endovascular treatment (EVT) of intracranial aneurysms (IAs). We report our mid-term experience with this device. Between January 2015 and February 2016, we retrospectively identified, in our prospectively maintained database, all patients treated with p64 FDs in two institutions. Independent clinical follow-up was performed by a vascular neurologist. Imaging follow-up included a digitalized subtraction angiography (DSA) at 3, 6, and 12 months and a magnetic resonance angiography (MRA) at 12 months. Thirty-nine patients (22 women/17 men; median age 54 years) with 48 IAs (median aneurysm size 6.2 mm; mean neck size 3.4 mm) were identified. All IAs were saccular and unruptured. Failure of safe stent delivery occurred in 15% of cases (7/48 IAs) which were excluded. Transient neurological morbidity occurred in 2/35 patients (5.7%) including one delayed thromboembolic complication. No permanent morbidity or mortality was encountered. Complete aneurysmal occlusion at 3, 6, and 12 months was 20/30 (66.6%), 18/27 (66.6%), and 24/28 (85.7%), respectively. Intra-stent stenosis was observed in 9/29 patients (31%) and classified as moderate in 4/29 (13.7%) and mild in 5/29 patients (17.2%). These stenoses gradually improved over time, with only mild stenoses being identified at 6 months and at 12 months. In our small case series, the p64 FD stent appears safe and effective for EVT of IAs. A high occlusion rate and a low morbidity rate were observed.

  7. Patellofemoral Osteoarthritis Progression and Alignment Changes after Open-Wedge High Tibial Osteotomy Do Not Affect Clinical Outcomes at Mid-term Follow-up.

    Science.gov (United States)

    Goshima, Kenichi; Sawaguchi, Takeshi; Shigemoto, Kenji; Iwai, Shintaro; Nakanishi, Akira; Ueoka, Ken

    2017-10-01

    To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved (P patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Short-Term and Mid-Term Effects of Fasting and Downset Meal Pattern on Dietary Intakes, Anthropometric Parameters, and Glycemic and Lipid Profile in Fasting Women

    Directory of Open Access Journals (Sweden)

    Narsis Afghari

    2012-12-01

    Full Text Available Background and Objective: This study assessed the mid-term changes in anthropometrical and biochemical factors as well as nutritional status and physical activity level with regard to nocturnal eating during Ramadan, for the first time.Materials and Methods: Via an easy sampling, the cohort study was conducted in 49 women aged between 20 and 45 years who were recruited from Shahid Motahari Hospital in Isfahan. The subjects were divided into two groups based on their nocturnal eating pattern. Anthropometrical and biochemical parameters were measured three days before Ramadan, on the third day of Ramadan, and thirty days after the end of Ramadan. A 147 food items frequency questionnaire was used for the assessment of nutritional status t. Repeated measure test was employed to determine changes over time, and the interaction effects between times and nocturnal eating status. Results: The body weight and body mass index of the women who consumed the nocturnal meal was significantly different from those of the subjects who did not consume the downset meal (p value =0.006. There were significant differences in energy, carbohydrate, and fat intake as well as serum triglycerides, HDL-cholesterol, and physical activity levels between the three time periods. Serum glucose, cholesterol, and LDL-cholesterol were not significantly different between the two groups.Conclusion: Ramadan fasting has beneficial effects on the body weight and body mass index. Fasting causes some changes in the lipid profile; these changes can be attributed to changes in dietary habits and physical activity level during Ramadan, rather than nocturnal eating status.

  9. Mid-term survival analysis of closed wedge high tibial osteotomy: A comparative study of computer-assisted and conventional techniques.

    Science.gov (United States)

    Bae, Dae Kyung; Song, Sang Jun; Kim, Kang Il; Hur, Dong; Jeong, Ho Yeon

    2016-03-01

    The purpose of the present study was to compare the clinical and radiographic results and survival rates between computer-assisted and conventional closing wedge high tibial osteotomies (HTOs). Data from a consecutive cohort comprised of 75 computer-assisted HTOs and 75 conventional HTOs were retrospectively reviewed. The Knee Society knee and function scores, Hospital for Special Surgery (HSS) score and femorotibial angle (FTA) were compared between the two groups. Survival rates were also compared with procedure failure. The knee and function scores at one year postoperatively were slightly better in the computer-assisted group than those in conventional group (90.1 vs. 86.1) (82.0 vs. 76.0). The HSS scores at one year postoperatively were slightly better for the computer-assisted HTOs than those of conventional HTOs (89.5 vs. 81.8). The inlier of the postoperative FTA was wider in the computer-assisted group than that in the conventional HTO group (88.0% vs. 58.7%), and mean postoperative FTA was greater in the computer-assisted group that in the conventional HTO group (valgus 9.0° vs. valgus 7.6°, pclinical and radiographic results were better in the computer-assisted group that those in the conventional HTO group. Mid-term survival rates did not differ between computer-assisted and conventional HTOs. A comparative analysis of longer-term survival rate is required to demonstrate the long-term benefit of computer-assisted HTO. III. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Towards improved public awareness for climate related disaster risk reduction in South Africa: A Participatory Development Communication perspective

    Directory of Open Access Journals (Sweden)

    Tigere Chagutah

    2009-04-01

    Full Text Available Southern Africa has frequently been struck by damaging climate hazards which increasingly continue to threaten sustainable development efforts. Ominously, climate models predict that the incidence of major ‘wet’ events, such as floods and cyclones will increase in frequency against the background of a changing climate. Unfortunately, local mechanisms for communicating and raising public awareness of the consequent risks and appropriate risk reduction options remain weak. At the core of policy responses to the threat posed by climate related hazards, the South African government has adopted a disaster risk reduction approach to disaster management. This article details how, among many other measures to limit the adverse impacts of natural hazards, South Africa’s National Disaster Management Framework calls for the implementation of effective public awareness activities to increase the knowledge among communities of the risks they face and what risk-minimising actions they can take. Emphasis is laid on the importance of information provision and knowledge building among at-risk communities. Citing established theories and strategies, the author proposes a participatory development communication approach through Development Support Communication strategies for the provision of disaster risk reduction public awareness activities by government and other disaster risk reduction role-players in South Africa. By way of a review of completed studies and literature, the article provides guidance on the planning and execution of successful public communication campaigns and also discusses the constraints of communication campaigns as an intervention for comprehensive disaster risk reduction.

  11. Reductive stress in young healthy individuals at risk of Alzheimer disease.

    Science.gov (United States)

    Badía, Mari-Carmen; Giraldo, Esther; Dasí, Francisco; Alonso, Dolores; Lainez, Jose M; Lloret, Ana; Viña, Jose

    2013-10-01

    Oxidative stress is a hallmark of Alzheimer disease (AD) but this has not been studied in young healthy persons at risk of the disease. Carrying an Apo ε4 allele is the major genetic risk factor for AD. We have observed that lymphocytes from young, healthy persons carrying at least one Apo ε4 allele suffer from reductive rather than oxidative stress, i.e., lower oxidized glutathione and P-p38 levels and higher expression of enzymes involved in antioxidant defense, such as glutamylcysteinyl ligase and glutathione peroxidase. In contrast, in the full-blown disease, the situation is reversed and oxidative stress occurs, probably because of the exhaustion of the antioxidant mechanisms just mentioned. These results provide insights into the early events of the progression of the disease that may allow us to find biomarkers of AD at its very early stages. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Review of the severe accident risk reduction program (SARRP) containment event trees

    International Nuclear Information System (INIS)

    1986-05-01

    A part of the Severe Accident Risk Reduction Program, researchers at Sandia National Laboratories have constructed a group of containment event trees to be used in the analysis of key accident sequences for light water reactors (LWR) during postulated severe accidents. The ultimate goal of the program is to provide to the NRC staff a current assessment of the risk from severe reactor accidents for a group of five light water reactors. This review specifically focuses on the development and construction of the containment event trees and the results for containment failure probability, modes and timing. The report first gives the background on the program, the review criteria, and a summary of the observations, findings and recommendations. secondly, the individual reviews of each committee member on the event trees is presented. Finally, a review is provided on the computer model used to construct and evaluate the event trees

  13. Hand hygiene regimens for the reduction of risk in food service environments.

    Science.gov (United States)

    Edmonds, Sarah L; McCormack, Robert R; Zhou, Sifang Steve; Macinga, David R; Fricker, Christopher M

    2012-07-01

    Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities.

  14. United States-Chile binational exchange for volcanic risk reduction, 2015—Activities and benefits

    Science.gov (United States)

    Pierson, Thomas C.; Mangan, Margaret T.; Lara Pulgar, Luis E.; Ramos Amigo, Álvaro

    2017-07-25

    In 2015, representatives from the United States and Chile exchanged visits to discuss and share their expertise and experiences dealing with volcano hazards. Communities in both countries are at risk from various volcano hazards. Risks to lives and property posed by these hazards are a function not only of the type and size of future eruptions but also of distances from volcanoes, structural integrity of volcanic edifices, landscape changes imposed by recent past eruptions, exposure of people and resources to harm, and any mitigative measures taken (or not taken) to reduce risk. Thus, effective risk-reduction efforts require the knowledge and consideration of many factors, and firsthand experience with past volcano crises provides a tremendous advantage for this work. However, most scientists monitoring volcanoes and most officials delegated with the responsibility for emergency response and management in volcanic areas have little or no firsthand experience with eruptions or volcano hazards. The reality is that eruptions are infrequent in most regions, and individual volcanoes may have dormant periods lasting hundreds to thousands of years. Knowledge may be lacking about how to best plan for and manage future volcanic crises, and much can be learned from the sharing of insights and experiences among counterpart specialists who have had direct, recent, or different experiences in dealing with restless volcanoes and threatened populations. The sharing of information and best practices can help all volcano scientists and officials to better prepare for future eruptions or noneruptive volcano hazards, such as large volcanic mudflows (lahars), which could affect their communities.

  15. Dam risk reduction study for a number of large tailings dams in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Verma, N. [AMEC Earth and Environmental Ltd., Mississauga, ON (Canada); Small, A. [AMEC Earth and Environmental Ltd., Fredericton, NB (Canada); Martin, T. [AMEC Earth and Environmental, Burnaby, BC (Canada); Cacciotti, D. [AMEC Earth and Environmental Ltd., Sudbury, ON (Canada); Ross, T. [Vale Inco Ltd., Sudbury, ON (Canada)

    2009-07-01

    This paper discussed a risk reduction study conducted for 10 large tailings dams located at a central tailings facility in Ontario. Located near large industrial and urban developments, the tailings dams were built using an upstream method of construction that did not involve beach compaction or the provision of under-drainage. The study provided a historical background for the dam and presented results from investigations and instrumentation data. The methods used to develop the dam configurations were discussed, and remedial measures and risk assessment measures used on the dams were reviewed. The aim of the study was to address key sources of risk, which include the presence of high pore pressures and hydraulic gradients; the potential for liquefaction; slope instability; and the potential for overtopping. A borehole investigation was conducted and piezocone probes were used to obtain continuous data and determine soil and groundwater conditions. The study identified that the lower portion of the dam slopes were of concern. Erosion gullies could lead to larger scale failures, and elevated pore pressures could lead to the risk of seepage breakouts. It was concluded that remedial measures are now being conducted to ensure slope stability. 6 refs., 1 tab., 6 figs.

  16. Correlates of HIV Risk Reduction Self-Efficacy among Youth in South Africa

    Directory of Open Access Journals (Sweden)

    Julia Louw

    2012-01-01

    Full Text Available Even though a decline in HIV prevalence has been reported among South African youth 15–24 from 10.3% in 2005 to 8.6% in 2008, the prevalence remains disproportionately high for females overall in comparison to males. This study examines factors associated by HIV risk reduction self-efficacy of South African youth as part of an evaluation of the impact of loveLife, a youth focused HIV prevention programme. A cross-sectional population-based household survey was conducted with persons of ages 18 to 24 years in four selected provinces in South Africa. Among female respondents (, factors associated with high self-efficacy in the adjusted model were having a low HIV risk perception, HIV/AIDS stigma, ever using drugs, and having life goals. Male respondents ( with high self-efficacy were more likely to have been tested for HIV, have concurrent sexual partners, have had a transactional sex partner in lifetime, a low HIV risk perception, difficulty in having condoms, agreed with coercive sex, high relationship control, and had loveLife face-to-face programme participation. The factors identified with high self-efficacy and HIV-sexual risk behaviour may be considered to strengthen youth HIV prevention programmes in South Africa.

  17. Workshop: Economic Valuation of Mortality Risk Reduction: Assessing the State of the Art for Policy Applications (2002)

    Science.gov (United States)

    This two-day workshop, co-sponsored by EPA's National Center for Environmental Economics and National Center for Environmental Research, was dedicated to exploring methods for valuing mortality risk reductions. There were six sessions held in total.

  18. Communicating Treatment Risk Reduction to People With Low Numeracy Skills: A Cross-Cultural Comparison

    Science.gov (United States)

    2009-01-01

    Objectives. We sought to address denominator neglect (i.e. the focus on the number of treated and nontreated patients who died, without sufficiently considering the overall numbers of patients) in estimates of treatment risk reduction, and analyzed whether icon arrays aid comprehension. Methods. We performed a survey of probabilistic, national samples in the United States and Germany in July and August of 2008. Participants received scenarios involving equally effective treatments but differing in the overall number of treated and nontreated patients. In some conditions, the number who received a treatment equaled the number who did not; in others the number was smaller or larger. Some participants received icon arrays. Results. Participants—particularly those with low numeracy skills—showed denominator neglect in treatment risk reduction perceptions. Icon arrays were an effective method for eliminating denominator neglect. We found cross-cultural differences that are important in light of the countries' different medical systems. Conclusions. Problems understanding numerical information often reside not in the mind but in the problem's representation. These findings suggest suitable ways to communicate quantitative medical data. PMID:19833983

  19. We4DRR: A brand new European network for women in Disaster Risk Reduction

    Science.gov (United States)

    Papathoma-Koehle, Maria; Keiler, Margreth; Promper, Catrin; Patek, Maria

    2017-04-01

    Natural hazards often intensify societal inequalities having disproportionate impact on some population groups including women. On the other hand, women working in the field of natural hazards, either on site as emergency workers or in research, policy and administration as scientists, experts and managers have to deal with a number of challenges. However, gender issues are often neglected and women networks related to natural hazards in Europe but also worldwide are scarce. We present here "We4DRR: Women exchange for Disaster Risk Reduction", a new women's network focusing on gender issues in the field of disaster risk reduction but also on women working in the field. The network was initiated and organised by the Austrian Federal Ministry of Agriculture, Forestry, Environment and Water Management (BMLFUW) and the University of Natural Resources and Life Sciences Vienna (BOKU) and was launched in Austria in March 2016. Its aims include collecting data on gender issues and DRR, empowerment of women, mentoring of young female professionals, and increasing the visibility of gender-specific aspects in DRR.

  20. Profile of elementary school science teacher instruction in disaster risk reduction: case study of volcano disaster

    Science.gov (United States)

    Pujianto; Prabowo; Wasis

    2018-04-01

    This study examined the profile of science' teacher instruction in Disaster Risk Reduction (DRR), as a feature of instructional quality, on students’ learning experiences. A qualitative study was done to observe teacher activities in teaching of disaster preparedness. Science teacher and 14 students at grade 4 of SDN (elementary school) Kiyaran 2 are involved as the subject of this study. Teacher’ instruction was coded with regard to preparation, action, and evaluation using observation sheets and documentation. Data analysis results showed a positive significant effect of the readiness during preparation on learning process of disaster risk reduction and an indirect effect of teacher’ action on students’ learning experiences. There is a lack of teaching materials about volcano disaster in the elementary school. Teacher found difficulties on evaluation of student achievement in disaster preparedness. These findings highlight the importance of DRR in uphold science teachers’ education. Items of teachers’ skill in preparing of DRR may be used to offer model of concrete instruction situation during university workshop for maintain teacher education.

  1. Assessing social vulnerability to drought in South Africa: Policy implication for drought risk reduction

    Directory of Open Access Journals (Sweden)

    Fumiso Muyambo

    2017-01-01

    Full Text Available The aim of this article was to assess and identify social vulnerability of communal farmers to drought in the O.R. Tambo district in the Eastern Cape province of South Africa using a survey data and social vulnerability index (SoVI. Eleven social vulnerability indicators were identified using Bogardi, Birkman and Cardona conceptual framework. The result found that an SoVI estimated for O.R. Tambo district was very high with a Likert scale of 5 for cultural values and practices, security or safety, social networks, social dependence, preparedness strategies and psychological stress attributed for the high value of social vulnerability to drought. Indigenous knowledge and education had an SoVI value of 2, which was of low vulnerability, contributing positively to resilience to drought. The study also found that government involvement in drought risk reduction is limited; as a result, the study recommends that a national, provincial and district municipalities policy on drought risk reduction and mitigation should be developed.

  2. Moderation and Mediation of an Efficacious Sexual Risk-Reduction Intervention for South African Adolescents

    Science.gov (United States)

    O’Leary, Ann; Jemmott, John B.; Jemmott, Loretta Sweet; Bellamy, Scarlett; Ngwane, Zolani; Icard, Larry

    2015-01-01

    Background “Let Us Protect Our Future” is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period. Purpose The present analyses were conducted to identify moderators of the intervention’s efficacy as well as which theory-based variables mediated the intervention’s effects. Methods: Intervention efficacy over the 3-, 6-, and 12-month follow-ups was tested using generalized estimating equation (GEE) models. Results Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention’s effect on abstinence. Conclusions This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents. PMID:22618963

  3. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

    Directory of Open Access Journals (Sweden)

    A. Gero

    2011-01-01

    Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

  4. Goals and activities of the JICA technical cooperation project on reduction of seismic risk in Romania

    International Nuclear Information System (INIS)

    Vacareanu, R.; Kato, H.

    2007-01-01

    Japan International Cooperation Agency (JICA) Technical Cooperation Project on Reduction of Seismic Risk for Buildings and Structures started in Romania on October 1, 2002. The aim of the Project is to strengthen the capacity of earthquake disaster related activities in Romania. The Project approval is the result of four years of intensive efforts made by professionals from Technical University of Civil Engineering Bucharest (UTCB), Ministry of Transport, Constructions and Tourism (MTCT), Romania, National Building Research Institute (INCERC) Bucharest, JICA, Building Research Institute (BRI), Tsukuba, and National Institute for Land, Infrastructure and Management (NILIM), Tsukuba, Japan. The duration of the Project is five years. The implementing agency is the National Center for Seismic Risk Reduction (NCSRR) as a public institution of national interest under MTCT. The activities are carried out by NCSRR in partnership with UTCB and INCERC. During the Project period, 29 young Romanian engineers were trained in Japan, 7 Japanese experts and 37 Japanese experts worked for long-term and short-term, respectively in Romania. Equipment for seismic instrumentation, dynamic characterization of soil and structural testing rising up approximately to 260 million yens (i.e. 2.17 million USD) were donated by JICA to Romania, through NCSRR. The total cost of the Project is roughly 7 million USD. The paper describes the main activities and results of the Project until the JICA Final Evaluation Mission (March 2007). (authors)

  5. The contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe: A big call to practitioners

    Directory of Open Access Journals (Sweden)

    Ernest Dube

    2018-03-01

    Full Text Available This article examined the contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe. The current discourse underrates the use of indigenous knowledge of communities by practitioners when dealing with disasters’, as the knowledge is often viewed as outdated and primitive. This study, which was conducted in 2016, sought to examine this problem through analysing the potential contribution of indigenous knowledge as a useful disaster risk reduction intervention. Tsholotsho district in Matabeleland, North province of Zimbabwe, which frequently experiences perennial devastating floods, was used as a case study. Interviews and researcher observations were used to gather data from 40 research participants. The findings were that communities understand weather patterns and could predict imminent flooding after studying trees and clouds, and the behaviours of certain animal species. Local communities also use available local resources to put structural measures in place as part of disaster risk reduction interventions. Despite this important potential, the study found that the indigenous knowledge of disaster risk reduction of the communities is often shunned by practitioners. The practitioners claim that indigenous knowledge lacks documentation, it is not found in all generational classes, it is contextualised to particular communities and the knowledge cannot be scientifically validated. The study concluded that both local communities and disaster risk reduction practitioners can benefit from the indigenous knowledge of communities. This research has the potential to benefit communities, policymakers and disaster risk reduction practitioners.

  6. Program for Volcanic Risk Reduction in the Americas: Translation of Science into Policy and Practice

    Science.gov (United States)

    Mangan, Margaret; Pierson, Thomas; Wilkinson, Stuart; Westby, Elizabeth; Driedger, Carolyn; Ewert, John

    2016-04-01

    In 2013, the United States Geological Survey (USGS) and the U.S. Agency for International Development/Office of Foreign Disaster Assistance (USAID/OFDA) inaugurated Volcanic Risk Reduction in the Americas, a program that brings together binational delegations of scientists, civil authorities, and emergency response managers to discuss the challenges of integrating volcano science into crisis response and risk reduction practices. During reciprocal visits, delegations tour areas impacted by volcanic unrest and/or eruption, meet with affected communities, and exchange insights and best practices. The 2013 exchange focused on hazards at Mount Rainier (Washington, USA) and Nevado del Ruiz (Caldas/Tolima, Colombia). Both of these volcanoes are highly susceptible to large volcanic mudflows (lahars). The Colombia-USA exchange allowed participants to share insights on lahar warning systems, self-evacuation planning, and effective education programs for at-risk communities. [See Driedger and Ewert (2015) Abstract 76171 presented at 2015 Fall AGU, San Francisco, Calif., Dec 14-18]. The second exchange, in 2015, took place between the USA and Chile, focusing on the Long Valley volcanic region (California, USA) and Chaitén volcano (Lagos, Chile) - both are centers of rhyolite volcanism. The high viscosity of rhyolite magma can cause explosive eruptions with widespread destruction. The rare but catastrophic "super eruptions" of the world have largely been the result of rhyolite volcanism. Chaitén produced the world's first explosive rhyolite eruption in the age of modern volcano monitoring in 2008-2009. Rhyolite eruptions of similar scale and style have occurred frequently in the Long Valley volcanic region, most recently about 600 years ago. The explosivity and relative rarity of rhyolite eruptions create unique challenges to risk reduction efforts. The recent Chaitén eruption was unexpected - little was known of Chaitén's eruptive history, and because of this, monitoring

  7. Mediation of an efficacious HIV risk reduction intervention for South African men.

    Science.gov (United States)

    O'Leary, Ann; Jemmott, John B; Jemmott, Loretta S; Bellamy, Scarlett; Icard, Larry D; Ngwane, Zolani

    2015-10-01

    "Men, Together Making a Difference!" is an HIV/STD risk-reduction intervention that significantly increased self-reported consistent condom use during vaginal intercourse compared with a health-promotion attention-control intervention among men (N = 1181) in Eastern Cape Province, South Africa. The present analyses were designed to identify mediators of the intervention's efficacy. The potential mediators were Social Cognitive Theory (SCT) constructs that the intervention targeted, including several aspects of condom-use self-efficacy, outcome expectancies, and knowledge. Mediation was assessed using a product-of-coefficients approach where an α path (the intervention's effect on the potential mediator) and a β path (the potential mediator's effect on the outcome of interest, adjusting for intervention) were estimated independently in a generalized estimating equations framework. Condom-use negotiation self-efficacy, technical-skill self-efficacy, and impulse-control self-efficacy were significant mediators. Although not mediators, descriptive norm and expected friends' approval of condom use predicted subsequent self-reported condom use, whereas the expected approval of sexual partner did not. The present results suggest that HIV/STD risk-reduction interventions that draw upon SCT and that address self-efficacy to negotiate condom use, to apply condoms correctly, and to exercise sufficient control when sexually aroused to use condoms may contribute to efforts to reduce sexual risk behavior among South African men. Future research must examine whether approaches that build normative support for condom use among men's friends are also efficacious.

  8. Impact of the new Sendai framework for disaster risk reduction on Paris flood prevention program

    Directory of Open Access Journals (Sweden)

    Thepot Regis

    2016-01-01

    Full Text Available The greater Paris region faces a significant risk of flooding due to potential spill-over from the Seine and the Marne. Because the last major flood occurred in 1910, the event has faded in the collective memory. Consequently, the population and the public authorities have difficulty imagining that such a catastrophe might repeat itself. In parallel, widespread urban expansion into flood zones has considerably aggravated the foreseeable damage if an event of a comparable intensity were to hit the region.In response to this situation, the EPTB Seine Grands Lacs – a public territorial basin establishment– decided to take action to reduce this risk.It began by commissioning a study from the OECD on flood risk prevention in the Seine Basin. This study was presented in January 2014 and highlighted the considerable risk of flooding in or near Paris, which could, affect a total of nearly 5 million people, cause up to €30 billion in direct damage and affect up to 400.000 jobs. It also put forward 14 recommendations that are being implemented by the public authorities, at either the national, basin or local level.The EPTB launched in partnership with the government a second initiative for which it steers and coordinates a coherent, balanced, relevant and gradual programme of 78 flood prevention actions. As a new post-2015 framework for disaster risk reduction was adopted in Sendai in March 2015 taking in account lessons learned during the 2005-2015 period, gaps identified and future challenges, this paper addresses the question of the impact of this new international framework on the implementation of the flood prevention of Paris region. One of the main points developed is the necessity to increase public awareness, to enhance disaster preparedness for effective response and to “build back better” in recovery rehabilitation and reconstruction.

  9. Interdisciplinary approach for disaster risk reduction in Valtellina Valley, northern Italy

    Science.gov (United States)

    Garcia, Carolina; Blahut, Jan; Luna, Byron Quan; Poretti, Ilaria; Camera, Corrado; de Amicis, Mattia; Sterlacchini, Simone

    2010-05-01

    Inside the framework of the European research network Mountain Risks, an interdisciplinary research group has been working in the Consortium of Mountain Municipalities of Valtellina di Tirano (northern Italy). This area has been continuously affected by several mountain hazards such as landslides, debris flows and floods that directly affect the population, and in some cases caused several deaths and million euros of losses. An aim of the interdisciplinary work in this study area, is to integrate different scientific products of the research group, in the areas of risk assessment, management and governance, in order to generate, among others, risk reduction tools addressed to general public and stakeholders. Two types of phenomena have been particularly investigated: debris flows and floods. The scientific products range from modeling to mapping of hazard and risk, emergency planning based on real time decision support systems, surveying for the evaluation of risk perception and preparedness, among others. Outputs from medium scale hazard and risk modeling could be used for decision makers and spatial planners as well as civil protection authorities to have a general overview of the area and indentify hot spots for further detailed analysis. Subsequently, local scale analysis is necessary to define possible events and risk scenarios for emergency planning. As for the modeling of past events and new scenarios of debris flows, physical outputs were used as inputs into physical vulnerability assessment and quantitative risk analysis within dynamic runout models. On a pilot zone, the physical damage was quantified for each affected structure within the context of physical vulnerability and different empirical vulnerability curves were obtained. Prospective economic direct losses were estimated. For floods hazard assessment, different approaches and models are being tested, in order to produce flood maps for various return periods, and related to registered rainfalls

  10. Combining Co-Benefits and Stakeholders Perceptions into Green Infrastructure Selection for Flood Risk Reduction

    Directory of Open Access Journals (Sweden)

    Alida Alves

    2018-02-01

    Full Text Available An important increase in flood risk levels is expected in future decades in many areas around the globe. In addition, the traditional approaches for flood management offer options with low sustainability. As a response, the use of non-traditional drainage measures, also called green infrastructures, has been increasingly suggested in the last years. One important reason for their increasing popularity has been the co-benefits that they offer to the environment. The development of an efficient planning for sustainable urban drainage systems is a complex process that needs the involvement of multiple stakeholders. Moreover, the measures to be adopted should be evaluated considering their potential to achieve multiple benefits related to human well-being, rather than just to flood risk management. In this work, we propose a framework for the selection of green infrastructures on the basis of a co-benefits analysis. The aim is to include the achievement of co-benefits and human well-being into decision-making for flood management, considering the stakeholders’ perceptions to define the most important benefits to be enhanced. The application of the framework presented here to a case study in Ayutthaya, Thailand, shows the importance of including different stakeholder’s opinions. In addition, it shows that decision makers should consider locally defined co-benefits as well as flood risk reduction when defining which green infrastructures to apply.

  11. The Community – Based Flood Disaster Risk Reduction (CBDRR in Beringin Watershed in Semarang City

    Directory of Open Access Journals (Sweden)

    Tiara Sartika Worowirasmi

    2015-08-01

    Full Text Available Population growth in Semarang city is certainly increasing land demand for settlement. Limited land and weak regulation enforcement of land control trigger the land use change including the watershed area. Semarang City Spatial Plan 2011-2031 has determined Beringin as a buffer area with limited physical development allocation but the citizens utilized the watershed area for settlement. Settlement developments in the area reduce the watershed ability to catch water and river capacity due to increased sedimentation. These two reasons are the main cause of the flash flood disaster (regularly in rainy season in seven villages of Beringin watershed. The condition is exacerbated by the tidal flood occurred in two village lies in coastal. In 2012, Semarang City government developed Flood Forecasting and Warning System as one of Climate Change Adaptation Measures known as Flood Early Warning System (FEWS. One of important output of FEWS is community-based disaster risk reduction. Community participation process in the FEWS has made it possible for the community to identify disaster risk characteristics, to propose solution for reducing flood risk which is suitable to the local wisdom, to increase the community capacity and to organize one of themselves in a disaster preparedness group which run quite independently.

  12. Analysis of risk-reduction measures for multiunit essential service water systems

    International Nuclear Information System (INIS)

    Kohut, P.; Musicki, Z.; Fitzpatrick, R.

    1989-01-01

    Many risk analyses have indicated the potentially significant contribution to core damage frequency (CDF) due to the loss of the essential service water (ESW) function. The ESW system serves as the ultimate heat sink, and its failure can affect numerous safety components and systems, although it does not directly perform a frontline safety function. As such, probabilistic risk assessment studies usually analyze its failures through support system modeling; however, the direct loss of the ESW as an initiator may or may not be explicitly treated. In addition, the actual analysis is made more complex due to the linked initiating event nature of these events, since the system fault trees are coupled to the initiator in these cases. Previously, a specific safety issue was identified concerning the increase in core-melt vulnerability caused by the failure of the ESW system in pressurized water reactor (PWR) multiplant units that have only two service water (SW) pumps per unit with a backup crosstie capability to the other unit. The main objective of the present study was to establish a realistic measure of the core damage vulnerability, to identify potential improvements for the ESW systems, and to obtain generic estimates of their risk-reduction potential and cost-effectiveness

  13. [Risk reduction and drug use in detention: study about the detainees of Liancourt Penitentiary].

    Science.gov (United States)

    Sannier, Olivier; Verfaillie, Florent; Lavielle, Dorothée

    2012-07-01

    The prison population is drug users. Recent debates around the provision of devices to reduce the risks associated with drug use (syringe exchange programs and snort kit) lead us to question local practices of the prison population. An anonymous questionnaire was offered to the prison population of the Liancourt penitentiary. The questions addressed the use of drugs before and during incarceration, knowledge of HIV and B and C hepatitis status, taking an opiate substitution treatment and advice on the implementation of syringe exchange programs and snort kit. A percentage of 54.4 of the prisoners responded to the questionnaire. An amount of 60.1 % of respondents consumed at least one drug before incarceration and 43.6 % of respondents consumed at least one drug during their incarceration. Cannabis was the most consumed drug before and during incarceration. Barely half of respondents reported knowing their HIV and hepatitis B and C status. Over 10 % of respondents said they were interesting in establishing needle exchange programs or snort kit. The prison concentrate drug users and is not a repressive tool of efficient risk reduction. The strategies implemented by the medical unit of Liancourt prison require adaptations that warrant development of health resources. Then, only new tools to reduce risks associated with drug use can be established. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Use of a New Hybrid Heparin-Bonded Nitinol Ring Stent in the Popliteal Artery: Procedural and Mid-term Clinical and Anatomical Outcomes

    International Nuclear Information System (INIS)

    Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis; Padayachee, Soundrie; Karunanithy, Narayan; Ahmed, Irfan; Zayed, Hany; Katsanos, Konstantinos

    2015-01-01

    PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery

  15. Use of a New Hybrid Heparin-Bonded Nitinol Ring Stent in the Popliteal Artery: Procedural and Mid-term Clinical and Anatomical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Parthipun, Aneeta; Diamantopoulos, Athanasios; Kitrou, Panagiotis [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Padayachee, Soundrie [King’s Health Partners, Department of Ultrasonic Angiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Karunanithy, Narayan; Ahmed, Irfan [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Zayed, Hany [King’s Health Partners, Department of Vascular Surgery, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Katsanos, Konstantinos, E-mail: konstantinos.katsanos@gstt.nhs.uk, E-mail: katsanos@med.upatras.gr [King’s Health Partners, Department of Interventional Radiology, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)

    2015-08-15

    PurposeTo report the immediate and mid-term clinical and anatomical outcomes of a novel, hybrid, heparin-bonded, nitinol ring stent (TIGRIS; Gore Medical) when used for the treatment of lesions located in the popliteal artery.Materials and MethodsThis was a prospective single-centre registry. Patients eligible for inclusion were individuals suffering from symptomatic popliteal arterial occlusive disease (Rutherford–Becker stage 3–6; P1–P3 segments) and treated with placement of the TIGRIS stent(s). Patients were prospectively scheduled for clinical review and duplex ultrasound follow-up after 6 and 12 months. Outcome measures included immediate technical success, primary vessel patency, in-stent binary restenosis (evaluable by Duplex at 50 % threshold; PSVR > 2.0), freedom from target lesion revascularization (TLR) and amputation-free survival (AFS) estimated by Kaplan–Meier (K–M) survival analysis. Cox proportional-hazards regression analysis was also performed to adjust for confounders and search for independent predictors of outcomes.ResultsFrom August 2012 to March 2014, a total of 54 popliteal TIGRIS stents were implanted in 50 limbs of 48 patients (27 men and 21 women; mean age 76.0 ± 1.7 years). Median Rutherford–Becker stage was five at baseline and 37/50 (74.0 %) were chronic total occlusions. Technical success was achieved in all cases (100 %). Stented lesion length was 114.2 ± 36.9 mm (range 6–20 cm). Median follow-up was 11.8 ± 0.8 months. After 12 months, primary patency of the TIGRIS stent was 69.5 ± 10.2 % with an 86.1 ± 5.9 % freedom from TLR and 87 ± 5.0 % AFS (K–M estimates).ConclusionThe TIGRIS hybrid heparin-bonded nitinol ring stent is a safe and effective endovascular option for complex occlusive disease of the popliteal artery.

  16. Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

    Directory of Open Access Journals (Sweden)

    Mallory C. McKenzie

    2012-01-01

    Full Text Available Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM, lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC and the Medication Possession Ratio (MPR. Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01. The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01. The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence pre enrollment versus post enrollment (+10%, P=0.086. The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for

  17. Coordination of International Risk-Reduction Investigations by the Multilateral Human Research Panel for Exploration

    Science.gov (United States)

    Charles, John B.; Bogomolov, Valery V.

    2015-01-01

    Effective use of the unique capabilities of the International Space Station (ISS) for risk reduction on future deep space missions involves preliminary work in analog environments to identify and evaluate the most promising techniques, interventions and treatments. This entails a consolidated multinational approach to biomedical research both on ISS and in ground analogs. The Multilateral Human Research Panel for Exploration (MHRPE) was chartered by the five ISS partners to recommend the best combination of partner investigations on ISS for risk reduction in the relatively short time available for ISS utilization. MHRPE will also make recommendations to funding agencies for appropriate preparatory analog work. In 2011, NASA's Human Research Program (HRP) and the Institute of Biomedical Problems (IBMP) of the Russian Academy of Science, acting for MHRPE, developed a joint US-Russian biomedical program for the 2015 one-year ISS mission (1YM) of American and Russian crewmembers. This was to evaluate the possibilities for multilateral research on ISS. An overlapping list of 16 HRP, 9 IBMP, 3 Japanese, 3 European and 1 Canadian investigations were selected to address risk-reduction goals in 7 categories: Functional Performance, Behavioral Health, Visual Impairment, Metabolism, Physical Capacity, Microbial and Human Factors. MHRPE intends to build on this bilateral foundation to recommend more fully-integrated multilateral investigations on future ISS missions commencing after the 1YM. MHRPE has also endorsed an on-going program of coordinated research on 6-month, one-year and 6-week missions ISS expeditions that is now under consideration by ISS managers. Preparatory work for these missions will require coordinated and collaborative campaigns especially in the psychological and psychosocial areas using analog isolation facilities in Houston, Köln and Moscow, and possibly elsewhere. The multilateral Human Analogs research working group (HANA) is the focal point of those

  18. Wildfire risk reduction in the United States: Leadership staff perceptions of local fire department roles and responsibilities

    Science.gov (United States)

    Rachel S. Madsen; Hylton J. G. Haynes; Sarah M. McCaffrey

    2018-01-01

    As wildland fires have had increasing negative impacts on a range of human values, in many parts of the United States (U.S.) and around the world, collaborative risk reduction efforts among agencies, homeowners, and fire departments are needed to improve wildfire safety and mitigate risk. Using interview data from 46 senior officers from local fire departments around...

  19. On the use of a risk ladder: Linking public perception of risks associated with indoor air with cognitive elements and attitudes toward risk reduction

    Science.gov (United States)

    Moschandreas, D. J.; Chang, P. E.

    In recent years a number of building managers have invested small amounts of money to measure indoor air quality in offices and other non-industrial buildings. Their objective is to reduce the number of occupant complaints, and not necessarily to reduce the risk associated with such complaints. Clearly, reduction of the risk would require greater investment of funds and effort. This paper focuses on individuals and the amount of money they are willing to invest in order to reduce risks associated with indoor air pollution in their home. Psychologists assert that lay judgement of risks are influenced by cognitive biases and attitudes. This study investigates the possibility that cognitive elements and general attitudes influence not only the perceived risk associated with exposures to indoor air pollutants, but also the willingness of individuals to invest in order to reduce the risk. A three-stage study was performed to determine some of the factors that influence public decisions to control the quality of the air inside their home. The study is focused on the design of a risk ladder, and the survey of 400 randomly selected individuals in the Chicago metropolitan area. The survey was designed to determine if demographics, smoking, education, or income influence the desire of individuals to invest in order to reduce indoor air pollution. The following conclusions were reached: (i) public awareness of indoor air pollution is high; (ii) media campaigns on indoor air pollution affect the determination of the specific pollutant the public perceives as important, but do not influence the public's desire to invest larger amounts of money to reduce risks from exposures to air pollutants in the residential environment; (iii) the public is not willing to spend large amounts of money to reduce indoor residential air pollution; (iv) education does not affect the level of awareness regarding indoor air pollution, but it increases the willingness to invest in an effort to reduce

  20. Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

    Science.gov (United States)

    Igel, L I; Saunders, K H; Fins, J J

    2018-05-21

    In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

  1. Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction

    Directory of Open Access Journals (Sweden)

    Rebecca Gyawu

    2015-01-01

    Full Text Available In-store measures were utilized to evaluate the availability of healthy food choices and nutrition/health promotion messages for cancer risk reduction in the selected Alabama Black Belt counties/cities. Sixty one retail food outlets (RFOs were audited in 12 Alabama Black Belt cities. Store types included convenience stores (49.2%, restaurants (19.7%, fast food restaurants (16.4%, small supermarkets (8.2%, and large supermarket and farmers' markets (3.3 %, respectively. Although there were low numbers of farmers' markets/street stands and large supermarkets, these had significantly (p < 0.0001 higher health scores than the other store types. A few health promotion messages were highly visible or obscurely positioned in some RFOs. The Alabama Black Belt food environment had limited opportunities for healthy food choices.

  2. Considerations on reduction of risk from anticipated transients without scram in a regulatory perspective

    International Nuclear Information System (INIS)

    Ahn, S. H.; Oh, D. Y.; Kim, I. K.; Lee, S. H.

    2002-01-01

    ATWS (Anticipated Transients Without Scram) are anticipated operational occurrences accompanied by the failure of the reactor trip portion of the reactor trip system. ATWS accidents are an cause of concern because under certain postulated conditions they could lead to significant core damage including core melt and to the large release of radioactivity to the environment. In this study, considerations on reduction of risk from ATWS were discussed with examination of the technical background of 10CFR 50.62. Considering the recent trends of the extended core cycle and the power uprating, it is recognized that the moderator temperature coefficient can become less negative than to suppress the RCS overpressure followed by ATWS. Because the negative reactivity feedback is one inherent level of multiple defenses, the effect against the RCS overpressure needs to be assessed in detail

  3. Traditional and Local Knowledge Practices for Disaster Risk Reduction in Northern Ghana

    Directory of Open Access Journals (Sweden)

    Nsioh Macnight Ngwese

    2018-03-01

    Full Text Available In order to deal with recurrent disasters, like floods and droughts coupled with the limited adaptive capacity, in the semiarid regions of Northern Ghana, local communities have no choice but to apply traditional and local knowledge practices. This study seeks to identify such practices employed in selected rural communities in Northern Ghana and to investigate their effectiveness. Data were collected through key informant interviews, household questionnaire surveys, focus group discussions, and participant observations. The findings indicated that although diverse practices were applied to predict and manage local disaster events, skepticism prevailed among locals toward these practices regarding their effectiveness. Due to the lack of science-based tools and systems for disaster prediction and management, local communities continually depended on these knowledge systems and practices. Integrating local and traditional disaster risk reduction (DRR efforts into modern scientific knowledge should be encouraged in order to reduce the vulnerability of local communities to disasters with thorough effectiveness evaluation protocols.

  4. Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees.

    Science.gov (United States)

    Lenz, Thomas L; Gillespie, Nicole D; Skrabal, Maryann Z; Faulkner, Michele A; Skradski, Jessica J; Ferguson, Liz A; Pagenkemper, Joni J; Moore, Geri A; Jorgensen, Diane

    2013-03-01

    A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

  5. The roles of exercise and fall risk reduction in the prevention of osteoporosis.

    Science.gov (United States)

    Henderson, N K; White, C P; Eisman, J A

    1998-06-01

    In summary, the optimal model for the prevention of osteoporotic fractures includes maximization and maintenance of bone strength and minimization of trauma. Numerous determinants of each have been identified, but further work to develop preventative strategies based on these determinants remains to be undertaken. Physical activity is a determinant of peak BMD. There also is evidence that activity during growth modulates the external geometry and trabecular architecture, potentially enhancing skeletal strength, while during the adult years activity may reduce age-related bone loss. The magnitude of the effect of a 7% to 8% increase in peak BMD, if maintained through the adult years, could translate to a 1.5-fold reduction in fracture risk. Moreover, in the older population, appropriate forms of exercise could reduce the risk of falling and, thus, further reduce fracture risk. These data must be considered as preliminary in view of the paucity of long-term fracture outcome data from randomized clinical trials. However, current information suggests that the optimal form of exercise to achieve these objectives may vary through life. Vigorous physical activity (including weight-bearing, resistance, and impact components) during childhood may maximize peak BMD. This type of activity seems optimal through the young adult years, but as inevitable age-related degeneration occurs, activity modification to limit the impact component of exercise may become necessary. In the elderly, progressive strength training has been demonstrated to be a safe and effective form of exercise that reduces risk factors for falling and may also enhance BMD. In the frail elderly, activity to improve balance and confidence also may be valuable. Group activities such as Tai Chi may be cost-effective. Precise prescriptions must await the outcome of well-designed, controlled longitudinal studies that include fracture as an outcome. However, increased physical activity seems to be a sensible

  6. Laypersons' understanding of relative risk reductions: Randomised cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kristiansen Ivar S

    2008-07-01

    Full Text Available Abstract Background Despite increasing recognition of the importance of involving patients in decisions on preventive healthcare interventions, little is known about how well patients understand and utilise information provided on the relative benefits from these interventions. The aim of this study was to explore whether lay people can discriminate between preventive interventions when effectiveness is presented in terms of relative risk reduction (RRR, and whether such discrimination is influenced by presentation of baseline risk. Methods The study was a randomised cross-sectional interview survey of a representative sample (n = 1,519 of lay people with mean age 59 (range 40–98 years in Denmark. In addition to demographic information, respondents were asked to consider a hypothetical drug treatment to prevent heart attack. Its effectiveness was randomly presented as RRR of 10, 20, 30, 40, 50 or 60 percent, and half of the respondents were presented with quantitative information on the baseline risk of heart attack. The respondents had also been asked whether they were diagnosed with hypercholesterolemia or had experienced a heart attack. Results In total, 873 (58% of the respondents consented to the hypothetical treatment. While 49% accepted the treatment when RRR = 10%, the acceptance rate was 58–60% for RRR>10. There was no significant difference in acceptance rates across respondents irrespective of whether they had been presented with quantitative information on baseline risk or not. Conclusion In this study, lay people's decisions about therapy were only slightly influenced by the magnitude of the effect when it was presented in terms of RRR. The results may indicate that lay people have difficulties in discriminating between levels of effectiveness when they are presented in terms of RRR.

  7. On-ground casualty risk reduction by structural design for demise

    Science.gov (United States)

    Lemmens, Stijn; Funke, Quirin; Krag, Holger

    2015-06-01

    In recent years, awareness concerning the on-ground risk posed by un-controlled re-entering space systems has increased. On average over the past decade, an object with mass above 800 kg re-enters every week from which only a few, e.g. ESA's GOCE in 2013 and NASA's UARS in 2011, appeared prominent in international media. Space agencies and nations have discussed requirements to limit the on-ground risk for future missions. To meet the requirements, the amount of debris falling back on Earth has to be limited in number, mass and size. Design for demise (D4D) refers to all measures taken in the design of a space object to increase the potential for demise of the object and its components during re-entry. SCARAB (Spacecraft Atmospheric Re-entry and Break-Up) is ESA's high-fidelity tool which analyses the thermal and structural effects of atmospheric re-entry on spacecraft with a finite-element approach. For this study, a model of a representative satellite is developed in SCARAB to serve as test-bed for D4D analyses on a structural level. The model is used as starting point for different D4D approaches based on increasing the exposure of the satellite components to the aero-thermal environment, as a way to speed up the demise. Statistical bootstrapping is applied to the resulting on-ground fragment lists in order to compare the different re-entry scenarios and to determine the uncertainties of the results. Moreover, the bootstrap results can be used to analyse the casualty risk estimator from a theoretical point of view. The risk reductions for the analysed D4D techniques are presented with respect to the reference scenario for the modelled representative satellite.

  8. Mapping Disaster Risk Reduction and Climate Change Adaptation: progress in South Africa

    Science.gov (United States)

    Storie, Judith M.

    2018-05-01

    Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) strategies in Africa are on the increase. South Africa is no different, and a number of strategies have seen the light in aid of reducing disaster risk and adapting to cli-mate change. The DRR and CCA processes include the mapping of location and extent of known and potential hazards, vulnerable communities and environments, and opportunities that may exist to manage these risks. However, the mapping of often fast-changing urban and rural spaces in a standardized manner presents challenges that relate to processes, scales of data capture, level of detail recorded, software and compatibility related to data formats and net-works, human resources skills and understanding, as well as differences in approaches to the nature in which the map-ping processes are executed and spatial data is managed. As a result, projects and implementation of strategies that re-late to the use of such data is affected, and the success of activities based on the data may therefore be uncertain. This paper investigates data custodianship and data categories that is processed and managed across South Africa. It explores the process and content management of disaster risk and climate change related information and defines the challenges that exist in terms of governance. The paper also comments on the challenges and potential solutions for the situation as it gives rise to varying degrees of accuracy, effectiveness for use, and applicability of the spatial data available to affect DRR and improve the value of CCA programmes in the region.

  9. The impact of collaborative strategies on disaster risk reduction in Zimbabwe dairy supply chains in 2016

    Directory of Open Access Journals (Sweden)

    Felix Chari

    2017-09-01

    Full Text Available Disasters are on the increase globally with accompanying devastating effects on dairy supply chains. The devastating effects, caused by disasters on economies in various countries such as United States of America, Japan, Kenya, Uganda, Mozambique and Zimbabwe call for urgent sustainable mitigating measures in disaster risk reduction. These countries have experienced notable natural and man-made disasters in the past. The disasters negatively impacted the economies of both developed and developing countries, causing misery to people as hunger and poverty drastically increased. Zimbabwe’s dairy industry was not spared from these devastating effects as it was vulnerable to disasters such as droughts and cyclones. Disasters adversely affected supply chains in the country as evidenced by the closure of some dairy firms between the years 2000 and 2014. This article is set against the backdrop of declining output across all agricultural sectors in Zimbabwe, evident particularly in the dairy farming sector which has witnessed inadequate supply of raw milk and dairy products by local producers. The article assesses the impact of dairy organisations’ partnerships with government departments and non-governmental organisations in reducing disaster risks on the dairy supply chain cost efficiency. It also aims to show how partnerships can reduce disaster risks and weighs the benefits of reduced supply chain costs in improving the affordability of milk and milk products to the general public. The study employs a mixed-methods approach comprising structured questionnaires, administered to a sample of 92 respondents out of a randomly sampled population of 122 participants from dairy farming clusters across the country, with an 85% response rate. Key informants in the form of 18 dairy officers were purposively sampled for interviews throughout the dairy farming regions. The research findings will help government in the formulation of public policies for the

  10. Earthquake risk reduction in the United States: An assessment of selected user needs and recommendations for the National Earthquake Hazards Reduction Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    This Assessment was conducted to improve the National Earthquake Hazards Reduction Program (NEHRP) by providing NEHRP agencies with information that supports their user-oriented setting of crosscutting priorities in the NEHRP strategic planning process. The primary objective of this Assessment was to take a ``snapshot`` evaluation of the needs of selected users throughout the major program elements of NEHRP. Secondary objectives were to conduct an assessment of the knowledge that exists (or is being developed by NEHRP) to support earthquake risk reduction, and to begin a process of evaluating how NEHRP is meeting user needs. An identification of NEHRP`s strengths also resulted from the effort, since those strengths demonstrate successful methods that may be useful to NEHRP in the future. These strengths are identified in the text, and many of them represent important achievements since the Earthquake Hazards Reduction Act was passed in 1977.

  11. Reduction of Perceived Social Distance as an Explanation for Media's Influence on Personal Risk Perceptions: A Test of the Risk Convergence Model

    Science.gov (United States)

    So, Jiyeon; Nabi, Robin

    2013-01-01

    The risk convergence model proposes reduction of perceived social distance to a mediated personality as a mechanism through which the mass media can influence audiences' personal risk perceptions. As an initial test of the model, this study examined whether 5 audience variables known to facilitate media effects on personal risk…

  12. Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico

    Science.gov (United States)

    Galárraga, Omar; Sosa-Rubí, Sandra G.; Infante, César; Gertler, Paul J.; Bertozzi, Stefano M.

    2014-01-01

    The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9% for the monthly model, and 80.4% for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and it was 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$288 per person per year, but it was lower for MSW: USD$156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM & MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average willingness-to-accept estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model for targeted HIV/STI prevention. PMID:23377757

  13. Pathogen reduction requirements for direct potable reuse in Antarctica: evaluating human health risks in small communities.

    Science.gov (United States)

    Barker, S Fiona; Packer, Michael; Scales, Peter J; Gray, Stephen; Snape, Ian; Hamilton, Andrew J

    2013-09-01

    Small, remote communities often have limited access to energy and water. Direct potable reuse of treated wastewater has recently gained attention as a potential solution for water-stressed regions, but requires further evaluation specific to small communities. The required pathogen reduction needed for safe implementation of direct potable reuse of treated sewage is an important consideration but these are typically quantified for larger communities and cities. A quantitative microbial risk assessment (QMRA) was conducted, using norovirus, giardia and Campylobacter as reference pathogens, to determine the level of treatment required to meet the tolerable annual disease burden of 10(-6) DALYs per person per year, using Davis Station in Antarctica as an example of a small remote community. Two scenarios were compared: published municipal sewage pathogen loads and estimated pathogen loads during a gastroenteritis outbreak. For the municipal sewage scenario, estimated required log10 reductions were 6.9, 8.0 and 7.4 for norovirus, giardia and Campylobacter respectively, while for the outbreak scenario the values were 12.1, 10.4 and 12.3 (95th percentiles). Pathogen concentrations are higher under outbreak conditions as a function of the relatively greater degree of contact between community members in a small population, compared with interactions in a large city, resulting in a higher proportion of the population being at risk of infection and illness. While the estimates of outbreak conditions may overestimate sewage concentration to some degree, the results suggest that additional treatment barriers would be required to achieve regulatory compliance for safe drinking water in small communities. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Centrality as a Method for the Evaluation of Semantic Resources for Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    Otakar Čerba

    2017-08-01

    Full Text Available Clear and straightforward communication is a key aspect of all human activities related to crisis management. Since crisis management activities involve professionals from various disciplines using different terminology, clear and straightforward communication is difficult to achieve. Semantics as a broad science can help to overcome communication difficulties. This research focuses on the evaluation of available semantic resources including ontologies, thesauri, and controlled vocabularies for disaster risk reduction as part of crisis management. The main idea of the study is that the most appropriate source of broadly understandable terminology is such a semantic resource, which is accepted by—or at least connected to the majority of other resources. Important is not only the number of interconnected resources, but also the concrete position of the resource in the complex network of Linked Data resources. Although this is usually done by user experience, objective methods of resource semantic centrality can be applied. This can be described by centrality methods used mainly in graph theory. This article describes the calculation of four types of centrality methods (Outdegree, Indegree, Closeness, and Betweenness applied to 160 geographic concepts published as Linked Data and related to disaster risk reduction. Centralities were calculated for graph structures containing particular semantic resources as nodes and identity links as edges. The results show that (with some discussed exceptions the datasets with high values of centrality serve as important information resources, but they also include more concepts from preselected 160 geographic concepts. Therefore, they could be considered as the most suitable resources of terminology to make communication in the domain easier. The main research goal is to automate the semantic resources evaluation and to apply a well-known theoretical method (centrality to the semantic issues of Linked Data. It

  15. Pronurturance Plus at birth: A risk reduction strategy for preventing postpartum haemorrhage.

    Science.gov (United States)

    Saxton, A; Fahy, K; Hastie, C

    2016-06-01

    Postpartum haemorrhage (PPH) rates continue to rise in the developed world. A recent study found that any skin-to-skin contact and breastfeeding within 30min of birth was associated with an almost 50% reduction in PPH rates. Improved oxytocin release is the biological reason proposed to explain this. The combination of skin-to-skin contact and breastfeeding within 30min of birth is termed 'Pronurturance'. Midwifery theory and research claims that optimal third stage care is more holistic than simple Pronurturnace which suggests that further reductions in PPH rates may be possible. What can midwives and women do to minimise blood loss in the third and fourth stages of labour? We present a new theory that describes and explains how to optimise the woman's reproductive psychophysiology in the third and fourth stages of labour to ensure a well contracted uterus which inhibits excessive bleeding regardless of risk status or whether active management was used. In developing the Pronurturance Plus theory we expand upon what is already known about oxytocin in relation to simple pronurturance to integrate concepts from birth territory theory, cognitive neuroscience, mindfulness psychology and the autonomic nervous system to develop an holistic understanding of how to optimise care and minimise PPH. Pronurturance Plus is a psycho-biologically grounded theory which is consistent with existing evidence. It is free, natural and socially desirable. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. Effects of three types of physical activity on reduction of metabolic parameters involved in cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Petrović-Oggiano Gordana

    2009-01-01

    Full Text Available The aim of present study was to investigate the effects of three different types of physical activity on reduction of the metabolic parameters mainly responsible for cardiovascular diseases. This prospective-intervention study was performed at the 'ČIGOTA' Thyroid Institute on Mt. Zlatibor (Serbia between August 2004 and June 2006. Sixty-eight overweight/obese patients aged 40-70 years with hyperlipidemia were divided into three groups according to their weight and overall health. The program of physical workout included: group I - fast walking; group II - gymnastic exercises and specially chosen exercises in the swimming pool; and group III - combined physical training of higher intensity and greater length. All patients were also on a special reduced diet of 1000 kcal per day, the AHA step-2 diet. We monitored the body mass index, body composition, glucose, cholesterol (total, LDL-, and HDL-, and triglycerides before, during, and after the intervention. After 2 and particularly 12 weeks of intervention, a significant improvement of all metabolic parameters was achieved in all three groups of patients. Although most patients completed the study with normal values of all parameters, the most desirable results were achieved in group III (combined exercises with an average energy expenditure of 900 kcal per day. Our research indicates that a specially conceived program of physical activity and diet intervention resulted in significant reduction of cardiovascular risk factors.

  17. Can I Count on Getting Better? Association between Math Anxiety and Poorer Understanding of Medical Risk Reductions.

    Science.gov (United States)

    Rolison, Jonathan J; Morsanyi, Kinga; O'Connor, Patrick A

    2016-10-01

    Lower numerical ability is associated with poorer understanding of health statistics, such as risk reductions of medical treatment. For many people, despite good numeracy skills, math provokes anxiety that impedes an ability to evaluate numerical information. Math-anxious individuals also report less confidence in their ability to perform math tasks. We hypothesized that, independent of objective numeracy, math anxiety would be associated with poorer responding and lower confidence when calculating risk reductions of medical treatments. Objective numeracy was assessed using an 11-item objective numeracy scale. A 13-item self-report scale was used to assess math anxiety. In experiment 1, participants were asked to interpret the baseline risk of disease and risk reductions associated with treatment options. Participants in experiment 2 were additionally provided a graphical display designed to facilitate the processing of math information and alleviate effects of math anxiety. Confidence ratings were provided on a 7-point scale. Individuals of higher objective numeracy were more likely to respond correctly to baseline risks and risk reductions associated with treatment options and were more confident in their interpretations. Individuals who scored high in math anxiety were instead less likely to correctly interpret the baseline risks and risk reductions and were less confident in their risk calculations as well as in their assessments of the effectiveness of treatment options. Math anxiety predicted confidence levels but not correct responding when controlling for objective numeracy. The graphical display was most effective in increasing confidence among math-anxious individuals. The findings suggest that math anxiety is associated with poorer medical risk interpretation but is more strongly related to confidence in interpretations. © The Author(s) 2015.

  18. Investing in finite-life carbon emissions reduction program under risk and idiosyncratic uncertainty

    International Nuclear Information System (INIS)

    Fouilloux, Jessica; Moraux, Franck; Viviani, Jean-Laurent

    2015-01-01

    This paper aims at emphasizing the ability of new frameworks of real option model to highlight key characteristics of industrial Carbon Emissions Reduction Program investment decision. We develop both theoretical arguments and numerical simulations with structural parameters calibrated on real-life data. We find that both radical uncertainty and risk lead to speed-up green investments, compared to the predictions of real option models that are normally used in green investment literature. The conventional “wait and see” attitude, questioned in recent developments of the real option theory, is not validated. In conclusion, our results should foster companies to implement green investments and help governments to define appropriate incentives to encourage green investments. Of particular note, the paper highlights that finance theory is not necessarily an obstacle to green investment decisions. -- Highlights: •We use real option model to identify key features of CERP investment decision. •We determine the optimal carbon price threshold to undertake a CERP. •Investment decision is a non-monotonic function of idiosyncratic uncertainty. •Increasing uncertainty until a moderate level can accelerate investment decision. •Decreasing idiosyncratic risk can accelerate investment decision

  19. Disaster risk reduction in the Omusati and Oshana regions of Namibia

    Directory of Open Access Journals (Sweden)

    Elina Amadhila

    2013-08-01

    Full Text Available Namibia often experiences heavy rains in the north and north-eastern parts of the country, which results in severe flooding. For this reason, the country has endorsed the Hyogo Framework for Action (HFA which seeks to develop the resilience of nations and communities to disasters and to assist countries to move away from the approach of emergency response to one of integrated disaster risk reduction. The aim of this article is to assess the resilience of the communities within the identified regions. A quantitative questionnaire was designed to assess people at risk of disaster related impacts. The questionnaire used 20 indicators to measure the level of progress at local level and how local governance plays a role in the mitigation and management of disasters. Analysis of data was done on a limited number of descriptors such as age, gender and local governance involvement, amongst others. There was generally a very high perception of threat (38% in the study regions. Women perceived threat more accurately (mean = 4.09 than men. The community perceived threat more accurately than local government and civil society (mean = 4.08.

  20. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Benjamin Ansa

    2015-12-01

    Full Text Available A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs. Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%, lack of physical activity (48.7%, and a high fat diet (63.2% are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5% agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9% believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M2 (p = 0.06; nearly all of the women (99.2% answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05. These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.

  1. Regulatory Risk Reduction for Advanced Reactor Technologies - FY2016 Status and Work Plan Summary

    International Nuclear Information System (INIS)

    Moe, Wayne Leland

    2016-01-01

    Millions of public and private sector dollars have been invested over recent decades to realize greater efficiency, reliability, and the inherent and passive safety offered by advanced nuclear reactor technologies. However, a major challenge in experiencing those benefits resides in the existing U.S. regulatory framework. This framework governs all commercial nuclear plant construction, operations, and safety issues and is highly large light water reactor (LWR) technology centric. The framework must be modernized to effectively deal with non-LWR advanced designs if those designs are to become part of the U.S energy supply. The U.S. Department of Energy's (DOE) Advanced Reactor Technologies (ART) Regulatory Risk Reduction (RRR) initiative, managed by the Regulatory Affairs Department at the Idaho National Laboratory (INL), is establishing a capability that can systematically retire extraneous licensing risks associated with regulatory framework incompatibilities. This capability proposes to rely heavily on the perspectives of the affected regulated community (i.e., commercial advanced reactor designers/vendors and prospective owner/operators) yet remain tuned to assuring public safety and acceptability by regulators responsible for license issuance. The extent to which broad industry perspectives are being incorporated into the proposed framework makes this initiative unique and of potential benefit to all future domestic non-LWR applicants

  2. Regulatory Risk Reduction for Advanced Reactor Technologies – FY2016 Status and Work Plan Summary

    Energy Technology Data Exchange (ETDEWEB)

    Moe, Wayne Leland [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-08-01

    Millions of public and private sector dollars have been invested over recent decades to realize greater efficiency, reliability, and the inherent and passive safety offered by advanced nuclear reactor technologies. However, a major challenge in experiencing those benefits resides in the existing U.S. regulatory framework. This framework governs all commercial nuclear plant construction, operations, and safety issues and is highly large light water reactor (LWR) technology centric. The framework must be modernized to effectively deal with non-LWR advanced designs if those designs are to become part of the U.S energy supply. The U.S. Department of Energy’s (DOE) Advanced Reactor Technologies (ART) Regulatory Risk Reduction (RRR) initiative, managed by the Regulatory Affairs Department at the Idaho National Laboratory (INL), is establishing a capability that can systematically retire extraneous licensing risks associated with regulatory framework incompatibilities. This capability proposes to rely heavily on the perspectives of the affected regulated community (i.e., commercial advanced reactor designers/vendors and prospective owner/operators) yet remain tuned to assuring public safety and acceptability by regulators responsible for license issuance. The extent to which broad industry perspectives are being incorporated into the proposed framework makes this initiative unique and of potential benefit to all future domestic non-LWR applicants

  3. Gender identity, healthcare access, and risk reduction among Malaysia’s mak nyah community

    Science.gov (United States)

    Gibson, Britton A.; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Altice, Frederick L.

    2016-01-01

    Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalize them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilization patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally-sensitive prevention and healthcare services for TGW. PMID:26824463

  4. Gender identity, healthcare access, and risk reduction among Malaysia's mak nyah community.

    Science.gov (United States)

    Gibson, Britton A; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A; Kamarulzaman, Adeeba; Altice, Frederick L

    2016-01-01

    Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalise them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilisation patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally sensitive prevention and healthcare services for TGW.

  5. An Overview of Propulsion Concept Studies and Risk Reduction Activities for Robotic Lunar Landers

    Science.gov (United States)

    Trinh, Huu P.; Story, George; Burnside, Chris; Kudlach, Al

    2010-01-01

    In support of designing robotic lunar lander concepts, the propulsion team at NASA Marshall Space Flight Center (MSFC) and the Johns Hopkins University Applied Physics Laboratory (APL), with participation from industry, conducted a series of trade studies on propulsion concepts with an emphasis on light-weight, advanced technology components. The results suggest a high-pressure propulsion system may offer some benefits in weight savings and system packaging. As part of the propulsion system, a solid rocket motor was selected to provide a large impulse to reduce the spacecraft s velocity prior to the lunar descent. In parallel to this study effort, the team also began technology risk reduction testing on a high thrust-to-weight descent thruster and a high-pressure regulator. A series of hot-fire tests was completed on the descent thruster in vacuum conditions at NASA White Sands Test Facility (WSTF) in New Mexico in 2009. Preparations for a hot-fire test series on the attitude control thruster at WSTF and for pressure regulator testing are now underway. This paper will provide an overview of the concept trade study results along with insight into the risk mitigation activities conducted to date.

  6. A human immunodeficiency virus risk reduction intervention for incarcerated youth: a randomized controlled trial.

    Science.gov (United States)

    Goldberg, Eudice; Millson, Peggy; Rivers, Stephen; Manning, Stephanie Jeanneret; Leslie, Karen; Read, Stanley; Shipley, Caitlin; Victor, J Charles

    2009-02-01

    To evaluate, by gender, the impact of a structured, comprehensive risk reduction intervention with and without boosters on human immunodeficiency virus (HIV) knowledge, attitudes and behaviors in incarcerated youth; and to determine predictors of increasing HIV knowledge and reducing high-risk attitudes and behaviors. This randomized controlled trial involved participants completing structured interviews at 1, 3, and 6 months. Repeated measures analysis of variance was used to analyze changes over time. The study was conducted in secure custody facilities and in the community. The study sample comprising 391 incarcerated youth, 102 female and 289 male aged 12-18, formed the voluntary sample. Participants were randomly assigned to one of three conditions: education intervention; education intervention with booster; or no systematic intervention. The outcome and predictor measures included the Rosenberg Self-Esteem Scale, Youth Self Report, Drug Use Inventory, and HIV Knowledge, Attitudes and Behavior Scale. The 6-month retention rate was 59.6%. At 6 months, males in the education and booster groups sustained increases in knowledge scores (p variations by gender underline the importance of gender issues in prevention interventions. Predictors of success were identified to inform future HIV education interventions.

  7. An obesity/cardiometabolic risk reduction disease management program: a population-based approach.

    Science.gov (United States)

    Villagra, Victor G

    2009-04-01

    Obesity is a critical health concern that has captured the attention of public and private healthcare payers who are interested in controlling costs and mitigating the long-term economic consequences of the obesity epidemic. Population-based approaches to obesity management have been proposed that take advantage of a chronic care model (CCM), including patient self-care, the use of community-based resources, and the realization of care continuity through ongoing communications with patients, information technology, and public policy changes. Payer-sponsored disease management programs represent an important conduit to delivering population-based care founded on similar CCM concepts. Disease management is founded on population-based disease identification, evidence-based care protocols, and collaborative practices between clinicians. While substantial clinician training, technology infrastructure commitments, and financial support at the payer level will be needed for the success of disease management programs in obesity and cardiometabolic risk reduction, these barriers can be overcome with the proper commitment. Disease management programs represent an important tool to combat the growing societal risks of overweight and obesity.

  8. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

    Science.gov (United States)

    Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

    2015-06-16

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

  9. A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.

    Science.gov (United States)

    Sheridan, Stacey L; Pignone, Michael P; Lewis, Carmen L

    2003-11-01

    Commentators have suggested that patients may understand quantitative information about treatment benefits better when they are presented as numbers needed to treat (NNT) rather than as absolute or relative risk reductions. To determine whether NNT helps patients interpret treatment benefits better than absolute risk reduction (ARR), relative risk reduction (RRR), or a combination of all three of these risk reduction presentations (COMBO). Randomized cross-sectional survey. University internal medicine clinic. Three hundred fifty-seven men and women, ages 50 to 80, who presented for health care. Subjects were given written information about the baseline risk of a hypothetical "disease Y" and were asked (1) to compare the benefits of two drug treatments for disease Y, stating which provided more benefit; and (2) to calculate the effect of one of those drug treatments on a given baseline risk of disease. Risk information was presented to each subject in one of four randomly allocated risk formats: NNT, ARR, RRR, or COMBO. When asked to state which of two treatments provided more benefit, subjects who received the RRR format responded correctly most often (60% correct vs 43% for COMBO, 42% for ARR, and 30% for NNT, P =.001). Most subjects were unable to calculate the effect of drug treatment on the given baseline risk of disease, although subjects receiving the RRR and ARR formats responded correctly more often (21% and 17% compared to 7% for COMBO and 6% for NNT, P =.004). Patients are best able to interpret the benefits of treatment when they are presented in an RRR format with a given baseline risk of disease. ARR also is easily interpreted. NNT is often misinterpreted by patients and should not be used alone to communicate risk to patients.

  10. Preferences for breast cancer risk reduction among BRCA1/BRCA2 mutation carriers: a discrete-choice experiment.

    Science.gov (United States)

    Liede, Alexander; Mansfield, Carol A; Metcalfe, Kelly A; Price, Melanie A; Snyder, Carrie; Lynch, Henry T; Friedman, Sue; Amelio, Justyna; Posner, Joshua; Narod, Steven A; Lindeman, Geoffrey J; Evans, D Gareth

    2017-09-01

    Unaffected women who carry BRCA1 or BRCA2 mutations face difficult choices about reducing their breast cancer risk. Understanding their treatment preferences could help us improve patient counseling and inform drug trials. The objective was to explore preferences for various risk-reducing options among women with germline BRCA1/2 mutations using a discrete-choice experiment survey and to compare expressed preferences with actual behaviors. A discrete-choice experiment survey was designed wherein women choose between hypothetical treatments to reduce breast cancer risk. The hypothetical treatments were characterized by the extent of breast cancer risk reduction, treatment duration, impact on fertility, hormone levels, risk of uterine cancer, and ease and mode of administration. Data were analyzed using a random-parameters logit model. Women were also asked to express their preference between surgical and chemoprevention options and to report on their actual risk-reduction actions. Women aged 25-55 years with germline BRCA1/2 mutations who were unaffected with breast or ovarian cancer were recruited through research registries at five clinics and a patient advocacy group. Between January 2015 and March 2016, 622 women completed the survey. Breast cancer risk reduction was the most important consideration expressed, followed by maintaining fertility. Among the subset of women who wished to have children in future, the ability to maintain fertility was the most important factor, followed by the extent of risk reduction. Many more women said they would take a chemoprevention drug than had actually taken chemoprevention. Women with BRCA1/2 mutations indicated strong preferences for breast cancer risk reduction and maintaining fertility. The expressed desire to have a safe chemoprevention drug available to them was not met by current chemoprevention options.

  11. A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Type 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, particularly given its cultural familiarity. Methods This was a parallel, randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes. Primary outcomes included: changes in BMI, waist circumference, fasting blood glucose, postprandial blood glucose, insulin, insulin resistance, blood pressure, and cholesterol. We also looked at measures of psychological well-being including changes in depression, anxiety, positive and negative affect and perceived stress. Forty-one participants with elevated fasting blood glucose in Bangalore, India were randomized to either yoga (n = 21) or a walking control (n = 20). Participants were asked to either attend yoga classes or complete monitored walking 3–6 days per week for eight weeks. Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed, opaque envelopes generated by off-site study staff. Data were analyzed based on intention to treat. Results This study was feasible in terms of recruitment, retention and adherence. In addition, yoga participants had significantly greater reductions in weight, waist circumference and BMI versus control (weight −0.8 ± 2.1 vs. 1.4 ± 3.6, p = 0.02; waist circumference −4.2 ± 4.8 vs. 0.7 ± 4.2, p yoga intervention and walking control over the course of the study. Conclusion Among Indians with elevated fasting blood glucose, we found that participation in an 8-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control. Yoga offers a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and potentially increasing

  12. What are the most effective risk-reduction strategies in sport concussion?

    Science.gov (United States)

    Benson, Brian W; McIntosh, Andrew S; Maddocks, David; Herring, Stanley A; Raftery, Martin; Dvorák, Jirí

    2013-04-01

    To critically review the evidence to determine the efficacy and effectiveness of protective equipment, rule changes, neck strength and legislation in reducing sport concussion risk. Electronic databases, grey literature and bibliographies were used to search the evidence using Medical Subject Headings and text words. Inclusion/exclusion criteria were used to select articles for the clinical equipment studies. The quality of evidence was assessed using epidemiological criteria regarding internal/external validity (eg, strength of design, sample size/power, bias and confounding). No new valid, conclusive evidence was provided to suggest the use of headgear in rugby, or mouth guards in American football, significantly reduced players' risk of concussion. No evidence was provided to suggest an association between neck strength increases and concussion risk reduction. There was evidence in ice hockey to suggest fair-play rules and eliminating body checking among 11-years-olds to 12-years-olds were effective injury prevention strategies. Evidence is lacking on the effects of legislation on concussion prevention. Equipment self-selection bias was a common limitation, as was the lack of measurement and control for potential confounding variables. Lastly, helmets need to be able to protect from impacts resulting in a head change in velocities of up to 10 and 7 m/s in professional American and Australian football, respectively, as well as reduce head resultant linear and angular acceleration to below 50 g and 1500 rad/s(2), respectively, to optimise their effectiveness. A multifactorial approach is needed for concussion prevention. Future well-designed and sport-specific prospective analytical studies of sufficient power are warranted.

  13. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

    Directory of Open Access Journals (Sweden)

    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  14. Ecohydrology of agroecosystems: probabilistic description of yield reduction risk under limited water availability

    Science.gov (United States)

    Vico, Giulia; Porporato, Amilcare

    2013-04-01

    Supplemental irrigation represents one of the main strategies to mitigate the effects of climate variability and stabilize yields. Irrigated agriculture currently provides 40% of food production and its relevance is expected to further increase in the near future, in face of the projected alterations of rainfall patterns and increase in food, fiber, and biofuel demand. Because of the significant investments and water requirements involved in irrigation, strategic choices are needed to preserve productivity and profitability, while maintaining a sustainable water management - a nontrivial task given the unpredictability of the rainfall forcing. To facilitate decision making under uncertainty, a widely applicable probabilistic framework is proposed. The occurrence of rainfall events and irrigation applications are linked probabilistically to crop development during the growing season and yields at harvest. Based on these linkages, the probability density function of yields and corresponding probability density function of required irrigation volumes, as well as the probability density function of yields under the most common case of limited water availability are obtained analytically, as a function of irrigation strategy, climate, soil and crop parameters. The full probabilistic description of the frequency of occurrence of yields and water requirements is a crucial tool for decision making under uncertainty, e.g., via expected utility analysis. Furthermore, the knowledge of the probability density function of yield allows us to quantify the yield reduction hydrologic risk. Two risk indices are defined and quantified: the long-term risk index, suitable for long-term irrigation strategy assessment and investment planning, and the real-time risk index, providing a rigorous probabilistic quantification of the emergence of drought conditions during a single growing season in an agricultural setting. Our approach employs relatively few parameters and is thus easily and

  15. Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

    Directory of Open Access Journals (Sweden)

    Sarah Bandali

    2014-01-01

    Full Text Available The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs.

  16. Application of Probabilistic Modeling to Quantify the Reduction Levels of Hepatocellular Carcinoma Risk Attributable to Chronic Aflatoxins Exposure.

    Science.gov (United States)

    Wambui, Joseph M; Karuri, Edward G; Ojiambo, Julia A; Njage, Patrick M K

    2017-01-01

    Epidemiological studies show a definite connection between areas of high aflatoxin content and a high occurrence of human hepatocellular carcinoma (HCC). Hepatitis B virus in individuals further increases the risk of HCC. The two risk factors are prevalent in rural Kenya and continuously predispose the rural populations to HCC. A quantitative cancer risk assessment therefore quantified the levels at which potential pre- and postharvest interventions reduce the HCC risk attributable to consumption of contaminated maize and groundnuts. The assessment applied a probabilistic model to derive probability distributions of HCC cases and percentage reductions levels of the risk from secondary data. Contaminated maize and groundnuts contributed to 1,847 ± 514 and 158 ± 52 HCC cases per annum, respectively. The total contribution of both foods to the risk was additive as it resulted in 2,000 ± 518 cases per annum. Consumption and contamination levels contributed significantly to the risk whereby lower age groups were most affected. Nonetheless, pre- and postharvest interventions might reduce the risk by 23.0-83.4% and 4.8-95.1%, respectively. Therefore, chronic exposure to aflatoxins increases the HCC risk in rural Kenya, but a significant reduction of the risk can be achieved by applying specific pre- and postharvest interventions.

  17. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio.

    Science.gov (United States)

    Spencer, Timothy R; Mahoney, Keegan J

    2017-11-01

    In vascular access practices, the internal vessel size is considered important, and a catheter to vessel ratio (CVR) is recommended to assist clinicians in selecting the most appropriate-sized device for the vessel. In 2016, new practice recommendations stated that the CVR can increase from 33 to 45% of the vessels diameter. There has been evidence on larger diameter catheters and increased thrombosis risk in recent literature, while insufficient information established on what relationship to vessel size is appropriate for any intra-vascular device. Earlier references to clinical standards and guidelines did not clearly address vessel size in relation to the area consumed or external catheter diameter. The aim of this manuscript is to present catheter-related thrombosis evidence and develop a standardized process of ultrasound-guided vessel assessment, integrating CVR, Virchow's triad phenomenon and vessel health and preservation strategies, empowering an evidence-based approach to device placement. Through review, calculation and assessment on the areas of the 33 and 45% rule, a preliminary clinical tool was developed to assist clinicians make cognizant decisions when placing intravascular devices relating to target vessel size, focusing on potential reduction in catheter-related thrombosis. Increasing the understanding and utilization of CVRs will lead to a safer, more consistent approach to device placement, with potential thrombosis reduction strategies. The future of evidence-based data relies on the clinician to capture accurate vessel measurements and device-related outcomes. This will lead to a more dependable data pool, driving the relationship of catheter-related thrombosis and vascular assessment.

  18. Nutritional approaches in the risk reduction and management of Alzheimer's disease.

    Science.gov (United States)

    Mi, Weiqian; van Wijk, Nick; Cansev, Mehmet; Sijben, John W C; Kamphuis, Patrick J G H

    2013-09-01

    Alzheimer's disease (AD) is a heterogeneous and devastating neurodegenerative disease with increasing socioeconomic burden for society. In the past 30 y, notwithstanding advances in the understanding of the pathogenesis of the disease and consequent development of therapeutic approaches to novel pathogenic targets, no cure has so far emerged. This contribution focuses on recent nutritional approaches in the risk reduction and management of AD with emphasis on factors providing a rationale for nutritional approaches in AD, including compromised nutritional status, altered nutrient uptake and metabolism, and nutrient requirements for synapse formation. Collectively these factors are believed to result in specific nutritional requirement in AD. The chapter also emphasizes investigated nutritional interventions in patients with AD, including studies with single nutrients and with the specific nutrient combination Fortasyn Connect and discusses the current shift of paradigm to intervene in earlier stages of AD, which offers opportunities for investigating nutritional strategies to reduce the risk for disease progression. Fortasyn Connect was designed to enhance synapse formation and function in AD by addressing the putative specific nutritional requirements and contains docosahexaenoic acid, eicosapentaenoic acid, uridine-5'-mono-phosphate, choline, phospholipids, antioxidants, and B vitamins. Two randomized controlled trials (RCTs) with the medical food Souvenaid, containing Fortasyn Connect, showed that this intervention improved memory performance in mild, drug-naïve patients with AD. Electroencephalography outcome in one of these clinical studies suggests that Souvenaid has an effect on brain functional connectivity, which is a derivative of changed synaptic activity. Thus, these studies suggest that nutritional requirements in AD can be successfully addressed and result in improvements in behavioral and neuro-physiological alterations that are characteristic to AD

  19. Cost and risk reduction using upfront licensing in Canada. Annex 15

    International Nuclear Information System (INIS)

    Snell, V.G.

    2002-01-01

    The paper summarizes the use of 'up-front' licensing in Canada - how licensing requirements are defined, and met - in advance of a project commitment. The approach to licensing in Canada has allowed flexibility in development of new designs. Since licensing was originally risk-based, and current regulatory policy allows cost-benefit considerations as part of the decision making, risk can be and should be used in novel circumstances as a licensing tool. Since the licensing framework is non-prescriptive, innovative approaches to design can be introduced and dispositioned without changing the legal structure. This flexibility has been used in several up-front licensing reviews: a small urban heating reactor, repeat CANDU 6 generating station units, and the single unit CANDU 9 generating station. In the future we expect to apply it to advanced designs, as an essential part of risk reduction and customer confidence in the product. The important lessons learned in Canada include: Up-front licensing is essential to reduce the risk of licensing-related delays once a project has been committed. It requires a significant investment in time and effort from both the designer and the regulator; The most effective scope for up-front licensing is for the regulator to thoroughly assess novel concepts, test the design against changed domestic requirements, and follow-up on known difficult areas; and for the designer to ensure foreign requirements are incorporated. There is little benefit in certifying the design in detail; Although it would be satisfying to have legally-binding certification, in the end there can be no legal obligation on the regulator, and agreement is pursued on the basis of good faith that the regulator will not make arbitrary decisions and that the designer will meet agreed targets or requirements; In almost all circumstances, issues will arise that are beyond the current 'rules', however expressed. Rather than rushing to create new rules, one reaches a

  20. 2nd Generation RLV Risk Definition Program

    Science.gov (United States)

    Davis, Robert M.; Stucker, Mark (Technical Monitor)

    2000-01-01

    The 2nd Generation RLV Risk Reduction Mid-Term Report summarizes the status of Kelly Space & Technology's activities during the first two and one half months of the program. This report was presented to the cognoscente Contracting Officer's Technical Representative (COTR) and selected Marshall Space Flight Center staff members on 26 September 2000. The report has been approved and is distributed on CD-ROM (as a PowerPoint file) in accordance with the terms of the subject contract, and contains information and data addressing the following: (1) Launch services demand and requirements; (2) Architecture, alternatives, and requirements; (3) Costs, pricing, and business cases analysis; (4) Commercial financing requirements, plans, and strategy; (5) System engineering processes and derived requirements; and (6) RLV system trade studies and design analysis.

  1. Geology for Global Development: Mobilising and equipping young geologists to engage in disaster risk reduction

    Science.gov (United States)

    Gill, Joel

    2016-04-01

    Geology for Global Development (GfGD) is a not-for-profit organisation working to mobilise and equip geologists to engage in all aspects of sustainable development, including disaster risk reduction (DRR). Geologists have a crucial role to play in DRR, and the recently agreed Sendai Framework for DRR 2015-2030. This framework aims to significantly reduce loss of lives and livelihoods due to disasters. The geology community have an understanding of the Earth, its physical structure, and the processes by which it is constantly being shaped which are of particular relevance to Priorities for Action 1 and 4 noted within the Sendai Framework. Effective engagement by geologists, however, requires many skills beyond the standard geology curriculum. Cultural understanding, cross-disciplinary communication, diplomacy, community mobilization and participation, knowledge exchange, and an understanding of social science research tools are commonly necessary for effective research and engagement in the science-policy-practice interface. Topical and disciplinary knowledge, such as understanding social vulnerability, international policy frameworks and development theory are also rarely included in the education and professional training of a young geologist. Through the work of GfGD, we are training young geologists with these skills and the supporting knowledge required to make an effective contribution to reducing disaster risk, support civil society, empower communities and help to strengthen resilience. University chapters have been established in 14 major UK and Irish universities, coordinating extra-curricular seminars, workshops and discussion activities. Our work is currently focused on supporting young geologists, but we are increasingly a respected voice at international geoscience forums that gather a wide range of students and professionals. Wider (national and international) activities include conferences, placements and facilitating youth engagement in education

  2. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  3. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  4. The potential of crowdsourcing and mobile technology to support flood disaster risk reduction

    Science.gov (United States)

    See, Linda; McCallum, Ian; Liu, Wei; Mechler, Reinhard; Keating, Adriana; Hochrainer-Stigler, Stefan; Mochizuki, Junko; Fritz, Steffen; Dugar, Sumit; Arestegui, Michael; Szoenyi, Michael; Laso-Bayas, Juan-Carlos; Burek, Peter; French, Adam; Moorthy, Inian

    2016-04-01

    The last decade has seen a rise in citizen science and crowdsourcing for carrying out a variety of tasks across a number of different fields, most notably the collection of data such as the identification of species (e.g. eBird and iNaturalist) and the classification of images (e.g. Galaxy Zoo and Geo-Wiki). Combining human computing with the proliferation of mobile technology has resulted in vast amounts of geo-located data that have considerable value across multiple domains including flood disaster risk reduction. Crowdsourcing technologies, in the form of online mapping, are now being utilized to great effect in post-disaster mapping and relief efforts, e.g. the activities of Humanitarian OpenStreetMap, complementing official channels of relief (e.g. Haiti, Nepal and New York). Disaster event monitoring efforts have been further complemented with the use of social media (e.g. twitter for earthquakes, flood monitoring, and fire detection). Much of the activity in this area has focused on ex-post emergency management while there is considerable potential for utilizing crowdsourcing and mobile technology for vulnerability assessment, early warning and to bolster resilience to flood events. This paper examines the use of crowdsourcing and mobile technology for measuring and monitoring flood hazards, exposure to floods, and vulnerability, drawing upon examples from the literature and ongoing projects on flooding and food security at IIASA.

  5. Synergies across the natural resources management fields in Southern Africa: Disaster Risk Reduction and One Health

    Directory of Open Access Journals (Sweden)

    Clara Bocchino

    2013-02-01

    Full Text Available For various reasons, Southern Africa may be considered the playground as well as the thinking tank for many theories and practices in the natural resources management field. History has contributed to reshape conservation practices through colonial times, and recent wars have led to the relocation of people from their homelands and the appropriation by people of previously protected areas due to socio-economic pressures. Contemporary practices stemming from sustainable development have not yielded the expected results in resolving critical socio-economic stresses that impact on environmental health. Furthermore, human health has deteriorated in remote rural areas due to the failures of governance systems and the perpetration of non-participatory models for natural resources management, especially conservation. This paper seeks to explore how two relatively new approaches, Disaster Risk Reduction and One Health, can together tap into the theoretical and practical gaps left by previous paradigms in order to instill a sustainable development approach that can benefit both people and natural resources in remote and poor rural areas.

  6. Can Resilience Thinking Inform Resilience Investments? Learning from Resilience Principles for Disaster Risk Reduction

    Directory of Open Access Journals (Sweden)

    Margot Hill Clarvis

    2015-07-01

    Full Text Available As the human and financial costs of natural disasters rise and state finances continue to deplete, increasing attention is being placed on the role of the private sector to support disaster and climate resilience. However, not only is there a recognised lack of private finance to fill this gap, but international institutional and financing bodies tend to prioritise specific reactive response over preparedness and general resilience building. This paper utilises the central tenets of resilience thinking that have emerged from scholarship on social-ecological system resilience as a lens through which to assess investing in disaster risk reduction (DRR for resilience. It draws on an established framework of resilience principles and examples of resilience investments to explore how resilience principles can actually inform decisions around DRR and resilience investing. It proposes some key lessons for diversifying sources of finance in order to, in turn, enhance “financial resilience”. In doing so, it suggests a series of questions to align investments with resilience building, and to better balance the achievement of the resilience principles with financial requirements such as financial diversification and replicability. It argues for a critical look to be taken at how resilience principles, which focus on longer-term systems perspectives, could complement the focus in DRR on critical and immediate stresses.

  7. Modeling Fuel Treatment Leverage: Encounter Rates, Risk Reduction, and Suppression Cost Impacts

    Directory of Open Access Journals (Sweden)

    Matthew P. Thompson

    2017-11-01

    Full Text Available The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the frequency and magnitude of fire-treatment encounters, which are critical determinants of treatment efficacy. Additionally, we examined avoided area burned, avoided suppression costs, and avoided damages, and combined all three under the umbrella of leverage to explore multiple dimensions with which to characterize return on investment. We chose the Sierra National Forest, California, USA, as our study site, due to previous work providing relevant data and analytical products, and because it has the potential for large, long-duration fires and corresponding potential for high suppression expenditures. Modeling results generally confirmed that fire-treatment encounters are rare, such that median suppression cost savings are zero, but in extreme years, savings can more than offset upfront investments. Further, reductions in risk can expand areas where moderated suppression response would be appropriate, and these areas can be mapped in relation to fire control opportunities.

  8. Education for Disaster Risk Reduction (DRR: Linking Theory with Practice in Ghana’s Basic Schools

    Directory of Open Access Journals (Sweden)

    Priscilla T. Apronti

    2015-07-01

    Full Text Available Current understanding of disaster risk reduction (DRR concurs that, when provided the right education, children have the potential to reduce their own vulnerability and the vulnerability of others in their community. What, then, comprises the right education for DRR? Research has established the need for disaster education to address the causes and effects, prevention and response, and management and recovery from disaster events. The educational process must include diverse and practical techniques that reinforce disaster knowledge and builds a culture of safety and resilience amongst students. Drawing on syllabus content analysis and field research in two rural communities in semi-arid Northern Ghana, this study explored the presence and nature of DRR within the syllabi of the basic school system. By comparing the result of the content analysis with results from interviews and questionnaires completed by teachers and students, significant gaps were identified between the disaster pedagogy outlined in the syllabi (theory and that which occurs in the classroom (practice. It was realized that while the theory outlines active and innovative techniques for teaching, learning, and evaluating DRR lessons, various challenges hinder the practical application of these techniques in the classroom. The study concludes that a lack of teacher training and professional development, and inadequate teaching and learning materials, generally account for these results. A new and consolidated effort is required from all stakeholders to train teachers and to provide the appropriate learning materials to improve on the current DRR education.

  9. Considering Vulnerability in Disaster Risk Reduction Plans: From Policy to Practice in Ladakh, India

    Directory of Open Access Journals (Sweden)

    Virginie Le Masson

    2015-05-01

    Full Text Available In Ladakh, India, a mountainous region prone to natural hazards, particularly floods, it is critical to adapt disaster risk reduction (DRR measures to the local environment. The floods that struck Ladakh in 2010 created momentum for local authorities and nongovernmental organizations (NGOs to engage in DRR initiatives in order to better prepare people to cope with and recover from emergencies. This paper analyzes the way DRR approaches in Ladakh, from the central government to the district level, take both vulnerability and capacity into account. National and state policies are integrated and reflect the vulnerability concept quite well. However, as the case of Ladakh shows, establishing policies does not guarantee that appropriate practices will follow. Although NGOs' relief efforts in 2010 were praised for building on local communities' context and capacities, most practitioners still view DRR through a hazard-focused lens. Likewise, the policy framework for DRR does not yet address the socioeconomic construction of disasters and is not translated into adequate interventions that build on lessons learned during the 2010 emergency. Development obstacles, such as corruption, may also compromise efforts to translate DRR policies into appropriate and sustainable practices. However, local development projects that enhance the resilience of local mountain communities exist and could be valued as effective DRR. Emphasis should be placed on the practical integration of DRR in sustainable development efforts in order to better tackle disasters.

  10. Physical exercises and risk of fall reduction in elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Diogo Homann

    2010-09-01

    Full Text Available Falls are associated with morbidity and mortality in older adults. The aim of this systematic review was to identify, describe and analyze the effects of physical exercise programs on the reduction of the risk of falls in adults above the age of 60. For this purpose, the Medline/Pubmed, Lilacs, and SciELO databases available at the site of the Latin American Center of Information in Health Sciences (BIREME were searched for articles comprising the period between 1999 and 2009 using the following keywords: accidental falls, elderly, exercise. A total of 385 publications were identified and 10 articles that met the criteria established in this study were selected. Strength and balance activities were the most frequent components of the exercise programs, in addition to coordination, flexibility and aerobic exercise. However, there was no clear information regarding the frequency, duration and intensity of the sessions. It was concluded that programs combining strength and balance components with other interventions, performed at least twice a week, and monitoring the participants for 3 to 6 months after intervention were the most effective in reducing and preventing falls in older adults. However, a more detailed presentation of some methodological aspects is necessary to permit the reproduction of these studies and the comparison of their results.

  11. Rethinking International Counterterrorism Assistance to the Greater Horn of Africa: Toward a Regional Risk Reduction Strategy

    Directory of Open Access Journals (Sweden)

    Matthew Schwartz

    2013-12-01

    Full Text Available The Horn of Africa has long been a recipient of foreign security assistance, with significant funds increasingly devoted to supporting subregional civilian-oriented counterterrorism efforts over the past decade. Despite efforts to better coordinate delivery, counterterrorism programming in the subregion generally remains fragmented, short-term, and siloed in implementation. This article argues that it is time to rethink the international community’s approach to counterterrorism assistance to the Horn of Africa and calls for a cohesive regional approach that not only bridges the gap between security and development, but also the gap between counterterrorism and human security. It emphasizes that the international community must not only better coordinate existing streams of counterterrorism assistance to the region, but also rethink how this assistance is designed and the ways it can be delivered to complement broader subregional development and security agendas. After a brief introduction to international counterterrorism assistance to the Horn of Africa, the article examines linkages across three thematic streams of programming being delivered to the subregion: anti-money laundering and countering the financing of terrorism; criminal justice capacity building assistance to counter terrorism; and, countering violent extremism. This discussion will highlight the need for a regional risk reduction strategy for the Horn of Africa that not only builds on the interplay of different streams of counterterrorism assistance, but on synergies across broader subregional development and security agendas as well.

  12. Vulnerability assessments, identity and spatial scale challenges in disaster-risk reduction

    Directory of Open Access Journals (Sweden)

    Edward R. Carr

    2015-11-01

    Full Text Available Current approaches to vulnerability assessment for disaster-risk reduction (DRR commonly apply generalised, a priori determinants of vulnerability to particular hazards in particular places. Although they may allow for policy-level legibility at high levels of spatial scale, these approaches suffer from attribution problems that become more acute as the level of analysis is localised and the population under investigation experiences greater vulnerability. In this article, we locate the source of this problem in a spatial scale mismatch between the essentialist framings of identity behind these generalised determinants of vulnerability and the intersectional, situational character of identity in the places where DRR interventions are designed and implemented. Using the Livelihoods as Intimate Government (LIG approach to identify and understand different vulnerabilities to flooding in a community in southern Zambia, we empirically demonstrate how essentialist framings of identity produce this mismatch. Further, we illustrate a means of operationalising intersectional, situational framings of identity to achieve greater and more productive understandings of hazard vulnerability than available through the application of general determinants of vulnerability to specific places and cases.

  13. A CONCEPTUAL DISASTER RISK REDUCTION FRAMEWORK FOR HEALTH AND SAFETY HAZARDS IN THE CONSTRUCTION INDUSTRY

    Directory of Open Access Journals (Sweden)

    Amir S. GOHARDANI

    2013-06-01

    Full Text Available The health and safety hazard status of construction workers is constantly challenged by the projects in the built environment. In this article, various aspects of health and safety hazards for construction workers have been reviewed and investigated through a disaster risk reduction prism. This approach has further led to the perception of glancing at the construction sector as an ongoing disaster zone and equally provides a new management perspective. From this perspective, the occurrence of a disaster within the construction sector corresponds to the temporary or permanent ill-health or death of a construction worker. Geographical location is one of the factors that play an important role in addressing the health and safety hazards for construction workers. In addition to the location, geographical considerations equally encapsulate regional, cultural, governmental and work ethical effects. These effects may potentially contribute to disparities in the construction sector. With an increasing level of understanding for health and safety hazards in the construction domain, more efficient prevention measures can be taken in order to enable a disaster management cycle, capable of responding to the rigorous demands of the construction sector.

  14. Natural hazards and risk reduction in Hawai'i: Chapter 10 in Characteristics of Hawaiian volcanoes

    Science.gov (United States)

    Kauahikaua, James P.; Tilling, Robert I.; Poland, Michael P.; Takahashi, T. Jane; Landowski, Claire M.

    2014-01-01

    Significant progress has been made over the past century in understanding, characterizing, and communicating the societal risks posed by volcanic, earthquake, and tsunami hazards in Hawai‘i. The work of the Hawaiian Volcano Observatory (HVO), with a century-long commitment to serving the public with credible hazards information, contributed substantially to this global progress. Thomas A. Jaggar, Jr., HVO’s founder, advocated that a scientific approach to understanding these hazards would result in strategies to mitigate their damaging effects. The resultant hazard-reduction methods range from prediction of eruptions and tsunamis, thereby providing early warnings for timely evacuation (if needed), to diversion of lava flows away from high-value infrastructure, such as hospitals. In addition to long-term volcano monitoring and multifaceted studies to better understand eruptive and seismic phenomena, HVO has continually and effectively communicated—through its publications, Web site, and public education/outreach programs—hazards information to emergency-management authorities, news media, and the public.

  15. Comparing expressed and revealed preferences for risk reduction: different hazards and question frames

    International Nuclear Information System (INIS)

    McDaniels, T.L.

    1988-01-01

    Studies often note the wide differences that exist in costs per death avoided across US federal programs and regulatory contexts. This paper explores two new, related explanations for these differences. First, it argues that the patterns of revealed preferences (public allocations) may be related to public values, which are measured here through subjects' expressed preference responses to a contingent valuation survey regarding risk reduction. Subjects' expressed values are compared to actual (and proposed) costs of safety regulations for a similar set of hazards. The authors discover strong congruence in the ranking of expressed values and actual values. Second, the paper presents the results of a subsequent survey that investigates why the patterns observed in the first survey might occur. It suggests that one reason for the observed similarities between revealed and expressed preferences may be in how choices are framed. The paper hypothesizes that both subjects and decision makers may frame valuation decisions in the same way: as percentage changes from the reference point provided by the base rate of deaths for that hazard

  16. Understanding Motivations for Abstinence among Adolescent Young Women: Insights into Effective Sexual Risk Reduction Strategies

    Science.gov (United States)

    Long-Middleton, Ellen R.; Burke, Pamela J.; Lawrence, Cheryl A. Cahill; Blanchard, Lauren B.; Amudala, Naomi H.; Rankin, Sally H.

    2012-01-01

    Introduction Pregnancy and sexually transmitted infections pose a significant threat to the health and wellbeing of adolescent young women. Abstinence when practiced provides the most effective means in preventing these problems, yet the perspective of abstinent young women is not well understood. The purpose of the investigation was to characterize female adolescents’ motivations for abstinence. Method As part of a larger, cross-sectional quantitative study investigating predictors of HIV risk reduction behaviors, qualitative responses from study participants who never had intercourse were analyzed in a consensus-based process using content analysis a