WorldWideScience

Sample records for risk reduction programmes

  1. 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 ...

  2. The District Nursing Clinical Error Reduction Programme.

    Science.gov (United States)

    McGraw, Caroline; Topping, Claire

    2011-01-01

    The District Nursing Clinical Error Reduction (DANCER) Programme was initiated in NHS Islington following an increase in the number of reported medication errors. The objectives were to reduce the actual degree of harm and the potential risk of harm associated with medication errors and to maintain the existing positive reporting culture, while robustly addressing performance issues. One hundred medication errors reported in 2007/08 were analysed using a framework that specifies the factors that predispose to adverse medication events in domiciliary care. Various contributory factors were identified and interventions were subsequently developed to address poor drug calculation and medication problem-solving skills and incorrectly transcribed medication administration record charts. Follow up data were obtained at 12 months and two years. The evaluation has shown that although medication errors do still occur, the programme has resulted in a marked shift towards a reduction in the associated actual degree of harm and the potential risk of harm.

  3. 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.

  4. The development of peer educator-based harm reduction programmes in Northern Vietnam.

    Science.gov (United States)

    Walsh, Nick; Gibbie, Tania M; Higgs, Peter

    2008-03-01

    Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

  5. How an integrated change programme has accelerated the reduction in high hazard nuclear facilities at Sellafield

    Energy Technology Data Exchange (ETDEWEB)

    Mackintosh, Angela [Change Manager, Decommissioning, Sellafield Ltd, Seascale, Cumbria (United Kingdom)

    2013-07-01

    For over five decades the Sellafield Site has been central to the UK's nuclear programme. Now operated by Sellafield Ltd, under the management of Parent Body Organisation Nuclear Management Partners (NMP), a consortium of URS Washington Division, AMEC and AREVA is focussed on the decommissioning of historical facilities. When Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of a company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for the customer, the Nuclear Decommissioning Authority. This paper will describe the management success by the Site owners in delivering a successful change programme. The paper will explain how the site has transitioned to the INPO Standard Nuclear Performance Model (SNPM) and how through the use of a change maturity matrix has contributed to the accelerated reduction in high risk high hazard nuclear facilities. The paper will explain in detail how the Decommissioning Programme Office has facilitated and coordinated the Governance and assured delivery of the change plan and how successful application of visual management has aided the communication of its progress. Finally, the paper will discuss how the Delivery Schedules have proved critical for presenting the change plan to Key Stakeholders, Government Owners and Powerful Regulators. Overall, this paper provides an insight into how a massive change programme is being managed within one of the world's highest regulated industries. (authors)

  6. How an integrated change programme has accelerated the reduction in high hazard nuclear facilities at Sellafield

    International Nuclear Information System (INIS)

    Mackintosh, Angela

    2013-01-01

    For over five decades the Sellafield Site has been central to the UK's nuclear programme. Now operated by Sellafield Ltd, under the management of Parent Body Organisation Nuclear Management Partners (NMP), a consortium of URS Washington Division, AMEC and AREVA is focussed on the decommissioning of historical facilities. When Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of a company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for the customer, the Nuclear Decommissioning Authority. This paper will describe the management success by the Site owners in delivering a successful change programme. The paper will explain how the site has transitioned to the INPO Standard Nuclear Performance Model (SNPM) and how through the use of a change maturity matrix has contributed to the accelerated reduction in high risk high hazard nuclear facilities. The paper will explain in detail how the Decommissioning Programme Office has facilitated and coordinated the Governance and assured delivery of the change plan and how successful application of visual management has aided the communication of its progress. Finally, the paper will discuss how the Delivery Schedules have proved critical for presenting the change plan to Key Stakeholders, Government Owners and Powerful Regulators. Overall, this paper provides an insight into how a massive change programme is being managed within one of the world's highest regulated industries. (authors)

  7. Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme.

    Science.gov (United States)

    Grabsch, E A; Mahony, A A; Cameron, D R M; Martin, R D; Heland, M; Davey, P; Petty, M; Xie, S; Grayson, M L

    2012-12-01

    Vancomycin-resistant enterococcus (VRE) colonization and infection have increased at our hospital, despite adherence to standard VRE control guidelines. We implemented a multi-modal, hospital-wide improvement programme including a bleach-based cleaning-disinfection programme ('Bleach-Clean'). VRE colonization, infection and environmental contamination were compared pre and post implementation. The programme included a new product (sodium hypochlorite 1000 ppm + detergent), standardized cleaning-disinfection practices, employment of cleaning supervisors, and modified protocols to rely on alcohol-based hand hygiene and sleeveless aprons instead of long-sleeved gowns and gloves. VRE was isolated using chromogenic agar and/or routine laboratory methods. Outcomes were assessed during the 6 months pre and 12 months post implementation, including proportions (per 100 patients screened) of VRE colonization in high-risk wards (HRWs: intensive care, liver transplant, renal, haematology/oncology); proportions of environmental contamination; and episodes of VRE bacteraemia throughout the entire hospital. Significant reductions in newly recognized VRE colonizations (208/1948 patients screened vs 324/4035, a 24.8% reduction, P = 0.001) and environmental contamination (66.4% reduction, P = 0.012) were observed, but the proportion of patients colonized on admission was stable. The total burden of inpatients with VRE in the HRWs also declined (median percentage of colonized inpatients per week, 19.4% vs 17.3%, P = 0.016). Hospital-wide VRE bacteraemia declined from 14/2935 patients investigated to 5/6194 (83.1% reduction; P Clean programme was associated with marked reductions in new VRE colonizations in high-risk patients, and VRE bacteraemia across the entire hospital. These findings have important implications for VRE control in endemic healthcare settings. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Memon Ashraf

    2007-02-01

    Full Text Available Abstract Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3% IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA method. Syphilis tests (RPR & TPHA were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5% IDUs. Over half 94 (58.3% reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%. 1 of 161 was HIV positive (0.6%. The prevalence of hepatitis B was 12 (7.5%, hepatitis C 151 (94.3% and syphilis 21 (13.1%. IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom

  9. Economic Programmes and Poverty Reduction: NGO Experiences from Tamil Nadu

    OpenAIRE

    D Rajasekhar; P Shobana

    2000-01-01

    The impact of economic programmes of SHARE, an NGO from Tamil Nadu, on poverty reduction is analysed with the help of data from 84 hosueholds. The economic programmes contributed to savings and income increase, and enhanced the leadership qualities, awareness and knowledge. The member group is not significantly different from the comparison group in terms of control over income and decision-making. This suggests that the NGO economic programmes have limitation is bringing about non-economic b...

  10. 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.

  11. Poverty Reduction Programme in Nigeria: An Assessment of its Implementation in Enugu State

    Directory of Open Access Journals (Sweden)

    Dilichukwu A. Omemma

    2014-03-01

    Full Text Available The study has as its main thrust the evaluation of the implementation of the national poverty reduction programme in Enugu State of Nigeria. Using cross-sectional and exploratory methods of data collection and analysis, the study discovered that, compared to most states in other parts of the country, Enugu State has a low poverty profile owing to the relative positive impact of the implementation of poverty alleviation programme. Nevertheless, policy inconsistency and mismanagement deny the programme from becoming a total success; hence the existence of a larger number of citizens that are in absolute poverty. It is therefore suggested that the way out of the ineffective poverty reduction programme in Enugu State is the effective monitoring mechanism and the creation of an enabling environment for wealth creation and employment generation.

  12. How an integrated change programme has accelerated the reduction in high hazard nuclear facilities at Sellafield - 59014

    International Nuclear Information System (INIS)

    Mackintosh, Angela

    2012-01-01

    For over five decades the Sellafield Site has been central to the UK's nuclear programme. Sellafield Ltd is managed by NMP (Nuclear Management Partners), a consortium of URS, AMEC and AREVA and is focussed on the decommissioning of historical facilities. When the activity of Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of an integrated company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for the customer, the Nuclear Decommissioning Authority (NDA). This paper will describe the management approach that is being taken and the planning tools that are being applied by the Site owners in delivering an integrated change programme across the Decommissioning Directorate. The paper will explain how the management approach to change uses Peer Assist, Rapid Improvement Events, Organisational Review Self Evaluation, Value Stream Analysis and Accelerated Improvement Events as improvement tools. Use of these has enabled down-sizing of the organisation, driven out hundreds of man day efficiencies within the maintenance and asset management areas, improved the management of spares reducing annual costs by Pounds 1000's, improved Commercial practices by fast tracking the preparation of invitations to tender for critical contracts, rolled back radiological control areas and enabled quicker access to the work-face at a reduced cost. This paper will explain in detail how the Decommissioning Directorate Programme Office has implemented planning tools such as governance, identification of opportunities, benefit evaluation and prioritisation and sanction of the optimum improvements and how through the use of a balanced scorecard, delivery of the improvements has been measured ensuring that the targets are met. Finally, the paper will discuss how the

  13. 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.

  14. Risks in teaching manipulation techniques in master programmes.

    Science.gov (United States)

    Pool, Jan; Cagnie, Barbara; Pool-Goudzwaard, Annelies

    2016-09-01

    High Velocity Techniques (HVT) in the (high) cervical spine are part of the standard curricula of manual therapy educational programmes. Little is known about the risk or the presence of adverse events during skills training sessions. This article describes two cases of students with both being at risk for an adverse event; one with a congenital artery aberration and one with cancer in the high cervical region. Teachers and educational programme developers should take risk management into account when teaching HVT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Information technologies for taking into account risks in business development programme

    Science.gov (United States)

    Kalach, A. V.; Khasianov, R. R.; Rossikhina, L. V.; Zybin, D. G.; Melnik, A. A.

    2018-05-01

    The paper describes the information technologies for taking into account risks in business development programme, which rely on the algorithm for assessment of programme project risks and the algorithm of programme forming with constrained financing of high-risk projects taken into account. A method of lower-bound estimate is suggested for subsets of solutions. The corresponding theorem and lemma and their proofs are given.

  16. Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

    Science.gov (United States)

    Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

    2013-01-01

    Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

  17. Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India.

    Science.gov (United States)

    Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca; Sgaier, Sema K

    2013-04-01

    Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines.

  18. Developing a national programme of flood risk management measures: Moldova

    Directory of Open Access Journals (Sweden)

    Ramsbottom David

    2016-01-01

    Full Text Available A Technical Assistance project funded by the European Investment Bank has been undertaken to develop a programme of flood risk management measures for Moldova that will address the main shortcomings in the present flood management system, and provide the basis for long-term improvement. Areas of significant flood risk were identified using national hydraulic and flood risk modelling, and flood hazard and flood risk maps were then prepared for these high risk areas. The flood risk was calculated using 12 indicators representing social, economic and environmental impacts of flooding. Indicator values were combined to provide overall estimates of flood risk. Strategic approaches to flood risk management were identified for each river basin using a multi-criteria analysis. Measures were then identified to achieve the strategic approaches. A programme of measures covering a 20-year period was developed together with a more detailed Short-Term Investment Plan covering the first seven years of the programme. Arrangements are now being made to implement the programme. The technical achievements of the project included national hydrological and hydraulic modelling covering 12,000 km of river, the development of 2-dimensional channel and floodplain hydraulic models from a range of topographic and bathymetric data, and an integrated flood risk assessment that takes account of both economic and non-monetary impacts.

  19. An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

    International Nuclear Information System (INIS)

    Schindera, Sebastian T.; Allmen, Gabriel von; Vock, Peter; Szucs-Farkas, Zsolt; Treier, Reto; Trueb, Philipp R.; Nauer, Claude

    2011-01-01

    To establish an education and training programme for the reduction of CT radiation doses and to assess this programme's efficacy. Ten radiological institutes were counselled. The optimisation programme included a small group workshop and a lecture on radiation dose reduction strategies. The radiation dose used for five CT protocols (paranasal sinuses, brain, chest, pulmonary angiography and abdomen) was assessed using the dose-length product (DLP) before and after the optimisation programme. The mean DLP values were compared with national diagnostic reference levels (DRLs). The average reduction of the DLP after optimisation was 37% for the sinuses (180 vs. 113 mGycm, P < 0.001), 9% for the brain (982 vs. 896 mGycm, P < 0.05), 24% for the chest (425 vs. 322 mGycm, P < 0.05) and 42% for the pulmonary arteries (352 vs. 203 mGycm, P < 0.001). No significant change in DLP was found for abdominal CT. The post-optimisation DLP values of the sinuses, brain, chest, pulmonary arteries and abdomen were 68%, 10%, 20%, 55% and 15% below the DRL, respectively. The education and training programme for radiological institutes is effective in achieving a substantial reduction in CT radiation dose. (orig.)

  20. Effect of sex education programme on at-risk sexual behaviour of ...

    African Journals Online (AJOL)

    Effect of sex education programme on at-risk sexual behaviour of ... that place them at risk for Sexually Transmitted Diseases (STDs). ... The treatment group evaluated the intervention programme positively and their knowledge of sexual health ...

  1. An evaluation of the UK programme for CO{sub 2} reduction

    Energy Technology Data Exchange (ETDEWEB)

    Buchdahl, J.M.; Longhurst, J.W.S.; Rowe, E.J. [Manchester Metropolitan University, Manchester (United Kingdom). Atmospheric Research and Information Centre, Dept. of Environmental and Geographic Sciences

    1995-12-31

    This paper is concerned with an evaluation of the UK national programme for carbon dioxide (CO{sub 2}) emission reduction, in the context of the Framework Convention on Climate Change. It assesses whether the precautionary approach, as it stands, fully meets the objective of the FCCC (Articla 2), in the light of current scientific evidence. It examines the approach of one developed economy, the UK, in developing its national programme and also the major issues which may affect the attainment of emissions abatement targets. 13 refs., 3 tabs.

  2. 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.

  3. Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, Jacques

    1989-08-01

    This case study, related to the design stage of a fuel fabrication facility, presents the evaluation of alternative options to manipulate mixed oxide fuel rods in a quality control shop. It is based on a study performed in the framework of the 'MELOX project' developed by COGEMA in France. The methodology for evaluating robotic actions is resulting from a research work part funded by the IAEA under the co-ordinated research programme on 'Comparison of cost-effectiveness of risk reduction among different energy systems', and by the commission of the European Communities under the research and training programme on radiation protection.

  4. Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility

    International Nuclear Information System (INIS)

    Lochard, Jacques

    1989-01-01

    This case study, related to the design stage of a fuel fabrication facility, presents the evaluation of alternative options to manipulate mixed oxide fuel rods in a quality control shop. It is based on a study performed in the framework of the 'MELOX project' developed by COGEMA in France. The methodology for evaluating robotic actions is resulting from a research work part funded by the IAEA under the co-ordinated research programme on 'Comparison of cost-effectiveness of risk reduction among different energy systems', and by the commission of the European Communities under the research and training programme on radiation protection

  5. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report for the period 1 May 1982 - 20 February 1988

    International Nuclear Information System (INIS)

    Lochard, J.

    1989-08-01

    The report presents the three French case studies performed in the framework of the co-ordinated research programme on ''Comparison of Cost-Effectiveness of Risk Reduction Among Different Energy Systems'': cost-effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; cost-effectiveness of protection actions to reduce occupational exposure in underground uranium mines; cost effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains. Figs and tabs

  6. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report for the period 1 May 1982 - 20 February 1988

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, J [CEPN Centre d` Etude sur l` Evaluation de la Protection dans le Domaine Nucleaire, Fontenay-Aux-Roses (France)

    1989-08-01

    The report presents the three French case studies performed in the framework of the co-ordinated research programme on ``Comparison of Cost-Effectiveness of Risk Reduction Among Different Energy Systems``: cost-effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; cost-effectiveness of protection actions to reduce occupational exposure in underground uranium mines; cost effectiveness of safety measures to reduce public risk associated with the transportation of UF{sub 6} by truck and trains. Figs and tabs.

  7. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report of the co-ordinated research programme

    International Nuclear Information System (INIS)

    Lochard, Jacques

    1989-08-01

    This report presents the three French case studies performed in the framework of the coordinated research program on 'Comparison of Cost-effectiveness of Risk Reduction among different Energy Systems': Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; Cost-effectiveness of protection actions to reduce occupational exposures in underground uranium mines; Cost-effectiveness of safety measures to reduce public risk associated with the transportation of UF 6 by truck and trains

  8. Study of radiological risk in breast cancer screening programme at Comunidad Valenciana

    International Nuclear Information System (INIS)

    Villaescusa, J.I.; Leon, A.; Verdu, G.; Cuevas, M.D.; Salas, M.D.

    2001-01-01

    It is demonstrated that screening mammography programmes reduce breast cancer mortality considerably. Nevertheless, radiology techniques have an intrinsic risk being the most important late somatic effect the induction of cancer. This study is made in order to evaluate the risk produced into the population by the Cimadon Valenciana Breast Screening Programme. All the calculations are carried out for two risk models, UNSCEAR 94 and NRPB 93. On the one hand, screening series detriment are investigated as a function of doses delivered and other parameters related to population structure and X-ray equipment. And on the other hand, radiation induced cancer probability for a woman who starts at 45 years and remains into the programme until 65 years old is calculated as a function of mammography unit's doses and average compression breast thickness. (author)

  9. Comparison of cost effectiveness of risk reduction among different energy systems: French case studies. Final report of the co-ordinated research programme

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, Jacques [ed.

    1989-08-01

    This report presents the three French case studies performed in the framework of the coordinated research program on 'Comparison of Cost-effectiveness of Risk Reduction among different Energy Systems': Cost effectiveness of robotics and remote tooling for occupational risk reduction at a nuclear fuel fabrication facility; Cost-effectiveness of protection actions to reduce occupational exposures in underground uranium mines; Cost-effectiveness of safety measures to reduce public risk associated with the transportation of UF{sub 6} by truck and trains.

  10. School scoliosis screening programme-a systematic review.

    Science.gov (United States)

    Sabirin, J; Bakri, R; Buang, S N; Abdullah, A T; Shapie, A

    2010-12-01

    A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.

  11. Risks in teaching manipulation techniques in master programmes

    NARCIS (Netherlands)

    Pool, Jan J.M.; Cagnie, B.; Pool-Goudzwaard, A.L.

    2016-01-01

    High Velocity Techniques (HVT) in the (high) cervical spine are part of the standard curricula of manual therapy educational programmes. Little is known about the risk or the presence of adverse events during skills training sessions. This article describes two cases of students with both being at

  12. 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.

  13. The Focus on Youth Prevention and Education Research Programme

    Directory of Open Access Journals (Sweden)

    Lynette Deveaux

    2016-10-01

    Full Text Available Like many developing or transitional countries affected by the HIV epidemic, The Bahamas has been deeply committed to HIV and sexually transmitted infection reduction and continues to make great strides in controlling the epidemic within its boundaries. Encouraged by the impact of the Focus on Youth Caribbean (FOYC, a school-based HIV/AIDS prevention programme and its parenting component on Grade 6 and Grade 10 students and their parents, a team of researchers from The Bahamas and the United States sought to implement a similar programme at a national level, while simultaneously evaluating factors that impact the sustainability of sexual risk-reduction programmes like FOYC. This paper describes five research projects conducted in The Bahamas between 1998 and 2016 and includes a list of over 40 published research articles

  14. Fraud Risk Factors and Audit Programme Modifications: Evidence from Jordan

    Directory of Open Access Journals (Sweden)

    Modar Abdullatif

    2013-03-01

    Full Text Available This study explores how audit firms in Jordan deal with the presence of fraud risk factors in audit clients. In doing so, the study seeks to explore which fraud risk factors are more important to Jordanianauditors, and how Jordanian auditors consider modifying their audit programmes when fraud risk factors are present in clients. The study uses a structured questionnaire that was administered to seniorlevel auditors in the largest Jordanian audit firms. The findings show that almost all of the 20 fraud risk factors included in the questionnaire were only slightly important (if not unimportant, a finding that is arguably alarming. The perceived importance of modifying the audit programme in the presence of each fraud risk factor was related to the perceived importance of the fraud risk factor itself. However, changes in the nature and extent of audit procedures were more important than changes in the timing of the procedures or the members of the audit team. The most important fraud risk factors were related to the characteristics of management and its attitude towards the audit, while the least important fraud risk factors were related to the difficulties in the client’s financial performance. Factor analysis found that the fraud risk factors could be classified into four separate groups. Possible interpretations of the findings were discussed, such as considering the Jordanian business environment characteristics, and the findings were compared to those of extant international studies.

  15. University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

    Science.gov (United States)

    Cameron, Craig; Klopper, Christopher

    2015-01-01

    Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

  16. Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial.

    Science.gov (United States)

    Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

    2017-08-01

    Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14-18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

  17. 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)

  18. [Conditions for success in a lifestyle intervention weight-reduction programme for overweight or obese children and adolescents].

    Science.gov (United States)

    Pott, Wilfried; Fröhlich, Georg; Albayrak, Ozgür; Hebebrand, Johannes; Pauli-Pott, Ursula

    2010-09-01

    To analyze whether caregiver and family characteristics predict success in a family-based lifestyle intervention programme for overweight or obese children and adolescents. Participants were 136 overweight or obese children and adolescents (7-15 years) who attended a family-based weight-reduction programme. BMI and BMI standard deviation scores (BMI-SDS) of the index child, BMI of family members, family adversity characteristics, and depression and attachment attitudes of the primary caregiver were assessed. 116 participants finished the 12-month programme: 100 (85.3%) showed a decrease of the BMI-SDS, 79 (68.1%) a more than 5% reduction of the BMI-SDS. These "successful" children were compared to 56 "unsuccessful" ones (dropouts and children with a BMI-SDS reduction of 5% or less). Failure to reduce weight considerably (≤ 5% reduction of BMI-SDS, or dropout) occurred more frequently in older children and in cases with obese sibling(s), maternal depression, and maternal avoidant attachment attitude. In a logistic regression analysis, maternal depression as well as attachment attitude, and the age of the index child explained common variance, while the presence of obese sibling(s) explained unique variance in non-responding. Our data suggest that special support should be provided to adolescents with obese sibling(s) and to adolescents with mothers suffering from depression and exhibiting an avoidant attachment style, so as to meet the specific needs of all participating families and to prevent the discouraging experience of failure in weight-control interventions. The efficacy of these modules must be tested in further studies.

  19. PORT (Programme of Recognition and Therapy): the first Polish recognition and treatment programme for patients with an at-risk mental state.

    Science.gov (United States)

    Kotlicka-Antczak, Magdalena; Pawełczyk, Tomasz; Rabe-Jabłońska, Jolanta; Pawełczyk, Agnieszka

    2015-08-01

    To present the activities of the first early intervention centre in Poland and the Programme of Recognition and Therapy (PORT) run by the centre. An overview of the admission process, diagnostic procedures and therapeutic interventions offered to individuals with an at-risk mental state. The PORT programme, developed in 2010, included 81 individuals, aged 15-29 years so far. The diagnostic procedures consists of evaluation of symptoms with the use of the Comprehensive Assessment of At-Risk Mental State (CAARMS), assessment of premorbid and current personality traits and the evaluation of cognitive functions. Therapeutic interventions include cognitive behavioural therapy, diet supplementation with omega-3 fatty acids and pharmacological treatment. Overall rate of conversion into psychosis within the years 2010-2103 was 18.5%. The programme has also been a source of research in the field of early psychosis. The PORT programme enables young people with an ARMS an easy access to the specialized service offering treatment tailored to their specific needs. © 2014 Wiley Publishing Asia Pty Ltd.

  20. 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.

  1. Results and assessment of participation of VUPEK in coordinated research project of the IAEA ''Comparison of cost-effectiveness of risk reduction among different energy systems''

    International Nuclear Information System (INIS)

    Kadlec, J.; Horacek, P.

    1989-01-01

    The results and conclusions are summarized of the research programme ''Comparison of cost-effectiveness of risk reduction among different energy systems'' co-ordinated in 1983 to 1988 by the International Atomic Energy Agency. Institutes in 18 member states were involved which performed 33 case studies in the field of risk reduction in various power systems or their parts. A comparison with cost-effectiveness of risk reduction in other fields was made as well. The health risks (occupational, those of population) and the environmental risks were evaluated. The case studies cover various stages of the decision-making process and various decision makers. The solution resulted in 5 methodological studies and 16 models. 11 case studies and 1 methodological study were conducted by the Research Institute of the Fuel and Energy Complex. The experiences obtained, the questions so far unanswered and recommendations for those who will perform similar studies are given. (author). 1 fig., 2 tabs., 3 refs

  2. 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)

  3. Pilot evaluation of an adolescent risk and injury prevention programme incorporating curriculum and school connectedness components.

    Science.gov (United States)

    Chapman, R L; Buckley, L; Sheehan, M; Shochet, I M

    2013-08-01

    School connectedness is an important protective factor for adolescent risk-taking behaviour. This study examined a pilot version of the Skills for Preventing Injury in Youth (SPIY) programme, combining teacher professional development (PD) for increasing school connectedness (connectedness component) with a risk and injury prevention curriculum for early adolescents (curriculum component). A process evaluation was conducted on the connectedness component, involving assessments of programme reach, participant receptiveness and initial use, and a preliminary impact evaluation was conducted on the combined connectedness and curriculum programme. The connectedness component was well received by teacher participants, who saw benefits for both themselves and their students. Classroom observation also showed that teachers who received PD made use of the programme strategies. Grade 8 students who participated in the SPIY programme were less likely to report violent behaviour at 6-month follow-up than were control students, and trends also suggested reduced transport injuries. The results of this research support the use of the combined SPIY connectedness and curriculum components in a large-scale effectiveness trial to assess the impact of the programme on students' connectedness, risk-taking and associated injuries.

  4. 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...

  5. 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.

  6. A Locus of Control-based HIV and AIDS Risk Reduction Training ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the effi cacy of a locus of control-based training programme in reducing HIV and AIDS risk among university students. The locus of control-based variables that formed the training programme were social systems control, deferment of gratifi cation, personal values and expectancies, ...

  7. Effect of Sex Education Programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria.

    Science.gov (United States)

    Esere, Mary Ogechi

    2008-06-01

    Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents. Pre-test, post-test control group quasi-experimental design. A randomly selected co-educational school in Ilorin Metropolis, Nigeria. 24 school-going adolescents aged 13-19 years. Sex Education Programme (treatment group) versus Control programme (placebo). Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom. When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention. Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.

  8. 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

  9. 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.)

  10. Non-animal approaches for consumer safety risk assessments: Unilever's scientific research programme.

    Science.gov (United States)

    Carmichael, Paul; Davies, Michael; Dent, Matt; Fentem, Julia; Fletcher, Samantha; Gilmour, Nicola; MacKay, Cameron; Maxwell, Gavin; Merolla, Leona; Pease, Camilla; Reynolds, Fiona; Westmoreland, Carl

    2009-12-01

    Non-animal based approaches to risk assessment are now routinely used for assuring consumer safety for some endpoints (such as skin irritation) following considerable investment in developing and applying new methods over the past 20 years. Unilever's research programme into non-animal approaches for safety assessment is currently focused on the application of new technologies to risk assessments in the areas of skin allergy, cancer and general toxicity (including inhalation toxicity). In all of these areas, a long-term investment is essential to increase the scientific understanding of the underlying biological and chemical processes that we believe will ultimately form a sound basis for novel risk assessment approaches. Our research programme in these priority areas consists of in-house research as well as Unilever-sponsored academic research, involvement with EU-funded projects (e.g. Sens-it-iv, carcinoGENOMICS), participation in cross-industry collaborative research (e.g. COLIPA, EPAA) and ongoing involvement with other scientific initiatives on non-animal approaches to risk assessment (e.g. UK NC3Rs, US 'Human Toxicology Project' consortium). 2009 FRAME.

  11. Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors.

    Science.gov (United States)

    Vos, Bénédicte; Senterre, Christelle; Lagasse, Raphaël; Levêque, Alain

    2015-10-16

    Understanding the risk factors for hearing loss is essential for designing the Belgian newborn hearing screening programme. Accordingly, they needed to be updated in accordance with current scientific knowledge. This study aimed to update the recommendations for the clinical management and follow-up of newborns with neonatal risk factors of hearing loss for the newborn screening programme in Belgium. A literature review was performed, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system assessment method was used to determine the level of evidence quality and strength of the recommendation for each risk factor. The state of scientific knowledge, levels of evidence quality, and graded recommendations were subsequently assessed using a three-round Delphi consensus process (two online questionnaires and one face-to-face meeting). Congenital infections (i.e., cytomegalovirus, toxoplasmosis, and syphilis), a family history of hearing loss, consanguinity in (grand)parents, malformation syndromes, and foetal alcohol syndrome presented a 'high' level of evidence quality as neonatal risk factors for hearing loss. Because of the sensitivity of auditory function to bilirubin toxicity, hyperbilirubinaemia was assessed at a 'moderate' level of evidence quality. In contrast, a very low birth weight, low Apgar score, and hospitalisation in the neonatal intensive care unit ranged from 'very low' to 'low' levels, and ototoxic drugs were evidenced as 'very low'. Possible explanations for these 'very low' and 'low' levels include the improved management of these health conditions or treatments, and methodological weaknesses such as confounding effects, which make it difficult to conclude on individual risk factors. In the recommendation statements, the experts emphasised avoiding unidentified neonatal hearing loss and opted to include risk factors for hearing loss even in cases with weak evidence. The panel also highlighted the cumulative effect

  12. 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...

  13. Programme for reducing the risk factors due to prenatal exposure

    International Nuclear Information System (INIS)

    Arranz, L.; Ferrer, N.; Sastre, J.M.

    2001-01-01

    When a patient is not aware of her pregnancy, the foetus/embryo may be inadvertently irradiated during a diagnostic exploration or therapeutic intervention. The radiosensitivity of the foetus/embryo changes during the different periods of gestation. For this reason there are different risk factors for each moment at which the patient may suffer irradiation. In the past 7 years, the Department of Radiophysics and Radiation Protection has been consulted 75 times for this reason, to evaluate the dose received in the uterus. Since the establishment of a programme to avoid inadvertent irradiation of the foetus/embryo, these consultations have been reduced. This programme is based on informing the patients and on training the medical staff. (author)

  14. 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.

  15. 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.

  16. ICRP publication 26. Its applicability in a nuclear power programme

    International Nuclear Information System (INIS)

    Wilson, R.; Donnelly, K.

    1980-01-01

    Ontario Hydro is a major Canadian provincial utility with more than 5 GW(e) installed nuclear electricity generating capacity and with a planned commitment to an additional 8.5 GW(e), all units being of the CANDU pressurized heavy-water type. The radiation protection programme, in addition to complying with Canadian Federal regulations, has been consistent with the philosophy and intent of ICRP recommendations and is frequently reviewed to ensure compliance with these recommendations, the most recent of which is ICRP-26. The application of the ALARA principle in this power reactor programme is described. A set of general guidelines has been established, the main features of which are: (a) achieving a dose consumption per unit of electricity generated which is low compared with reactors of a similar type; (b) ensuring that stations are operable with the dose equivalent of their labour-dictated manpower; (c) ensuring that the risk to atomic radiation workers is compatible with a corporate fatality rate standard of 8 man-hours worked. Achievement of these guidelines has necessitated implementing a continued dose-management programme. This programme is described generally. The cost applied to justify a dose reduction of 1 man.Sv is given, and a comparison is made with the equivalent life costs this implies and the costs used by safety agencies for other risk-reduction activities. Finally, some practical problems associated with some of the recommendations of ICRP-26 are discussed. (author)

  17. Public Information Programmes on Risks Due to Radon. Annex V

    International Nuclear Information System (INIS)

    2015-01-01

    Public concern about radon is generally lower than public concern about other comparable risks, or about much lower risks such as those associated with artificial radiation. The public tends to be most concerned about hazards that are: (a) Human made rather than natural; (b) Imposed by a human agency rather than arising by chance; (c) Able to cause harm to groups rather than individuals; (d) Obvious, immediate and ‘dread’ rather than covert, delayed and familiar. None of the four above mentioned factors that would increase concern apply to radon, and a study has found that householders often deny that a health risk exists. For this reason, public information programmes are necessary for the risks due to radon to be taken seriously

  18. Fundamentals for the evaluation of irradiation experiments on enrichment reduction in the FRJ-2 (AF-Programme)

    International Nuclear Information System (INIS)

    Borchardt, G.; Krug, W.; Weise, L.

    1984-01-01

    For the evaluation of irradiation experiments in the framework of the AF-Programme (Enrichment Reduction for Research Reactors) a computer code for the determination of burn-up was developed. The energy-integral cross-sections, which were needed for this purpose, has been determined appropriate to the specific problem in question. First results of an evaluation are reported in this paper. (orig.) [de

  19. 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

  20. 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.

  1. Generic learning skills in academically-at-risk medical students: a development programme bridges the gap.

    Science.gov (United States)

    Burch, Vanessa C; Sikakana, Cynthia N T; Gunston, Geney D; Shamley, Delva R; Murdoch-Eaton, Deborah

    2013-08-01

    Widening access to medical students from diverse educational backgrounds is a global educational mandate. The impact, on students' generic learning skills profiles, of development programmes designed for students at risk of attrition is unknown. This study investigated the impact of a 12-month Intervention Programme (IP) on the generic learning skills profile of academically-at-risk students who, after failing at the end of the first semester, completed the IP before entering the second semester of a conventional medical training programme. This prospective study surveyed medical students admitted in 2009 and 2010, on entry and on completion of first year, on their reported practice and confidence in information handling, managing own learning, technical and numeracy, computer, organisational and presentation skills. Of 414 first year students, 80 (19%) entered the IP. Levels of practice and confidence for five of the six skills categories were significantly poorer at entry for IP students compared to conventional stream students. In four categories these differences were no longer statistically significant after students had completed the IP; 62 IP students (77.5%) progressed to second year. A 12-month development programme, the IP, effectively addressed generic learning skills deficiencies present in academically-at-risk students entering medical school.

  2. Reduction of work-related musculoskeletal risk factors following ergonomics education of sewing machine operators.

    Science.gov (United States)

    Bulduk, Sıdıka; Bulduk, Emre Özgür; Süren, Tufan

    2017-09-01

    Work-related musculoskeletal disorders (WMSDs) are a major hazard for sewing machine operators. Ergonomics education is recommended for reducing musculoskeletal disorders at workstations. This study aimed to evaluate the effect of an ergonomics education in reducing the exposure to risk factors for WMSDs among sewing machine operators. In this study of 278 workers, their exposure to the risk of WMSDs was assessed using the quick exposure check scale prior to them attending an ergonomics education programme and then again 3 months after the programme. The scores for risk exposure before the education programme were moderate for back (static) and back (dynamic), high for shoulder/arm and very high for wrist/hand and neck. The results obtained 3 months later were low for back (static) and shoulder/arm, and moderate for back (dynamic), wrist/hand and neck. Based on our results, ergonomics education can reduce the exposure to risk factors for WMSDs in the workplace.

  3. 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...

  4. Cigotica programme: pediatric experiences

    Directory of Open Access Journals (Sweden)

    Lešović Snežana

    2011-01-01

    Full Text Available Introduction The alarming spread of obesity epidemic in children and adolsecents, as well as the absence of tested and efficient measures and programmes on obesity preven­tion indicate the necessity for the establishment of the Centre for the prevention, treatment and rehabilitation of obesity in children and adolescents and the 'Cigotica Programme' at the Special Hospital 'Zlatibor'. The advantage of the 'Cigotica' Programme is the multidisciplinary approach to treating obese children, which implies specific education, dietetic interventions with the reduction in the total daily calorie intake, physical activity, medical, educational and psychological support, change of behavior and lifestyle. Objective To define obesity complications, metabolic risk factors and treatment effects on body composition and metabolic parameters in adolescents participating in the 'Cigotica' Programme. Method 1,030 adolescents were examined (498 girls and 532 boys, aged 12 to 18, average age 15.45, diagnosed with primary obesity, hospitalized at the Centre for the prevention, treatment and rehabilitation of obesity in children and adolescents at the Special Hospital 'Zlatibor', in the period from 27/07/2008 to 03/10/2010. Hospitalization lasted 21 days. Obesity criterion was body mass index (BMI > +2 SD . Body The Special Hospital for the Thyroid Gland and Metabolism Zlatibor mass, BMI, % of fat were obtained by means of Tanita scales for determining body composition using the impendence method. Apart from medical examination, blood pressure was also taken. The levels of triglycerides, total HDL and LDL cholesterols, uric acids and glycemia were determined on the second and twenty-first day of hospitalization after a 12-day fasting period. Results After the multidisciplinary treatment, the average reduction in body mass (p< 0.05 in all adolescents was 5.92 ± 2.71 kg, in boys - 6.24 ±3.24 kg, and in girls -5.86±2.4. During the 21-day hospitalization, the average

  5. 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.

  6. Overview of programmes for the assessment of risks to the environment from ionising radiation and hazardous chemicals

    International Nuclear Information System (INIS)

    Jones, C; Gilek, M

    2004-01-01

    Within the FASSET project, a review of existing programmes for the assessment of environmental risks from radioactive or hazardous substances was carried out in order to identify appropriate aspects that could be incorporated into the FASSET framework. The review revealed a number of different approaches, arising from the need to balance the information value of the assessment against the availability of data and the need to keep the assessment manageable. Most of the existing assessment programmes fit into a three-phase approach to environmental risk assessment: problem formulation, assessment and risk characterisation. However, the emphasis on particular assessment phases varies between programmes. The main differences between the different programmes are: the degree of specificity to a particular site, the level of detail of the assessment, the point at which a comparison is made between a criterion intended to represent 'what is acceptable' and a measured or predicted quantity, the choice of end-point for the assessment and the relationship between measurement end-points and assessment end-points. The existing assessment programmes are based on a similar general structure, which is suitable for use as a basis for the FASSET framework. However, certain aspects of the assessment of exposure and effects of ionising contaminants, e.g. dosimetry, require further development before incorporation into such a framework

  7. 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.

  8. Assessing Progress in Reducing the At-Risk Population after 13 Years of the Global Programme to Eliminate Lymphatic Filariasis

    Science.gov (United States)

    Hooper, Pamela J.; Chu, Brian K.; Mikhailov, Alexei; Ottesen, Eric A.; Bradley, Mark

    2014-01-01

    Background In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000—during which over 4.4 billion treatments have been distributed in 56 endemic countries—it is most appropriate to estimate the impact that the MDA has had on reducing the population at risk of LF. Methodology/Principal Findings To assess GPELF progress in reducing the population at-risk for LF, we developed a model based on defining reductions in risk of infection among cohorts of treated populations following each round of MDA. The model estimates that the number of people currently at risk of infection decreased by 46% to 789 million through 2012. Conclusions/Significance Important progress has been made in the global efforts to eliminate LF, but significant scale-up is required over the next 8 years to reach the 2020 elimination goal. PMID:25411843

  9. 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

  10. 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...

  11. 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

  12. Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme

    Science.gov (United States)

    Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

    2014-01-01

    Background: The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Methods: Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50–64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. Results: The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1 000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15–20% reduction in interval cancer rates in the NHSBSP. Conclusion: The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens. PMID:24366303

  13. 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....

  14. 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

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

    Science.gov (United States)

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

    2017-05-01

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

  16. 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

  17. Development of a module for Cost-Benefit analysis of risk reduction measures for natural hazards for the CHANGES-SDSS platform

    Science.gov (United States)

    Berlin, Julian; Bogaard, Thom; Van Westen, Cees; Bakker, Wim; Mostert, Eric; Dopheide, Emile

    2014-05-01

    Cost benefit analysis (CBA) is a well know method used widely for the assessment of investments either in the private and public sector. In the context of risk mitigation and the evaluation of risk reduction alternatives for natural hazards its use is very important to evaluate the effectiveness of such efforts in terms of avoided monetary losses. However the current method has some disadvantages related to the spatial distribution of the costs and benefits, the geographical distribution of the avoided damage and losses, the variation in areas that are benefited in terms of invested money and avoided monetary risk. Decision-makers are often interested in how the costs and benefits are distributed among different administrative units of a large area or region, so they will be able to compare and analyse the cost and benefits per administrative unit as a result of the implementation of the risk reduction projects. In this work we first examined the Cost benefit procedure for natural hazards, how the costs are assessed for several structural and non-structural risk reduction alternatives, we also examined the current problems of the method such as the inclusion of cultural and social considerations that are complex to monetize , the problem of discounting future values using a defined interest rate and the spatial distribution of cost and benefits. We also examined the additional benefits and the indirect costs associated with the implementation of the risk reduction alternatives such as the cost of having a ugly landscape (also called negative benefits). In the last part we examined the current tools and software used in natural hazards assessment with support to conduct CBA and we propose design considerations for the implementation of the CBA module for the CHANGES-SDSS Platform an initiative of the ongoing 7th Framework Programme "CHANGES of the European commission. Keywords: Risk management, Economics of risk mitigation, EU Flood Directive, resilience, prevention

  18. 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

  19. 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.

  20. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  1. Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

    Science.gov (United States)

    Cerqueiro, J M; González-Franco, A; Montero-Pérez-Barquero, M; Llácer, P; Conde, A; Dávila, M F; Carrera, M; Serrado, A; Suárez, I; Pérez-Silvestre, J; Satué, J A; Arévalo-Lorido, J C; Rodríguez, A; Herrero, A; Jordana, R; Manzano, L

    2016-01-01

    Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, Pde Medicina Interna (SEMI). All rights reserved.

  2. Withdrawing low risk women from cervical screening programmes: mathematical modelling study.

    Science.gov (United States)

    Sherlaw-Johnson, C; Gallivan, S; Jenkins, D

    1999-02-06

    To evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for cervical cancer in the United Kingdom. A mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures. Two policies are compared: one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus. United Kingdom cervical screening programme. The incidence of invasive cervical cancer and the use of resources. Early withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study. An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted. Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome. This model systematically analyses the consequences of screening options using available data and the clinical course of precancerous lesions. If further audit studies confirm the model's forecasts, a policy of early withdrawal might be considered. This would be likely to release substantial resources which could be channelled into other aspects of health care or may be more effectively used within the cervical screening programme to counteract the possible increase in cancer incidence that early withdrawal might bring.

  3. 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.

  4. 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.

  5. Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

    Science.gov (United States)

    Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

    2017-06-01

    The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

  6. Management of uncertainties and the role of risk in Andra programme

    International Nuclear Information System (INIS)

    Grevoz, A.

    2004-01-01

    This paper aims at presenting some aspects of the management of uncertainties in the programmes of Andra for the study of a deep geological repository for high level, long-lived wastes. After presenting very briefly the context of risk-management in the French safety rules, it will discuss how Andra has attempted to link the notions of uncertainties and risk in its 'Dossier 2001' for the clay medium, how this could be made compatible with a deterministic safety approach, what feedback it got from this first exercise, and what are the perspectives for future work. (author)

  7. Evolution of the excess absolute risk (EAR) in the Valencian breast cancer screening programme

    International Nuclear Information System (INIS)

    Ferrer, S.; Ramos, M.; Villaescusa, J. I.; Verdu, G.; Salas, M. D.; Cuevas, M. D.

    2004-01-01

    Breast cancer is one of the most frequent diseases in women, with a high incidence rate. The best fight against the breast cancer is the early detection by menas of mammograms in a screening programme. The Valencian Breast Cancer Screening Programme (VBCSP) started at 1992, and it is composed of twenty-two mammography units. The programme is targeted towards asympotomatic women dfrom 45 to 69 years old, but this screening has a negative influence in the studied woman, whatever the diagnosis was. By means of MCNP-4c2 Monte Carlo code, some conversion factors from air kerma air kerma to glandular dose have been developed. Different breast woamn models, according to the Valencian brest anathomy (taking into account the relation breast radius / breast compression thickness obtained from real samples, have been simulated in order to obtain the glandular breast dose values. Quality control parameters as ESAK values were also employed for developing the methods. The conversion factors give a simple and fast wasy to obtain the mean glandular dose from mammography exposition parameters. The glandular dose has been also calculated following the European Protocol on Dosimetry in order to compare the results of the new methodology. Four sample populations of 100 omen from each uunit of the VBCSP have been taken innnn order to estimate the mean glandular dose and the associated excess absolute risk (EAR). Once the doses for each woman from the samples are obtained and according to the age of them, the EAR value for each sample has been determinated following the UNSCEAR 2000 projection risk model, which takes into account the characteristics of the Valencian population and gives the EAR for radio-induced breast cancer. The results have been calculated and compared by means of the ASQRAD software, but with an older risk projection model, the UNSCEAR 1994. Once the four sample average EAR have been calculated, the evolution of the induced risk in the Valencian Breast Cancer

  8. 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.

  9. 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

  10. 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

  11. Programme of identification and assessment of risks at Ukrainian milk processing factories

    Directory of Open Access Journals (Sweden)

    Shvets Victor H.

    2014-01-01

    Full Text Available The goal of the article lies in the study of possible risks at a milk processing factory and their identification and assessment by relevant criteria and creation of the efficient risk management system with the help of methods of reacting to them. The article considers the economic risk of production processes at a milk processing factory and control of their limit, studies identification and assessment of possible risks in accordance with the international practice pursuant to the COSO concept, and analyses methods of identification of assessment of the risk level and relevant methods of reacting to them. The authors offer the milk processing factory risk identification and assessment programme, which would ensure timely detection of the most important risks, which require relevant reactions, and development of new methods of internal control and recommendations on improvement of the risk assessment system for ensuring efficient activity of a factory in general.

  12. 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.

  13. Radiation risk, medical surveillance programme and radiation protection in mining and milling of uranium ores

    International Nuclear Information System (INIS)

    Rakshit, A.K.

    1991-01-01

    Mining and milling of uranium ores comprise multiple operations such as developement, drilling, blasting, handling, crushing, grinding, leaching of the ore and concentration, drying, packaging and storing of the concentrate product. Apart from the hazards of any metal mining and milling operations due to dust, noise, chemicals, accidents etc there are radiation risks also resulting from exposure to airborne radioactivity and external radiation. The inhalation risk is of more concern in underground mines than in open pit mines. The objective of a Medical Surveillance Programme (an occupational Health Programme) is to ensure a healthy work force. It should ultimately lead to health maintenance and improvement, less absenteeism increased productivity and the achievement of worker and corporate goals. The programme includes prevention, acute care, counselling and rehabilitation. Radiological workers require special monitoring for their work-related radiation exposure effect by film monitoring service, whole body counting and bioassay. Radiation protection in the mining and milling of Uranium ores include the use of personal protective equipment, work station protection, personal hygiene and house keeping. (author). 15 refs

  14. 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.

  15. Guidelines for integrated risk assessment and management in large industrial areas. Inter-Agency programme on the assessment and management of health and environmental risks from energy and other complex industrial systems

    International Nuclear Information System (INIS)

    1998-01-01

    The IAEA, the United Nations Environment Programme (UNEP) within the framework of the Awareness and Preparedness for Emergencies at Local Level (APELL), the United Nations Industrial Development Organization (UNIDO) and the World Health Organization (WHO) decided in 1986 to join forces in order to promote the use of integrated area wide approaches to risk management. An Inter-Agency Programme, which brings together expertise in health the environment, industry and energy, all vital for effective risk management, was established. The Inter-Agency Programme on the assessment and Management of Health and Environmental Risks from Energy and Other Complex Industrial Systems aims at promoting and facilitating the implementation of integrated risk assessment and management for large industrial areas. This initiative includes the compilation of procedures and methods for environmental and public health risk assessment, the transfer of knowledge and experience amongst countries in the application of these procedures and the implementation of an integrated approach to risk management. The purpose of the Inter-Agency Programme is to develop a broad approach to the identification, prioritization and minimization of industrial hazards in a given geographical area. The UN organizations sponsoring this programme have been involved for several years in activities aimed at assessment and management of environmental and health risks, prevention of major accidents and emergency preparedness. These Guidelines have been developed on the basis of experience from these activities to assist in the planning and conduct of regional risk management projects. They provide a reference framework for the undertaking of integrated health and environmental risk assessment for large industrial areas and for the formulation of appropriate risk management strategies

  16. Guidelines for integrated risk assessment and management in large industrial areas. Inter-Agency programme on the assessment and management of health and environmental risks from energy and other complex industrial systems

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    The IAEA, the United Nations Environment Programme (UNEP) within the framework of the Awareness and Preparedness for Emergencies at Local Level (APELL), the United Nations Industrial Development Organization (UNIDO) and the World Health Organization (WHO) decided in 1986 to join forces in order to promote the use of integrated area wide approaches to risk management. An Inter-Agency Programme, which brings together expertise in health the environment, industry and energy, all vital for effective risk management, was established. The Inter-Agency Programme on the assessment and Management of Health and Environmental Risks from Energy and Other Complex Industrial Systems aims at promoting and facilitating the implementation of integrated risk assessment and management for large industrial areas. This initiative includes the compilation of procedures and methods for environmental and public health risk assessment, the transfer of knowledge and experience amongst countries in the application of these procedures and the implementation of an integrated approach to risk management. The purpose of the Inter-Agency Programme is to develop a broad approach to the identification, prioritization and minimization of industrial hazards in a given geographical area. The UN organizations sponsoring this programme have been involved for several years in activities aimed at assessment and management of environmental and health risks, prevention of major accidents and emergency preparedness. These Guidelines have been developed on the basis of experience from these activities to assist in the planning and conduct of regional risk management projects. They provide a reference framework for the undertaking of integrated health and environmental risk assessment for large industrial areas and for the formulation of appropriate risk management strategies. Refs, figs, tabs.

  17. 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…

  18. Managed alcohol as a harm reduction intervention for alcohol addiction in populations at high risk for substance abuse.

    Science.gov (United States)

    Muckle, Wendy; Muckle, Jamie; Welch, Vivian; Tugwell, Peter

    2012-12-12

    Managed alcohol programmes (MAP) are a harm reduction strategy used to minimise the personal harm and adverse societal effects that alcohol dependence can lead to by providing an alternative to zero-tolerance approaches that incorporate drinking goals (abstinence or moderation) that are compatible with the needs of the individual, and promoting access to services by offering low-threshold alternatives. This enables clients to gain access to services despite continued alcohol consumption and works to help the patient understand the risks involved in their behaviour and make decisions about their own treatment goals. To assess the effectiveness of MAP treatment regimens (serving limited quantities of alcohol daily to alcoholics) on their own or as compared to moderate drinking (self-controlled drinking), screening and brief intervention using a harm reduction approach, traditional abstinence-based interventions (12 step programmes) and no intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO up to March 2012. This search was expanded by handsearching of high-yield journals and conference proceedings that had not already been handsearched on behalf of The Cochrane Collaboration, searching reference lists of all papers and relevant reviews identified, references to ongoing and recently completed clinical trials in the National Research Register and IFPMA Clinical Trials Database (which contains ClinicalTrials.gov, Centerwatch, Current Controlled Trials and ClinicalStudyResults.gov, and Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali). Trials registers, grey literature and reference lists were also searched. Individuals, organisations and experts in the field were contacted. Randomised control trials (RCT), controlled clinical trials (CCT), interrupted time series (ITS) studies, and control before and after (CBA) studies involving vulnerable people aged 18 years or older who were

  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. 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.

  1. Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

    2011-01-01

    To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

  2. 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

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Van Loon-Steensma Jantsje M.

    2016-01-01

    Full Text Available In the Netherlands, the concept of a multifunctional dike has already often been implemented, and has been identified as a promising climate adaptation measure. In a multifunctional dike, functions like urban development, transport infrastructure, recreation, agriculture or nature are deliberately combined with its primary flood protection function. This means that the design must be based on the requirements and life span of all different functions, while in a monofunctional dike only the flood protection function is considered. By accommodating other functions, a multifunctional dike may easier fit into, or even contribute to the quality of the landscape. Moreover, these other functions may help in financing the flood protection works, but governance is more complicated. To avoid costly adjustments forthcoming from changed safety standards, incorporation of multiple functions can require a more “robust” flood defence than a monofunctional flood defence. A robust flood defence can withstand more extreme situations than required by the present safety standards, and has a substantially lower flooding probability. Therefore, a multifunctional dike may be attractive in view of the uncertainties regarding the effects of climate change and a changing world. Moreover, it will result in reduced flood risk. As part of the Dutch Delta programme, several explorative studies on multifunctional dikes were initiated. Most studies focused on urban areas, but also in the rural area interest emerged for multifunctional dikes, e.g. for the integration of salt marshes into the flood defences. Marshes provide valuable habitat for vegetation and invertebrate species, and are important for wading birds. Furthermore, under condition of abundant sediment availability they can keep pace with sea level rise. Explorative modelling results indicate that vegetated forelands affect wave heights, even under extreme conditions. However, the inclusion of a vegetated

  6. 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.

  7. Factors associated with dropout in a group weight-loss programme: a longitudinal investigation.

    Science.gov (United States)

    Yackobovitch-Gavan, M; Steinberg, D M; Endevelt, R; Benyamini, Y

    2015-02-01

    Attrition is a major limitation of most weight management intervention programmes. The present study aimed to conduct an extensive investigation of personal, sociodemographic and treatment-related factors associated with attrition at different stages of a 10-week group weight-loss programme. The present study is part of a longitudinal, clinical intervention study comparing three conditions in a 10-week group programme: Control, Behavioural Intentions and Implementation Intentions. The study included 587 participants with a mean (SD) age of 46 (11) years (range 18-78 years) and a mean (SD) body mass index (BMI) of 31.9 (5.5) kg m(-2), with 90% being female. To characterise dropout in each week separately, as well as overall dropout (dropout until week 9, the median time of dropout), we tested several logistic regression models, including multiple imputations to cope with missing data. The results of the different dropout models consistently showed that a smaller reduction in BMI in the first 2 weeks of the programme was the strongest predictor of dropout. Dropout in the tenth and last week differed from the earlier weeks both in the relatively high dropout rate (56% of total dropout) and in that, in contrast to earlier weeks, the week 10 model included the reduction in BMI during the last 2 weeks before dropout but did not include the reduction in BMI at the initiation of the intervention. Weight-loss in the beginning of the programme is a crucial independent determinant of dropout in each week except the last one. This finding is important because it suggests a simple assessment for a major dropout risk factor in adult weight-loss intervention programmes. © 2014 The British Dietetic Association Ltd.

  8. 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

  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. 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...

  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. Spatiotemporal distribution and population at risk of soil-transmitted helminth infections following an eight-year school-based deworming programme in Burundi, 2007–2014

    Directory of Open Access Journals (Sweden)

    Mohamad Assoum

    2017-11-01

    Full Text Available Abstract Background Investigating the effect of successive annual deworming rounds on the spatiotemporal distribution of infection prevalence and numbers at risk for soil-transmitted helminths (STHs can help identify communities nearing elimination and those needing further interventions. In this study, we aim to quantify the impact of an 8-year mass drug administration (MDA programme (from 2007 to 2014 on the spatiotemporal distribution of prevalence of STH infections and to estimate the number of school-aged children infected with STHs in Burundi. Methods During annual longitudinal school-based surveys in Burundi between 2007 and 2011, STH infection and anthropometric data for a total of 40,656 children were collected; these data were supplemented with data from a national survey conducted in 2014. Bayesian model based geostatistics (MBG were used to generate predictive prevalence maps for each STH species and year. The numbers of children at-risk of infection per district between 2008 and 2014 were estimated as the product of the predictive prevalence maps and population density maps. Results Overall, the degree of spatial clustering of STH infections decreased between 2008 and 2011; in 2014 the geographical clusters of all STH infections reappeared. The reduction in prevalence was small for Ascaris lumbricoides and Trichuris trichiura in the centre and central north of the country. Our predictive prevalence maps for hookworm indicate a reduction in prevalence along the periphery of the country. The predicted number of children infected with any STH species decreased substantially between 2007 and 2011, but in 2014 there was an increase in the predicted number of children infected with A. lumbricoides and T. trichiura. In 2014, the districts with the highest predicted number of children infected with A. lumbricoides, T. trichiura and hookworms were Kibuye district (n = 128,903, Mabayi district (n = 35,302 and Kiremba (n = 87

  13. LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth.

    Science.gov (United States)

    Gatto, N M; Martinez, L C; Spruijt-Metz, D; Davis, J N

    2017-02-01

    Many programmes for children that involve gardening and nutrition components exist; however, none include experimental designs allowing more rigorous evaluation of their impact on obesity. The objective of this study is to explore the effects of a novel 12-week gardening, nutrition and cooking intervention {'LA Sprouts'} on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles.. This study used a randomized control trial involving four elementary schools [two randomized to intervention {172, 3rd-5th grade students}; two randomized to control {147, 3rd-5th grade students}]. Classes were taught in 90-min sessions once per week for 12 weeks. Data collected at pre-intervention and post-intervention included dietary intake via food frequency questionnaire, anthropometric measures {body mass index, waist circumference}, body fat, and fasting blood samples. LA Sprouts participants compared with controls had significantly greater reductions in body mass index z-scores {-0.1 vs. -0.04, respectively; p = 0.01} and waist circumference {-1.2 vs. 0.1 cm; p obesity and metabolic risk; however, additional larger and longer-term studies are warranted. © 2016 World Obesity Federation.

  14. 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

  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. 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

  17. Semaglutide, reduction in HbA1c and the risk of diabetic retinopathy

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Bain, Stephen C; Leiter, Lawrence A

    2018-01-01

    AIMS: To evaluate diabetic retinopathy data from across the SUSTAIN clinical trial programme. MATERIALS AND METHODS: The SUSTAIN clinical trial programme evaluated the efficacy and safety of semaglutide, a glucagon-like peptide-1 analogue, for the treatment of type 2 diabetes (T2D). In SUSTAIN 6...... - a 2-year, preapproval cardiovascular outcomes trial - semaglutide was associated with a significant increase in the risk of diabetic retinopathy complications (DRC) versus placebo. Diabetic retinopathy (DR) data from across the SUSTAIN trials were evaluated and post hoc analyses of the SUSTAIN 6 data...

  18. 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.

  19. Radiation doses in diagnostic radiology and methods for dose reduction. Report of a co-ordinated research programme (1991-1993)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    It is well recognized that diagnostic radiology is the largest contributor to the collective dose from all man-made sources of radiation. Large differences in radiation doses from the same procedures among different X ray rooms have led to the conclusion that there is a potential for dose reduction. A Co-ordinated Research Programme on Radiation Doses in Diagnostic Radiology and Methods for Dose Reduction, involving Member States with different degrees of development, was launched by the IAEA in co-operation with the CEC. This report summarizes the results of the second and final Research Co-ordination Meeting held in Vienna from 4 to 8 October 1993. 22 refs, 6 figs and tabs.

  20. Radiation doses in diagnostic radiology and methods for dose reduction. Report of a co-ordinated research programme (1991-1993)

    International Nuclear Information System (INIS)

    1995-04-01

    It is well recognized that diagnostic radiology is the largest contributor to the collective dose from all man-made sources of radiation. Large differences in radiation doses from the same procedures among different X ray rooms have led to the conclusion that there is a potential for dose reduction. A Co-ordinated Research Programme on Radiation Doses in Diagnostic Radiology and Methods for Dose Reduction, involving Member States with different degrees of development, was launched by the IAEA in co-operation with the CEC. This report summarizes the results of the second and final Research Co-ordination Meeting held in Vienna from 4 to 8 October 1993. 22 refs, 6 figs and tabs

  1. 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.

  2. 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

  3. 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.

  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. 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.

  6. 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...

  7. 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.

  8. 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.

  9. Evaluating a Pregnancy and STI Prevention Programme in Rural, At-Risk, Middle School Girls in the USA

    Science.gov (United States)

    Hill, Julie C.; Lynne-Landsman, Sarah D.; Graber, Julia A.; Johnson, Kelly J.

    2016-01-01

    Objective: Young people in urban areas are often the focus of pregnancy and sexually transmitted infection (STI) prevention programmes because of their high risk of unwanted pregnancy and contracting an STI. Young people in rural areas are far less studied but also have a high risk of similar outcomes. This study evaluates Giving Our Girls…

  10. A One-to-One Programme for At-Risk Readers Delivered by Older Adult Volunteers

    Science.gov (United States)

    Fives, Allyn; Kearns, Noreen; Devaney, Carmel; Canavan, John; Russell, Dan; Lyons, Rena; Eaton, Patricia; O'Brien, Aoife

    2013-01-01

    This paper is based on a randomized controlled trial (RCT) evaluation of a reading programme delivered by older adult volunteers for at-risk early readers. Wizards of Words (WoW) was targeted at socially disadvantaged children in first and second grade experiencing delays in reading but who were not eligible for formal literacy supports. The…

  11. 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....

  12. 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

  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. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

    Science.gov (United States)

    Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

    2014-01-21

    The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in

  15. 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.

  16. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Krommes, Kasper Kühn; Esteve, Ernest

    2017-01-01

    Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham...... intervention) among football players. Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention...... programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio...

  17. Trends and risk factors of hepatitis A in Catalonia after the introduction of a hepatitis A+B vaccination programme.

    Science.gov (United States)

    Godoy, P; Carmona, G; Manzanares, S; Jane, M; Borràs, E; Camps, N; Álvarez, J; Barrabeig, I; Sala, M-R; Rius, C; Minguell, S; Carol, M; Ferras, J; Domínguez, A

    2018-03-31

    At the end of 1998, universal hepatitis A+B vaccination of 12 year olds was introduced in Catalonia. The aim was to examine trends in hepatitis A during 2005-2015 and assess risk factors by age group. We carried out an observational epidemiological study of the incidence and risk factors of hepatitis A reported to the surveillance system. Information on exposure was recorded for each case for the 2-6 weeks before symptom onset. Spearman's coefficient was used to evaluate the trends of rates. The chi-square test was used to compare categorical. We studied 2621 hepatitis A cases; the age mean was 26.6 years (SD=18.2), and >50% of cases were in the 20-49 years age group. The incidence decreased from 3.28/100 000 in 2005 to 1.50/100 000 in 2015. The rate for women decreased over time (P = .008), but the reduction was not significant in men (P = .234). Men consistently had higher rates than women with the biggest difference being in the 20-34 years age group (rate 8.8 vs 2.8). The greatest risk factor was travel to an endemic country (42.1%) in the 0-19 years age group and male-to-male sexual contact (18.6%) in the 20-49 years age group. The case fatality rate in adults aged >49 years was 0.4%. In conclusion, the vaccination programme of preadolescents resulted in a reduction in hepatitis A cases. However, a significant amount of cases still appear in immigrants and men who have sex with men. Hepatitis A in adults is an emerging health problem that will require new strategies. © 2018 John Wiley & Sons Ltd.

  18. 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.

  19. 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

  20. Therapeutic Responses to "At Risk" Disengaged Early School Leavers in a Rural Alternative Education Programme

    Science.gov (United States)

    Fish, Tim

    2017-01-01

    The identification of disengaged early school leavers as young people "at risk" can lead to a deficit-based framing of how educational institutions respond to them. A rural secondary school in Victoria, Australia established an alternative education programme to cater for local disengaged young people. A critical ethnographic study was…

  1. 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)

  2. 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)

  3. 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.

  4. 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.

  5. 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

  6. Chemical exposure reduction: Factors impacting on South African herbicide sprayers' personal protective equipment compliance and high risk work practices.

    Science.gov (United States)

    Andrade-Rivas, Federico; Rother, Hanna-Andrea

    2015-10-01

    The high exposure risks of workers to herbicides in low- and middle-income countries is an important public health concern because of the potential resulting negative impacts on workers' health. This study investigated workers' personal protective equipment (PPE) compliance as a risk mitigation measure; particularly workers who apply herbicides for Working for Water (WfW) - a South African invasive alien vegetation control programme. The study aim was to understand workers' low PPE compliance by analysing their risk perceptions of herbicide use, working conditions and socio-cultural context. Research methods included ethnographic observations, informal interviews, visual media, questionnaires and a focus group. Study results indicated that low PPE compliance persists despite workers' awareness of herbicide exposure risks and as a result of the influence from workers' socio-cultural context (i.e. gender dynamics and social status), herbicide risk perceptions and working conditions (i.e. environmental and logistical). Interestingly, teams comprised of mostly women had the highest compliance rate. These findings highlighted that given the complexity of PPE compliance, especially in countries with several economic and social constraints, exposure reduction interventions should not rely solely on PPE use promotion. Instead, other control strategies requiring less worker input for effectiveness should be implemented, such as elimination and substitution of highly hazardous pesticides, and altering application methods. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

    Science.gov (United States)

    Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

    2013-05-01

    Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

  8. 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.

  9. 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.

  10. 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.

  11. 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)

  12. 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.

  13. Effects of 6-month soccer and traditional physical activity programmes on body composition, cardiometabolic risk factors, inflammatory, oxidative stress markers and cardiorespiratory fitness in obese boys.

    Science.gov (United States)

    Seabra, André; Katzmarzyk, Peter; Carvalho, Maria José; Seabra, Ana; Coelho-E-Silva, Manuel; Abreu, Sandra; Vale, Susana; Póvoas, Susana; Nascimento, Henrique; Belo, Luís; Torres, Sandra; Oliveira, José; Mota, Jorge; Santos-Silva, Alice; Rêgo, Carla; Malina, Robert M

    2016-10-01

    Physical activity is important in obesity prevention, but the effectiveness of different physical activity modalities remains to be determined among children. The main purpose of this study was to compare the effects of a 6-month soccer programme and a traditional physical activity programme on changes in body composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status in obese boys. Eighty-eight boys (8-12 years; BMI > +2 standard deviations of WHO reference values) participated in one of three groups: soccer, traditional activity and control. Soccer and traditional activity programmes involved 3 sessions per week for 60-90 min at an average intensity of 70-80% of maximal heart rate. Control group participated in activities of normal daily living. All boys participated in school physical education, two sessions per week of 45-90-min. Measurements were taken at baseline and after 6 months, and included body size and composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status. Physical activity and dietary intake were assessed before and immediately following the intervention. The three groups had similar characteristics at baseline. After 6 months, both intervention groups had significantly lower relative fatness (% fat), waist circumference and total cholesterol, and higher cardiorespiratory fitness, self-esteem, perceived physical competence and attraction to physical activity compared with control group. In conclusion, physical activity interventions over 6 months positively influenced several indicators of health status among obese boys. The results also suggested that soccer has the potential as an effective tool for the prevention and reduction of childhood obesity and associated consequences.

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction).

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Hobbs, Fd Richard; Kelly, Jo; Smith, Emily R; Bradbury, Katherine J; Hughes, Stephanie; Smith, Peter Wf; Moore, Michael V; Lean, Mike Ej; Margetts, Barrie M; Byrne, Christopher D; Griffin, Simon; Davoudianfar, Mina; Hooper, Julie; Yao, Guiqing; Zhu, Shihua; Raftery, James; Yardley, Lucy

    2017-01-01

    maintained nearly 3 kg of weight loss per person (mean weight per person: baseline, 104.4 kg; 6 months, 101.9 kg; 12 months, 101.7 kg). Compared with the control group, the estimated additional weight reduction with POWeR+F was 1.5 kg [95% confidence interval (CI) 0.6 to 2.4 kg; p  = 0.001] and with POWeR+R was 1.3 kg (95% CI 0.34 to 2.2 kg; p  = 0.007). By 12 months the mean weight loss was not statistically significantly different between groups, but 20.8% of control participants, 29.2% of POWeR+F participants (risk ratio 1.56, 95% CI 0.96 to 2.51; p  = 0.070) and 32.4% of POWeR+R participants (risk ratio 1.82, 95% CI 1.31 to 2.74; p  = 0.004) maintained a clinically significant 5% weight reduction. The POWeR+R group had fewer individuals who reported doing another activity to help lose weight [control, 47.1% (64/136); POWeR+F, 37.2% (51/137); POWeR+R, 26.7% (40/150)]. The incremental cost to the health service per kilogram weight lost, compared with the control group, was £18 (95% CI -£129 to £195) for POWeR+F and -£25 (95% CI -£268 to £157) for POWeR+R. The probability of being cost-effective at a threshold of £100 per kilogram was 88% and 98% for POWeR+F and POWeR+R, respectively. POWeR+R was dominant compared with the control group. No harms were reported and participants using POWeR+ felt more enabled in managing their weight. The qualitative studies documented that POWeR+ was viewed positively by patients and that health-care professionals generally enjoyed supporting patients using POWeR+. Maintenance of weight loss after 1 year is unknown. Identifying strategies for longer-term engagement, impact in community settings and increasing physical activity. Clinically valuable weight loss (> 5%) is maintained in 20% of individuals using novel written materials with brief follow-up. A web-based behavioural programme and brief support results in greater mean weight loss and 10% more participants maintain valuable weight loss; it

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. Peer-Assisted Learning Programme: Supporting Students in High-Risk Subjects at the Mechanical Engineering Department at Walter Sisulu University

    Directory of Open Access Journals (Sweden)

    Makala Qonda

    2017-12-01

    Full Text Available The majority of the students who enroll at the Walter Sisulu University (WSU in South Africa are not equipped with the necessary academic/learning skills to cope with the university environment, especially in Mechanical Engineering. The Department of Higher Education and Training (2013, p. 17, further states that “students’ support is crucial to ensure that students adapt to the demands of college life and that they can meet the demands of college programmes”. Particularly in South Africa, the school environment might also contribute to poor student performance as a result of insufficient student support, and a lack of facilities and resources. In order to address this gap, a Peer-Assisted Learning (PAL programme was implemented to provide support targeting high-risk subjects for at-risk students in Mechanical Engineering at WSU. The programme therefore is pro-active and student-driven in that senior students assist junior students with their academic work and learning processes. The programme is designed to encourage collaborative and cooperative learning approaches during group sessions and active student engagement to support student learning (Laal & Laal, 2012. The programme requires substantial resources and time commitments. It is important from an operational, learning, and student perspective to understand in what ways the PAL programme assists students (if at all. Eliciting the experiences of students also helps the department to design interventions from a student-centred perspective using the lens of learning theories.  This qualitative case study explores the student experience of the Peer-Assisted Learning (PAL programme. Open-ended questionnaires/survey from 20 first-year students elicited their perceptions and experiences of the PAL programme. Responses were analysed thematically. Findings indicated that the students had useful insights that may contribute to revising the programme. Aspects mentioned were improved study

  6. Profile of atrial fibrillation inpatients: Cardiovascular risk factors and cardiac rehabilitation programme delivery and referral patterns.

    Science.gov (United States)

    Gallagher, Robyn; Zhang, Ling; Roach, Kellie; Sadler, Leonie; Belshaw, Julie; Kirkness, Ann; Proctor, Ross; Neubeck, Lis

    2015-12-01

    Atrial fibrillation (AF) is increasingly common; however, the cardiovascular risk factor profile and the patterns of delivery and referral to cardiac rehabilitation (CR) in this population are poorly described. We conducted an audit of medical records (n = 145) of patients admitted with AF in one local health district in Sydney, Australia. Patients were aged a mean 72 years, and 51% were male. Lack of risk factor documentation was common. Despite this, 65% had two or more modifiable cardiovascular risk factors, including hypertension (63%) and hypercholesterolaemia (52%). Referral to Phase II CR occurred for 25% and was decreased with permanent AF diagnosis and increased with more risk factors. AF patients admitted to hospital have multiple cardiovascular risk factors but limited risk factor screening and/or referral to outpatient CR programmes. © 2014 Wiley Publishing Asia Pty Ltd.

  7. Cardiovascular risk reduction by reversing endothelial dysfunction: ARBs, ACE inhibitors,  or both? Expectations from The ONTARGET  Trial Programme

    Directory of Open Access Journals (Sweden)

    Luis Miguel  Ruilope

    2007-03-01

    Full Text Available Luis Miguel  Ruilope1, Josep Redón2, Roland Schmieder31Servicio de Nefrologia, Unidad de Hipertension Hospital, 12 de Octubre, Madrid, Spain; 2Department of Internal Medicine, Hospital Clinico University of Valencia, Valencia, Spain; 3Department of Nephrology and Hypertension, Friedrich-Alexander-Universitat, Erlangen-Nurnberg, GermanyAbstract: Endothelial dysfunction is the initial pathophysiological step in a progression of vascular damage that leads to overt cardiovascular and chronic kidney disease. Angiotensin II, the primary agent of the renin–angiotensin system (RAS, has a central role in endothelial dysfunction. Therefore, RAS blockade with an angiotensin receptor blocker (ARB and/or angiotensin-converting enzyme (ACE inhibitor provides a rational approach to reverse endothelial dysfunction, reduce microalbuminuria, and, thus, improves cardiovascular and renal prognosis. ARBs and ACE inhibitors act at different points in the RAS pathway and recent evidence suggests that there are differences regarding their effects on endothelial dysfunction. In addition to blood pressure lowering, studies have shown that ARBs reduce target-organ damage, including improvements in endothelial dysfunction, arterial stiffness, the progression of renal dysfunction in patients with type 2 diabetes, proteinuria, and left ventricular hypertrophy. The ONgoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial (ONTARGET Programme is expected to provide the ultimate evidence of whether improved endothelial func tion translates into reduced cardiovascular and renal events in high-risk patients, and to assess possible differential outcomes with telmisartan, the ACE inhibitor ramipril, or a combination of both (dual RAS blockade. Completion of ONTARGET is expected in 2008. Keywords: angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, endothelial dysfunction, ONTARGET, renin–angiotensin system, telmisartan

  8. 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

  9. Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.

    Science.gov (United States)

    Sayal, K; Taylor, J A; Valentine, A; Guo, B; Sampson, C J; Sellman, E; James, M; Hollis, C; Daley, D

    2016-07-01

    interventions acceptable. For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. © 2016 John Wiley & Sons Ltd.

  10. 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.

  11. The costs of a sexually transmitted infection outreach and treatment programme targeting most at risk youth in Tajikistan

    Directory of Open Access Journals (Sweden)

    Johns Benjamin

    2009-11-01

    Full Text Available Abstract Background Targeted outreach, counselling, and treatment of sexually transmitted infections (STIs are among the most cost-effective interventions aimed at ameliorating the burden of HIV/STIs. Since many new HIV infections occur in people under the age of 25, youth, and especially most at risk adolescents (MARA, need to be able to access HIV/STI services. Starting in 2006, a programme targeting MARA including outreach, confidential and voluntary counselling and testing, and STI diagnosis and treatment was piloted in three cities in Tajikistan. This study uses data from these pilot sites to estimate the costs of a national programme. Methods Cost data were collected from the three pilot sites. Then, the target population and the number of patients receiving specific types of services are calculated for other areas. The unit costs from the pilot sites are multiplied by usage rates to determine the total costs of a national programme. Scenarios were developed to reflect data uncertainty. The government's ability to finance the programme was estimated using Ministry of Health budget data. Further analyses were done for one of the pilot cities where more detailed data were available. Results In total, costs were projected for eight programme sites, covering an estimated 8,020 MARA. Operational and variable cost for the programme are projected to be US$ 119,159 (range US$ 104,953 to 151,524 per year. Including annual equivalent cost for capital and start-up items raises this to US$ 137,082 (range: US$ 123,022 to 169,597 per year. The analyses of potential sources of financing for the programme remain inconclusive, but it may take multiple sources of financing to fund the programme. Conclusion While the cost-effectiveness of similar programmes have been previously assessed using modelled data, more work needs to be done to assess the costs of new programmes in relation to financial resources available. Full costing should consider cost

  12. 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 ...

  13. 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

  14. [The issue of harm reduction in Polish legislation concerning drug addiction. A comparative study].

    Science.gov (United States)

    Sobeyko, Justyna

    2008-01-01

    The aim of work is the assessment of legal permissibility for health and social harm reduction programmes resulting from drug use in the context of the polish legislation on narcotic drug use and drug addiction. The thesis outlines harm reduction programmes implemented worldwide, role of penal code in counteracting both narcotic drug supply and demand, attitude of United Nations and European Union to the drug problem including harm reduction programmes, solutions adopted in the selected European Union member states. The main part of the thesis presents the evolution of polish legislation regarding drug use and analysis of legal permissibility for harm reduction programmes in this context. The conclusion inferred is the statement that implementation of the harm reduction programmes requires a certain minimal depenalisation of the drug use by a legislator and the fact that restrictive legal system impedes programme realization. Thus the thesis postulates depenalisation of small drug quantities for personal use.

  15. 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

  16. Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

    Directory of Open Access Journals (Sweden)

    M Kamal Pasa

    Full Text Available Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID, examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV and hepatitis in a region where these dual epidemics are likely to expand.We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software.We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms.Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle

  17. 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

  18. Outcomes following a programme for lifestyle changes with people with hypertension.

    Science.gov (United States)

    Drevenhorn, Eva; Kjellgren, Karin I; Bengtson, Ann

    2007-07-01

    The purpose of the study was to explore the effects of using a structured nursing intervention programme in hypertension care. Counselling on lifestyle changes to address hypertension helps patients reduce risk factors such as smoking, high alcohol consumption, overweight, dyslipidemia, negative stress and physical inactivity. The study was performed as a pre-test-post-test study. All 177 patients diagnosed with hypertension visiting a health centre in Southern Sweden were invited to be counselled by a public health nurse about hypertension, cardiovascular risk factors and non-pharmacological treatment with 15 months follow up. One hundred patients participated in the study. Systolic blood pressure decreased overall (p changed their medication. The level of exercise increased and a reduction in systolic blood pressure and in women's weight were the most obvious results of this intervention study. The study elucidates the challenge of executing health behaviour changes. Counselling following a hypertension programme gives hypertensive patients a chance to execute lifestyle changes and have their medication adjusted to achieve goals for blood pressure control. Further prospective studies in this area, with well-defined intervention approaches and several years of follow up, are necessary.

  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. Impact of a multifactorial treatment programme on clinical outcomes and cardiovascular risk estimates

    DEFF Research Database (Denmark)

    Safai, Narges; Carstensen, Bendix; Vestergaard, Henrik

    2018-01-01

    ), blood pressure (BP) and low-density lipoprotein (LDL) cholesterol as well as proportion reaching treatment targets. Our secondary outcome was to investigate changes in antidiabetic, antihypertensive and lipid-lowering treatment, together with the impact on estimated CVD risk. Linear mixed model....... SETTING: Tertiary diabetes centre in Denmark. PARTICIPANTS: Patients with type 2 diabetes (n=4299) referred to a programme with focus on treatment of hyperglycaemia, hypertension and dyslipidaemia between 1 January 2001 and 1 April 2016. OUTCOMES: Primary outcomes were changes in haemoglobin A1c (HbA1c...

  2. 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.

  3. 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...

  4. The CEC radon research programme

    International Nuclear Information System (INIS)

    Olast, M.

    1990-01-01

    Following a council decision of 20 June 1989, a CEC research and training programme in the field of radiation protection has been adopted for the period 1990-1991. The european research programme is divided into three main areas, one being 'Risks and Management of Radiation Exposure': this includes a section on 'Exposure to natural radioactivity and evaluation of parameters influencing these risks'. The importance given to this field led to an impressive number of research proposals. The proposals accepted are grouped in three large multinational contracts covering radon exposure, and in one multinational contract dealing with environmental radon epidemiology. (author)

  5. 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

  6. Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults.

    Science.gov (United States)

    Crowe, Catherine; Gibson, Irene; Cunningham, Katie; Kerins, Claire; Costello, Caroline; Windle, Jane; O Shea, Paula M; Hynes, Mary; McGuire, Brian; Kilkelly, Katriona; Griffin, Helena; O Brien, Tim; Jones, Jenni; Finucane, Francis M

    2015-08-01

    Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme. We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥ 40 kgm(-2) (or ≥ 35 kgm(-2) with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses. Of 183 bariatric patients enrolled, 150 (81.9%) completed the programme. Mean age of completers was 47.9 ± 1.2 years. 34.7% were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg, p triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic equivalents of thermogenesis (METS), p structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted.

  7. 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.

  8. 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.

  9. Radiological impact of the Argentine Nuclear Programme

    International Nuclear Information System (INIS)

    Gonzalez, A.J.

    1983-01-01

    An assessment is made of the radiological impact resulting from the activities carried out so far under the Argentine Nuclear Programme, together with a prediction of the impact which could result from the future activities planned under that Programme. The average individual risks and the radiological detriment due to the various activities are determined in terms of the average individual effective dose equivalents and the collective effective dose equivalent commitments. The assessments cover exposures of occupationally exposed workers and the public. The data obtained indicate that both the risks and the resultant detriment are reasonably comparable with those derived from other similar programmes. Moreover, they clearly indicate that the radiological impact of the Programme is tending to decrease with time so that it can be assumed that the radiological impact per unit of practice will be even lower in future. (author)

  10. The role of social risk in an early preventative care programme for infants born very preterm: a randomized controlled trial.

    Science.gov (United States)

    Spittle, Alicia J; Treyvaud, Karli; Lee, Katherine J; Anderson, Peter J; Doyle, Lex W

    2018-01-01

    To examine the differential effects of an early intervention programme for infants born preterm on neurodevelopment and parental mental health according to family social risk. One hundred and twenty infants born earlier than 30 weeks' gestation were randomized to early intervention (n=61) or control groups (n=59). Cognitive, language, and motor outcomes were assessed by blinded assessors at 2 years, 4 years, and 8 years, and primary caregivers completed questionnaires on their anxiety and depression. Outcomes at each time point were compared between groups using linear regression with an interaction term for social risk (higher/lower). There was evidence of interactions between intervention group and social risk for cognition at 2 years and 4 years, motor function at 4 years, and language at 8 years, with a greater intervention effect in children from higher social risk environments. In contrast, the impact of early intervention on parental depressive symptoms was greater for parents of lower social risk than for those of higher social risk. Effects of early intervention on outcomes for children born preterm and their caregivers varied according to family social risk. Family social risk should be considered when implementing early intervention programmes for children born preterm and their families. Intervention is associated with better early cognitive functioning for children in higher social risk families. Positive effects of intervention for the high risk group were not sustained at school-age. Intervention has a greater effect on primary caregiver mental health in the lower social risk group compared with higher social risk. © 2017 Mac Keith Press.

  11. Nuclear power programmes in developing countries

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    The paper on ''Nuclear power programmes in developing countries'' is a report to the IAEA by a Senior Expert Group. A description is given of the requirements for a successful nuclear power programme, including the constraints that developing countries might face in the introduction and execution of the programme. The group attempted to identify the main issues affecting the financing of nuclear power projects and suggested specific actions that could be undertaken in order to reduce economic and financial risks. The various issues were discussed under the topic headings:-programme-project-related factors, investment climate, financing plan, export credits and creditworthiness. (U.K.)

  12. Impacts of Poverty Reduction Programmes in Nigeria: The Case of ...

    African Journals Online (AJOL)

    The trainings provided by the scheme include tailoring, soap-making, hair dressing, photographing, IT training, etc. Loans were also given to successful trainees after the training to establish their workshops and other businesses. However, like most past poverty alleviation programmes in the country, the YES Scheme was ...

  13. 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

  14. Multidimensional improvements induced by an intensive obesity inpatients rehabilitation programme.

    Science.gov (United States)

    Giordano, Francesca; Berteotti, Michela; Budui, Simona; Calgaro, Nicole; Franceschini, Laura; Gilli, Federica; Masiero, Marina; Raschellà, Guido; Salvetti, Sabrina; Taddei, Micol; Schena, Federico; Busetto, Luca

    2017-06-01

    To analyse the short-term effectiveness of an intensive multidimensional inpatient programme specifically developed for patients with severe obesity. A multidisciplinary team managed a 3-week residential programme characterised by the integration of nutritional and physical rehabilitation with psychological and educational intervention. All patients consecutively admitted in 10 months were analysed at admission and discharge for changes in the following domains: anthropometry (weight, body mass index (BMI), waist and neck circumferences), cardiovascular risk factors (glycaemia, HbA1c, lipid profile, blood pressure), quality of life, eating behaviour, and physical performance (VO 2peak by incremental cycle ergometer test, 6-min walking test (6MWT), chair stands test). 136 subjects (61% females, median age 52.7 years) with obesity (mean BMI 43.2 kg/m 2 ) and multiple comorbidities were analysed. A 3.9% BMI reduction and a reduction in waist (-3.8%) and neck (-3.3%) circumferences were observed. Glycaemic control was achieved in 68% of patients with uncontrolled diabetes at admission. Blood pressure control was achieved in all patients with uncontrolled hypertension at admission. Total cholesterol (-16%), LDL-cholesterol (-19%) and triglycerides (-9%) were significantly reduced. Psychometric assessment showed improvements in quality of life perception and binge eating disorder. Finally, a significant improvement in physical performance (+4.7% improvement in VO 2peak , with longer distances in 6MWT and a higher number of standings) was observed. Our preliminary data prove that a 3-week programme determined a clinically significant multi-dimensional improvement in patients with severe obesity. Long-term follow-up data are needed to confirm the efficacy of our rehabilitation setting.

  15. The Danish Pesticide Leaching Assessment Programme

    DEFF Research Database (Denmark)

    Rosenbom, Annette Elisabeth; Brüsch, Walter Michael; Juhler, Rene K.

    In 1998, the Danish Parliament initiated the Pesticide Leaching Assessment Programme (PLAP), an intensive monitoring programme aimed at evaluating the leaching risk of pesticides under field conditions. The objective of the PLAP is to improve the scientific foundation for decision......-making in the Danish regulation of pesticides. The specific aim is to analyse whether pesticides applied in accordance with current regulations leach to groundwater in unacceptable concentrations. The programme currently evaluates the leaching risk of 41 pesticides and 40 degradation products at five agricultural......, thiamethoxam, tribenuronmethyl, and triasulfuron) did not leach during the 1999-2009 monitoring period. 13 of the applied pesticides exhibited pronounced leaching of the pesticide and/or their degradation product(-s) 1 m b.g.s. in yearly average concentrations exceeding 0.1 μg/l (maximum allowable...

  16. Evaluation of cardiovascular risk-lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes.

    Science.gov (United States)

    Webb, R; Thompson, J E S; Ruffino, J-S; Davies, N A; Watkeys, L; Hooper, S; Jones, P M; Walters, G; Clayton, D; Thomas, A W; Morris, K; Llewellyn, D H; Ward, M; Wyatt-Williams, J; McDonnell, B J

    2016-01-01

    To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques. In studies 1-3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3. Because cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued

  17. Beneficial effects of a woman-focused development programme on child survival: evidence from rural Bangladesh.

    Science.gov (United States)

    Bhuiya, Abbas; Chowdhury, Mushtaque

    2002-11-01

    This paper reports results from a prospective study of the impact of a woman-focused development programme on child survival in Matlab, a rural area of Bangladesh. The programme was targeted to households owning less than 50 decimals of land and members selling more than 100 days of labour for living in a year. Programme components included formation of women's groups for saving and credit, training on skill development, functional literacy including legal and social awareness, and technical and marketing support to projects undertaken with the loan money from the organization. A total of 13,549 children born alive during 1988-97 in the study area were included in the study. Hazards of mortality during pre- and post-intervention periods were compared among the programme participants and non-participants controlling the effects of other relevant variables. There has been a substantial reduction in mortality during the post-intervention period; however, the reduction was much greater for infants whose mothers participated in the development programme compared to infants of non-participant mothers from similar socioeconomic background. In a relative sense, there has been a 52% reduction of the pre-intervention level hazard of death of children during infancy of participant mothers compared to 31% reduction for the infants of non-participant mothers from similar socioeconomic background. There had also been a substantial reduction in hazard of death during childhood (1-4 year age group), however, the reduction was statistically similar for all groups of children irrespective of their mothers' participation in the development programmes.

  18. 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...

  19. The Milan Project: a newborn hearing screening programme.

    Science.gov (United States)

    Pastorino, Giancarlo; Sergi, Paola; Mastrangelo, Massimo; Ravazzani, Paolo; Tognola, Gabriella; Parazzini, Marta; Mosca, Fabio; Pugni, Lorenza; Grandori, Ferdinando

    2005-04-01

    Since 1997 a newborn hearing screening programme has been implemented by the U.O. Neurologia-Neurofisiopatologia and Dipartimento di Neonatologia of the Istituti Clinici di Perfezionamento ICP in Milan for both babies with no risk and those at risk of hearing impairment. This programme was named the Milan Project. The protocol for no-risk babies consisted of three stages: in the first two stages, newborns were tested with transient click-evoked otoacoustic emissions (TEOAE), in the third one with conventional auditory brainstem responses (ABR). The first TEOAE test was performed by 36 h of age, before discharge, the second one after 15-30 d in case of referral, and the third one, by ABR, for those babies who failed the second TEOAE stage. Newborns at audiological risk were submitted to conventional ABR before the third month of corrected age. Some of this latter population was also submitted to the TEOAE test. The entire tested population (no-risk babies and newborns at audiological risk) consisted of 19 777 babies: 19 290 without risk ("no risk") and 487 at risk ("at risk"). During the course of the Milan Project, hearing impairment (ABR threshold equal to or greater than 40 dB nHL) was identified in 63 newborns (19 from the no-risk and 44 from the at-risk population), with a prevalence of 0.32%. Bilateral hearing impairment (BHI) was found in 33 newborns (10 from the no-risk and 23 from the at-risk population), corresponding to 0.17%. Among infants with bilateral hearing impairment, 30.3% had no risk factors. The prevalence of hearing impairment was determined on days 15-30 after birth. The results show that the implementation of a hospital-based, universal neonatal hearing screening programme for babies with and without audiological risk is feasible and effective. The effectiveness of the programme has increased as a function of the years since its inception, with a strong decrease in the referral rate. Further improvement is obtained if the TEOAE measurements

  20. All-cause mortality of patients with dyslipidemia up to 19 years after a multidisciplinary lifestyle modification programme: a randomized trial.

    Science.gov (United States)

    Håglin, Lena; Lundström, Sara; Kaati, Gunnar; Bäckman, Lennart; Bygren, Lars Olov

    2011-02-01

    Many studies have shown that individual lifestyle factors are associated with cardiovascular mortality and all-cause mortality. Observational studies of comprehensive programmes have reported risk reductions. The objectives were to assess the long-term all-cause mortality by diagnosis in patients referred to a lifestyle modification programme, aimed at combating coronary heart disease and stroke. A randomized trial with 325 patients referred to the centre between 1988 and 1989 for dyslipidemia, hypertension, type 2 diabetes and coronary heart disease; 239 patients were randomized to the programme, 86 randomized to usual care. Cases were admitted to the centre in groups of 30 for a 4-week residential comprehensive activity, in total 114 full-time hours, focusing on food preferences and selections, and physical exercise. The activities were repeated during a 4-day revisit to the centre 1 year and 5 years after the 4-week intervention. Controls were referred back to their doctors, mainly in primary care, for usual care. Main outcome measure was all-cause mortality during 11–12 and 18–19 years after intervention. At follow-up 11–12 years after referral, the relative risk reduction (RRR) was 76% with the intention-to-treat analysis among cases admitted for dyslipidemia (hazards ratio 0.24, confidence interval 0.06–0.89, P = 0.033). After 18–19 years, the RRR was 66% (hazards ratio 0.34, confidence interval 0.13–0.88, P = 0.026). No RRR was found for the other three diagnoses. Patients admitted for dyslipidemia reached a real long-term RRR of all-cause mortality. They had by definition a need for this programme.

  1. Risk and benefit associated with radiation dose in breast screening programmes - an update

    International Nuclear Information System (INIS)

    Law, J.

    1995-01-01

    This paper discusses and attempts to estimate the very small numbers of women attending the UK Breast Screening Programme for whom the risk of cancer induction may exceed the probability of cancer detection. It updates a previous paper on the same topic. Variations in breast dose between individuals, due to differences in breast size and in numbers of views and films taken, are considered and revised. New data on cancer induction and its variation with age at exposure have been employed. The overall effect of these changes is generally to improve the balance of benefit against risk compared with the previous paper referred to, the very few exceptions being categories where the numbers of women in question remain of the order of one in a million. The implications for certain alternative screening schedules and for some current trials are also discussed, the conclusions being again reasonably reassuring. (author)

  2. 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.

  3. Summary and conclusions of Conference in SAVE programme: For millennium of energetic efficiency

    International Nuclear Information System (INIS)

    1999-01-01

    SAVE is general programme of society which tendency is to improve energy efficiency in all sectors of consumption. it seems to be a necessary instrument for Kyoto protocol purposes, specially CO 2 emission reduction. SAVE Programme will become very soon a part of Energy Framework Programme containing several energy programmes including SAVE and ALTENER with tendency to improve coordination and transparency among contents

  4. The integration of studio cycling into a worksite stress management programme.

    Science.gov (United States)

    Clark, Matthew M; Soyring, Jason E; Jenkins, Sarah M; Daniels, Denise C; Berkland, Bridget E; Werneburg, Brooke L; Hagen, Philip T; Lopez-Jimenez, Francisco; Warren, Beth A; Olsen, Kerry D

    2014-04-01

    High stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single-arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive-behavioural stress management programme. Eighty-four adults, 75% female, mostly aged 40+ years, participated in an integrated 12-week cycling studio and cognitive-behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p manage stress at the programme's end and at a 1-month follow-up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well-being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12-week programme and 1-month follow-up. These findings provide further support for an integrated exercise and stress management programme. © 2013 John Wiley & Sons, Ltd.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. The effectiveness of the cardiovascular disease prevention programme 'KardioPro' initiated by a German sickness fund: a time-to-event analysis of routine data.

    Directory of Open Access Journals (Sweden)

    Sabine Witt

    Full Text Available Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund ('Siemens-Betriebskrankenkasse', SBK initiated the prevention programme 'KardioPro' including primary (risk factor reduction and secondary (screening prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of 'KardioPro' as it is implemented in the real world.The study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint 'all-cause mortality, acute myocardial infarction (MI and ischemic stroke (1', 'all-cause mortality (2' and 'non-fatal acute MI and ischemic stroke (3'.A total of 26,202 insurants were included, 13,101 participants and 13,101 control subjects. 'KardioPro' enrollment was associated with risk reductions of 23.5% (95% confidence interval (CI 13.0-32.7% (1, 41.7% (95% CI 30.2-51.2% (2 and 3.5% (hazard ratio 0.965, 95% CI 0.811-1.148 (3. This corresponds to an absolute risk reduction of 0.29% (1, 0.31% (2 and 0.03% (3 per year.The prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

  10. Radon programmes and health marketing.

    Science.gov (United States)

    Fojtikova, Ivana; Rovenska, Katerina

    2011-05-01

    Being aware of negative health effects of radon exposure, many countries aim for the reduction of the radon exposure of their population. The Czech radon programme was commenced >20 y ago. Since then experts have gathered a lot of knowledge, necessary legislation has been enacted, tens of thousands of inhabitants have been offered free measurement and subsidy for the mitigation. Despite the effort, the effectiveness of the radon programme seems to be poor. Newly built houses still exhibit elevated radon concentrations and the number of houses mitigated is very low. Is it possible to enhance the effectivity of radon programme while keeping it on a voluntary basis? One possible way is to employ health marketing that draws together traditional marketing theories and science-based strategies to prevention. The potential of using marketing principles in communication and delivery of radon information will be discussed.

  11. Audit Programmes in a Diagnostic Radiological Facility (invited paper)

    International Nuclear Information System (INIS)

    Moores, B.M.; Connolly, P.A.; Cole, P.R.

    1998-01-01

    The effective implementation of optimisation strategies for radiation protection in diagnostic radiology including nuclear medicine requires mechanisms for ongoing audit of all relevant factors. The Quality Criteria of the Commission of European Communities highlights clearly the three aspects of a radiological examination which needed to be considered, which are: (i) radiographic technique, (ii) patient dose, and (iii) image quality. Therefore, it is important that the choice of a known and acceptable radiographic technique provides a known outcome in terms of patient dose and image quality. This requirement should be capable of being achieved throughout Europe and capable of being updated as new radiological strategies are developed. Audit programmes aimed at monitoring that this situation exists may be considered at three levels: Level 1 involves routine, periodic, assessment of patient doses on a representative sample of patients undergoing a particular type of examination. Results from this audit are then compared with acceptable and clearly defined diagnostic reference levels or reference dose values which provides a framework for guidance on acceptable practice. A summary of such level 1 programmes which are being pursued in Europe is presented. Level 2 audit programmes, beside patient dose assessment, will also involve an assessment of all those parameters relevant to an X ray examination which may have a bearing on the actual dose delivered to the patient. Such level 2 audit programmes provide the basis for implementation of optimisation strategies for radiation protection in terms of risk reduction, one of the fundamental tenets of radiation protection philosophy. Level 3 audit programmes also include assessment and verification of image quality requirements for particular examinations. This latter aspect is a necessary basis for overall optimisation of radiation protection in diagnostic radiology. (author)

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. The use of geographical information systems for disaster risk reduction strategies: a case study of Volcan de Colima, Mexico

    Science.gov (United States)

    Landeg, O.

    Contemporary disaster risk management requires the analysis of vulnerability and hazard exposure, which is imperative at Volcan de Colima (VdC), Mexico, due to the predicted, large-magnitude eruption forecast to occur before 2025. The methods used to gauge social vulnerability included the development and application of proxies to census records, the undertaking of a building vulnerability survey and the spatial mapping of civil and emergency infrastructure. Hazard exposure was assessed using primary modelling of laharic events and the digitalisation of secondary data sources detailing the modelled extent of pyroclastic flows and tephra deposition associated with a large-magnitude (VEI 5) eruption at VdC. The undertaking and analysis of a risk perception survey of the population enabled an understanding of the cognitive behaviour of residents towards the volcanic risk. In comparison to the published hazard map, the GIS analysis highlighted an underestimation of lahar hazard on the western flank of VdC and the regional tephra hazard. Vulnerability analysis identified three communities where social deprivation is relatively high, and those with significant elderly and transient populations near the volcano. Furthermore, recognition of the possibility of an eruption in the near future was found to be low across the study region. These results also contributed to the analysis of emergency management procedures and the preparedness of the regional authorities. This multidisciplinary research programme demonstrates the success of applying a GIS platform to varied integrative spatial and temporal analysis. Furthermore, ascertaining the impact of future activity at VdC upon its surrounding populations permits the evaluation of emergency preparedness and disaster risk reduction strategies.

  19. 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.

  20. A new nuclear safety programme for areas adjacent to Finland

    International Nuclear Information System (INIS)

    Varjoranta, T.

    1997-01-01

    The projects aimed at improving nuclear and radiation safety in areas adjacent to Finland have been compiled into one programme. The purpose of the programme is to promote activities that minimise accident risks at nuclear power plants and that improve preparedness for situations involving a risk. Nuclear materials are also to be kept under strict control. In the last few years, nuclear and radiation safety has clearly improved in areas adjacent to Finland. But work is still needed to reduce the remaining risks. The Finnish support programme comprises two very definite functions. On one hand, the programme acts as a catalyst for projects launched by the Russians themselves or by the Western partners together, and strives to pave the way for international financing projects. On the other hand, assistance is given as direct support for certain hand-picked projects. (orig.)

  1. Smoke and mirrors: Limited value of relative risk reductions for assessing the benefits of disease-modifying therapies for multiple sclerosis.

    Science.gov (United States)

    Zakaria, Magd

    2015-05-01

    A reduction in relapse rate is the main primary outcome in most clinical trials in patients with multiple sclerosis (MS), with the effect of a treatment commonly expressed as relative risk reduction for this outcome. Physicians often assume that a drug with a higher relative risk reduction demonstrated in one trial is more effective than a drug with a lower relative risk reduction in another, and may pass this idea on to younger physicians and to patients. The use of the relative risk reduction as a measure of drug efficacy can be misleading, as it depends on the nature of the population studied: a treatment effect characterized by a lower relative risk reduction may be more clinically meaningful than one with a higher relative risk reduction. This concept is especially important with regard to clinical trials in patients with MS, where relapse rates in placebo groups have been declining in recent decades. Direct, head-to-head comparisons are the only way to compare the efficacy of the different treatments for MS. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Radon programme: presence and future

    International Nuclear Information System (INIS)

    Hulka, J.

    2009-01-01

    In this presentation an overview of radon programme experiences is presented. The paper summarises national radon policy, national programmes, legislation, the role of preventive measures and interventions with respect to existing and future exposure and knowledge of radon risk, problems of remediation strategies, practical protection in dwellings, radon measurements strategies, progress in radon measurement of an individual house (radon diagnosis), radon mapping process and sense of delineation of radon prone areas, natural radioactivity of building materials and radioactivity in public water and their role in the radon programme, public awareness on radon issue and publicity campaign. Some research activities are proposed aiming at effective solutions of radon issues in future

  3. A Mathematics Support Programme for First-Year Engineering Students

    Science.gov (United States)

    Hillock, Poh Wah; Jennings, Michael; Roberts, Anthony; Scharaschkin, Victor

    2013-01-01

    This article describes a mathematics support programme at the University of Queensland, targeted at first-year engineering students identified as having a high risk of failing a first-year mathematics course in calculus and linear algebra. It describes how students were identified for the programme and the main features of the programme. The…

  4. 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...

  5. 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.

  6. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players

    Directory of Open Access Journals (Sweden)

    M Lehnert

    2017-04-01

    Full Text Available The purpose of the study was to analyse the changes in muscle strength, power, and somatic parameters in elite volleyball players after a specific pre-season training programme aimed at improving jumping and strength performance and injury prevention. Twelve junior female volleyball players participated in an 8-week training programme. Anthropometric characteristics, isokinetic peak torque (PT single-joint knee flexion (H and extension (Q at 60º/s and 180º/s, counter movement jump (CMJ, squat jump (SJ, and reactive strength index (RSI were measured before and after intervention. Significant moderate effects were found in flexor concentric PT at 60º/s and at 180 º/s in the dominant leg (DL (18.3±15.1%, likely; 17.8±11.2%, very likely and in extensor concentric PT at 180º/s (7.4%±7.8%, very likely in the DL. In the non-dominant leg (NL significant moderate effects were found in flexor concentric PT at 60º/s and at 180º/s (13.7±11.3%, likely; 13.4±8.0%, very likely and in extensor concentric PT at 180º/s (10.7±11.5%, very likely. Small to moderate changes were observed for H/QCONV in the DL at 60º/s and 180º/s (15.9±14.1%; 9.6±10.4%, both likely and in the NL at 60º/s (moderate change, 9.6±11.8%, likely, and small to moderate decreases were detected for H/QFUNC at 180º/s, in both the DL and NL (-7.0±8.3%, likely; -9.5±10.0%, likely. Training-induced changes in jumping performance were trivial (for RSI to small (for CMJ and SJ. The applied pre-season training programme induced a number of positive changes in physical performance and risk of injury, despite a lack of changes in body mass and composition. CITATION: Lehnert M, Sigmund M, Lipinska P et al. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players. Biol Sport. 2017;34(2:205-213.

  7. Diabetic retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme.

    Science.gov (United States)

    Cleland, Charles R; Burton, Matthew J; Hall, Claudette; Hall, Anthony; Courtright, Paul; Makupa, William U; Philippin, Heiko

    2016-03-01

    The number of adults with diabetes in sub-Saharan Africa (SSA) is expected to almost double by 2035. This study investigated the prevalence of diabetic retinopathy (DR) and its risk factors at entry into a community-based screening programme. All persons with diabetes screened for retinopathy at entry into a screening programme in Kilimanjaro Region, Tanzania between November 2010 and December 2014 were included. Fundus photographs were taken with a Topcon retinal camera following pupil dilation. Data were collected on BP, random blood sugar, duration of diabetes, BMI and visual acuity on entry. A total of 3187 persons were screened for DR. The prevalence of any DR was 27.9% (95%CI 26.4-29.5%) with background diabetic retinopathy (BDR), pre-proliferative diabetic retinopathy (PPDR) and proliferative diabetic retinopathy (PDR) having a prevalence of 19.1% (95% CI 17.7-20.4%), 6.0% (95%CI 5.2-6.8%) and 2.9% (95%CI 2.3-3.5%), respectively. Maculopathy was present in 16.1% (95%CI 14.8-17.4%) of participants. Multivariable logistic regression analysis for the presence of any DR found independent associations with duration of diabetes (P planning of DR screening and treatment services in the African region. The study highlights the importance of managing comorbidities within DR screening programmes. © 2015 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  8. Sociocultural dimensions of HIV/AIDS among Middle Eastern immigrants in the US: bridging culture with HIV/AIDS programmes.

    Science.gov (United States)

    Ehsanzadeh-Cheemeh, Parvaneh; Sadeque, Abul; Grimes, Richard M; Essien, E James

    2009-09-01

    The population of Middle Eastern immigrants in the US has been increasing dramatically over the past 30 years, growing from 200,000 in 1970 to 1.5 million in 2000. These immigrants and their descendants constitute an important new population of interest for public health and other social programmes. With this addition to the cultural diversity of American society, it is important for healthcare programmes to be responsive to the unique cultural needs of those of Middle Eastern origin and to include them in healthcare curricula. This need is particularly imperative for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) intervention programmes, where the reduction of risky behaviours is essential to controlling the epidemic. When Middle Easterners emigrate to the US they must adjust to the American culture, which leads to preservation of some aspects of their culture and adjustment of behaviors to match American customs. This article aims to present sociocultural factors of HIV risk behaviours that are specific to Middle Eastern culture. The article also provides recommendations for HIV/AIDS-culturally appropriate intervention programmes.

  9. 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.

  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. Final Draft Programme Support Document

    DEFF Research Database (Denmark)

    Enemark, Ulrika; Schleimann, Finn; Vagnby, Bo Hellisen

    The HSPS III is the third phase of Danish support to the Ghanaian Health Sector. The support is in line with the Ministy of Health's Medium Term Strategy and the Second Five-Year Programme of Work; the latter also bring in line with the Ghana Poverty Reduction Strategy. The majority of funds (340...

  12. An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial.

    Science.gov (United States)

    Gouveia, Bruna Raquel; Gonçalves Jardim, Helena; Martins, Maria Manuela; Gouveia, Élvio Rúbio; de Freitas, Duarte Luís; Maia, José António; Rose, Debra J

    2016-04-01

    This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. Single-blind, randomised controlled trial. University laboratory. Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, pbalance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. ACTRN12612000301864. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Radon programmes and health marketing

    International Nuclear Information System (INIS)

    Fojtikova, I.; Rovenska, K.

    2011-01-01

    Being aware of negative health effects of radon exposure, many countries aim for the reduction of the radon exposure of their population. The Czech radon programme was commenced >20 y ago. Since then experts have gathered a lot of knowledge, necessary legislation has been enacted, tens of thousands of inhabitants have been offered free measurement and subsidy for the mitigation. Despite the effort, the effectiveness of the radon programme seems to be poor. Newly built houses still exhibit elevated radon concentrations and the number of houses mitigated is very low. Is it possible to enhance the effectivity of radon programme while keeping it on a voluntary basis? One possible way is to employ health marketing that draws together traditional marketing theories and science-based strategies to prevention. The potential of using marketing principles in communication and delivery of radon information will be discussed. (authors)

  14. Radiation protection programme at Krsko nuclear power plant

    International Nuclear Information System (INIS)

    Breznik, B.

    1996-01-01

    Krsko NPP, a Westinghouse two-loop PWR of 632 M We power, is in commercial operation since 1982. Reduction of radioactive releases to the environment and the reduction of doses to workers is the basic goal in the plant radiological protection. The radiation protection programme is established to ensure that the radiation exposures to workers and members of the public are minimized according to the As Low As Reasonably Achievable approach and controlled in accordance with international safety standards and Slovenian regulations. The basis for the operational and technical measures has been provided according to the industrial good practice. The effluent control is based on the Standard Radioactive Effluent Technical Specifications, and environmental surveillance is established according to the programme defined by the regulations. The dose constraints and performance indicators are used to assure the effectiveness of the radiation protection programme and provide a convenient follow-up tool. The monitoring programme results of each year show that there is no measurable dose to the public due to radioactive releases. The commitment to the dose burden of any member of a critical group is assessed to be below the dose constraint. Individual and collective doses of the workers are within a range typical for the PWRs of a similar type. (author)

  15. 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

  16. The effect of risk perception on public preferences and willingness to pay for reductions in the health risks posed by toxic cyanobacterial blooms.

    Science.gov (United States)

    Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A

    2012-06-01

    Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. The EU THERMIE energy support programme

    International Nuclear Information System (INIS)

    Sampaio Nunes, P. de

    1994-01-01

    THERMIE is a five-year (1990-1994) European Union programme to encourage the development of innovative energy technologies. The financial support of projects is aimed in particular at promoting and disseminating advanced and innovative technologies which might not easily be put into effect otherwise, owing to financial (rather than technological) risks. A THERMIE programme covering the period 1995-1998 is being prepared. (author). 1 fig., 2 tabs

  18. VIP in construction: systematic development and evaluation of a multifaceted health programme aiming to improve physical activity levels and dietary patterns among construction workers

    Directory of Open Access Journals (Sweden)

    Viester Laura

    2012-01-01

    Full Text Available Abstract Background The prevalence of both overweight and musculoskeletal disorders (MSD in the construction industry is high. Many interventions in the occupational setting aim at the prevention and reduction of these health problems, but it is still unclear how these programmes should be designed. To determine the effectiveness of interventions on these health outcomes randomised controlled trials (RCTs are needed. The aim of this study is to systematically develop a tailored intervention for prevention and reduction of overweight and MSD among construction workers and to describe the evaluation study regarding its (cost-effectiveness. Methods/Design The Intervention Mapping (IM protocol was applied to develop and implement a tailored programme aimed at the prevention and reduction of overweight and MSD. The (cost- effectiveness of the intervention programme will be evaluated using an RCT. Furthermore, a process evaluation will be conducted. The research population will consist of blue collar workers of a large construction company in the Netherlands. Intervention The intervention programme will be aimed at improving (vigorous physical activity levels and healthy dietary behaviour and will consist of tailored information, face-to-face and telephone counselling, training instruction (a fitness "card" to be used for exercises, and materials designed for the intervention (overview of the company health promoting facilities, waist circumference measuring tape, pedometer, BMI card, calorie guide, recipes, and knowledge test. Main study parameters/endpoints The intervention effect on body weight and waist circumference (primary outcome measures, as well as on lifestyle behaviour, MSD, fitness, CVD risk indicators, and work-related outcomes (i.e. productivity, sick leave (secondary outcome measures will be assessed. Discussion The development of the VIP in construction intervention led to a health programme tailored to the needs of construction

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. Present conditions of the water reactor technology sophistication programme in Japan

    International Nuclear Information System (INIS)

    Miwa, T.

    1989-01-01

    The Advanced Standardization Programme of LWR's was organized in Japan in 1975 in several phases. The first and the second phases (1975-1977 and 1978-1980 respectively) have obtained the goal of improved reliability and reduction of occupational exposure. The third phase (1981-1985) has carried out the development of 1300 MWe class LWRs (A-BWR and A-PWR) to achieve a higher level of reliability, reduction of occupational exposure and higher economic efficiency. This paper gives a brief summary description of the above mentioned programmes. 1 tab

  4. 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.

  5. 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...

  6. Monitoring programmes for internal exposure: designing criteria

    International Nuclear Information System (INIS)

    Rojo, Ana M.; Gomez Parada, Ines.

    2007-01-01

    The purpose of this document is to offer guidance for the decision whether a monitoring programme is required and how it should be designed. It can be also used as a tool for making the standing programmes consistent with the most recent publications on internal dosimetry, such as ISO 20553 'Monitoring of workers occupationally exposed to a risk of internal contamination with radioactive material', specific publications of the IAEA and ICRP, and including the conclusions of the OMINEX Project ('Optimisation of Monitoring for Internal Exposures') and IDEAS Project. It is established that the general purpose of the monitoring is verify that each worker is protected adequately against risks from radionuclide intakes and document that the protection complies with legal requirements. The criteria for a particular monitoring programme designing is based on the magnitude of the probable intake and the possibility of detecting a significant event when it occurs. So, the risk assessment for each work process must be evaluated and each worker is classified accordingly. This classification implies the acceptance of reference effective dose values (1 y 6 mSv/y ). (author) [es

  7. Dose reduction in mammography as a consequence of quality assurance programme

    International Nuclear Information System (INIS)

    Staniszewska, M. A.; Jankowski, J.

    2003-01-01

    Mammography became one of more frequent radiological examinations in the most of European countries. This is accepted as a sensitive method for detection of early breast cancers. On the other hand, this is the special imaging technique, where reliability of result is strongly influenced by technical conditions. Hence, the exposure parameters should have been chosen in dependence on image recording system. In opposite, an informative quality of the produced image is not sufficient for a true clinical diagnosis. Thus, optimisation of the practice is not achieved and a benefit for patient is none. Implementation of Quality Assurance programme can prevent the situation: systematic quality control of mammographic x-ray units allows finding the technical and methodological incorrectness. If these findings are followed by the appropriate remedial actions, the main aim will be achieved, i.e. good quality of image with reasonable low doses to patients. This approach was verified on 15 mammographic units in Lodz, covered by full cycle of quality control programme. Doses were measured during CC projection for over 100 patients. Quality of image was evaluated for RMI 156 accreditation phantom as a standard object. The main technical incorrectness was found for automatic exposure control system, and especially for compensation of object thickness. The available remedial actions allowed reducing the doses to patients by 21% (on average). Additionally, after the remedial action quality of phantom image was found better for 3 facilities where primary had been below the acceptance level. The main points of Quality Assurance programme are available for most of x-ray diagnostic facilities and should have been obligatory. (authors)

  8. 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.

  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. 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

  11. 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.

  12. Effect of diet and physical exercise intervention programmes on coronary heart disease risk in smoking and non-smoking men in Sweden.

    Science.gov (United States)

    Näslund, G K; Fredrikson, M; Hellénius, M L; de Faire, U

    1996-01-01

    STUDY OBJECTIVE: To investigate differences between smokers and non-smokers in health behaviour, cardiovascular risk factors, coronary heart disease (CHD) risks, health knowledge, health attitudes, and compliance with a CHD prevention programme. DESIGN: Differences between smokers and non-smokers were studied via medical examinations, questionnaires, physical exercise activity logs, and food record sheets. Data were analysed using univariate and multivariate analyses. The five and 10 year CHD risks were assessed using the Framingham CHD risk estimate. SETTING: The Karolinska Hospital, Stockholm, and Sollentuna Primary Health Centre, Sollentuna, Sweden. PARTICIPANTS: The analyses were based on 158 healthy smoking and non-smoking men aged 35-60 years with raised cardiovascular risk factors who enrolled in controlled, randomised six month diet and exercise programmes. MAIN RESULTS: Discriminant analysis suggested that smokers, compared with non-smokers, were characterised by a higher alcohol energy percent, lower HDL cholesterol concentration, lower systolic blood pressure, and a higher plasminogen activator inhibitor-1 (PAI-1) value. Knowledge of the risk factors for CHD was not a discriminating factor. Both smokers and non-smokers increased the exercise taken, improved their diet, and lowered their CHD risk. Before, as well as after the intervention, smokers had a higher CHD risk than non-smokers. CONCLUSIONS: The best CHD prevention action that could be taken by smokers would of course be to quit smoking. Those who cannot stop should be encouraged to improve their diet and increase the amount of physical exercise they take in order to reduce the health hazards of their smoking behaviour. PMID:8762375

  13. Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes

    Directory of Open Access Journals (Sweden)

    Serena Lucrezi

    2018-03-01

    Full Text Available Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers’ and dive centres’ perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry.Materials and Methods: Two structured questionnaire surveys were prepared by the organisation Divers Alert Network and administered online to scuba diving operators in Italy and scuba divers in Europe, using a mixture of convenience and snowball sampling. Questions in the survey included experience and safety offered at the dive centre; the buddy system; equipment and accessories for safe diving activities; safety issues in the certification of new scuba divers; incidents/accidents; and attitudes toward safety.Results: 91 scuba diving centres and 3,766 scuba divers participated in the study. Scuba divers gave importance to safety and the responsiveness of service providers, here represented by the dive centres. However, they underestimated the importance of a personal emergency action/assistance plan and, partly, of the buddy system alongside other safety procedures. Scuba divers agreed that some risks, such as those associated with running out of gas, deserve attention. Dive centres gave importance to aspects such as training and emergency action/assistance plans. However, they were limitedly involved in safety campaigning. Dive centres’ perceptions of safety in part aligned with those of scuba divers, with some exceptions.Conclusion: Greater responsibility is required in raising awareness and educating scuba divers, through participation in

  14. Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes

    Science.gov (United States)

    Lucrezi, Serena; Egi, Salih Murat; Pieri, Massimo; Burman, Francois; Ozyigit, Tamer; Cialoni, Danilo; Thomas, Guy; Marroni, Alessandro; Saayman, Melville

    2018-01-01

    Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers’ and dive centres’ perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry. Materials and Methods: Two structured questionnaire surveys were prepared by the organisation Divers Alert Network and administered online to scuba diving operators in Italy and scuba divers in Europe, using a mixture of convenience and snowball sampling. Questions in the survey included experience and safety offered at the dive centre; the buddy system; equipment and accessories for safe diving activities; safety issues in the certification of new scuba divers; incidents/accidents; and attitudes toward safety. Results: 91 scuba diving centres and 3,766 scuba divers participated in the study. Scuba divers gave importance to safety and the responsiveness of service providers, here represented by the dive centres. However, they underestimated the importance of a personal emergency action/assistance plan and, partly, of the buddy system alongside other safety procedures. Scuba divers agreed that some risks, such as those associated with running out of gas, deserve attention. Dive centres gave importance to aspects such as training and emergency action/assistance plans. However, they were limitedly involved in safety campaigning. Dive centres’ perceptions of safety in part aligned with those of scuba divers, with some exceptions. Conclusion: Greater responsibility is required in raising awareness and educating scuba divers, through participation in prevention

  15. Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes.

    Science.gov (United States)

    Lucrezi, Serena; Egi, Salih Murat; Pieri, Massimo; Burman, Francois; Ozyigit, Tamer; Cialoni, Danilo; Thomas, Guy; Marroni, Alessandro; Saayman, Melville

    2018-01-01

    Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers' and dive centres' perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry. Materials and Methods: Two structured questionnaire surveys were prepared by the organisation Divers Alert Network and administered online to scuba diving operators in Italy and scuba divers in Europe, using a mixture of convenience and snowball sampling. Questions in the survey included experience and safety offered at the dive centre; the buddy system; equipment and accessories for safe diving activities; safety issues in the certification of new scuba divers; incidents/accidents; and attitudes toward safety. Results: 91 scuba diving centres and 3,766 scuba divers participated in the study. Scuba divers gave importance to safety and the responsiveness of service providers, here represented by the dive centres. However, they underestimated the importance of a personal emergency action/assistance plan and, partly, of the buddy system alongside other safety procedures. Scuba divers agreed that some risks, such as those associated with running out of gas, deserve attention. Dive centres gave importance to aspects such as training and emergency action/assistance plans. However, they were limitedly involved in safety campaigning. Dive centres' perceptions of safety in part aligned with those of scuba divers, with some exceptions. Conclusion: Greater responsibility is required in raising awareness and educating scuba divers, through participation in prevention campaigns

  16. 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.

  17. The regulatory evaluation of radiation protection training programmes at Canadian nuclear power plants

    International Nuclear Information System (INIS)

    Legare, M.; Tennant, D.

    1996-01-01

    The responsibility for providing the necessary assurance that the use of nuclear energy in Canada does not pose undue risk to health, safety, security and the environment is vested with the Atomic Energy Control Board (AECB). This responsibility has led the Operator Certification Division of the AECB to develop methods to obtain assurance that nuclear power plant operations personnel are well trained and adequately competent to perform their duties. The features of the AECB approach to evaluation of training programmes based on a systematic approach to training is described. An overview of the Canadian nuclear power plants' radiation protection qualification levels is given. The developing evaluation process is contributing to the improvement of licensee radiation protection training programmes. This is making possible the transfer of part of the responsibility for licensed personnel radiation protection qualification assessment to the licensees, thus enabling a reduction in the operator certification division formal qualification activities. (author)

  18. 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...

  19. 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

  20. 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.

  1. 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)

  2. The WEST programme: Minimizing technology and operational risks of a full actively cooled tungsten divertor on ITER

    Energy Technology Data Exchange (ETDEWEB)

    Grosman, André, E-mail: andre.grosman@cea.fr [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Bucalossi, Jérôme; Doceul, Louis [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Escourbiac, Frédéric [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Lipa, Manfred [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Merola, Mario [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Missirlian, Marc [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Pitts, Richard A. [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Samaille, Franck; Tsitrone, Emmanuelle [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France)

    2013-10-15

    Highlights: ► The WEST programme is a unique opportunity to experience the industrial scale manufacture of tungsten plasma-facing components similar to the ITER divertor ones. ► In Tore Supra, it will bring important know how for actively cooled W divertor operation. ► This can be done by a reasonable modification of the Tore Supra tokamak. ► A fast implementation of the project would make this information available in due time. ► This allows a significant contribution to the W ITER divertor risk minimization in its manufacturing and operation phase. -- Abstract: The WEST programme consists in transforming the Tore Supra tokamak into an X point divertor device, while taking advantage of its long discharge capability. This is obtained by inserting in vessel coils to create the X point while adapting the in-vessel elements to this new geometry. This will allow the full tungsten divertor technology to be used on ITER to be tested in anticipation of its use on ITER under relevant heat loading conditions and pulse duration. The early manufacturing of a significant industrial series of ITER-similar W plasma-facing units will contribute to the ITER divertor manufacturing risk mitigation and to that associated with early W divertor plasma operation on ITER.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. The radiation exposure control programme - its effect on design

    International Nuclear Information System (INIS)

    Simmons, R.B.V.

    1975-01-01

    The paper discusses how the Power Projects design organization has responded to the problem of operational exposure. This response took the form of an organized formal Programme developed during the Bruce G.S. design phase. This Radiation Exposure Control Programme considered: radiation conditions, number of items requiring attention, number of occasions item requires attention and manhours involved on each occasion. Analysis of these factors and comparison with target values enabled worthwhile reductions to be made in estimated operating exposure. Activity transport studies, reliability and design detail improvements have all received an impetus from the Programme. The Programme which has value both from the economic and the health physics points of view is now a continuing feature of the CANDU plant design process. (author)

  8. Rapid recovery programmes for hip and knee arthroplasty. An update.

    Science.gov (United States)

    Molko, S; Combalia, A

    Fast-track surgery, or enhanced recovery, has appeared in the last 20 years or so as a combination of the optimisation of clinical protocols and organisational processes, pursuing the reduction in surgical stress with the aim of reducing peri-operative comorbidities, convalescence time, and functional recovery, resulting in a reduction in admission time. After a review of the European literature available on this subject, this article attempts to present an update. It highlights its interest and origins, basically being set out as a response to the question: 'Why is this patient in Hospital today?' It also attempts to summarise the essence of such programmes: the search for immediate post-surgical mobilisation, being supported in a multidisciplinary approach. This includes a multimodal intervention and analgesia, a limitation in the use of opiates, and the active participation by the patients in their own recovery. Furthermore, mention is made of the initiatives by European State organisation as a boost to enhanced recovery programmes in their respective countries, as is the case in Denmark, France, and the United Kingdom. The clinical outcomes published up to September 2015 have been reviewed. A subsequent decrease in mean hospital stay is observed in 11 studies, achieving patient satisfaction, low complication rates, a reduction in the transfusion rates, and with no apparent increase in re-admissions. Mention is also made of the financial consequences, and how to implement these protocols. As a conclusion, an analysis is made of the future challenges fast-track surgery, such as the possibility of moving towards outpatient surgery, or the obtaining of a surgery 'with no risk or pain' in general, for which there are other still open lines of work. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. 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.

  10. 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.

  11. Bioenergy in the national forestry programme

    International Nuclear Information System (INIS)

    Heikurainen, M.

    1998-01-01

    The objective of the national forestry programme is to develop the treatment, utilization and protection of forests in order to increase the employment level in the forestry sector as well as enhance the utilization of the forests for recreation purposes. Increment of the utilization of wood energy is one of the means for meeting the objective of the programme. In addition to the silvicultural reasons, one of the main reasons for increasing of the utilization of energy wood is the possibilities of energywood-related small and medium-sized entrepreneurship to employ people. The emission reduction requirements of the Kyoto summit offer also a reason for the increment of the utilization of wood energy, because the carbon dioxide emissions of biofuels are not included in the emission share of the country. The techno-economically viable unutilized wood energy potential of clearcuts has been estimated to 3.7 million m 3 and that of the integrated harvesting of first thinnings 2.3 million m 3 . On the basis of these figures the latest objective of the programme has been set to increase the energy wood harvesting and utilization to 5.0 million m 3 /a up to the year 2010. The main means listed in the programme are: Development of integrated harvesting methods, by which it is possible to produce energy wood economically (price less than 45 FIM/MWh) as a byproduct of commercial timber; The environmental support paid to the forest chips purchasers; Bioenergy capacity developed in the forest industry; Social support for product development and entrepreneurhip in the field of bioenergy; Reduction of the value added taxes of the end users of split firewood and wood briquettes

  12. 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.

  13. Road accident rates: strategies and programmes for improving road traffic safety.

    Science.gov (United States)

    Goniewicz, K; Goniewicz, M; Pawłowski, W; Fiedor, P

    2016-08-01

    Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

  14. The implications of the relative risk for road mortality on road safety programmes in Qatar.

    Science.gov (United States)

    Consunji, Rafael J; Peralta, Ruben R; Al-Thani, Hassan; Latifi, Rifat

    2015-04-01

    The epidemiology of road deaths and in particular the relative risk for road mortality (RRRM) in Qatar has not been fully defined. This study will analyse and compare the proportionate mortality and age-specific death rates from road traffic injuries (RTIs) and make recommendations for targeted injury prevention programmes for road safety in Qatar. Data from the Qatar Statistics Authority (QSA), for the year 2010, was collected and analysed. All deaths classified as 'ICD-10 (V89) Motor- or Nonmotor-Vehicle, Accident Type of Vehicle Unspecified' were included. There were 247 RTI related deaths in Qatar in 2010. An overall death rate was computed at 14.4 deaths per 100 000 population. The RRRM varied over 10 times among different populations with Qatari males (QM) having an increased RRRM from 10 years of age, those aged 20-29 years had the highest RRRM of 10.2. The lowest RRRM was for Qatari females who did not have a single reported road fatality in 2010. Populations with a significantly elevated RRRM (ie, RRRM>1.0) were non-Qatari men older than 50 years and Qatari males from the age of 10 onward. Proven and definite programmes must be implemented to reduce these unnecessary deaths among the populations at the highest risk. Multidisciplinary approaches must be implemented and their efficacy evaluated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. De-Radicalising Prisoners in Nigeria: developing a basic prison based de-radicalisation programme

    Directory of Open Access Journals (Sweden)

    Atta Barkindo

    2016-06-01

    Full Text Available The Nigerian Counter Terrorism Strategy recognised that force alone was not enough to combat violent extremist elements in Nigeria and that a multi-faceted approach was required to counter the threat of violent extremism. The Office of the National Security Advisor (ONSA was tasked with developing an ambitious countering violent extremism (CVE programme consisting of three elements: community-based counter radicalisation; strategic communications; and de-radicalisation. The de-radicalisation element of the CVE programme included establishing a prison based de-radicalisation programme for sentenced and pre-trial prisoners. The challenge facing ONSA and the Nigerian Prisons Service (NPS in setting up the de-radicalisation programme was considerable. Prison conditions were basic; there were no existing offending behaviour programmes on which to build; risk assessment was rudimentary and focussed on escape risk; awareness among staff at all levels of de-radicalisation programmes, their content and how they should be managed, was minimal; specialist staff were in short supply and had no training in running interventions; and resources, both physical and financial, were limited. This paper sets out how ONSA and NPS went about establishing the de-radicalisation programme and describes key elements of that programme, including: creating a supportive operating environment; risk and needs assessment; types of intervention; and programme management and staffing. It highlights the challenges and lessons that can be drawn from the operation of the programme during its first 18 months, which will be of particular interest to low resource, post-conflict and fragile states that are seeking to establish their own basic de-radicalisation programmes.

  16. Running for your life: A review of physical activity and cardiovascular disease risk reduction in individuals with schizophrenia.

    Science.gov (United States)

    Chalfoun, Claire; Karelis, Antony D; Stip, Emmanuel; Abdel-Baki, Amal

    2016-08-01

    Individuals with schizophrenia have a greater risk for cardiometabolic risk factors (e.g. central obesity, insulin resistance, hypertension and dyslipidaemia), cardiovascular diseases and mortality. This risky profile may be explained by the adverse effects of antipsychotic medications and an unhealthy lifestyle (e.g. smoking, poor nutrition and low physical activity). In the general population, physical activity has been shown to be the optimal strategy to improve both cardiometabolic parameters and cardiorespiratory fitness levels. Accordingly, an emerging literature of non-pharmacological interventions (e.g. cognitive behavioural therapy, diet and physical activity) has been studied in individuals with schizophrenia. Therefore, the purpose of this review was 1) to conduct a critical literature review of non-pharmacological interventions that included some kind of physical activity (including supervised and unsupervised exercise training) and target cardiometabolic risk factors in individuals with schizophrenia. 2) To describe the contribution of physical activity alone by reviewing trials of supervised exercise training programmes only. A literature review via systematic keyword search for publications in Medline, PubMed, Embase and PsycINFO was performed. Many non-pharmacological interventions are efficient in reducing cardiovascular disease risk factors when combined with physical activity. Supervised physical activity has been successful in decreasing cardiovascular disease risk, and aerobic interval training appears to provide more benefits by specifically targeting cardiorespiratory fitness levels. In conclusion, physical activity is an effective strategy for addressing cardiovascular disease risk in individuals with schizophrenia. Long-term studies are needed to evaluate the feasibility and impact of exercise training programmes in individuals with schizophrenia.

  17. 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

  18. 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.

  19. Cost-effectiveness of a cardiovascular disease primary prevention programme in a primary health care setting. Results of the Polish part of the EUROACTION project.

    Science.gov (United States)

    Sović, Nevena; Pająk, Andrzej; Jankowski, Piotr; Duenas, Alejandra; Kawecka-Jaszcz, Kalina; Wolfshaut-Wolak, Renata; Stepaniak, Urszula; Kawalec, Paweł

    2013-01-01

    Well designed cardiovascular disease (CVD) prevention programmes appear to be generally applicable and effective in reducing exposure to risk factors and the incidence of disease. However, introducing them broadly into clinical practice would have a significant impact on the healthcare budget, and requires careful consideration. The purpose of this health economic analysis was to assess the potential cost-effectiveness of the model nurse-led, comprehensive CVD primary prevention programme which was prepared and introduced in the EUROACTION project, in high-risk patients in Poland. A Markov model was developed to assess the long-term costs of preventive intervention. The health states modelled were: event-free (all patients at the beginning of observation), stable angina first year, acute myocardial infarction, stable angina subsequent year, myocardial infarction subsequent year, CVD death, and other causes of death. Health benefits from the reduction in risk factors were estimated based on Framingham risk function assuming the probability of defined health states according to British registers. The time horizon of the analysis was ten years, and one Markov cycle length was one year. The analysis was prepared from the healthcare payer's perspective. A willingness to pay threshold of three gross domestic product (GDP) per capita / quality-adjusted life years (QALY) was used. Univariate sensitivity analysis was conducted. Results were presented as an incremental cost-effectiveness ratio (ICER) expressed as an incremental cost per QALY. In Poland, EUROACTION intervention resulted mainly in reductions in the prevalence of smoking (by 14%) and high blood pressure (by 7%). Intervention on other risk factors, including blood lipids, was found to be less effective. Estimated ICERs were 19,524 PLN for men and 82,262 PLN for women. The programme was even more cost-effective in smokers i.e. estimated ICERs were 12,377 PLN in men and 53,471 PLN in women. The results were most

  20. 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.

  1. 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

  2. Reduction in advanced breast cancer after introduction of a mammography screening program in Tyrol/Austria.

    Science.gov (United States)

    Oberaigner, W; Geiger-Gritsch, Sabine; Edlinger, M; Daniaux, M; Knapp, R; Hubalek, M; Siebert, U; Marth, C; Buchberger, W

    2017-06-01

    We analysed all female breast cancer (BC) cases in Tyrol/Austria regarding the shift in cancer characteristics, especially the shift in advanced BC, for the group exposed to screening as compared to the group unexposed to screening. The analysis was based on all BC cases diagnosed in women aged 40-69 years, resident in Tyrol, and diagnosed between 2009 and 2013. The data were linked to the Tyrolean mammography screening programme database to classify BC cases as "exposed to screening" or "unexposed to screening". Age-adjusted relative risks (RR) were estimated by relating the exposed to the unexposed group. In a total of about 145,000 women aged 40-69 years living in Tyrol during the study period, 1475 invasive BC cases were registered. We estimated an age-adjusted relative risk (RR) for tumour size ≥ 21 mm of 0.72 (95% confidence interval (CI) 0.60 to 0.86), for metastatic BC of 0.27 (95% CI 0.17 to 0.46) and for advanced BC of 0.83 (95% CI 0.71 to 0.96), each comparing those exposed to those unexposed to screening, respectively. In our population-based registry analysis we observed that participation in the mammography screening programme in Tyrol is associated with a 28% decrease in risk for BC cases with tumour size ≥ 21 mm and a 17% decrease in risk for advanced BC. We therefore expect the Tyrolean mammography programme to show a reduction in BC mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A pilot study to evaluate the efficacy of adding a structured home visiting intervention to improve outcomes for high-risk families attending the Incredible Years Parent Programme: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Lees, Dianne G; Fergusson, David M; Frampton, Christopher M; Merry, Sally N

    2014-02-25

    Antisocial behaviour and adult criminality often have their origins in childhood and are best addressed early in the child's life using evidence-based treatments such as the 'Incredible Years Parent Programme'. However, families with additional risk factors who are at highest risk for poor outcomes do not always make sufficient change while attending such programmes. Additional support to address barriers and improve implementation of positive parenting strategies while these families attend the Incredible Years Programme may improve overall outcomes.The study aims to evaluate the efficacy of adding a structured home visiting intervention (Home Parent Support) to improve outcomes in families most at risk of poor treatment response from the Incredible Years intervention. This study will inform the design of a larger prospective randomised controlled trial. A pilot single-blind, parallel, superiority, randomised controlled trial. Randomisation will be undertaken using a computer-generated sequence in a 1:1 ratio to the two treatments arranged in permuted blocks with stratification by age, sex, and ethnicity. One hundred and twenty six participants enrolled in the Incredible Years Parent Programme who meet the high-risk criteria will be randomly allocated to receive either Incredible Years Parent Programme and Home Parent Support, or the Incredible Years Parent Programme alone. The Home Parent Support is a 10-session structured home visiting intervention provided by a trained therapist, alongside the usual Incredible Years Parent Programme, to enhance the adoption of key parenting skills. The primary outcome is the change in child behaviour from baseline to post-intervention in parent reported Eyberg Child Behavior Inventory Problem Scale. This is the first formal evaluation of adding Home Parent Support alongside Incredible Years Parent Programme for families with risk factors who typically have poorer treatment outcomes. We anticipate that the intervention will help

  4. 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.

  5. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    Science.gov (United States)

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  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. 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.

  8. Benefit of cardiac rehabilitation programme in revascularized coronary patient

    Directory of Open Access Journals (Sweden)

    Laura Crăciun

    2009-06-01

    Full Text Available Objective: Evaluating the cardiovascular risk profile in revascularized coronary patients at 16 months after revascularization(PCI+CABG. Material and method: We evaluated the cardiovascular risk profile, compliance to the secondary preventionmeasures and reaching guideline targets in revascularized coronary patients included in EuroASpire III Romania. The patientswere divided in two groups: the selection criteria was the adherence to cardiac rehabilitation programme (CRP+/CRP-. Result:The prevelence of cardiovascular risk factors was about 76%, with an increased significance in CRP- group (p0.05, OR>1. Conclusion: At 16 months after revascularisation, the patientsstill present a high risk. The level of cardio-metabolic and hemodynamic risk are maintained the same by unreaching thetargeted values recomended by ESC prevention guideline. The patients in CPR+ group had a significant improvement ofcardiovascular risk factors. Indication but also compliance to structured cardiac rehabilitation programme after myocardialrevascularisation remains at a suboptimal level.

  9. Alzheimer's disease prevention: from risk factors to early intervention.

    Science.gov (United States)

    Crous-Bou, Marta; Minguillón, Carolina; Gramunt, Nina; Molinuevo, José Luis

    2017-09-12

    Due to the progressive aging of the population, Alzheimer's disease (AD) is becoming a healthcare burden of epidemic proportions for which there is currently no cure. Disappointing results from clinical trials performed in mild-moderate AD dementia combined with clear epidemiological evidence on AD risk factors are contributing to the development of primary prevention initiatives. In addition, the characterization of the long asymptomatic stage of AD is allowing the development of intervention studies and secondary prevention programmes on asymptomatic at-risk individuals, before substantial irreversible neuronal dysfunction and loss have occurred, an approach that emerges as highly relevant.In this manuscript, we review current strategies for AD prevention, from primary prevention strategies based on identifying risk factors and risk reduction, to secondary prevention initiatives based on the early detection of the pathophysiological hallmarks and intervention at the preclinical stage of the disease. Firstly, we summarize the evidence on several AD risk factors, which are the rationale for the establishment of primary prevention programmes as well as revising current primary prevention strategies. Secondly, we review the development of public-private partnerships for disease prevention that aim to characterize the AD continuum as well as serving as platforms for secondary prevention trials. Finally, we summarize currently ongoing clinical trials recruiting participants with preclinical AD or a higher risk for the onset of AD-related cognitive impairment.The growing body of research on the risk factors for AD and its preclinical stage is favouring the development of AD prevention programmes that, by delaying the onset of Alzheimer's dementia for only a few years, would have a huge impact on public health.

  10. 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

  11. 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

  12. 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...

  13. Manual for the classification and prioritization of risks due to major accidents in process and related industries. Inter-Agency programme on the assessment and management of health and environmental risks from energy and other complex industrial systems

    International Nuclear Information System (INIS)

    1996-11-01

    The IAEA, the United Nations Environment Programme (UNEP), the United Nations Industrial Development Organization (UNIDO) and the World Health Organization (WHO) decided in 1986 to join forces in order to promote the use of integrated areas wide approaches to risk management. The Inter-Agency Programme brings together expertise in health, the environment, industry and energy, all vital for effective risk management. The purpose of the Inter-Agency Programme is to develop a broad approach to the identification, prioritization and minimization of industrial hazards in a given geographical area. This is one of a series of publications intended to be issued on behalf of the four participating UN organizations. This is the first revision of the original report, distributed in December 1993. The revision was undertaken in the light of experience with the original edition and was prompted by the wish to add the results of a practical case study and some new developments. 13 figs, 23 tabs

  14. 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.

  15. 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

  16. A Case Analysis of Disaster Risk Reduction Preparedness of Iloilo Province: Basis for A Comprehensive Intervention Program

    Directory of Open Access Journals (Sweden)

    Victoria D. Jurilla

    2016-08-01

    Full Text Available - This study determined the effectiveness of Disaster Risk Reduction Preparedness of Iloilo Province, Philippines in the areas of Dissemination, Implementation, and Resource Utilization and Operation as evaluated by the 390 citizens of the ten (10 selected municipalities from the five (5 Congressional Districts in the Province of Iloilo, Philippines. This descriptive method of research employed researcher-made instruments and random interviews. Descriptive statistics used were the mean and standard deviation while inferential statistics employed Ttest for independent samples and one-way analysis for variance set at .05 level of significances. Findings revealed that Disaster Risk Reduction Preparedness of Iloilo Province, Philippines is “more effective” in terms of dissemination, implementation, and resource utilization and operation according to the assessment of the 390 respondents of the ten (10 selected municipalities from the five (5 Congressional Districts when they were grouped as to personal variables. Finally, the findings revealed that three (3 out of ten (10 municipalities were very effective and among the five (5 districts, first district was very effective as to dissemination and resource utilization and operation of their respective Disaster Risk Reduction Preparedness Program but as a whole, Iloilo Province was more effective in its Disaster Risk Reduction Preparedness.

  17. The use of expert scientific advice in regulating risk

    International Nuclear Information System (INIS)

    Foster, R.; Mcquaid, J.

    1998-01-01

    Today the accidents prevention and environmental protection activity in Bashkortostan Republic is regulated by Governmental Programme including risk management as one of the main parts. The authors of the present paper accumulated some experience in risk management system creation because they took part in the investigation according to the mentioned Programme Their proposal concerns this closed-loop system general structure which is planned to be based on three kinds of feedback: internal feedback (it utilizes the special Russian institutions for the plants state observation and limitation such 'Gosfortechnodzor' 'Gossanepidnadzor', etc.; all the noted institutions must be informed of the current situation and fulfill the actions oriented towards risk indices reduction); intermediate feedback (it is represented by the insurance system functioning with respect to insurance agencies investments into the plants operational security); external feedback (it includes the subsystem of HP security declarations analysis mechanism, special HP regional register and the expert commission whose decisions become the foundations for governmental responses). The authors consider all the feedbacks interaction in order to provide the stability of region development. The resulting strategy for accidents risk level management has been confirmed now by some normative documents in Bashkortostan Republic. (authors)

  18. Decommissioning Programme Management: reducing risk and cost while accelerating schedules through improved planning, Earned Value Management and safe work execution

    International Nuclear Information System (INIS)

    Hansen, S.E.

    2008-01-01

    CH2M HILL experience includes more than two decades of managing nuclear facilities and providing clean-up and operations support for commercial and government facilities worldwide. Our expertise ranges from decommissioning and defence sector businesses to nuclear technology development and innovation. Our approach places top priority on the safe execution of work while reducing both risk and cost. Our nuclear services include: programme management, nuclear safety analysis, radiological protection, radioactive waste management, nuclear remediation, nuclear materials and waste transportation management, nuclear safeguards and security services, and nuclear decontamination and decommissioning. This paper will discuss our approach which has resulted in a strong track record of accelerating schedules and reducing costs of major nuclear programmes, including Rocky Flats, Idaho, and our work at UKAEA sites. (author)

  19. Hepatitis B immunisation programmes in European Union, Norway and Iceland: where we were in 2009?

    Science.gov (United States)

    Mereckiene, Jolita; Cotter, Suzanne; Lopalco, Pierluigi; D'Ancona, Fortunato; Levy-Bruhl, Daniel; Giambi, Cristina; Johansen, Kari; Dematte, Luca; Salmaso, Stefania; Stefanoff, Pawel; O'Flanagan, Darina

    2010-06-17

    In January 2009 25 European Union (EU) Member States (MSs), Norway and Iceland, participated in a survey seeking information on national hepatitis B vaccination programmes. Details of vaccination policy, schedule, population groups targeted for vaccination, programme funding, vaccine coverage and methods of monitoring of vaccine coverage were obtained. Twenty (74%) countries reported that they have a universal hepatitis B vaccination programme, in addition to immunisation of at risk groups; seven (26%) countries recommend HBV for high risk groups only (with some inter-country variation on groups considered at high risk). Among countries without universal hepatitis B vaccination programmes, the major factor for non-introduction is low disease endemicity. 2010 Elsevier Ltd. All rights reserved.

  20. 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.

  1. 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.

  2. 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.

  3. Resolving a double standard for risk management of thalidomide: an evaluation of two different risk management programmes in Japan.

    Science.gov (United States)

    Ooba, Nobuhiro; Sato, Tsugumichi; Watanabe, Hikaru; Kubota, Kiyoshi

    2010-01-01

    Thalidomide, once withdrawn because of its teratogenicity, has now been re-launched worldwide. In Japan, thalidomide has been imported by individual doctors since around the year 2000. In October 2008, it was approved for the treatment of multiple myeloma (MM) by the Ministry of Health, Labour and Welfare (MHLW) on the condition that the manufacturer implemented a risk management programme termed the Thalidomide Education and Risk Management System (TERMS). It is likely that the imports of thalidomide will be used off-label to treat diseases other than MM. Thus, the MHLW is also planning to introduce a web-based registration system, referred to as the Safety Management System for Unapproved Drugs (SMUD), for thalidomide imported by individual doctors. To evaluate the difference between TERMS and SMUD and establish a way to resolve the 'double standard' for risk management of thalidomide treatment in Japan. The fraction of patients with disorders other than MM was estimated by the volume of annual imports obtained from the MHLW and records of the imports for patients with MM, other oncological diseases (ODs) and non-ODs in 2007 through a major supplier covering 63% of the total imported thalidomide. The information for TERMS was obtained from web pages of the manufacturer and the MHLW. The components of TERMS were compared with those in SMUD. Provided that the distribution of the indication for thalidomide (MM) in 2007, estimated from the records of imports through the major supplier, is representative of the entire nation, it is estimated that on average 866 patients, including 851 (98.3%) with MM, are using thalidomide on any one day. However, if the major supplier's imports, which account for 63% of the total imports, are not representative of the nation as a whole, possibly only half of the patients treated with thalidomide in Japan have MM. This would be the case in a scenario where the remaining 37% of imports are exclusively used to treat disorders other than

  4. 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.

  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. Development of risk reduction behavioral counseling for Ebola virus disease survivors enrolled in the Sierra Leone Ebola Virus Persistence Study, 2015-2016.

    Science.gov (United States)

    Abad, Neetu; Malik, Tasneem; Ariyarajah, Archchun; Ongpin, Patricia; Hogben, Matthew; McDonald, Suzanna L R; Marrinan, Jaclyn; Massaquoi, Thomas; Thorson, Anna; Ervin, Elizabeth; Bernstein, Kyle; Ross, Christine; Liu, William J; Kroeger, Karen; Durski, Kara N; Broutet, Nathalie; Knust, Barbara; Deen, Gibrilla F

    2017-09-01

    During the 2014-2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants' individual test results. The behavioral counseling protocol enabled study staff to translate the study's body fluid test results into individualized information for study participants. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries.

  7. 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…

  8. A comparison of mantle versus involved-field radiotherapy for Hodgkin's lymphoma: reduction in normal tissue dose and second cancer risk

    International Nuclear Information System (INIS)

    Koh, Eng-Siew; Paul, Narinder; Hodgson, David C; Tran, Tu Huan; Heydarian, Mostafa; Sachs, Rainer K; Tsang, Richard W; Brenner, David J; Pintilie, Melania; Xu, Tony; Chung, June

    2007-01-01

    Hodgkin's lymphoma (HL) survivors who undergo radiotherapy experience increased risks of second cancers (SC) and cardiac sequelae. To reduce such risks, extended-field radiotherapy (RT) for HL has largely been replaced by involved field radiotherapy (IFRT). While it has generally been assumed that IFRT will reduce SC risks, there are few data that quantify the reduction in dose to normal tissues associated with modern RT practice for patients with mediastinal HL, and no estimates of the expected reduction in SC risk. Organ-specific dose-volume histograms (DVH) were generated for 41 patients receiving 35 Gy mantle RT, 35 Gy IFRT, or 20 Gy IFRT, and integrated organ mean doses were compared for the three protocols. Organ-specific SC risk estimates were estimated using a dosimetric risk-modeling approach, analyzing DVH data with quantitative, mechanistic models of radiation-induced cancer. Dose reductions resulted in corresponding reductions in predicted excess relative risks (ERR) for SC induction. Moving from 35 Gy mantle RT to 35 Gy IFRT reduces predicted ERR for female breast and lung cancer by approximately 65%, and for male lung cancer by approximately 35%; moving from 35 Gy IFRT to 20 Gy IFRT reduces predicted ERRs approximately 40% more. The median reduction in integral dose to the whole heart with the transition to 35 Gy IFRT was 35%, with a smaller (2%) reduction in dose to proximal coronary arteries. There was no significant reduction in thyroid dose. The significant decreases estimated for radiation-induced SC risks associated with modern IFRT provide strong support for the use of IFRT to reduce the late effects of treatment. The approach employed here can provide new insight into the risks associated with contemporary IFRT for HL, and may facilitate the counseling of patients regarding the risks associated with this treatment

  9. Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: A Taiwan nationwide population-based cohort study.

    Science.gov (United States)

    Liang, Sophie Hsin-Yi; Yang, Yao-Hsu; Kuo, Ting-Yu; Liao, Yin-To; Lin, Tzu-Chin; Lee, Yena; McIntyre, Roger S; Kelsen, Brent A; Wang, Tsu-Nai; Chen, Vincent Chin-Hung

    2018-01-01

    Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. To investigate the MPH usage and the risk of suicide attempt among ADHD youths. We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models. Among ADHD youths, reduction of suicide risk was found in patients prescribed 90-180days of MPH after adjusting for confounding factors (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.19-0.90) and a greater reduction in those prescribed more than 180days of MPH (HR: 0.28, 95% CI: 0.17-0.48). We observed a 59% suicide attempt risk reduction among ADHD youths prescribed between 90 and 180days and a 72% risk reduction in those prescribed more than 180days of MPH. The protective benefit observed by the group prescribed MPH for longer duration underscores the importance of psychoeducation and compliance enhancement as part of ADHD management. Indication bias is identified as a limitation of this study, and future self-case control study to investigate the association between suicide attempt and ADHD medication is suggested. This nationwide population-based cohort study showed that among ADHD youths, reduction of suicide risk was observed in patients prescribed MPH for duration 90days and longer, underscoring the importance of appropriate ADHD pharmacotherapy and enhancing drug compliance. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Efficacy of Motivational Interviewing in Conjunction with Caries Risk Assessment (MICRA) Programmes in Improving the Dental Health Status of Preschool Children: A Randomised Controlled Trial.

    Science.gov (United States)

    Saengtipbovorn, Saruta

    To assess the efficacy of motivational interviewing in conjuction with a caries risk assessment (MICRA) programme to improve the dental health status of preschool children. A randomised controlled trial was conducted among 214 parents or caregivers and their children at Health Centre 54, Bangkok, Thailand, from September 2015 to February 2016. The participants were randomised to the intervention and the control groups (107 participants per group). At baseline, the intervention group received a caries risk assessment, individual counseling by using motivational interviewing, and oral hygiene instruction. The intervention group received reinforcement education and individual counseling by motivational interviewing every 3 months. The control group received a routine programme. Participants were assessed at baseline, 3 months, and 6 months for plaque index and caries. The data were analysed by using descriptive statistics, the chi-squared test, Fisher's exact test, t-test, repeated-measures ANOVA, and negative binomial distribution. After the 6-month follow-up, participants in the intervention group had a significantly lower plaque index, non-cavitated plus cavitated carious lesions, and cavitated carious lesions when compared to the control group. The intervention group had a lower caries incidence, non-cavitated plus cavitated carious lesions (1.81 times) and cavitated carious lesions (2.04 times) than the control group. The combination of motivational interviewing and caries risk assessment in one programme decreased early childhood caries in preschool children. It is not known whether the effects are due to the motivational interviewing, the caries risk assessment, or the combination of both.

  11. 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…

  12. Assessment of nutrition and physical activity education programmes in children.

    Science.gov (United States)

    Burke, V; Beilin, L J; Milligan, R; Thompson, C

    1995-03-01

    1. Studies in children relating blood lipids to the extent of atherosclerosis at post-mortem suggest a link between risk factors for cardiovascular disease in childhood and adult life. Tracking of blood pressure (BP) and cholesterol from childhood also supports this association. However, prospective studies have not yet established the outcome in children with increased levels of risk factors. 2. In a controlled trial in Perth, Western Australia, involving over 1000 10-12 year old children, fitness was improved by physical activity programmes which were associated with a greater fall in diastolic BP and triceps skinfolds in girls compared with controls. Sugar intake decreased in boys and fat intake fell in girls, mainly affecting participants in home nutrition programmes. 3. In higher risk children, identified by cluster analysis, major benefits were associated with the fitness and home nutrition programmes. Physical activity combined with involvement of the family in nutrition education is likely to be the most successful approach to modifying lifestyle in children, including those with higher levels of risk. 4. Undernutrition by too rigid restriction of fat intake must be avoided in young children who need calorie-dense foods. Undernutrition, in itself, may predispose to cardiovascular disease in later life. Programmes should aim to establish a prudent diet appropriate to the age of the child combined with physical activity. As regular activity and a healthy diet in adult life will reduce risks of cardiovascular disease it is likely that childhood education will establish lifestyle habits of potential long-term benefit.

  13. 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.

  14. PREDICTING SUCCESS INDICATORS OF AN INTERVENTION PROGRAMME FOR CONVICTED INTIMATE-PARTNER VIOLENCE OFFENDERS: THE CONTEXTO PROGRAMME

    Directory of Open Access Journals (Sweden)

    Enrique Gracia

    2013-01-01

    Full Text Available Recent legal changes in Spain have led to an important increase in the number of men court-mandated to community-based partner violence offender intervention programmes. However, just a few of those interventions have been systematically examined. This study aims to predict success indicators of an intervention programme for convicted intimate-partner violence offenders. The sample consisted of 212 convicted intimate-partner violence offenders who participated in the Contexto Programme. Three “intervention gains” or target criteria were established (increasing the perceived severity of violence, increasing the responsibility assumption for one’s actions, and reducing the risk of recidivism. A structural equations model was tested, fitting data appropriately. Participants with major gain in recidivism risk were those who presented lower levels of alcohol consumption, shorter sentences, lower impulsivity, and a higher degree of life satisfaction. The largest gain in perceived severity was found in younger participants, participants with shorter sentences, lower alcohol consumption, higher life satisfaction, higher participation in their community, and higher self-esteem. And, finally, participants with the highest gains in responsibility assumption were older participants, participants who presented higher intimate support, higher anxiety, higher sexism, lower anger control, higher depression, higher impulsivity and higher self-esteem.

  15. Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

    Science.gov (United States)

    El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Landis, J Richard; Remien, Robert H

    2016-06-01

    Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.

  16. The European programme on climatic change. Assessment and perspectives

    International Nuclear Information System (INIS)

    Creach, Morgane

    2008-09-01

    After having recalled how the ratification of the Kyoto protocol became the basis of the European programme for the struggle against climatic change (operation of flexibility mechanisms) and how this programme has been implemented, this report describes the content of the first European Climate Change Programme which notably addressed the energy sector with the promotion of energy efficiency and renewable energies, the transport sector, the industry sector with the implementation of the European trading scheme for CO 2 emissions, and a regulation on some fluoridated gases. The second part proposes a contrasted assessment of this first programme. It outlines the difficulties to meet the Kyoto objective and identifies the main reason for that, i.e. the limited abilities of the EU to apply the Kyoto protocol. The third part presents the second programme with an integrated climate-energy policy, the integration of the air transport sector within the ETS, a new strategy of reduction of CO 2 emissions by cars, and the definition of a strategy for adaptation to climate change in Europe

  17. Chronic kidney disease risk reduction in a Hispanic population through pharmacist-based disease-state management.

    Science.gov (United States)

    Leal, Sandra; Soto, Marisa

    2008-04-01

    The purpose of this study was to evaluate the ability of a pharmacist-based disease-state management service to improve the care of indigent, predominately Spanish-speaking patients with diabetes mellitus and common comorbid conditions at high risk for the development of chronic kidney disease (CKD). Patients at high risk for developing CKD who have diabetes at a community health center were placed in a pharmacist-based disease state management service for CKD risk reduction. A residency-trained, bilingual, certified diabetes educator, with a PharmD served as the patient's provider using diagnostic, educational, and therapeutic management services under a medical staff approved collaborative practice agreement. Outcomes were assessed by using national standards of care for disease control and prevention screening. The impact on CKD was shown with a mean A1C decrease of 2% and improvement in the proportion of patients at target goals for blood pressure, A1C, and cholesterol levels and receiving aspirin and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. A pharmacist-based disease-state management service for CKD risk reduction, care of diabetes, and frequently associated comorbid conditions improved compliance with national standards for diabetes care in a high-risk population.

  18. CACTUS technology programme. Yearbook 1998; CACTUS teknologiaohjelman vuosikirja 1998

    Energy Technology Data Exchange (ETDEWEB)

    Alakangas, E. [ed.

    1998-12-31

    In the future, the paper industry must be prepared for more environmentally friendly. The main challenge is to develop technologies capable of lowering emissions to air and water and at the same time reducing the formation of waste. To achieve a significant reduction in water consumption at paper mills it will be necessary to develop and to introduce new processes and products. The requirements are better paper quality and runnability and better process management. To assess the process alternatives a technology programme was established in 1996. The goal of this four year programme is to create knowledge that can be used at paper mills to achieve substantial reductions in raw water consumption without jeopardizing paper quality and runnability, increasing the consumption chemicals and impairing the energy efficiency. The costs of the programme are evaluated to be FIM 140-160 million, of which Tekes will supply FIM 70-80 million. The rest of funding is covered by participating companies from paper and chemical industry and from equipment producers. At present, the CACTUS Programme is focused on four research areas, (1) separation techniques and treatment methods, (2) measurements and process chemistry, (3) process modelling and simulation and (4) final placement of concentrates. The total cost of research projects within these areas in 1998 is about FIM 14 million. This yearbook summarises the main research results and future plans of the CACTUS projects. There are 26 research projects and 15 industrial joint projects going on in 1997- 1998. (orig.)

  19. CACTUS technology programme. Yearbook 1998; CACTUS teknologiaohjelman vuosikirja 1998

    Energy Technology Data Exchange (ETDEWEB)

    Alakangas, E [ed.

    1999-12-31

    In the future, the paper industry must be prepared for more environmentally friendly. The main challenge is to develop technologies capable of lowering emissions to air and water and at the same time reducing the formation of waste. To achieve a significant reduction in water consumption at paper mills it will be necessary to develop and to introduce new processes and products. The requirements are better paper quality and runnability and better process management. To assess the process alternatives a technology programme was established in 1996. The goal of this four year programme is to create knowledge that can be used at paper mills to achieve substantial reductions in raw water consumption without jeopardizing paper quality and runnability, increasing the consumption chemicals and impairing the energy efficiency. The costs of the programme are evaluated to be FIM 140-160 million, of which Tekes will supply FIM 70-80 million. The rest of funding is covered by participating companies from paper and chemical industry and from equipment producers. At present, the CACTUS Programme is focused on four research areas, (1) separation techniques and treatment methods, (2) measurements and process chemistry, (3) process modelling and simulation and (4) final placement of concentrates. The total cost of research projects within these areas in 1998 is about FIM 14 million. This yearbook summarises the main research results and future plans of the CACTUS projects. There are 26 research projects and 15 industrial joint projects going on in 1997- 1998. (orig.)

  20. 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

  1. 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

  2. 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…

  3. 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.

  4. 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

  5. Making integrated rural development programmes work: A ...

    African Journals Online (AJOL)

    It follows from the foregoing that The Bank will assist poor countries with grants or soft loans to pilot-test the C4D strategy. The C4D strategy has been field-tested and, therefore, offers great promise of making poverty reduction programmes work more sustainably. It is inexcusable, therefore, for developing countries not to try ...

  6. 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

  7. 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.

  8. An assessment of oral cancer curricula in dental hygiene programmes: implications for cancer control.

    Science.gov (United States)

    Thacker, K K; Kaste, L M; Homsi, K D; LeHew, C W

    2016-11-01

    To assess oral cancer prevention and early detection curricula in Illinois associate-degree dental hygiene programmes and highlight global health applications. An email invitation was sent to each Illinois associate-degree granting dental hygiene programme's oral cancer contact to participate in a survey via a SurveyMonkey™ link to a 21-item questionnaire. Questions elicited background information on each programme and inquired about curriculum and methods used for teaching oral cancer prevention and early detection. Eight of the 12 (67%) programmes responded. Three (37.5%) reported having a specific oral cancer curriculum. Five (62.5%) require students to perform examinations for signs and symptoms of oral cancer at each clinic visit. Variations exist across the programmes in the number of patients each student sees annually and the number of oral cancer examinations each student performs before graduation. Seven programmes (87.5%) conduct early detection screening in community settings. All programmes included risk assessment associated with tobacco. All other risk factors measured were treated inconsistently. Significant differences in training and experience were reported across Illinois dental hygiene programmes. Training is neither standardized nor uniformly comprehensive. Students' preparation for delivering prevention and early detection services to their patients could be strengthened to ensure competence including reflection of risk factors and behaviours in a global context. Regular review of curricular guidelines and programme content would help dental hygienists meet the expectations of the Crete Declaration on Oral Cancer Prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. A qualitative study of older and middle-aged adults' perception and attitudes towards dementia and dementia risk reduction.

    Science.gov (United States)

    Kim, Sarang; Sargent-Cox, Kerry A; Anstey, Kaarin J

    2015-07-01

    To investigate perceptions of dementia and dementia risk reduction held by people without dementia. Dementia does not only affect individuals with dementia, but also has an impact on family and friends, society and healthcare professionals. Recent research has identified modifiable risk and protective factors for dementia. However, it is unclear what knowledge people without dementia have about these risk factors and their attitudes towards addressing these risk factors to achieve dementia risk reduction are not known. Qualitative descriptive study using focus group methodology. A focus group study was conducted in February 2011 with 34 older adults aged between 52-90 years. The long-table approach was used to identify themes and categorize data on dementia knowledge, risk and attitudes. Participants correctly identified dementia risk factors as a group. Participants' responses about their perceived likelihood of developing dementia could be classified into three distinctive themes; fear, rational and cynical perceptions. Both fear of developing dementia and the need to improve dementia knowledge were considered major motivators towards adopting healthier lifestyle and health behaviours. Lack of knowledge on risk factors for dementia was identified as a major barrier for behavioural and lifestyle change. These findings can be used to develop effective and personalized interventions that increase motivators and reduce barriers by tailoring interventions to individual's dementia risk reduction literacy and motivations to change behaviours. Greater public-health promotion and education about risk and protective factors for dementia are also necessary to increase dementia health literacy and to reduce overall dementia prevalence. © 2015 John Wiley & Sons Ltd.

  10. 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)

  11. Radiation and nuclear safety included in the environmental health programme

    International Nuclear Information System (INIS)

    Salomaa, S.

    1996-01-01

    Finland is currently preparing a national environmental health programme, the objective of which is to chart the main environmental health problems in Finland, to identify means for securing a healthy environment, and to draw up a practical action programme for preventing and rectifying problems pertaining to environmental health. Radiation and nuclear safety form an essential part of preventive health care. The action programme is based on decisions and programmes approved at the WHO Conference on the Environment and Health, held in Helsinki in June 1994. In addition to the state of the Finnish environment and the health of the Finnish population, the programme addresses the relevant international issues, in particular in areas adjacent to Finland. The Committee on Environmental Health is expected to complete its work by the end of the year. A wide range of representatives from various branches of administration have contributed to the preparation of the programme. Besides physical, biological and chemical factors, the environmental factors affecting health also include the physical environment and the psychological, social and aesthetic features of the environment. Similarly, environmental factors that have an impact on the health of present or future generations, on the essential preconditions of life and on the quality of life are investigated. The serious risk to nature caused by human actions is also considered as a potential risk to human health. (orig.)

  12. 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.

  13. 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.

  14. 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...

  15. 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.

  16. Select barriers to harm-reduction services for IDUs in eastern Europe

    DEFF Research Database (Denmark)

    Curth, Nadja Kehler; Hansson, Liv Nanna; Storm, Frederikke

    2009-01-01

    In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infecti...

  17. 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

  18. Evaluation of a Surfing Programme Designed to Increase Personal Well-Being and Connectedness to the Natural Environment among "At Risk" Young People

    Science.gov (United States)

    Hignett, Amanda; White, Mathew P.; Pahl, Sabine; Jenkin, Rebecca; Froy, Mod Le

    2018-01-01

    Outdoor activities can be an important complement to classroom learning, especially for children/young people excluded, or at risk of exclusion, from mainstream schooling. The current research explored the impact of a 12-week surfing programme among such a group in the UK. Pre-post data on physiological health (heart rate (HR)/blood pressure),…

  19. Solar-assisted district heating systems: The Solarthermie 2000-programme; Solarunterstuetzte Nahwaermeversorgung: Programm Solarthermie-2000

    Energy Technology Data Exchange (ETDEWEB)

    Lottner, V. [Forschungszentrum Juelich GmbH (Germany). Projekttraeger Biologie, Energie, Umwelt (BEO)

    1998-12-31

    In Germany, utilisation of solar energy for thermal energy supply has a considerable technical and economic potential in terms of substitution of fossil fuels and reduction of CO{sub 2} emission. If appropriate technologies are used, solar-assisted district heat supply systems can be a cost-efficient concept for thermal utilisation of solar energy. The BMBF -programme `Solarthermie 2000` supports a number of pilot and demonstration plants in order to test and develop the most promising systems and storage facilities under real conditions. Long-term measuring programmes generate reliable data on thermal performance and cost of the plant concepts and create a solid basis for a technical and economic evaluation. (orig.) [Deutsch] Die Nutzung von Solarenergie fuer die Waermeversorgung bietet in Deutschland ein grosses technisches und wirtschaftliches Potential zur Substitution fossiler Energietraeger und Reduzierung der CO{sub 2} Emissionen in die Atmosphaere. Solarunterstuetzte Nahwaermesysteme stellen unter guenstigen technischen Bedingungen ein kostenguenstiges Konzept der thermischen Nutzung der Solarenergie dar. In dem BMBF-Programm Solarthermie-2000 werden Pilot- und Demonstrationsanlagen gefoerdert, so dass die aussichtsreichsten System- und Speicherkonzepte in der Praxis erprobt und gezielt weiterentwickelt werden koennen. Mit Langzeit-Messprogrammen werden belastbare Werte der thermischen Leistung und Kosten der Anlagenkonzepte ermittelt und eine zuverlaessige Grundlage fuer die technisch-wirtschaftliche Bewertung geschaffen. (orig.)

  20. 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.

  1. Cost reduction through system integration

    International Nuclear Information System (INIS)

    Helsing, P.

    1994-01-01

    In resent years cost reduction has been a key issue in the petroleum industry. Several findings are not economically attractive at the current cost level, and for this and other reasons some of the major oil companies require the suppliers to have implemented a cost reduction programme to prequalify for projects. The present paper addresses cost reduction through system design and integration in both product development and working methods. This is to be obtained by the combination of contracts by reducing unnecessary coordination and allow re-use of proven interface designs, improve subsystem integration by ''top down'' system design, and improve communication and exchange of experience. 3 figs

  2. The effect of alternative summary statistics for communicating risk reduction on decisions about taking statins: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Cheryl L L Carling

    2009-08-01

    Full Text Available BACKGROUND: While different ways of presenting treatment effects can affect health care decisions, little is known about which presentations best help people make decisions consistent with their own values. We compared six summary statistics for communicating coronary heart disease (CHD risk reduction with statins: relative risk reduction and five absolute summary measures-absolute risk reduction, number needed to treat, event rates, tablets needed to take, and natural frequencies. METHODS AND FINDINGS: We conducted a randomized trial to determine which presentation resulted in choices most consistent with participants' values. We recruited adult volunteers who participated through an interactive Web site. Participants rated the relative importance of outcomes using visual analogue scales (VAS. We then randomized participants to one of the six summary statistics and asked them to choose whether to take statins based on this information. We calculated a relative importance score (RIS by subtracting the VAS scores for the downsides of taking statins from the VAS score for CHD. We used logistic regression to determine the association between participants' RIS and their choice. 2,978 participants completed the study. Relative risk reduction resulted in a 21% higher probability of choosing to take statins over all values of RIS compared to the absolute summary statistics. This corresponds to a number needed to treat (NNT of 5; i.e., for every five participants shown the relative risk reduction one additional participant chose to take statins, compared to the other summary statistics. There were no significant differences among the absolute summary statistics in the association between RIS and participants' decisions whether to take statins. Natural frequencies were best understood (86% reported they understood them well or very well, and participants were most satisfied with this information. CONCLUSIONS: Presenting the benefits of taking statins as

  3. 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

  4. Poverty alleviation aspects of successful improved household stoves programmes

    International Nuclear Information System (INIS)

    2000-01-01

    Programmes to improve household wood and charcoal stove efficiencies have been launched throughout the developing world over the past 20 years. Their main driver has been to reduce environmental degradation resulting from the removal of trees for charcoal and fuel wood production. In addition, health benefits arise from the reduction or removal of smoke in people's homes. Unfortunately, many programmes have failed to establish sustainable improved stove production - primarily through lack of sufficient attention to consumer tastes and market dynamics. This project, carried out in Kenya, Ethiopia and Uganda, has identified key success factors for sustainable stove production and supply by determining the poverty impacts of successful, commercially-based, improved household biomass stove programmes on producers, consumers and others associated with the household fuel and stove supply and end-use business. (author)

  5. Patient and physician attitudes regarding risk and benefit in streamlined development programmes for antibacterial drugs: a qualitative analysis.

    Science.gov (United States)

    Holland, Thomas L; Mikita, Stephen; Bloom, Diane; Roberts, Jamie; McCall, Jonathan; Collyar, Deborah; Santiago, Jonas; Tiernan, Rosemary; Toerner, Joseph

    2016-11-10

    To explore patient, caregiver and physician perceptions and attitudes regarding the balance of benefit and risk in using antibacterial drugs developed through streamlined development processes. Semistructured focus groups and in-depth interviews were conducted to elicit perceptions and attitudes about the use of antibacterial drugs to treat multidrug-resistant infections. Participants were given background information about antibiotic resistance, streamlined drug development programmes and FDA drug approval processes. Audio recordings of focus groups/interviews were reviewed and quotes excerpted and categorised to identify key themes. Two primary stakeholder groups were engaged: one comprising caregivers, healthy persons and patients who had recovered from or were at risk of resistant infection (N=67; 11 focus groups); and one comprising physicians who treat resistant infections (N=23). Responses from focus groups/interviews indicated widespread awareness among patients/caregivers and physicians of the seriousness of the problem of antibacterial resistance. Both groups were willing to accept a degree of uncertainty regarding the balance of risk and benefit in a new therapy where a serious unmet need exists, but also expressed a desire for rigorous monitoring and rapid, transparent reporting of safety/effectiveness data. Both groups wanted to ensure that >1 physician had input on whether to treat patients with antibiotics developed through a streamlined process. Some patients/caregivers unfamiliar with exigencies of critical care suggested a relatively large multidisciplinary team, while physicians believed individual expert consultations would be preferable. Both groups agreed that careful oversight and stewardship of antibacterial drugs are needed to ensure patient safety, preserve efficacy and prevent abuse. Groups comprising patients/caregivers and physicians were aware of serious issues posed by resistant infections and the lack of effective antibacterial drug

  6. A national programme for mastitis control in Australia: Countdown Downunder

    Directory of Open Access Journals (Sweden)

    Brightling PB

    2009-04-01

    Full Text Available Abstract In 1998, Countdown Downunder, Australia's national mastitis and cell count control programme, was created. With funding from the country's leading dairy organisation, Dairy Australia, this programme was originally intended to run for three years but is now in its tenth year. As it was the first time Australia had attempted a national approach to mastitis control on the farm, the first three years of the programme were largely concerned with the development of resources to be used by farmers and service providers. The second three years were devoted to training with both groups. Since that time, Countdown Downunder has entered into a second resource development phase. The goal of the programme was to achieve a reduction in the bulk milk somatic cell count from the Australian dairy herd. To achieve this, the programme had to develop resources with clear and consistent messages around mastitis and somatic cell count control on farms. It was determined that progress toward the goals would be made more rapidly if service providers were trained in the use of these resources prior to farmers. This paper reviews the Countdown Downunder programme from 1998 to 2007.

  7. 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.

  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. Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes.

    Science.gov (United States)

    Taylor, S

    2009-01-01

    Control and reduction of infectious diseases is a key to attaining the Millennium Development Goals. An important element of this work is the successful immunisation, especially in resource-poor countries. Mass immunisation, most intensively in the case of eradication, depends on a combination of reliable demand (e.g. public willingness to comply with the vaccine protocol) and effective supply (e.g. robust, generally state-led, vaccine delivery). This balance of compliance and enforceability is, quintessentially, socio-political in nature - conditioned by popular perceptions of disease and risk, wider conditions of economic development and poverty, technical aspects of vaccine delivery, and the prevailing international norms regarding power relations between states and peoples. In the past 100 years, three out of six disease eradication programmes have failed. The explanations for failure have focused on biotechnical and managerial or financial issues. Less attention is paid to socio-political aspects. Yet socio-political explanations are key. Eradication is neither inherently prone to failure, nor necessarily doomed in the case of polio. However, eradication, and similar mass immunisation initiatives, which fail to address social and political realities of intervention may be. A comparison of the smallpox and polio eradication programmes illustrates the importance of disease-specific socio-political analysis in programme conceptualisation, design, and management.

  10. 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.

  11. Healthcare Programmes for Truck Drivers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lalla-Edward, Samanta Tresha; Fobosi, Siyabulela Christopher; Hankins, Catherine; Case, Kelsey; Venter, W D Francois; Gomez, Gabriela

    2016-01-01

    Truck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population's health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes. We searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio) and model to summarise results (fixed vs. random effects). Thirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most programmes showed

  12. Prevalence of malaria and use of malaria risk reduction measures among resettled pregnant women in South Sudan

    DEFF Research Database (Denmark)

    Dræbel, Tania; Gueth Kueil, Bill; Meyrowitsch, Dan Wolf

    2013-01-01

    Background: The study assessed aspects of malaria infection, prevention and treatment in a population of resettled pregnant women in South Sudan. Methods: During April and May 2008, a cross-sectional study was carried out to estimate malaria prevalence and to assess the use of malaria risk...... ¼ 3.20, 95% CI 1.26–8.16; p ¼ 0.015). Conclusions: The results suggest that educational attainment need not be very advanced to affect practices of malaria prevention and treatment. Primary school attendance was a stronger predictor for use of malaria risk reduction measures than any of the other...... selected background characteristics. Educational attainment, information and communication about malaria prevention and control play a pivotal role in increasing and improving use of malaria risk reduction measures....

  13. How effective are exercise-based injury prevention programmes for soccer players? : A systematic review.

    Science.gov (United States)

    van Beijsterveldt, A M C; van der Horst, Nick; van de Port, Ingrid G L; Backx, Frank J G

    2013-04-01

    The incidence of soccer (football) injuries is among the highest in sports. Despite this high rate, insufficient evidence is available on the efficacy of preventive training programmes on injury incidence. To systematically study the evidence on preventive exercise-based training programmes to reduce the incidence of injuries in soccer. The databases EMBASE/MEDLINE, PubMed, CINAHL, Cochrane Central Register of controlled trials, PEDro and SPORTDiscus™ were searched for relevant articles, from inception until 20 December 2011. The methodological quality of the included studies was assessed using the PEDro scale. The inclusion criteria for this review were (1) randomized controlled trials or controlled clinical trials; (2) primary outcome of the study is the number of soccer injuries and/or injury incidence; (3) intervention focusing on a preventive training programme, including a set of exercises aimed at improving strength, coordination, flexibility or agility; and (4) study sample of soccer players (no restrictions as to level of play, age or sex). The exclusion criteria were: (1) the article was not available as full text; (2) the article was not published in English, German or Dutch; and (3) the trial and/or training programme relates only to specific injuries and/or specific joints. To compare the effects of the different interventions, we calculated the incidence risk ratio (IRR) for each study. Six studies involving a total of 6,099 participants met the inclusion criteria. The results of the included studies were contradictory. Two of the six studies (one of high and one of moderate quality) reported a statistical significant reduction in terms of their primary outcome, i.e. injuries overall. Four of the six studies described an overall preventive effect (IRRbased programmes to prevent soccer injuries. Some reasons for the contradictory findings could be different study samples (in terms of sex and soccer type) in the included studies, differences between

  14. 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 ...

  15. 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.

  16. 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

  17. Radiation protection programme progress report 1988

    International Nuclear Information System (INIS)

    1988-01-01

    The progress report of the radiation protection programme outlines the research work carried out in 1988 under contracts between the Commission of the European Communities and research groups in the Member States. Results of more than 350 projects are reported. They are grouped into six sectors: Radiation dosimetry and its interpretation; Behaviour and control of radionuclides in the environment; Nonstochastic effects of ionizing radiation; Radiation carcinogenesis; Genetic effects of ionizing radiation; Evaluation of radiation risks and optimization of protection. Within the framework programme, the aim of this scientific research is to improve the conditions of life with respect to work and protection of man and his environment and to assure a safe production of energy, i.e.: (i) to improve methods necessary to protect workers and the population by updating the scientific basis for appropriate standards; (ii) to prevent and counteract harmful effects of radiation; (iii) to assess radiation risks and provide methods to cope with the consequences of radiation accidents

  18. Status of the German AF-programme. Considerations with respect to INFCE recommendations and criteria[AF = Anreicherungsreduzierung in Forschungsreaktoren (Enrichment reduction in research reactors)

    Energy Technology Data Exchange (ETDEWEB)

    Thamm, Gerd H [Kernforschungsanlage Juelich GmbH, Research Reactor Division, Juelich (Germany)

    1983-09-01

    As is generally known, the INFCE studies carried out on a worldwide scale from 1977 to 1979 for research reactors using primarily highly enriched uranium (HEU 80% to 93% U-235) have led to the important recommendation that an effective reduction in the proliferation of weapons-usable nuclear material can be achieved by converting the fuel cycles from HEU to low-enriched uranium (LEU, U-235 enrichment 20%). Further recommendations made by INFCE to the effect of restricting or markedly reducing the stockpiles of HEU materials and diminishing the production of fissile materials due to irradiation in research reactors, however, have been given secondary attention in the course of development as compared to the first recommendation mentioned above. As a result of the INFCE studies, national programmes were initiated in various countries aiming at enrichment reduction in research reactors. Essential work in this connection was commenced above all in the USA (RERTR programme), in France, Japan and in the Federal Republic of Germany (AF programme). Added to this was an IAEA support programme intended primarily for developing and threshold countries. Essential conditions in the form of criteria were elaborated by the INFCE Working Group 8C in connection with the recommendation for enrichment reduction in research reactors. These criteria are: 1. The safety margins and fuel reliability should not be reduced by a conversion from HEU to LEU cycles. 2. Losses in reactor performance (e.g. the ratio of neutron flux available for experiments) to reactor power should not be more than marginal. 3. The cost of conversion for research reactors should be kept as low as possible. 4. Any increase in operating costs after conversion should not be more than marginal. The first three criteria mentioned have been given particular attention and have a good chance of being complied with in the current worldwide development activities for a conversion of research reactors to LEU fuel cycle

  19. Justice policy reform for high-risk juveniles: using science to achieve large-scale crime reduction.

    Science.gov (United States)

    Skeem, Jennifer L; Scott, Elizabeth; Mulvey, Edward P

    2014-01-01

    After a distinctly punitive era, a period of remarkable reform in juvenile crime regulation has begun. Practical urgency has fueled interest in both crime reduction and research on the prediction and malleability of criminal behavior. In this rapidly changing context, high-risk juveniles--the small proportion of the population where crime becomes concentrated--present a conundrum. Research indicates that these are precisely the individuals to treat intensively to maximize crime reduction, but there are both real and imagined barriers to doing so. Mitigation principles (during early adolescence, ages 10-13) and institutional placement or criminal court processing (during mid-late adolescence, ages 14-18) can prevent these juveniles from receiving interventions that would best protect public safety. In this review, we synthesize relevant research to help resolve this challenge in a manner that is consistent with the law's core principles. In our view, early adolescence offers unique opportunities for risk reduction that could (with modifications) be realized in the juvenile justice system in cooperation with other social institutions.

  20. Effectiveness of a 12-week school-based educational preventive programme on weight and fasting blood glucose in "at-risk" adolescents of type 2 diabetes mellitus: Randomized controlled trial.

    Science.gov (United States)

    Bani Salameh, Ayman; Al-Sheyab, Nihaya; El-Hneiti, Mamdouh; Shaheen, Abeer; Williams, Leonie M; Gallagher, Robyn

    2017-06-01

    To assess the effectiveness of a 12-week school-based educational preventive programme for type 2 diabetes by change in weight and fasting blood glucose level in Jordanian adolescents. Sixteen percent of Jordanian adults have obesity-related type 2 diabetes and 5.6% of obese adolescents examined, however one-third unexamined. Rates in Arabic countries will double in 20 years, but this can be prevented and reversed by controlling obesity. A single-blinded randomized controlled trial was conducted in 2 unisex high schools in Irbid, Jordan, in 2012. Intervention and control participants, aged 12 to 18 years, were visibly overweight/obese. They were randomly allocated to the intervention (n = 205) or control (n = 196) groups. At-risk students were assessed before and after the 12-week intervention, for change in weight and fasting blood glucose level following preventive instruction and parent-supported changes. Mean age of participants was 15.3 years with equal percentages of both males (49.4%) and females. Post intervention, the intervention group, demonstrated statistically significant reductions: mean difference of 3.3 kg in weight (P blood glucose (P blood glucose in Jordanian at-risk adolescents. © 2017 John Wiley & Sons Australia, Ltd.

  1. 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

  2. An assessment of individual health benefits from a domestic Radon remediation programme

    International Nuclear Information System (INIS)

    Denman, A.R.; Phillips, P.S.; McClatchey, J.

    2002-01-01

    Radon gas occurs naturally in the environment and has been shown to cause increased numbers of lung cancers in miners when present at high levels in underground workings. Reviews of the miners' studies suggest that levels found in some homes can give rise to increased lung cancer incidence, and this has been confirmed by recent case control studies in South West England, and Germany. The current scientific consensus, expressed in the BEIR 6. report is that the risk of lung cancer has a linear relation with increasing radon exposure, and that there is no threshold of risk. The distribution of such excessive levels is geographically varied, and many countries have established programmes to identify the homes at risk, and encourage homeowners to remediate to reduce levels. Northamptonshire, in the centre of England, has been declared a radon Affected Area by the National Radiological Protection Board (NRPB), and has an average of 6.3 % of homes above the UK domestic Action Level of 200 Bq m -3 . Several studies have suggested that theoretically such programmes can be justified on the basis of health benefits and cost effectiveness. Our group was the first to study actual radon remediation programmes - in Northamptonshire, studying first National Health Service properties, schools, and homes. These studies demonstrated that remediation programmes in Northamptonshire could be justified. The domestic radon remediation programme in Northamptonshire, once complete, could be favourably compared to other health initiatives such as the UK mammography screening programme for women aged 50 to 65

  3. Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP).

    Science.gov (United States)

    Lindsay, Geoff; Strand, Steve

    2013-10-19

    Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8-13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006-08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8-13 years. The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10-14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen's d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures for Triple P, but not all between

  4. The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

    Science.gov (United States)

    Tiemessen, Ivo JH; Hulshof, Carel TJ; Frings-Dresen, Monique HW

    2007-01-01

    Background Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP. Methods/Design The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE) of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements. Discussion The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure. PMID:18005400

  5. The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

    Directory of Open Access Journals (Sweden)

    Frings-Dresen Monique HW

    2007-11-01

    Full Text Available Abstract Background Whole body vibration (WBV exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP. A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP. Methods/Design The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements. Discussion The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure.

  6. A national public health programme on gambling policy development in New Zealand: insights from a process evaluation.

    Science.gov (United States)

    Kolandai-Matchett, Komathi; Landon, Jason; Bellringer, Maria; Abbott, Max

    2018-03-06

    In New Zealand, a public health programme on gambling policy development is part of a national gambling harm reduction and prevention strategy mandated by the Gambling Act 2003. Funded by the Ministry of Health, the programme directs workplace/organisational gambling policies, non-gambling fundraising policies, and local council policies on electronic gaming machines (EGMs). We carried out a process evaluation of this programme to identify practical information (e.g. advocacy approaches; challenges and ameliorating strategies) that can be used by programme planners and implementers to reinforce programme effectiveness and serve to guide similar policy-focused public health initiatives elsewhere. Evaluation criteria, based on the programme's official service specifications, guided our evaluation questions, analysis and reporting. To identify informative aspects of programme delivery, we thematically analysed over 100 six-monthly implementer progress reports (representing 3 years of programme delivery) and transcript of a focus group with public health staff. Identified output-related themes included purposeful awareness raising to build understanding about gambling harms and the need for harm-reduction policies and stakeholder relationship development. Outcome-related themes included enhanced community awareness about gambling harms, community involvement in policy development, some workplace/organisational policy development, and some influences on council EGM policies. Non-gambling fundraising policy development was not common. The programme offers an unprecedented gambling harm reduction approach. Although complex (due to its three distinct policy focus areas targeting different sectors) and challenging (due to the extensive time and resources needed to develop relationships and overcome counteractive views), the programme resulted in some policy development. Encouraging workplace/organisational policy development requires increased awareness of costs to

  7. Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme.

    Science.gov (United States)

    Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin

    2016-06-01

    Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  8. Science and Technology Networks : A Helping Hand to Boost Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030?

    NARCIS (Netherlands)

    Trogrlić, RobertŠakić; Cumiskey, Lydia; Triyanti, Annisa; Duncan, Melanie J.; Eltinay, Nuha; Hogeboom, Rick J.; Jasuja, Mansi; Meechaiya, Chinaporn; Pickering, Christina J.; Murray, Virginia

    2017-01-01

    The Sendai Framework for Disaster Risk Reduction 2015–2030 underlines the importance of Science and Technology (S&T) and S&T networks for effective disaster risk reduction (DRR). The knowledge of existing S&T networks and their exact role in DRR, however, is limited. This opinion piece initiates a

  9. Walking away from type 2 diabetes: trial protocol of a cluster randomised controlled trial evaluating a structured education programme in those at high risk of developing type 2 diabetes.

    Science.gov (United States)

    Yates, Thomas; Davies, Melanie J; Henson, Joe; Troughton, Jacqui; Edwardson, Charlotte; Gray, Laura J; Khunti, Kamlesh

    2012-05-29

    The prevention of type 2 diabetes is a recognised health care priority globally. Within the United Kingdom, there is a lack of research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. This study aims to establish the behavioural and clinical effectiveness of a structured educational programme designed to target perceptions and knowledge of diabetes risk and promote a healthily lifestyle, particularly increased walking activity, in a multi-ethnic population at a high risk of developing type 2 diabetes. Cluster randomised controlled trial undertaken at the level of primary care practices. Follow-up will be conducted at 12, 24 and 36 months. The primary outcome is change in objectively measured ambulatory activity. Secondary outcomes include progression to type 2 diabetes, biochemical variables (including fasting glucose, 2-h glucose, HbA1c and lipids), anthropometric variables, quality of life and depression. 10 primary care practices will be recruited to the study (5 intervention, 5 control). Within each practice, individuals at high risk of impaired glucose regulation will be identified using an automated version of the Leicester Risk Assessment tool. Individuals scoring within the 90th percentile in each practice will be invited to take part in the study. Practices will be assigned to either the control group (advice leaflet) or the intervention group, in which participants will be invited to attend a 3 hour structured educational programme designed to promote physical activity and a healthy lifestyle. Participants in the intervention practices will also be invited to attend annual group-based maintenance workshops and will receive telephone contact halfway between annual sessions. The study will run from 2010-2014. This study will provide new evidence surrounding the long-term effectiveness of a diabetes prevention programme run within routine primary care in

  10. Entrepreneurial training for girls empowerment in Lesotho: A process evaluation of a model programme.

    Science.gov (United States)

    Berry, Mary O'Neill; Kuriansky, Judy; Lytle, Megan; Vistman, Bozhena; Mosisili, 'Mathato S; Hlothoane, Lieketso; Matlanyane, Mapeo; Mokobori, Thabang; Mosuhli, Silas; Pebane, Jane

    2013-12-01

    A Girls Empowerment Programme held in 2010 in Lesotho, Sub-Saharan Africa, focused on HIV/AIDS risk reduction and prevention, life skills and entrepreneurial training (income-generating activities). Entrepreneurial training was a crucial part of equipping the camp attendees with basic skills to help them develop sustainable livelihoods. Such skills and financial independence are essential to enable rural girls to complete their secondary schooling (in a fee-based educational system) and to pursue a career, as well as to further help them be less susceptible to transactional sex and its significant risks. The results of a brief process evaluation with some nested supporting data showed considerable improvement in the girls' knowledge about income-generating activities. In addition, almost half of the camp attendees participated in further entrepreneurial training and about half of these girls went on to develop small businesses. Replication of this model of camp training is recommended and being explored in other African countries.

  11. The vaccination programme in Indonesia.

    Science.gov (United States)

    Sawitri Siregar, E; Darminto; Weaver, J; Bouma, A

    2007-01-01

    The Indonesian response to the outbreak of highly pathogenic avian influenza (HPAI) is being strengthened by increased intersectoral commitment and greater availability of staff and resources. Vaccination against avian influenza has been used widely in large commercial sectors but less so in other sectors. Generally, there has been a reduction in outbreaks and in the impact of HPAI on the commercial industry. Afield trial is described that might provide insight into the efficacy of vaccination on farms in sector 3. Preliminary data suggest that vaccination of layers induces high titres, whereas vaccination of native chickens might be difficult owing to a low response in these breeds. A much greater commitment of management, staff and resources is required before vaccination can become part of a successful sustainable campaign to eradicate HPAI. For success, the commercial poultry industry must become an integral part of the control programme, providing information and having the opportunity to identify or modify the priorities of the control programme.

  12. The Italian hydrogen programme

    International Nuclear Information System (INIS)

    Raffaele Vellone

    2001-01-01

    Hydrogen could become an important option in the new millennium. It provides the potential for a sustainable energy system as it can be used to meet most energy needs without harming the environment. In fact, hydrogen has the potential for contributing to the reduction of climate-changing emissions and other air pollutants as it exhibits clean combustion with no carbon or sulphur oxide emissions and very low nitrogen oxide emissions. Furthermore, it is capable of direct conversion to electricity in systems such as fuel cells without generating pollution. However, widespread use of hydrogen is not feasible today because of economic and technological barriers. In Italy, there is an ongoing national programme to facilitate the introduction of hydrogen as an energy carrier. This programme aims to promote, in an organic frame, a series of actions regarding the whole hydrogen cycle. It foresees the development of technologies in the areas of production, storage, transport and utilisation. Research addresses the development of technologies for separation and sequestration of CO 2 , The programme is shared by public organisations (research institutions and universities) and national industry (oil companies, electric and gas utilities and research institutions). Hydrogen can be used as a fuel, with significant advantages, both for electric energy generation/ co-generation (thermo-dynamic cycles and fuel cells) and transportation (internal combustion engine and fuel cells). One focus of research will be the development of fuel cell technologies. Fuel cells possess all necessary characteristics to be a key technology in a future economy based on hydrogen. During the initial phase of the project, hydrogen will be derived from fossil sources (natural gas), and in the second phase it will be generated from renewable electricity or nuclear energy. The presentation will provide a review of the hydrogen programme and highlight future goals. (author)

  13. Reliability assurance programme guidebook for advanced light water reactors

    International Nuclear Information System (INIS)

    2001-12-01

    To facilitate the implementation of reliability assurance programmes (RAP) within future advanced reactor programmes and to ensure that the next generation of commercial nuclear reactors achieves the very high levels of safety, reliability and economy which are expected of them, in 1996, the International Atomic Energy Agency (IAEA) established a task to develop a guidebook for reliability assurance programmes. The draft RAP guidebook was prepared by an expert consultant and was reviewed/modified at an Advisory Group meeting (7-10 April 1997) and at a consults meeting (7-10 October 1997). The programme for the RAP guidebook was reported to and guided by the Technical Working Group on Advanced Technologies for Light Water Reactors (TWG-LWR). This guidebook will demonstrate how the designers and operators of future commercial nuclear plants can exploit the risk, reliability and availability engineering methods and techniques developed over the past two decades to augment existing design and operational nuclear plant decision-making capabilities. This guidebook is intended to provide the necessary understanding, insights and examples of RAP management systems and processes from which a future user can derive his own plant specific reliability assurance programmes. The RAP guidebook is intended to augment, not replace, specific reliability assurance requirements defined by the utility requirements documents and by individual nuclear steam supply system (NSSS) designers. This guidebook draws from utility experience gained during implementation of reliability and availability improvement and risk based management programmes to provide both written and diagrammatic 'how to' guidance which can be followed to assure conformance with the specific requirements outlined by utility requirements documents and in the development of a practical and effective plant specific RAP in any IAEA Member State

  14. The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

    Directory of Open Access Journals (Sweden)

    Thanh Duong

    2009-04-01

    Full Text Available Abstract Background Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. Methods This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. Results The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. Conclusion HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.

  15. Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa.

    Science.gov (United States)

    Visser, Maretha; Thurman, Tonya R; Spyrelis, Alexandra; Taylor, Tory M; Nice, Johanna K; Finestone, Michelle

    2018-03-06

    Preventing HIV among young people is critical to achieving and sustaining global epidemic control. Evidence from Western settings suggests that family-centred prevention interventions may be associated with greater reductions in risk behaviour than standard adolescent-only models. Despite this, family-centred models for adolescent HIV prevention are nearly non-existent in South Africa - home to more people living with HIV than any other country. This paper describes the development and formative evaluation of one such intervention: an evidence-informed, locally relevant, adolescent prevention intervention engaging caregivers as co-participants. The programme, originally consisting of 19 sessions for caregivers and 14 for adolescents, was piloted with 12 groups of caregiver-adolescent dyads by community-based organizations (CBOs) in KwaZulu-Natal and Gauteng provinces. Literature and expert reviews were employed in the development process, and evaluation methods included analysis of attendance records, session-level fidelity checklists and facilitator feedback forms collected during the programme pilot. Facilitator focus group discussions and an implementer programme workshop were also held. Results highlighted the need to enhance training content related to cognitive behavioural theory and group management techniques, as well as increase the cultural relevance of activities in the curriculum. Participant attendance challenges were also identified, leading to a shortened and simplified session set. Findings overall were used to finalize materials and guidance for a revised 14-week group programme consisting of individual and joint sessions for adolescents and their caregivers, which may be implemented by community-based facilitators in other settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Steinhaeusler, F.

    1994-01-01

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

  17. The cardiovascular event reduction tool (CERT)--a simplified cardiac risk prediction model developed from the West of Scotland Coronary Prevention Study (WOSCOPS).

    Science.gov (United States)

    L'Italien, G; Ford, I; Norrie, J; LaPuerta, P; Ehreth, J; Jackson, J; Shepherd, J

    2000-03-15

    The clinical decision to treat hypercholesterolemia is premised on an awareness of patient risk, and cardiac risk prediction models offer a practical means of determining such risk. However, these models are based on observational cohorts where estimates of the treatment benefit are largely inferred. The West of Scotland Coronary Prevention Study (WOSCOPS) provides an opportunity to develop a risk-benefit prediction model from the actual observed primary event reduction seen in the trial. Five-year Cox model risk estimates were derived from all WOSCOPS subjects (n = 6,595 men, aged 45 to 64 years old at baseline) using factors previously shown to be predictive of definite fatal coronary heart disease or nonfatal myocardial infarction. Model risk factors included age, diastolic blood pressure, total cholesterol/ high-density lipoprotein ratio (TC/HDL), current smoking, diabetes, family history of fatal coronary heart disease, nitrate use or angina, and treatment (placebo/ 40-mg pravastatin). All risk factors were expressed as categorical variables to facilitate risk assessment. Risk estimates were incorporated into a simple, hand-held slide rule or risk tool. Risk estimates were identified for 5-year age bands (45 to 65 years), 4 categories of TC/HDL ratio ( or = 7.5), 2 levels of diastolic blood pressure ( or = 90 mm Hg), from 0 to 3 additional risk factors (current smoking, diabetes, family history of premature fatal coronary heart disease, nitrate use or angina), and pravastatin treatment. Five-year risk estimates ranged from 2% in very low-risk subjects to 61% in the very high-risk subjects. Risk reduction due to pravastatin treatment averaged 31%. Thus, the Cardiovascular Event Reduction Tool (CERT) is a risk prediction model derived from the WOSCOPS trial. Its use will help physicians identify patients who will benefit from cholesterol reduction.

  18. 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.

  19. 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...

  20. 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

  1. partnering, poverty reduction and rural enterprise advancement

    African Journals Online (AJOL)

    p2333147

    establishment of the Rural Enterprise Advancement Programme (REAP) and its ... poverty, enabling food security and managing natural resources in a sustainable ... Extending the area under sustainable land management and .... the challenges facing the implementation of poverty reduction .... perceived “most beneficial.

  2. Territory of Upper Volta. Interest and Programme of Prospecting for Radioactive Metals

    International Nuclear Information System (INIS)

    1958-04-01

    The costs of a programme for prospecting for radioactive metals (esp. Uranium) can amount to a total cost of the order of 600 to 700 millions FF over 10 years. Such a programme represents a rather high risk, because in order to succeed, a reserve capable to pay for the programme must be found in the foreseen period. The first part of the report describes the Uranium reserves already known in Africa [fr

  3. A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP).

    Science.gov (United States)

    Lindsay, Geoff; Strand, Steve; Davis, Hilton

    2011-12-30

    There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period. The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Evidence-based parenting programmes can be implemented

  4. 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.

  5. 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

  6. Radiation protection programme for nuclear gauges

    International Nuclear Information System (INIS)

    Muzongomerwa, A.

    2014-04-01

    Ionizing radiation including the use of nuclear gauges can be very hazardous to humans and steps must be taken to minimize the risks so as to prevent deterministic effects and limiting chances for stochastic effects. The availability of a Radiation Protection Programme and its effective implementation ensures appropriate safety and security provisions for sealed radiation sources and promotes a safety culture within a facility that utilizes these sources. This study aims at establishing a guide on the radiation protection programme in nuclear gauges that comply with national requirements derived from current international recommendations. Elements that form part of a radiation protection programme are covered in detail as well as recommendations. The overall objective is to protect people (operators and the public) and the environment from the harmful effects of these sources if they are not properly controlled. Nuclear gauges for well logging and X-ray based gauges are outside the scope of this study. (au)

  7. How can health care organisations make and justify decisions about risk reduction? Lessons from a cross-industry review and a health care stakeholder consensus development process

    International Nuclear Information System (INIS)

    Sujan, Mark A.; Habli, Ibrahim; Kelly, Tim P.; Gühnemann, Astrid; Pozzi, Simone; Johnson, Christopher W.

    2017-01-01

    Interventions to reduce risk often have an associated cost. In UK industries decisions about risk reduction are made and justified within a shared regulatory framework that requires that risk be reduced as low as reasonably practicable. In health care no such regulatory framework exists, and the practice of making decisions about risk reduction is varied and lacks transparency. Can health care organisations learn from relevant industry experiences about making and justifying risk reduction decisions? This paper presents lessons from a qualitative study undertaken with 21 participants from five industries about how such decisions are made and justified in UK industry. Recommendations were developed based on a consensus development exercise undertaken with 20 health care stakeholders. The paper argues that there is a need in health care to develop a regulatory framework and an agreed process for managing explicitly the trade-off between risk reduction and cost. The framework should include guidance about a health care specific notion of acceptable levels of risk, guidance about standardised risk reduction interventions, it should include regulatory incentives for health care organisations to reduce risk, and it should encourage the adoption of an approach for documenting explicitly an organisation's risk position. - Highlights: • Empirical description of industry perceptions on making risk reduction decisions. • Health care consensus development identified five recommendations. • Risk concept should be better integrated into safety management. • Education and awareness about risk concept are required. • Health systems need to start a dialogue about acceptable levels of risk.

  8. Evaluation of an occupational health intervention programme on whole‐body vibration in forklift truck drivers: a controlled trial

    Science.gov (United States)

    Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H

    2006-01-01

    Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole‐body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post‐test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post‐test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p = 0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762

  9. 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.

  10. 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

  11. Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement.

    Science.gov (United States)

    Aherne, Declan; Farrant, Katie; Hickey, Louise; Hickey, Emma; McGrath, Lisa; McGrath, Deirdre

    2016-08-18

    Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1(st) year (compulsory) and 2(nd) year (optional) Graduate Entry Medical School students. A mixed method pre and post study of Year 1 (n = 140) and Year 2 (n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out. Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) (p levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

  12. Reducing the risk of baby falls in maternity units.

    Science.gov (United States)

    Janiszewski, Helen

    During a 12-month period there were 17 baby falls on the maternity wards at Nottingham University Hospitals Trust; two of the babies who fell were injured. By collecting information about the baby falls and how they happened, we were able to compile a guideline for both preventing and managing baby falls. This formed part of the trust's patient safety programme. We then piloted and implemented risk-prevention strategies for baby falls. These involved a risk assessment to identify women needing closer observation and the installation of bedside cots. These strategies brought about a marked reduction of baby falls and are now being established across all the maternity units across the trust.

  13. 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.

  14. 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…

  15. 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.

  16. 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.

  17. Programmable calculator: alternative to minicomputer-based analyzer

    International Nuclear Information System (INIS)

    Hochel, R.C.

    1979-01-01

    Described are a number of typical field and laboratory counting systems that use standard stand-alone multichannel analyzers (MCA) interfaced to a Hewlett-Packard Company (HP 9830) programmable calculator. Such systems can offer significant advantages in cost and flexibility over a minicomputyr-based system. Because most laboratories tend to accumulate MCA's over the years, the programmable calculator also offers an easy way to upgrade the laboratory while making optimum use of existing systems. Software programs are easily tailored to fit a variety of general or specific applications. The only disadvantage of the calculator vs a computer-based system is in speed of analyses; however, for most applications this handicap is minimal. Applications discussed give a brief overview of the power and flexibility of the MCA-calculator approach to automated counting and data reduction

  18. Radiation protection programme progress report 1985-89. Volume 1

    International Nuclear Information System (INIS)

    1991-01-01

    The final report of the 1985-89 radiation protection programme outlines the research work carried out during the whole contractual period under all contracts between the Commission of the European Communities and research groups in the Member States. More than 700 scientists collaborated on this programme. Results of more than 440 projects are reported. They are grouped into six sectors: radiation dosimetry and its interpretation; behaviour and control of radionuclides in the environment; non-stochastic effects of ionizing radiation; radiation carcinogenesis; genetic effects of ionizing radiation; evaluation of radiation risks and optimization of protection. Within the framework programme, the aim of this scientific research is to improve the conditions of life with respect to work and protection of man and his environment and to assure safe production of energy, i.e.: (i) to improve methods necessary to protect workers and the population by updating the scientific basis for appropriate standards; (ii) to prevent and counteract harmful effects of radiation; (iii) to assess radiation risks and provide methods to cope with the consequences of radiation accidents

  19. Radiation protection programme progress report 1985-89. Volume 3

    International Nuclear Information System (INIS)

    1991-01-01

    The final report of the 1985-89 radiation protection programme outlines the research work carried out during the whole contractual period under all contracts between the Commission of the European Communities and research groups in the Member States. More than 700 scientists collaborated on this programme. Results of more than 440 projects are reported. They are grouped into six sectors: radiation dosimetry and its interpretation; behaviour and control of radionuclides in the environment; non-stochastic effects of ionizing radiation; radiation carcinogenesis; genetic effects of ionizing radiation; evaluation of radiation risks and optimization of protection. Within the framework programme, the aim of this scientific research is to improve the conditions of life with respect to work and protection of man and his environment and to assure safe production of energy, i.e.: (i) to improve methods necessary to protect workers and the population by updating the scientific basis for appropriate standards; (ii) to prevent and counteract harmful effects of radiation; (iii) to assess radiation risks and provide methods to cope with the consequences of radiation accidents

  20. Radiation protection programme progress report 1985-89. Volume 2

    International Nuclear Information System (INIS)

    1991-01-01

    The final report of the 1985-89 radiation protection programme outlines the research work carried out during the whole contractual period under all contracts between the Commission of the European Communities and research groups in the Member States. More than 700 scientists collaborated on this programme. Results of more than 440 projects are reported. They are grouped into six sectors: radiation dosimetry and its interpretation; behaviour and control of radionuclides in the environment; non-stochastic effects of ionizing radiation; radiation carcinogenesis; genetic effects of ionizing radiation; evaluation of radiation risks and optimization of protection. Within the framework programme, the aim of this scientific research is to improve the conditions of life with respect to work and protection of man and his environment and to assure safe production of energy, i.e.: (i) to improve methods necessary to protect workers and the population by updating the scientific basis for appropriate standards; (ii) to prevent and counteract harmful effects of radiation; (iii) to assess radiation risks and provide methods to cope with the consequences of radiation accidents

  1. A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme.

    Science.gov (United States)

    Geurtsen, G J; Martina, J D; Van Heugten, C M; Geurts, A C H

    2008-07-01

    To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. Prospective cohort study. Twenty-four participants with acquired brain injury (traumatic n = 18; stroke n = 3, tumour n = 2, encephalitis n = 1). Participants had impaired illness awareness, alcohol and drug problems and/or behavioural problems. A skills-oriented programme with modules related to independent living, work, social and emotional well-being. The Community Integration Questionnaire, CES-Depression, EuroQOL, Employability Rating Scale, living situation and work status were scored at the start (T0), end of treatment (T1) and 1-year follow-up (T2). Significant effects on the majority of outcome measures were present at T1. Employability significantly improved at T2 and living independently rose from 42% to over 70%. Participants working increased from 38% to 58% and the hours of work per week increased from 8 to 15. The Brain Integration Programme led to a sustained reduction in experienced problems and improved community integration. It is concluded that even participants with complex problems due to severe brain injury who got stuck in life could improve their social participation and emotional well-being through a residential community reintegration programme.

  2. A proposed programme for energy risk research

    International Nuclear Information System (INIS)

    1979-01-01

    The report consists of two parts. Part I presents an overview of technological risk management, noting major contributions and current research needs. Part II details a proposed program of energy research, including discussions of some seven recommended projects. The proposed energy risk research program addresses two basic problem areas: improving the management of energy risks and energy risk communication and public response. Specific recommended projects are given for each. (Auth.)

  3. Availability of HIV/AIDS community intervention programmes and ...

    African Journals Online (AJOL)

    As a result, mining sites are at great risk of HIV transmission. While a ... Both quantitative and qualitative methods were used to collect data. ... The programmes carried out intervention activities which included HIV/AIDS education campaigns, ...

  4. Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP)

    Science.gov (United States)

    2013-01-01

    Background Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8–13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006–08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8–13 years. Methods The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10–14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. Results 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen’s d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures

  5. 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

  6. Reduction of radiation risks in patients undergoing some X-ray examinations by using optimal projections: A Monte Carlo program-based mathematical calculation

    Directory of Open Access Journals (Sweden)

    A Chaparian

    2014-01-01

    Full Text Available The objectives of this paper were calculation and comparison of the effective doses, the risks of exposure-induced cancer, and dose reduction in the gonads for male and female patients in different projections of some X-ray examinations. Radiographies of lumbar spine [in the eight projections of anteroposterior (AP, posteroanterior (PA, right lateral (RLAT, left lateral (LLAT, right anterior-posterior oblique (RAO, left anterior-posterior oblique (LAO, right posterior-anterior oblique (RPO, and left posterior-anterior oblique (LPO], abdomen (in the two projections of AP and PA, and pelvis (in the two projections of AP and PA were investigated. A solid-state dosimeter was used for the measuring of the entrance skin exposure. A Monte Carlo program was used for calculation of effective doses, the risks of radiation-induced cancer, and doses to the gonads related to the different projections. Results of this study showed that PA projection of abdomen, lumbar spine, and pelvis radiographies caused 50%-57% lower effective doses than AP projection and 50%-60% reduction in radiation risks. Also use of LAO projection of lumbar spine X-ray examination caused 53% lower effective dose than RPO projection and 56% and 63% reduction in radiation risk for male and female, respectively, and RAO projection caused 28% lower effective dose than LPO projection and 52% and 39% reduction in radiation risk for males and females, respectively. About dose reduction in the gonads, using of the PA position rather than AP in the radiographies of the abdomen, lumbar spine, and pelvis can result in reduction of the ovaries doses in women, 38%, 31%, and 25%, respectively and reduction of the testicles doses in males, 76%, 86%, and 94%, respectively. Also for oblique projections of lumbar spine X-ray examination, with employment of LAO rather than RPO and also RAO rather than LPO, demonstrated 22% and 13% reductions to the ovaries doses and 66% and 54% reductions in the

  7. A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls

    OpenAIRE

    Conroy, Simon; Kendrick, Denise; Harwood, Rowan; Gladman, John; Coupland, Carol; Sach, Tracey; Drummond, Avril; Youde, Jane; Edmans, Judi; Masud, Tahir

    2010-01-01

    Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process. Design: multicentre randomised controlled trial. Setting: eight general practices and three day hospitals based in the East Midlands, UK. Participants: three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at ...

  8. EPIC Trial: education programme impact on serum phosphorous control in CKD 5D patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Carmen Tzanno Branco Martins

    Full Text Available Abstract Introduction: In stage 5D chronic kidney disease (CKD 5D patients, the encouragement of treatment adherence by health professionals is a significant clinical challenge. Objectives: This study evaluates the impact of a nutritional education programme on hyperphosphatemia, utilizing the transtheoretical model of behavior change (TMBC. Subjects and Methods: A prospective interventional study comprising 179 CKD 5D patients with hypophosphatemia. The 4-month educational programme took place during dialysis sessions. Demographic and laboratory data were evaluated, whilst the TMBC was utilized both pre- and post-intervention. Results: 132 patients showed a positive change and significant reduction in phosphate levels, whilst 47 patients showed a negative change and little reduction in phosphate levels. Positive changes were identified at different levels of literacy. 117/179 participants had ongoing treatment with sevelamer throughout the trial period. 61 patients with intact parathyroid hormone (iPTH 300 pg/ml also showed a decrease in phosphate levels. Conclusions: Nutritional education programmes can achieve excellent results when appropriately applied. An education programme may be effective across different literacy levels.

  9. Weight reduction intervention for obese infertile women prior to IVF

    DEFF Research Database (Denmark)

    Einarsson, Snorri; Bergh, Christina; Friberg, Britt

    2017-01-01

    in the weight reduction group reaching BMI ≤ 25 kg/m2 or reaching a weight loss of at least five BMI units to the IVF only group. No statistical differences in live birth rates between the groups in either subgroup analysis were found. LIMITATIONS, REASON FOR CAUTION: The study was not powered to detect a small......STUDY QUESTION: Does an intensive weight reduction programme prior to IVF increase live birth rates for infertile obese women? SUMMARY ANSWER: An intensive weight reduction programme resulted in a large weight loss but did not substantially affect live birth rates in obese women scheduled for IVF...... in infertile obese women. STUDY DESIGN, SIZE, DURATION: A prospective, multicentre, randomized controlled trial was performed between 2010 and 2016 in the Nordic countries. In total, 962 women were assessed for eligibility and 317 women were randomized. Computerized randomization with concealed allocation...

  10. A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme.

    Science.gov (United States)

    Brunelli, Alessandro; Tentzeris, Vasileios; Sandri, Alberto; McKenna, Alexandra; Liew, Shan Liung; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2016-05-01

    To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses. Costs were calculated in GBP and expressed in Euros (EUR:GBP exchange rate 1.4). The average total cost of a VATS lobectomy was €11 368 (range €6992-€62 535). Average intraoperative (including surgical and anaesthetic time, overhead, disposable materials) and postoperative costs [including ward stay, high dependency unit (HDU) or intensive care unit (ICU) and variable costs associated with management of complications] were €8226 (range €5656-€13 296) and €3029 (range €529-€51 970), respectively. The following variables remained reliably associated with total costs after linear regression analysis and bootstrap: carbon monoxide lung diffusion capacity (DLCO) 0.05) in 86% of the samples. A hypothetical patient with COPD and DLCO less than 60% would cost €4270 more than a patient without COPD and with higher DLCO values (€14 793 vs €10 523). Risk-adjusting financial data can help estimate the total cost associated with VATS lobectomy based on clinical factors. This model can be used to audit the internal financial performance of a VATS lobectomy programme for budgeting, planning and for appropriate bundled payment reimbursements. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  11. 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

  12. Prevalence and risk factors for proteinuria: the National Kidney Foundation of Malaysia Lifecheck Health Screening programme.

    Science.gov (United States)

    Ong, Loke Meng; Punithavathi, Narayanan; Thurairatnam, Dharminy; Zainal, Hadzlinda; Beh, Mei Li; Morad, Zaki; Lee, Sharleen Ys; Bavanandan, Sunita; Kok, Lai Sun

    2013-08-01

    Treatment of chronic kidney disease (CKD) poses a huge burden to the healthcare system. To address the problem, the National Kidney Foundation of Malaysia embarked on a programme to screen for proteinuria and educate the public on CKD. The public was invited for health screening and the data collected over a 21 month period was analyzed. In total, 40400 adults from all the states in Malaysia were screened. The screening population had a mean age of 41 years, 30.1% had hypertension and 10.6% had diabetes. Proteinuria was detected in 1.4% and haematuria in 8.9% of the participants. Factors associated with the highest risk for proteinuria were the presence of diabetes (adjusted odds ratio (OR) 2.63 (95% confidence interval (CI) 2.16-3.21)), hypertension (OR 2.49 (95% CI 2.03-3.07)) and cardiac disease (OR 2.05 (95% CI 1.50-2.81)). Other risk factors identified were lower educational level, family history of kidney disease, hypercholesterolaemia, obesity and lack of regular exercise. Chinese had the lowest risk for proteinuria among the races (OR 0.71 (95% CI 0.57-0.87) compared with Malays). The combination of high blood glucose and high blood pressure (BP) substantially increased the risk for proteinuria (OR 38.1 for glucose ≥ 10 mmol/L and systolic BP ≥ 180 mm Hg and OR 47.9 for glucose ≥ 10 mmol/L and diastolic BP ≥ 110 mm Hg). The prevalence of proteinuria in Malaysia is similar to other countries. The major risk factors for proteinuria were diabetes, hypertension and cardiac disease. The presence of both high blood pressure and high blood glucose exert a synergistic effect in substantially increasing the risk for proteinuria. © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.

  13. Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal.

    Science.gov (United States)

    Poudel, Krishna C; Buchanan, David R; Poudel-Tandukar, Kalpana

    2015-06-01

    We evaluated the efficacy of a sexual risk reduction intervention utilizing protection motivation and social cognitive theories to address knowledge, threat and coping appraisals, and condom use intentions among HIV-positive individuals in Nepal. Using a quasi-experimental research design, we assigned 277 participants to intervention (n=146) and control (n=131) groups. The intervention group received six sessions on sexual risk reduction strategies and the control group six sessions on medication adherence, smoking, and mental health. Data were collected at baseline and immediately after the intervention. Results indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners. The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders. In conclusion, our theory-based sexual risk reduction intervention was effective in improving HIV transmission knowledge, perceived threat and coping appraisals, and condom use intentions. Further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors.

  14. 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.

  15. 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.

  16. Breast Reduction Surgery

    Science.gov (United States)

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as ...

  17. 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.

  18. Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

    Science.gov (United States)

    Wang, Wenyu; Jin, Jianjun; He, Rui; Gong, Haozhou; Tian, Yuhong

    2018-01-01

    This study aimed to estimate farmers’ willingness to pay (WTP) for health risk reductions of pesticide use by applying the contingent valuation method (CVM) and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income) per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers’ socioeconomic and attitudinal factors that significantly affect their WTP include farmers’ farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents’ social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world. PMID:29596345

  19. Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study

    Directory of Open Access Journals (Sweden)

    Wenyu Wang

    2018-03-01

    Full Text Available This study aimed to estimate farmers’ willingness to pay (WTP for health risk reductions of pesticide use by applying the contingent valuation method (CVM and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers’ socioeconomic and attitudinal factors that significantly affect their WTP include farmers’ farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents’ social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world.

  20. Reduction of operative mortality after implementation of Surgical Outcomes Monitoring and Improvement Programme by Hong Kong Hospital Authority.

    Science.gov (United States)

    Yuen, W C; Wong, K; Cheung, Y S; Lai, P Bs

    2018-04-01

    Since 2008, the Hong Kong Hospital Authority has implemented a Surgical Outcomes Monitoring and Improvement Programme (SOMIP) at 17 public hospitals with surgical departments. This study aimed to assess the change in operative mortality rate after implementation of SOMIP. The SOMIP included all Hospital Authority patients undergoing major/ultra-major procedures in general surgery, urology, plastic surgery, and paediatric surgery. Patients undergoing liver or renal transplantation or who had multiple trauma or massive bowel ischaemia were excluded. In SOMIP, data retrieval from the Hospital Authority patient database was performed by six full-time nurse reviewers following a set of precise data definitions. A total of 230 variables were collected for each patient, on demographics, preoperative and operative variables, laboratory test results, and postoperative complications up to 30 days after surgery. In this study, we used SOMIP cumulative 5-year data to generate risk-adjusted 30-day mortality models by hierarchical logistic regression for both emergency and elective operations. The models expressed overall performance as an annual observed-to-expected mortality ratio. From 2009/2010 to 2015/2016, the overall crude mortality rate decreased from 10.8% to 5.6% for emergency procedures and from 0.9% to 0.4% for elective procedures. From 2011/2012 to 2015/2016, the risk-adjusted observed-to-expected mortality ratios showed a significant downward trend for both emergency and elective operations: from 1.126 to 0.796 and from 1.150 to 0.859, respectively (Mann- Kendall statistic = -0.8; PAuthority's overall crude mortality rates and risk-adjusted observed-to-expected mortality ratios for emergency and elective operations significantly declined after SOMIP was implemented.

  1. 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.

  2. The ProActive trial protocol – a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766

    Directory of Open Access Journals (Sweden)

    Ekelund Ulf

    2004-10-01

    Full Text Available Abstract Background Increasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem. While previous evaluations of interventions to increase physical activity have involved communities or individuals with established disease, less attention has been given to interventions for individuals at risk of disease. Methods/design ProActive aims to evaluate the efficacy of a theoretical, evidence- and family-based intervention programme to increase physical activity in a sedentary population, defined as being at-risk through having a parental family history of diabetes. Primary care diabetes or family history registers were used to recruit 365 individuals aged 30–50 years, screened for activity level. Participants were assigned by central randomisation to three intervention programmes: brief written advice (comparison group, or a psychologically based behavioural change programme, delivered either by telephone (distance group or face-to-face in the family home over one year. The protocol-driven intervention programme is delivered by trained facilitators, and aims to support increases in physical activity through the introduction and facilitation of a range of self-regulatory skills (e.g. goal setting. The primary outcome is daytime energy expenditure and its ratio to resting energy expenditure, measured at baseline and one year using individually calibrated heart rate monitoring. Secondary measures include self-report of individual and family activity, psychological mediators of behaviour change, physiological and biochemical correlates, acceptability, and costs, measured at baseline, six months and one year. The primary intention to treat analysis will compare groups at one-year post randomisation. Estimation of the impact on diabetes incidence will be modelled using data from a parallel ten-year cohort study using similar measures. Discussion ProActive is the first efficacy trial of an

  3. Weight reduction intervention for obese infertile women prior to IVF: a randomized controlled trial.

    Science.gov (United States)

    Einarsson, Snorri; Bergh, Christina; Friberg, Britt; Pinborg, Anja; Klajnbard, Anna; Karlström, Per-Olof; Kluge, Linda; Larsson, Ingrid; Loft, Anne; Mikkelsen-Englund, Anne-Lis; Stenlöf, Kaj; Wistrand, Anna; Thurin-Kjellberg, Ann

    2017-08-01

    Does an intensive weight reduction programme prior to IVF increase live birth rates for infertile obese women? An intensive weight reduction programme resulted in a large weight loss but did not substantially affect live birth rates in obese women scheduled for IVF. Among obese women, fertility and obstetric outcomes are influenced negatively with increased risk of miscarriage and a higher risk of maternal and neonatal complications. A recent large randomized controlled trial found no effect of lifestyle intervention on live birth in infertile obese women. A prospective, multicentre, randomized controlled trial was performed between 2010 and 2016 in the Nordic countries. In total, 962 women were assessed for eligibility and 317 women were randomized. Computerized randomization with concealed allocation was performed in the proportions 1:1 to one of two groups: weight reduction intervention followed by IVF-treatment or IVF-treatment only. One cycle per patient was included. Nine infertility clinics in Sweden, Denmark and Iceland participated. Women under 38 years of age planning IVF, and having a BMI ≥30 and non-financial support from Impolin AB, during the conduct of the study, and personal fees from Merck outside the submitted work. Dr Friberg reports personal fees from Ferring, Merck, MSD, Finox and personal fees from Studentlitteratur, outside the submitted work. Dr Englund reports personal fees from Ferring, and non-financial support from Merck, outside the submitted work. Dr Bergh reports and has been reimbursed for: writing a newsletter twice a year (Ferring), lectures (Ferring, MSD, Merck), and Nordic working group meetings (Finox). Dr Karlström reports lectures (Ferring, Finox, Merck, MSD) and Nordic working group meetings (Ferring). Ms Kluge, Dr Einarsson, Dr Pinborg, Dr Klajnbard, Dr Stenlöf, Dr Larsson, Dr Loft and Dr Wistrand have nothing to disclose. ClinicalTrials.gov number, NCT01566929. 23-03-2012. 05-10-2010. © The Author 2017. Published by

  4. Educating educators about alcoholism and drug addiction: the role of employee assistance programmes.

    Science.gov (United States)

    Van den Bergh, N

    1990-01-01

    The historical development of employee assistance programmes (EAPs) from occupational alcoholism programmes is outlined. Services for the three prevention levels of a 'broad brush' programme are described. The 'at-risk' characteristics of academia in potentiating alcoholism and addiction are noted, including several intrinsic characteristics of academics which could predispose to substance abuse. Ways in which EAPs enhance organizational goals are noted and several crucial steps in designing an academic EAP are suggested.

  5. Mission creep or responding to wider security needs? The evolving role of mine action organisations in Armed Violence Reduction

    Directory of Open Access Journals (Sweden)

    Sharmala Naidoo

    2013-04-01

    Full Text Available Since the late 1980s, mine action organisations have focused their efforts on reducing the social, economic and environmental impacts of anti-personnel mines and other explosive remnants of war (ERW through a broad range of activities, including survey, clearance, mine risk education (MRE, victim assistance, stockpile destruction and advocacy. In recent years, an increasing number of mine action organisations are using their mine action technical expertise and their capacities to operate in difficult environments to reduce armed violence and promote public safety. Several organisations now have armed violence reduction (AVR-related policies, programmes and staff in place. Some may argue that this shift towards AVR is a diversion from the core mandate of mine action organisations. But does this represent a loss of focus and thereby ‘mission creep’ on the part of these organisations? This practice note examines the factors underlying the evolving role of mine action organisations, discusses how these new programmes are contributing to the wider domain of AVR and explores whether these new programmes have resulted in a loss of organisational focus.

  6. 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...

  7. Islam and harm reduction.

    Science.gov (United States)

    Kamarulzaman, A; Saifuddeen, S M

    2010-03-01

    Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed. Copyright (c) 2009. Published by Elsevier B.V.

  8. 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

  9. Data poverty: A global evaluation for 2009 to 2013 - implications for sustainable development and disaster risk reduction

    Science.gov (United States)

    Leidig, Mathias; Teeuw, Richard M.; Gibson, Andrew D.

    2016-08-01

    The article presents a time series (2009-2013) analysis for a new version of the ;Digital Divide; concept that developed in the 1990s. Digital information technologies, such as the Internet, mobile phones and social media, provide vast amounts of data for decision-making and resource management. The Data Poverty Index (DPI) provides an open-source means of annually evaluating global access to data and information. The DPI can be used to monitor aspects of data and information availability at global and national levels, with potential application at local (district) levels. Access to data and information is a major factor in disaster risk reduction, increased resilience to disaster and improved adaptation to climate change. In that context, the DPI could be a useful tool for monitoring the Sustainable Development Goals of the Sendai Framework for Disaster Risk Reduction (2015-2030). The effects of severe data poverty, particularly limited access to geoinformatic data, free software and online training materials, are discussed in the context of sustainable development and disaster risk reduction. Unlike many other indices, the DPI is underpinned by datasets that are consistently provided annually for almost all the countries of the world and can be downloaded without restriction or cost.

  10. A systematic review of education programmes to prevent concussion in rugby union.

    Science.gov (United States)

    Fraas, Michael R; Burchiel, Jessica

    2016-11-01

    There is a high incidence of concussion sustained by athletes participating in rugby union, many of which go unreported. A lack of sufficient knowledge about concussion injuries may explain athletes' failure to report. Several rugby union-playing countries have developed injury education and prevention programmes to address this issue. The aim of the current review was to systematically assess the content and level of evidence on concussion education/prevention programmes in rugby union and to make recommendations for the quality, strength, and consistency of this evidence. We searched PubMed, PsycInfo, MEDLINE, SPORTDiscuss, Webofscience, and conducted a manual search for articles. Ten articles were included for review. Of these, six focused on the BokSmart injury prevention programme in South Africa, two focused on the RugbySmart injury prevention programme in New Zealand, one was an analysis of prevention programmes, and one was a systematic review of rugby injury prevention strategies. Despite the initiative to develop concussion education and prevention programmes, there is little evidence to support the effectiveness of such programmes. There is evidence to support education of coaches and referees. In addition, there is scant evidence to suggest that education and rule changes may have the benefit of changing athlete behaviours resulting in a reduction in catastrophic injury.

  11. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

    Science.gov (United States)

    Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

    2009-06-27

    This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

  12. Walking away from type 2 diabetes: trial protocol of a cluster randomised controlled trial evaluating a structured education programme in those at high risk of developing type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Yates Thomas

    2012-05-01

    Full Text Available Abstract Background The prevention of type 2 diabetes is a recognised health care priority globally. Within the United Kingdom, there is a lack of research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. This study aims to establish the behavioural and clinical effectiveness of a structured educational programme designed to target perceptions and knowledge of diabetes risk and promote a healthily lifestyle, particularly increased walking activity, in a multi-ethnic population at a high risk of developing type 2 diabetes. Design Cluster randomised controlled trial undertaken at the level of primary care practices. Follow-up will be conducted at 12, 24 and 36 months. The primary outcome is change in objectively measured ambulatory activity. Secondary outcomes include progression to type 2 diabetes, biochemical variables (including fasting glucose, 2-h glucose, HbA1c and lipids, anthropometric variables, quality of life and depression. Methods 10 primary care practices will be recruited to the study (5 intervention, 5 control. Within each practice, individuals at high risk of impaired glucose regulation will be identified using an automated version of the Leicester Risk Assessment tool. Individuals scoring within the 90th percentile in each practice will be invited to take part in the study. Practices will be assigned to either the control group (advice leaflet or the intervention group, in which participants will be invited to attend a 3 hour structured educational programme designed to promote physical activity and a healthy lifestyle. Participants in the intervention practices will also be invited to attend annual group-based maintenance workshops and will receive telephone contact halfway between annual sessions. The study will run from 2010–2014. Discussion This study will provide new evidence surrounding the long-term effectiveness of a

  13. 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.

  14. 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

  15. driven and community-driven poverty reduction strategies/progr

    African Journals Online (AJOL)

    World Bank assisted Community-Based Poverty Reduction Programme ... economic performance and in the absence of adequate social safety net, the per capita income ... the international community, development workers, the political class, scholars, activists, ..... Manufacturing and Direct Public Policy in South Western.

  16. 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

  17. 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.

  18. Risk stratification in secondary cardiovascular prevention.

    Science.gov (United States)

    Lazzeroni, Davide; Coruzzi, Paolo

    2018-02-19

    Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

  19. Cost-benefit evaluation in a quality control programme for conventional radiodiagnosis

    International Nuclear Information System (INIS)

    Gallini, R.; Belletti, S.; Giugni, U.

    1985-01-01

    A comparison is being made between the cost of the staff and equipment in a quality control programme of conventional radiodiagnosis and the benefit obtained in the reduction of spoilt films and in the reduction of dose to patients and workers. For over two years the programme has followed a protocol verified on about 50 X-ray tubes, 25 radiological devices and four automatic processors. The present research, based on previous data, works on a limited but representative sample of radiological X-ray tubes and accessories. The control procedures are carried out periodically to improve and make constant the efficiency of the radiological devices. An evaluation of the cost of these procedures is made. In the meantime the dose to the patients undergoing radiodiagnostic examinations is evaluated by a transmission chamber. Comparison between the values obtained before and after the control enables the benefits to be evaluated. Rejection of radiographic films is evaluated before and after the control to obtain the cost reduction. During the one year control period, there were no variations in the technical characteristics of the personnel, in the operational procedures or in the work-load. (author)

  20. 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.

  1. Spinoffs from radiological emergency preparedness programmes to generic emergency management

    International Nuclear Information System (INIS)

    Sanders, M.E.

    1986-01-01

    In the USA, the radiological emergency preparedness (REP) programme for nuclear power plants is being used to enhance emergency management programmes for other types of emergencies. The REP programme is particularly useful in developing plans and preparedness measures for chemical accidents. The Integrated Emergency Management System (IEMS) approach provides a means for maximizing relationships between the REP programme and other programmes. IEMS essentially involves applying common elements of planning and preparedness to all types of emergencies, while recognizing that unique characteristics of specific natural and man-made emergencies require special planning and preparedness considerations. Features of the REP programme that make it compatible with the IEMS approach and useful in coping with other types of emergencies are: (1) the close co-operation between the national nuclear regulatory and emergency management organizations; (2) the programme integration among all levels of government, the nuclear power industry, public interest groups and the general public and (3) the comprehensiveness and sophistication of the programme. The REP programme in the USA represents a state-of-the-art emergency management capability. Some of its elements are readily transferrable to most other types of emergency preparedness programmes, while other elements can be adapted more readily to other hazard-specific programmes. The Bhopal accident has been a catalyst for this adaptation to chemical accidents, in such areas as furnishing hazard-specific information to the public, alert and notification systems, definition of the hazards and risks involved, establishing planning zones and developing close working relationships among the industry, the public and government

  2. Territory of Upper Volta. Interest and Programme of Prospecting for Radioactive Metals; Territoire de la Haute-Volta. Interet et Programme d'une Prospection pour Metaux Radioactifs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1958-04-15

    The costs of a programme for prospecting for radioactive metals (esp. Uranium) can amount to a total cost of the order of 600 to 700 millions FF over 10 years. Such a programme represents a rather high risk, because in order to succeed, a reserve capable to pay for the programme must be found in the foreseen period. The first part of the report describes the Uranium reserves already known in Africa. [French] Un programme de prospection pour metaux radioactifs (notamment l'Uranium) pourrait etaler des depenses totales de l'ordre de 600 a 700 millions FF sur 10 ans. Un tel programme represente un risque assez grand, puisque pour reussir, il faut trouver dans le delai envisage, et avec les moyens prevus, un gisement capable d'amortir une telle depense. Une premiere partie du rapport expose les caracteres des gisments d'Uranium actuellement connus en Afrique.

  3. Effectiveness of a patient blood management protocol on reduction of allogenic red blood cell transfusions in orthopedic surgery.

    Science.gov (United States)

    Polanco-García, Mauricio; Capielo, Ana María; Miret, Xavier; Chamero, Antonio; Sainz, Julio; Revilla, Elena; Guinjoan, Antoni; Arranz, Teresa

    2018-06-07

    Patient blood management in orthopaedic surgery reduces transfusion risk. The best protocol is unknown. The effectiveness of a protocol based on the Seville Consensus on the reduction of transfusion risk is evaluated and a predictive transfusion equation is proposed in knee surgery. Cohort study in patients undergoing knee and hip arthroplasty from January 2014 to December 2015 at a second level complexity hospital in Vilafranca del Penedès (Barcelona). Patients with Hb between 10 and 13g/dL were classified as anaemic with or without iron deficiency and received iron or combination of iron and erythropoietin. On the day of surgery, tranexamic acid was administered, the Hb drop was measured the next day and the requirements and the transfusion lintel were measured during the stay. A total of 334 patients were included in the study. The implementation of the programme decreased the transfusion risk from 41.5% to 14.8% at the end of the study. In hip surgery, transfused patients were significantly older, sicker and with lower preoperative Hb. Tranexamic acid did not decrease bleeding. In knee surgery, the administration of tranexamic acid was the variable that most decreased the transfusion risk followed by a high preoperative Hb. The equation predicts transfusion risk with a sensitivity of 55% and specificity of 95.7%. The implementation of the programme reduces transfusion risk. The effectiveness of tranexamic acid varies according to surgery site. The use of iron and recombinant human erythropoietin is necessary to improve Hb. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  4. Reducing shame in a game that predicts HIV risk reduction for young adult MSM: a randomized trial delivered nationally over the Web.

    Science.gov (United States)

    Christensen, John L; Miller, Lynn Carol; Appleby, Paul Robert; Corsbie-Massay, Charisse; Godoy, Carlos Gustavo; Marsella, Stacy C; Read, Stephen J

    2013-11-13

    Men who have sex with men (MSM) often face socially sanctioned disapproval of sexual deviance from the heterosexual "normal." Such sexual stigma can be internalized producing a painful affective state (i.e., shame). Although shame (e.g., addiction) can predict risk-taking (e.g., alcohol abuse), sexual shame's link to sexual risk-taking is unclear. Socially Optimized Learning in Virtual Environments (SOLVE) was designed to reduce MSM's sexual shame, but whether it does so, and if that reduction predicts HIV risk reduction, is unclear. To test if at baseline, MSM's reported past unprotected anal intercourse (UAI) is related to shame; MSM's exposure to SOLVE compared to a wait-list control (WLC) condition reduces MSM's shame; and shame-reduction mediates the link between WLC condition and UAI risk reduction. HIV-negative, self-identified African American, Latino or White MSM, aged 18-24 years, who had had UAI with a non-primary/casual partner in the past three months were recruited for a national online study. Eligible MSM were computer randomized to either WLC or a web-delivered SOLVE. Retained MSM completed baseline measures (e.g., UAI in the past three months; current level of shame) and, in the SOLVE group, viewed at least one level of the game. At the end of the first session, shame was measured again. MSM completed follow-up UAI measures three months later. All data from 921 retained MSM (WLC condition, 484; SOLVE condition, 437) were analyzed, with missing data multiply imputed. At baseline, MSM reporting more risky sexual behaviour reported more shame (r s=0.21; peffect was significant (point estimate -0.10, 95% bias-corrected CI [-0.01 to -0.23] such that participants in the SOLVE treatment condition reported greater reductions in shame, which in turn predicted reductions in risky sexual behaviour at follow-up. The direct effect, however, was not significant. SOLVE is the first intervention to: (1) significantly reduce shame for MSM; and (2) demonstrate that

  5. 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

  6. Risk-based enteric pathogen reduction targets for non-potable and direct potable use of roof runoff, stormwater, and greywater

    Science.gov (United States)

    This paper presents risk-based enteric pathogen log reduction targets for non-potable and potable uses of a variety of alternative source waters (i.e., locally-collected greywater, roof runoff, and stormwater). A probabilistic Quantitative Microbial Risk Assessment (QMRA) was use...

  7. (Re)conceptualising Risk: Left Numb and Unengaged and Lost in a No-Man's-Land or What (Seems to) Work for At-Risk Students

    Science.gov (United States)

    Zyngier, David

    2011-01-01

    This review of current research into at-risk programmes serves to categorise and characterise existing programmes and to evaluate the contribution of these programmes to assisting students at risk from marginalised backgrounds. This characterisation questions the (sometimes) implicit assumptions and the consequences of those assumptions inherent…

  8. 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…

  9. School Area Road Safety Assessment and Improvements (SARSAI) programme reduces road traffic injuries among children in Tanzania.

    Science.gov (United States)

    Poswayo, Ayikai; Kalolo, Simon; Rabonovitz, Katheryn; Witte, Jeffrey; Guerrero, Alejandro

    2018-05-19

    To determine the impact of a paediatric road traffic injury (RTI) prevention programme in urban Sub-Saharan Africa. Dares Salaam, Republic of Tanzania. Household surveys were conducted in catchment areas around 18 primary schools in Dar es Salaam, Republic of Tanzania; the catchment areas were divided into control and intervention groups. Collected data included basic demographic information on all school-aged household members and whether or not they had been involved in an RTI in the previous 12 months, and, if so, what the characteristics of that RTI were. Based on these findings, a separate road safety engineering site analysis and consultation with the communities and other stakeholders, an injury-prevention programme was developed and implemented, consisting of infrastructure enhancements and a site-specific educational programme. The programme was initially implemented at the intervention schools. After 1 year, data were collected in the same manner. The control group received the same intervention after follow-up data were collected. Data were collected on 12 957 school-aged children in the baseline period and 13 555 school-aged children in the post-intervention period, in both the control and intervention communities. There was a statistically significant reduction in RTIs in the intervention group and a non-significant increase in RTI in the control group. The greatest reduction was in motorcycle-pedestrian RTI, private vehicle-pedestrian RTI and morning RTI. The programme demonstrated a significant reduction in paediatric RTI after its implementation, in very specific ways. This study demonstrates that for a reasonable investment, scientifically driven injury-prevention programmes are feasible in resource-limited settings with high paediatric RTI rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Risk management and lessons learned solutions for satellite product assurance

    Science.gov (United States)

    Larrère, Jean-Luc

    2004-08-01

    The historic trend of the space industry towards lower cost programmes and more generally a better economic efficiency raises a difficult question to the quality assurance community: how to achieve the same—or better—mission success rate while drastically reducing the cost of programmes, hence the cost and level of quality assurance activities. EADS Astrium Earth Observation and Science (France) Business Unit have experimented Risk Management and Lessons Learned on their satellite programmes to achieve this goal. Risk analysis and management are deployed from the programme proposal phase through the development and operations phases. Results of the analysis and the corresponding risk mitigation actions are used to tailor the product assurance programme and activities. Lessons learned have been deployed as a systematic process to collect positive and negative experience from past and on-going programmes and feed them into new programmes. Monitoring and justification of their implementation in programmes is done under supervision from the BU quality assurance function. Control of the system is ensured by the company internal review system. Deployment of these methods has shown that the quality assurance function becomes more integrated in the programme team and development process and that its tasks gain focus and efficiency while minimising the risks associated with new space programmes.

  11. Programme

    OpenAIRE

    Hobday, E, fl. 1905, artist

    2003-01-01

    A photograph of an illustrated programme listing dances. The illustration shows a snake charmer playing to a snake while another man watches. Buildings and trees can be seen behind a wall in the distance. In the lower right-hand corner of the programme is the signature 'E. Hobday'. The programme is almost certainly related to the Punjab Ball, Lahore. It is placed next to the Punjab Ball Menu in the album and the Menu is also illustrated by 'E. Hobday'.

  12. The French nuclear power programme and energy policy in France

    International Nuclear Information System (INIS)

    Carle, R.

    1988-01-01

    After briefly describing the Chernobyl reactor accident and its consequences in Western Europe, especially its psychological effects, the French nuclear energy programme is presented in detail. The role of standardization and education as well as of construction time and cost is pointed out. Moreover, the results of the programme are given including extension of the capable French nuclear power industry, economical and ecological benefits. Future measures such as increase of the flexibility of nuclear power plants, improved fuel management, reduction of personnel radiation doses and employment of advanced reactors (the reactor system N4) will facilitate French efforts to free the country from mineral oil and coal imports. (author)

  13. Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes.

    Science.gov (United States)

    O'Sullivan, Ronan; Murphy, Aileen; O'Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D William

    2016-04-26

    Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation of the LMD-ACP combined with a palliative care education programme. The LMD-ACP was introduced into three long-term care (LTC) facilities in Southern Ireland and outcomes were compared pre and post implementation. In addition, 90 staff were trained in a palliative care educational programme. Economic analysis including probabilistic sensitivity analysis was performed. The uptake of an ACD or end-of-life care post-implementation rose from 25 to 76%. Post implementation, there were statistically significant decreases in hospitalisation rates from baseline (hospitalisation incidents declined from 27.8 to 14.6%, z = 3.96, p Economic analysis suggested a cost-reduction related to reduced hospitalisations ranging between €10 and €17.8 million/annum and reduction in ambulance transfers, estimated at €0.4 million/annum if these results were extrapolated nationally. When unit costs and LOS estimates were varied in scenario analyses, the expected cost reduction owing to reduced hospitalisations, ranged from €17.7 to €42.4 million nationally. Implementation of the LMD-ACP (ACD/end-of-life care plans combined with palliative care education) programme resulted in reduced rates of hospitalisation. Despite an increase in LOS, likely reflecting more complex care needs of admitted residents, gross costs were reduced and scenario analysis projected large annual savings if these results were extrapolated to the wider LTC population in Ireland.

  14. Susceptibility of murine norovirus and hepatitis A virus to electron beam irradiation in oysters and quantifying the reduction in potential infection risks.

    Science.gov (United States)

    Praveen, Chandni; Dancho, Brooke A; Kingsley, David H; Calci, Kevin R; Meade, Gloria K; Mena, Kristina D; Pillai, Suresh D

    2013-06-01

    Consumption of raw oysters is an exposure route for human norovirus (NoV) and hepatitis A virus (HAV). Therefore, efficient postharvest oyster treatment technology is needed to reduce public health risks. This study evaluated the inactivation of HAV and the NoV research surrogate, murine norovirus-1 (MNV-1), in oysters (Crassostrea virginica) by electron beam (E-beam) irradiation. The reduction of potential infection risks was quantified for E-beam irradiation technology employed on raw oysters at various virus contamination levels. The E-beam dose required to reduce the MNV and HAV titer by 90% (D(10) value) in whole oysters was 4.05 (standard deviations [SD], ±0.63) and 4.83 (SD, ±0.08) kGy, respectively. Microbial risk assessment suggests that if a typical serving of 12 raw oysters was contaminated with 10(5) PFU, a 5-kGy treatment would achieve a 12% reduction (from 4.49 out of 10 persons to 3.95 out of 10 persons) in NoV infection and a 16% reduction (from 9.21 out of 10 persons to 7.76 out of 10 persons) in HAV infections. If the serving size contained only 10(2) PFU of viruses, a 5-kGy treatment would achieve a 26% reduction (2.74 out of 10 persons to 2.03 out of 10 persons) of NoV and 91% reduction (2.1 out of 10 persons to 1.93 out of 100 persons) of HAV infection risks. This study shows that although E-beam processing cannot completely eliminate the risk of viral illness, infection risks can be reduced.

  15. An interdisciplinary approach to volcanic risk reduction under conditions of uncertainty: a case study of Tristan da Cunha

    Science.gov (United States)

    Hicks, A.; Barclay, J.; Simmons, P.; Loughlin, S.

    2014-07-01

    The uncertainty brought about by intermittent volcanic activity is fairly common at volcanoes worldwide. While better knowledge of any one volcano's behavioural characteristics has the potential to reduce this uncertainty, the subsequent reduction of risk from volcanic threats is only realised if that knowledge is pertinent to stakeholders and effectively communicated to inform good decision making. Success requires integration of methods, skills and expertise across disciplinary boundaries. This research project develops and trials a novel interdisciplinary approach to volcanic risk reduction on the remote volcanic island of Tristan da Cunha (South Atlantic). For the first time, volcanological techniques, probabilistic decision support and social scientific methods were integrated in a single study. New data were produced that (1) established no spatio-temporal pattern to recent volcanic activity; (2) quantified the high degree of scientific uncertainty around future eruptive scenarios; (3) analysed the physical vulnerability of the community as a consequence of their geographical isolation and exposure to volcanic hazards; (4) evaluated social and cultural influences on vulnerability and resilience; and (5) evaluated the effectiveness of a scenario planning approach, both as a method for integrating the different strands of the research and as a way of enabling on-island decision makers to take ownership of risk identification and management, and capacity building within their community. The paper provides empirical evidence of the value of an innovative interdisciplinary framework for reducing volcanic risk. It also provides evidence for the strength that comes from integrating social and physical sciences with the development of effective, tailored engagement and communication strategies in volcanic risk reduction.

  16. Addressing health inequalities in the delivery of the human papillomavirus vaccination programme: examining the role of the school nurse.

    Directory of Open Access Journals (Sweden)

    Tammy Boyce

    Full Text Available HPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake.A rapid evidence assessment (REA and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake.Despite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities

  17. Fusion - the programme in the UK - and other thoughts

    International Nuclear Information System (INIS)

    Carruthers, R

    1978-01-01

    The Fusion Programme in the Euratom--UKAEA Fusion Association is mainly one of plasma confinement studies in four major experimental areas. Conceptual studies of fusion reactors have been based upon the tokamak and the reversed field pinch. Particular attention has been given to the potential operating problems of toroidal fusion reactors in order to establish design principles which take note of the high availability essential in a power plant. Future plans for fusion power programmes are discussed and it is suggested that they are not obviously the quickest or most cost effective ways to establishing the credibility of fusion. It is proposed that a more aggressive programme which involved taking calculated risks could be quicker and cheaper. An additional, important advantage would be to attract into the fusion programme good engineers who feel the need to be motivated by action on a time scale less than the 30 to 50 years of much present planning

  18. Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs

    Science.gov (United States)

    Platt, Lucy; Minozzi, Silvia; Reed, Jennifer; Vickerman, Peter; Hagan, Holly; French, Clare; Jordan, Ashly; Degenhardt, Louisa; Hope, Vivian; Hutchinson, Sharon; Maher, Lisa; Palmateer, Norah; Taylor, Avril; Bruneau, Julie; Hickman, Matthew

    2017-01-01

    very low-quality evidence that high NSP coverage did not reduce risk of HCV acquisition (RR 0.79, 95% CI 0.39 to 1.61) with high heterogeneity (I2 = 77%) based on five studies from North America and Europe involving 3530 participants. After stratification by region, high NSP coverage in Europe was associated with a 76% reduction in HCV acquisition risk (RR 0.24, 95% CI 0.09 to 0.62) with less heterogeneity (I2 =0%). We found low-quality evidence of the impact of combined high coverage of NSP and OST, from three studies involving 3241 participants, resulting in a 74% reduction in the risk of HCV acquisition (RR 0.26 95% CI 0.07 to 0.89). Authors' conclusions OST is associated with a reduction in the risk of HCV acquisition, which is strengthened in studies that assess the combination of OST and NSP. There was greater heterogeneity between studies and weaker evidence for the impact of NSP on HCV acquisition. High NSP coverage was associated with a reduction in the risk of HCV acquisition in studies in Europe. Interventions for reducing hepatitis C infection in people who inject drugs Review question We examine research on the effect of needle syringe programmes (NSP) and opioid substitution treatment (OST) in reducing the risk of becoming infected with the hepatitis C virus. Background There are around 114.9 million people living with hepatitis C and 3 to 4 million people newly infected each year. The main risk for becoming infected is sharing used needles/syringes. Almost half the people who inject drugs have hepatitis C. The provision of sterile injecting equipment through NSPs reduces the need for sharing equipment when preparing and injecting drugs. OST is taken orally and reduces frequency of injection and unsafe injecting practices. We examined whether NSP and OST, provided alone or together, are effective in reducing the chances of becoming infected with hepatitis C in people who inject drugs. Search date The evidence is current to November 2015. Study

  19. Outcomes of a Community-Based Paediatric Weight Management Programme in an Irish Midlands Setting

    LENUS (Irish Health Repository)

    Bennett, AE

    2018-02-01

    Ongoing investigation is needed into feasible approaches which reduce excess weight in childhood. This study aimed to assess the effectiveness of an adapted version of the Scottish Childhood Overweight Treatment Trial (SCOTT) in an Irish primary care setting. Families were offered monthly dietitian-led sessions for six months. These sessions targeted dietary habits, family meals, screen time and exercise. Of the 95 children (mean age 7.6 years) referred, 90.5% (n86) were obese and 9.5% (n9) were overweight. Fifty-one (53.7%) families opted into the programme from referral, and 18 completed the programme (64.7% attrition). Statistically significant reductions in body mass index (BMI) were observed between sessions one and six (25.7±4.2kg\\/m2 and 25.3±4.8kg\\/m2, respectively, p<0.01). BMI z-score modestly decreased by 0.2 (p=0.01). Despite these reductions, issues with programme referral, attrition and long-term effectiveness were evident. Further investigation into strategies which reduce paediatric overweight is warranted.

  20. 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

  1. Crispv programme

    International Nuclear Information System (INIS)

    Marinkovicj, N.

    CRISPV (Criticality and Spectrum code) is a multigroup neutron spectrum code for homogeneous reactor cores and is actually a somewhat modified version of the original CRISP programme. It is a combination of DATAPREP-II and BIGG-II programmes. It is assumed that the reactor cell is a cylindrical fuel rod in the light or heavy water moderator. DATEPREP-II CODE forms the multigroup data for homogeneous reactor and prepares the input parameters for the BIGG-II code. It has its own nuclear data library on a separate tape in binary mode. BIGG-II code is a multigroup neutron spectrum and criticality code for a homogenized medium. It has as well its own separate data library. In the CRISPV programme the overlay structure enables automatic handling of data calculated in the DATAPREP-II programme and needed in the BIGG-II core. Both programmes are written in FORTRAN for CDC 3600. Using the programme is very efficient and simple

  2. Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure.

    Science.gov (United States)

    Benotti, Peter N; Wood, G Craig; Carey, David J; Mehra, Vishal C; Mirshahi, Tooraj; Lent, Michelle R; Petrick, Anthony T; Still, Christopher; Gerhard, Glenn S; Hirsch, Annemarie G

    2017-05-23

    Obesity and its association with reduced life expectancy are well established, with cardiovascular disease as one of the major causes of fatality. Metabolic surgery is a powerful intervention for severe obesity, resulting in improvement in comorbid diseases and in cardiovascular risk factors. This study investigates the relationship between metabolic surgery and long-term cardiovascular events. A cohort of Roux-en-Y gastric bypass surgery (RYGB) patients was tightly matched by age, body mass index, sex, Framingham Risk Score, smoking history, use of antihypertension medication, diabetes mellitus status, and calendar year with a concurrent cohort of nonoperated control patients. The primary study end points of major cardiovascular events (myocardial infarction, stroke, and congestive heart failure) were evaluated using Cox regression. Secondary end points of longitudinal cardiovascular risk factors were evaluated using repeated-measures regression. The RYGB and matched controls (N=1724 in each cohort) were followed for up to 12 years after surgery (overall median of 6.3 years). Kaplan-Meier analysis revealed a statistically significant reduction in incident major composite cardiovascular events ( P =0.017) and congestive heart failure (0.0077) for the RYGB cohort. Adjusted Cox regression models confirmed the reductions in severe composite cardiovascular events in the RYGB cohort (hazard ratio=0.58, 95% CI=0.42-0.82). Improvements of cardiovascular risk factors (eg, 10-year cardiovascular risk score, total cholesterol, high-density lipoprotein, systolic blood pressure, and diabetes mellitus) were observed within the RYGB cohort after surgery. Gastric bypass is associated with a reduced risk of major cardiovascular events and the development of congestive heart failure. © 2017 The Authors and Geisinger Clinic. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. Evolving strategies, opportunistic implementation: HIV risk reduction in Tanzania in the context of an incentive-based HIV prevention intervention.

    Directory of Open Access Journals (Sweden)

    Laura Packel

    Full Text Available Behavior change communication (BCC interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection.In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction.We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence.Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for

  4. Using the intervention mapping protocol to develop a maintenance programme for the SLIMMER diabetes prevention intervention.

    Science.gov (United States)

    Elsman, Ellen B M; Leerlooijer, Joanne N; Ter Beek, Josien; Duijzer, Geerke; Jansen, Sophia C; Hiddink, Gerrit J; Feskens, Edith J M; Haveman-Nies, Annemien

    2014-10-27

    Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands. The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention. The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme. The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.

  5. A PROgramme of Lifestyle Intervention in Families for Cardiovascular risk reduction (PROLIFIC Study: design and rationale of a family based randomized controlled trial in individuals with family history of premature coronary heart disease

    Directory of Open Access Journals (Sweden)

    Panniyammakal Jeemon

    2017-01-01

    Full Text Available Abstract Background Recognizing patterns of coronary heart disease (CHD risk in families helps to identify and target individuals who may have the most to gain from preventive interventions. The overall goal of the study is to test the effectiveness and sustainability of an integrated care model for managing cardiovascular risk in high risk families. The proposed care model targets the structural and environmental conditions that predispose high risk families to development of CHD through the following interventions: 1 screening for cardiovascular risk factors, 2 providing lifestyle interventions 3 providing a framework for linkage to appropriate primary health care facility, and 4 active follow-up of intervention adherence. Methods Initially, a formative qualitative research component will gather information on understanding of diseases, barriers to care, specific components of the intervention package and feedback on the intervention. Then a cluster randomized controlled trial involving 740 families comprising 1480 participants will be conducted to determine whether the package of interventions (integrated care model is effective in reducing or preventing the progression of CHD risk factors and risk factor clustering in families. The sustainability and scalability of this intervention will be assessed through economic (cost-effectiveness analyses and qualitative evaluation (process outcomes to estimate value and acceptability. Scalability is informed by cost-effectiveness and acceptability of the integrated cardiovascular risk reduction approach. Discussion Knowledge generated from this trial has the potential to significantly affect new programmatic policy and clinical guidelines that will lead to improvements in cardiovascular health in India. Trial registration number NCT02771873, registered in May 2016 ( https://clinicaltrials.gov/ct2/show/results/NCT02771873

  6. National programme: Finland

    International Nuclear Information System (INIS)

    Forsten, J.

    1986-01-01

    Finland's programmes in the field of reactor pressure components are presented in this paper. The following information on each of these programmes is given: the brief description of the programme; the programme's schedule and duration; the name of the project manager

  7. Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Tom P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Technologies Area. Building Technology and Urban Systems Division

    2016-08-22

    This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses in these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.

  8. Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

    Science.gov (United States)

    Sranacharoenpong, Kitti; Hanning, Rhona M

    2011-10-01

    The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the

  9. The British flue gas desulphurisation programme

    Energy Technology Data Exchange (ETDEWEB)

    Longhurst, J.W.S.

    1989-09-01

    Retrofitting UK power plants with flue gas desulfurization equipment should reduce SO{sub 2} emission by around 15%. Three systems appear suitable for UK installations: limestone/gypsum, regenerative Wellman Lord, and spray dry. The CEGB has used limestone/gypsum at Drax A B, West Burton, Fawley and Kingsnorth, and Wellman Lord at Fiddlers Ferry. Despite the environmental benefits, however, there is concern that the negative aspects of the programme (choice of technology, waste disposal, by-product disposal) may delay implementation and thus threaten Britain's aim of 30% reduction by 1999. 3 tabs.

  10. A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP

    Directory of Open Access Journals (Sweden)

    Lindsay Geoff

    2011-12-01

    Full Text Available Abstract Background There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP. This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs over a 2 year period. Methods The UK government's Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour. Results A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen's d ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from -0.44 to -0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years. Conclusions

  11. Evaluation of severe accident risks and the potential for risk reduction: Peach Bottom, Unit 2. Main report. Draft for comment, February 1987

    Energy Technology Data Exchange (ETDEWEB)

    Amos, C N [Technadyne Engineering Consultants, Inc., Albuquerque, NM (United States); Benjamin, A S; Griesmeyer, J M; Haskin, F E; Kunsman, D M [Sandia National Laboratories, Albuquerque, NM (United States); Boyd, G J; Lewis, S R [Safety and Reliability Optimization Services, Inc., Knoxville, TN (United States); Helton, J C [Arizona State University, Tempe, AZ (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 I containment (Peach Bottom, Unit 2). 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 modeling of the common-mode failures for the dc power system, the likelihood of offsite power recovery versus time during a station blackout, the probability of drywell failure resulting from meltthrough of the drywell shell, the magnitude of the fission product releases during core-concrete interactions, and the decontamination effectiveness of the reactor enclosure building. Most of the postulated safety options do not appear to be cost effective, although some based on changes to procedures or inexpensive hardware additions may be marginally cost effective. This draft for comment of the SARRP report for Peach Bottom does not include detailed technical appendices, which are still in preparation. The appendices will be issued under separate cover when completed. This work supports the Nuclear Regulatory Commission's assessment of severe accidents in NUREG-1150. (author)

  12. Horizontal schools-based health programme in rural Kenya.

    Science.gov (United States)

    Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina

    2017-09-01

    Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. 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

  14. A computer programme for use in the development of multi-element x-ray-fluorescence methods of analysis

    International Nuclear Information System (INIS)

    Wall, G.J.

    1985-01-01

    A computer programme (written in BASIC) is described for the evaluation of spectral-line intensities in X-ray-fluorescence spectrometry. The programme is designed to assist the analyst while he is developing new analytical methods, because it facilitates the selection of the following evaluation parameters: calculation models, spectral-line correction factors, calibration curves, calibration ranges, and point deletions. In addition, the programme enables the analyst to undertake routine calculations of data from multi-element analyses in which variable data-reduction parameters are used for each element

  15. The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review.

    Science.gov (United States)

    Hammond, Alison; Prior, Yeliz

    2016-09-01

    Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA. We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016. Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength. Heterogeneity of outcome measures meant meta-analysis was not possible. Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective. Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

    2017-05-01

    This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

  17. Increase in physical activity and cardiometabolic risk profile change during lifestyle intervention in primary healthcare: 1-year follow-up study among individuals at high risk for type 2 diabetes.

    Science.gov (United States)

    Kujala, Urho M; Jokelainen, Jari; Oksa, Heikki; Saaristo, Timo; Rautio, Nina; Moilanen, Leena; Korpi-Hyövälti, Eeva; Saltevo, Juha; Vanhala, Mauno; Niskanen, Leo; Peltonen, Markku; Tuomilehto, Jaakko; Uusitupa, Matti; Keinänen-Kiukaannemi, Sirkka

    2011-01-01

    Objectives To investigate the association between increase in physical activity and changes in cardiometabolic risk factors during a lifestyle intervention programme in routine clinical settings. Design Prospective follow-up. Setting 400 primary healthcare centres and occupational healthcare outpatient clinics in Finland. Participants Individuals at high risk for type 2 diabetes identified in the implementation project of the national diabetes prevention programme (FIN-D2D) and participating in baseline and 1-year follow-up visits. Final study group comprised the 1871 non-diabetic participants who responded at follow-up visit to a question on stability versus increase of physical activity. Interventions Lifestyle intervention. Primary outcome measures Cardiometabolic risk factors (body composition, blood pressure and those measured from fasting venous blood samples) measured at baseline and follow-up visits. Results Of the participants, 310 (16.6% of all responders) reported at follow-up having clearly increased their physical activity during the past year, while 1380 (73.8%) had been unable to increase their physical activity. Those who increased their activity decreased their weight by 3.6 kg (95% CI 2.9 to 4.3, age and sex adjusted, p<0.001) and waist circumference by 3.6 cm (95% CI 2.9 to 4.3, p<0.001) more than those who did not increase their activity. Similarly, those who increased their physical activity had greater reductions in total cholesterol (group difference in reduction 0.17 mmol/l, 95% CI 0.06 to 0.28, p=0.002), low-density lipoprotein cholesterol (0.16 mmol/l, 95% CI 0.06 to 0.26, p=0.001), low-density lipoprotein/high-density lipoprotein ratio (0.17, 95% CI 0.08 to 0.25, p<0.001) as well as fasting glucose (0.09 mmol/l, 95% CI 0.03 to 0.15, p=0.004) and 2 h glucose levels (0.36 mmol/l, 95% CI 0.17 to 0.55, p=0.023) than those who did not increase their physical activity. Conclusion Increasing physical activity seems to be an important feature of

  18. Prospective study of factors influencing conditional discharge from a forensic hospital: the DUNDRUM-3 programme completion and DUNDRUM-4 recovery structured professional judgement instruments and risk.

    LENUS (Irish Health Repository)

    Davoren, Mary

    2013-01-01

    We set out to examine whether structured professional judgement instruments DUNDRUM-3 programme completion (D-3) and DUNDRUM-4 recovery (D-4) scales along with measures of risk, mental state and global function could distinguish between those forensic patients detained in a secure forensic hospital (not guilty by reason of insanity or unfit to stand trial) who were subsequently discharged by a mental health review board. We also examined the interaction between these measures and risk, need for therapeutic security and eventual conditional discharge.

  19. Findings of the Work Improvement on Board (WIB) programme by the Fishery Agency in Japan.

    Science.gov (United States)

    Hisamune, Shuji; Kogi, Kazutaka

    2015-01-01

    Concerns are growing about the safety and health of seamen exposed to high risks while working on vessels. Their accident rate in 2013 was 9.9 per 1000 workers, 5 times higher than that in industry. In order to mitigate the risks of seamen, we developed the Work Improvement on Board (WIB) programme by applying participatory action-oriented training (PAOT) methods that have proven effective for reducing work-related risks in small enterprises, construction sites, and agriculture. We analysed which features of the WIB programme would be most effective for facilitating the planning and implementation of practical improvements on vessels. We examined action -oriented tools used, including a WIB action checklist and good examples, and practical improvements proposed by the participants in 1-day or half-day WIB workshops. To study the effectiveness of the WIB programme, we analysed 1121 replies of a questionnaire distributed to 1459 participants of the programme. We compared the types of improvements achieved and the improvement costs in the WIB programme with those in other PAOT programmes. The impact of the WIB programme on promoting primary prevention by seamen and fishermen was discussed. The action checklist listing practical improvements on board and good example photos apparently facilitated the planning and implementation of improvements feasible on board. The participating crews could propose readily applicable improvements of their vessels within short time. In the case of workshops held in 10 harbours between August and October 2014, participants coming from 110 vessels presented 228 improvement proposals which were mostly feasible at low cost. Among the 1121 questionnaire replies from participants of the WIB programme, over 75% evaluated the programme as necessary, practical and easy-to-understand. These positive results led to the adoption of the WIB programme for training fishermen and seamen on commercial vessels by the Fishery Agency and the Ministry of

  20. Deconstructing anti-harm-reduction metaphors; mortality risk from falls and other traumatic injuries compared to smokeless tobacco use

    Directory of Open Access Journals (Sweden)

    Bergen Paul

    2006-04-01

    Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.

  1. 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.

  2. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. 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.

  4. The effectiveness of universal parenting programmes: the CANparent trial.

    Science.gov (United States)

    Lindsay, Geoff; Totsika, Vasiliki

    2017-10-23

    There is substantial evidence for the efficacy and effectiveness of targeted parenting programmes but much less evidence regarding universal parenting programmes. The aim of the present study was to evaluate the effectiveness of the CANparent Trial of 12 universal parenting programmes, which were made available to parents of all children aged 0-6 years in three local authorities in England. To the best of our knowledge, this is the first study of universal parenting programmes on this scale. Parents accessed a voucher, value £100, to attend an accredited programme of parenting classes. Parents completed measures of their mental well-being, parenting efficacy, parenting satisfaction, and parenting stress, at pre- and post-course. Comparative data were derived from a sample of non-participant parents in 16 local authorities not providing CANparent programmes. A quasi-experimental design was adopted following estimation of propensity scores to balance the two groups on socio-demographic variables. Following their programme, changes in parenting stress were small and nonsignificant (Cohen's d frequency 0.07; intensity, 0.17). Participating parents showed significantly greater improvements than the comparison group for parenting efficacy (0.89) but not parenting satisfaction (-0.01). Mental well-being improved from 0.29 SD below the national norm to the national norm after the course. Parents were overwhelmingly positive about their course (88-94%) but this was lower for improvement in their relationship with their child (74%) and being a better parent (76%). The CANparent Trial demonstrated that universal parenting programmes can be effective in improving parents' sense of parenting efficacy and mental well-being when delivered to the full range of parents in community settings. However, there was no evidence of a reduction in levels of parenting stress; nor was there a significant improvement in satisfaction with being a parent. This is the first study of its kind

  5. 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.

  6. COPE-ICD: Patient experience of participation in an ICD specific rehabilitation programme

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Pedersen, Birthe Dagmar; Svendsen, Jesper Hastrup

    2012-01-01

    individualized care. Four themes emerged: Knowledge: patients gained much needed understanding; Physical attention: patients interpreted body signals and adjusted their exercise behaviour; Trust: patients regained trust, felt secure and dared to live again; Strategies of living: patients' coping was supported...... through reflection and professional dialogue, and they dealt with the risk of shock or death. CONCLUSION: Participating in an ICD-specific rehabilitation programme can make patients feel inspired and secure through individualized care. They discover that they have to rethink some of their strategies......PURPOSE: Evaluating rehabilitation programmes from the patient's perspective is much needed, as the patients are the most important stakeholders in the health care system. A comprehensive rehabilitation programme, COPE-ICD programme, consists of exercise training and nursing consultations during...

  7. US DoE clean-up programme: an update

    International Nuclear Information System (INIS)

    Whitfield, R.P.

    1993-01-01

    The Office of Environmental Restoration and Waste Management (EM) was established in 1989, when the US DoE's priority changed from nuclear weapons production to environmental clean-up. Both the decreased need for nuclear weapons due to global changes and decreasing threats from the Cold War, and the increased emphasis on environmental stewardship contributed to this change. The Environmental Restoration (ER) programme within EM was tasked to ensure that risks to human health and the environment posed by the DoE's past operations at its nuclear facilities and sites are eliminated or reduced to prescribed, safe levels. This article is a progress report on the programme. (author)

  8. 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.

  9. 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.

  10. 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.

  11. Objectives for an HTR R and D physics programme

    Energy Technology Data Exchange (ETDEWEB)

    Johnstone, I; Scott, J A

    1973-10-15

    The paper reviews important objectives for an HTR R and D programme and the importance of particular characteristics for safety and reactor performance is discussed. Uncertainties in the physics characteristics influence reactor design through the inclusion of design margins and contingency allowances and may even eliminate certain design variants. The paper discusses quantitatively the relationship between some important uncertainties and reactor design and operating costs and derives targets for the precision with which it should be possible to compute the corresponding physics characteristics. To extrapolate to power reactor conditions, the need for a comprehensive computational scheme validated by an adequate experimental programme is emphasised. The reduction in uncertainty as the theoretical and experimental reactor physics development proceeds in order to meet the desired target uncertainty is illustrated with respect to the UK's programme in support of the low enriched HTR concept. The current situation for this concept is discussed and compared briefly with that for the Th cycle HTR for which somewhat less zero energy experimental data are available. (auth)

  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. Randomized Comparison of Mobile and Web-Tools to Provide Dementia Risk Reduction Education: Use, Engagement and Participant Satisfaction.

    Science.gov (United States)

    O'Connor, Elodie; Farrow, Maree; Hatherly, Chris

    2014-01-01

    Encouraging middle-aged adults to maintain their physical and cognitive health may have a significant impact on reducing the prevalence of dementia in the future. Mobile phone apps and interactive websites may be one effective way to target this age group. However, to date there has been little research investigating the user experience of dementia risk reduction tools delivered in this way. The aim of this study was to explore participant engagement and evaluations of three different targeted smartphone and Web-based dementia risk reduction tools following a four-week intervention. Participants completed a Web-based screening questionnaire to collect eligibility information. Eligible participants were asked to complete a Web-based baseline questionnaire and were then randomly assigned to use one of the three dementia risk reduction tools for a period of four weeks: (1) a mobile phone application; (2) an information-based website; and (3) an interactive website. User evaluations were obtained via a Web-based follow-up questionnaire after completion of the intervention. Of 415 eligible participants, 370 (89.16%) completed the baseline questionnaire and were assigned to an intervention group; 200 (54.05%) completed the post-intervention questionnaire. The average age of participants was 52 years, and 149 (75%) were female. Findings indicated that participants from all three intervention groups reported a generally positive impression of the tools across a range of domains. Participants using the information-based website reported higher ratings of their overall impression of the tool, F2,191=4.12, P=.02; how interesting the information was, F2,189=3.53, P=.03; how helpful the information was, F2,192=4.15, P=.02; and how much they learned, F2,188=3.86, P=.02. Group differences were significant between the mobile phone app and information-based website users, but not between the interactive website users and the other two groups. Additionally, participants using the

  14. Randomized Comparison of Mobile and Web-Tools to Provide Dementia Risk Reduction Education: Use, Engagement and Participant Satisfaction

    Science.gov (United States)

    O'Connor, Elodie; Hatherly, Chris

    2014-01-01

    Background Encouraging middle-aged adults to maintain their physical and cognitive health may have a significant impact on reducing the prevalence of dementia in the future. Mobile phone apps and interactive websites may be one effective way to target this age group. However, to date there has been little research investigating the user experience of dementia risk reduction tools delivered in this way. Objective The aim of this study was to explore participant engagement and evaluations of three different targeted smartphone and Web-based dementia risk reduction tools following a four-week intervention. Methods Participants completed a Web-based screening questionnaire to collect eligibility information. Eligible participants were asked to complete a Web-based baseline questionnaire and were then randomly assigned to use one of the three dementia risk reduction tools for a period of four weeks: (1) a mobile phone application; (2) an information-based website; and (3) an interactive website. User evaluations were obtained via a Web-based follow-up questionnaire after completion of the intervention. Results Of 415 eligible participants, 370 (89.16%) completed the baseline questionnaire and were assigned to an intervention group; 200 (54.05%) completed the post-intervention questionnaire. The average age of participants was 52 years, and 149 (75%) were female. Findings indicated that participants from all three intervention groups reported a generally positive impression of the tools across a range of domains. Participants using the information-based website reported higher ratings of their overall impression of the tool, F2,191=4.12, P=.02; how interesting the information was, F2,189=3.53, P=.03; how helpful the information was, F2,192=4.15, P=.02; and how much they learned, F2,188=3.86, P=.02. Group differences were significant between the mobile phone app and information-based website users, but not between the interactive website users and the other two groups

  15. Responding to Sea Level Rise: Does Short-Term Risk Reduction Inhibit Successful Long-Term Adaptation?

    Science.gov (United States)

    Keeler, A. G.; McNamara, D. E.; Irish, J. L.

    2018-04-01

    Most existing coastal climate-adaptation planning processes, and the research supporting them, tightly focus on how to use land use planning, policy tools, and infrastructure spending to reduce risks from rising seas and changing storm conditions. While central to community response to sea level rise, we argue that the exclusive nature of this focus biases against and delays decisions to take more discontinuous, yet proactive, actions to adapt—for example, relocation and aggressive individual protection investments. Public policies should anticipate real estate market responses to risk reduction to avoid large costs—social and financial—when and if sea level rise and other climate-related factors elevate the risks to such high levels that discontinuous responses become the least bad alternative.

  16. Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

    Science.gov (United States)

    Parry, C D H; Carney, T; Petersen Williams, P

    2017-12-01

    Alcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants

  17. Modern Risk Assessment for Nuclear Power Plants High-Voltage Substations

    International Nuclear Information System (INIS)

    Ioan, S.; Hurdubetiu, S.; Marza, F.; Mocanu, M.; Stefan, M.

    2002-01-01

    The paper describes a first Romanian attempt to set up the methodology for risk assessment and control within high-voltage substations, developed for the Nuclear power plant in Cernavoda (Romania). Considering the present risk assessment methods the MENER Project will develop a new methodology, in line with the European Community legislation and with the specific regional needs. In order to correctly shape the necessary resources required by a risk analysis a large size enterprise (a nuclear power plant) is selected and the following five indicators will be estimated: the economic profit, environmental risk, indirect (future) risk, technology improvement and physic and psychological risk. The results are expected to considerably facilitate risk assessment, by: evaluating project acceptability; evaluating equipment compliance to regulatory criteria; estimating excluding clearances; easing the design of emergency programmes; identifying the equipment use restrictions; identifying the risk sources; selecting the maintenance and risk reduction methods; testing the procedures leading to future regulatory norms; suitability of the risk management system modification. The immediate result of employing modern risk assessment methods could be the decrease by one third of the expenses required by environment protection, staff health and labor safety and quality management. (author)

  18. 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.

  19. Status report on research programmes of the Commission of European Communities related to risk evaluation of geological disposal of radioactive waste

    International Nuclear Information System (INIS)

    Girardi, F.

    1977-01-01

    The programmes of the Commission of European Communities related to risk evaluation of geological disposal of radioactive waste are presented. The Joint Research Centre carries out theoretical modelling activities and a few selected experimental activities which are related to model development and verification. A set of contractual research activities, coordinated by the General Directorate of Research, Scientific Affairs and Education and set up primarily to encourage development of optimised waste management strategies will provide the many additional experimental data which are necessary for a realistic evaluation of long term hazard to man and the environment

  20. Alternative education programmes and middle school dropout in Honduras

    Science.gov (United States)

    Marshall, Jeffery H.; Aguilar, Claudia R.; Alas, Mario; Castellanos, Renán Rápalo; Castro, Levi; Enamorado, Ramón; Fonseca, Esther

    2014-05-01

    Honduras has made steady progress in expanding post-primary school coverage in recent years, but many rural communities still do not provide a middle (lower secondary) school. As a result, Honduras has implemented a number of middle school alternative programmes designed to meet the needs of at-risk populations throughout the country. This article analyses dropout in three of the four main alternative lower secondary school programmes in Honduras over a three-year period for a cohort of roughly 5,500 students. The results show that these programmes are indeed reaching a vulnerable population in the country, but dropout rates are generally very high - upwards of 50 per cent in some cases - between Grades 7 and 9. Furthermore, even in the control school comparison samples made up of formal lower secondary schools, about 25 per cent of children leave school between Grades 7 and 9. The authors' analysis includes propensity score matching (PSM) methods that make more focused comparisons between students in alternative programmes and control samples. These results show that dropout rates in alternative programmes are not much different than in control schools, and only significant in one programme comparison, when taking into account family background characteristics like socioeconomic status (SES). Multivariate analysis within alternative programme samples finds that attrition is lower in those learning centres which have adopted key features of formal schools, such as university-educated teachers. The results highlight the tremendous variation in the alternative middle school sector in terms of programme features, school quality and student outcomes, as well as the challenges of expanding this sector to meet the growing demand for lower secondary schooling in Honduras.