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

Science.gov (United States)

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

2017-08-01

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

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

Science.gov (United States)

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

2012-01-01

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

Risk Jyouhou Navi (risk information navigator). Web tool for fostering of risk literacy. Set of data

International Nuclear Information System (INIS)

Mitsui, Seiichiro

2003-06-01

In addition to the conventional public understanding activities, Risk communication study team of Japan Nuclear Cycle Development Institutes (JNC) Tokai Works has started practical studies to promote risk communication with its local communities. Since its establishment in 2001, Risk communication study team has conducted analyses of already available results of public attitude surveys, case studies of domestic and overseas risk communication activities, and development of risk communication tools. A web tool for fostering of risk literacy 'Risk Jyouhou Navi (risk information navigator in English)', was developed as a web content for the official home page of Techno Kouryuu Kan Ricotti (Techno Community Square Ricotti in English)'. The objectives of this content are to provide risk information for public and to provide an electronic platform for promoting risk communication with the local community. To develop 'Risk Jyouhou Navi', the following concepts were considered. 1) To create public interest in risks in daily lives and in global risks. 2) To provide risk knowledge and information. 3) To support risk communication activities in Techno community square ricotti. (author)

Develop risk-based procurement management tools for SMEs

NARCIS (Netherlands)

Staal, Anne; Hagelaar, Geoffrey; Walhof, Gert; Holman, Richard

2016-01-01

This paper provides guidance for developing risk-based management tools to improve the procurement (purchasing) performance of SMEs. Extant academic literature only offers little support on developing such tools and does not consider the wide variety of SMEs. The paper defines a procurement tool for

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-12-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Traerup, S.; Olhoff, A.

2011-07-01

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

ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

Science.gov (United States)

Johnson, Paul W.

2008-01-01

ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

An Integrative Review of Pediatric Fall Risk Assessment Tools.

Science.gov (United States)

DiGerolamo, Kimberly; Davis, Katherine Finn

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

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

International Nuclear Information System (INIS)

Unwin, Stephen D.; Seiple, Timothy E.

2009-01-01

Report describes process and methodology associated with a rapid prototype tool for integrating project risk analysis and health and safety risk analysis for decontamination and decommissioning projects. The objective of the Decontamination and Decommissioning (D and D) Risk Management Evaluation and Work Sequencing Standardization Project under DOE EM-23 is to recommend or develop practical risk-management tools for decommissioning of nuclear facilities. PNNL has responsibility under this project for recommending or developing computer-based tools that facilitate the evaluation of risks in order to optimize the sequencing of D and D work. PNNL's approach is to adapt, augment, and integrate existing resources rather than to develop a new suite of tools. Methods for the evaluation of H and S risks associated with work in potentially hazardous environments are well-established. Several approaches exist which, collectively, are referred to as process hazard analysis (PHA). A PHA generally involves the systematic identification of accidents, exposures, and other adverse events associated with a given process or work flow. This identification process is usually achieved in a brainstorming environment or by other means of eliciting informed opinion. The likelihoods of adverse events (scenarios) and their associated consequence severities are estimated against pre-defined scales, based on which risk indices are then calculated. A similar process is encoded in various project risk software products that facilitate the quantification of schedule and cost risks associated with adverse scenarios. However, risk models do not generally capture both project risk and H and S risk. The intent of the project reported here is to produce a tool that facilitates the elicitation, characterization, and documentation of both project risk and H and S risk based on defined sequences of D and D activities. By considering alternative D and D sequences, comparison of the predicted risks can

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

Science.gov (United States)

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

2015-06-01

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

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

DEFF Research Database (Denmark)

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

2013-01-01

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

The use of current risk analysis tools evaluated towards preventing external domino accidents

NARCIS (Netherlands)

Reniers, Genserik L L; Dullaert, W.; Ale, B. J.M.; Soudan, K.

Risk analysis is an essential tool for company safety policy. Risk analysis consists of identifying and evaluating all possible risks. The efficiency of risk analysis tools depends on the rigueur of identifying and evaluating all possible risks. The diversity in risk analysis procedures is such that

Chemical Risk Assessment Screening Tool of a Global Chemical Company

Directory of Open Access Journals (Sweden)

Evelyn Tjoe-Nij

2018-03-01

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

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.

Risk based decision tool for space exploration missions

Science.gov (United States)

Meshkat, Leila; Cornford, Steve; Moran, Terrence

2003-01-01

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

Qualitative risk assessment as a remediation management tool

International Nuclear Information System (INIS)

Knutson, D.E.

1991-01-01

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

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.

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-01-22

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

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

Science.gov (United States)

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

2015-01-01

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

Aqueduct: an interactive tool to empower global water risk assessment

Science.gov (United States)

Reig, Paul; Gassert, Francis

2013-04-01

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

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

Science.gov (United States)

Flemming, Patricia J; Ramsay, Katherine

2012-10-01

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

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

DEFF Research Database (Denmark)

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

2011-01-01

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

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

Science.gov (United States)

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

2014-07-01

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

Cognitive mapping tools: review and risk management needs.

Science.gov (United States)

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

2012-08-01

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

Optimising preoperative risk stratification tools for prostate cancer using mpMRI

Energy Technology Data Exchange (ETDEWEB)

Reisaeter, Lars A.R.; Losnegaard, Are; Biermann, Martin; Roervik, Jarle [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Clinical Medicine, Bergen (Norway); Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Nygaard, Yngve [Haukeland University Hospital, Department of Urology, Bergen (Norway); Monssen, Jan [Haukeland University Hospital, Department of Radiology, Bergen (Norway); Gravdal, Karsten [Haukeland University Hospital, Department of Pathology, Bergen (Norway); Halvorsen, Ole J.; Akslen, Lars A. [Haukeland University Hospital, Department of Pathology, Bergen (Norway); Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen (Norway); Haukaas, Svein; Beisland, Christian [University of Bergen, Department of Clinical Medicine, Bergen (Norway); Haukeland University Hospital, Department of Urology, Bergen (Norway)

2018-03-15

To improve preoperative risk stratification for prostate cancer (PCa) by incorporating multiparametric MRI (mpMRI) features into risk stratification tools for PCa, CAPRA and D'Amico. 807 consecutive patients operated on by robot-assisted radical prostatectomy at our institution during the period 2010-2015 were followed to identify biochemical recurrence (BCR). 591 patients were eligible for final analysis. We employed stepwise backward likelihood methodology and penalised Cox cross-validation to identify the most significant predictors of BCR including mpMRI features. mpMRI features were then integrated into image-adjusted (IA) risk prediction models and the two risk prediction tools were then evaluated both with and without image adjustment using receiver operating characteristics, survival and decision curve analyses. 37 patients suffered BCR. Apparent diffusion coefficient (ADC) and radiological extraprostatic extension (rEPE) from mpMRI were both significant predictors of BCR. Both IA prediction models reallocated more than 20% of intermediate-risk patients to the low-risk group, reducing their estimated cumulative BCR risk from approximately 5% to 1.1%. Both IA models showed improved prognostic performance with a better separation of the survival curves. Integrating ADC and rEPE from mpMRI of the prostate into risk stratification tools improves preoperative risk estimation for BCR. (orig.)

Cardiovascular risk prediction tools for populations in Asia.

Science.gov (United States)

Barzi, F; Patel, A; Gu, D; Sritara, P; Lam, T H; Rodgers, A; Woodward, M

2007-02-01

Cardiovascular risk equations are traditionally derived from the Framingham Study. The accuracy of this approach in Asian populations, where resources for risk factor measurement may be limited, is unclear. To compare "low-information" equations (derived using only age, systolic blood pressure, total cholesterol and smoking status) derived from the Framingham Study with those derived from the Asian cohorts, on the accuracy of cardiovascular risk prediction. Separate equations to predict the 8-year risk of a cardiovascular event were derived from Asian and Framingham cohorts. The performance of these equations, and a subsequently "recalibrated" Framingham equation, were evaluated among participants from independent Chinese cohorts. Six cohort studies from Japan, Korea and Singapore (Asian cohorts); six cohort studies from China; the Framingham Study from the US. 172,077 participants from the Asian cohorts; 25,682 participants from Chinese cohorts and 6053 participants from the Framingham Study. In the Chinese cohorts, 542 cardiovascular events occurred during 8 years of follow-up. Both the Asian cohorts and the Framingham equations discriminated cardiovascular risk well in the Chinese cohorts; the area under the receiver-operator characteristic curve was at least 0.75 for men and women. However, the Framingham risk equation systematically overestimated risk in the Chinese cohorts by an average of 276% among men and 102% among women. The corresponding average overestimation using the Asian cohorts equation was 11% and 10%, respectively. Recalibrating the Framingham risk equation using cardiovascular disease incidence from the non-Chinese Asian cohorts led to an overestimation of risk by an average of 4% in women and underestimation of risk by an average of 2% in men. A low-information Framingham cardiovascular risk prediction tool, which, when recalibrated with contemporary data, is likely to estimate future cardiovascular risk with similar accuracy in Asian

Strategic Risk Assessment: A Decision Tool for Complex Decisions

Energy Technology Data Exchange (ETDEWEB)

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

2001-07-01

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

Strategic Risk Assessment: A Decision Tool for Complex Decisions

International Nuclear Information System (INIS)

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

2001-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

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

International Nuclear Information System (INIS)

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

2001-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-11-15

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

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

International Nuclear Information System (INIS)

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

2016-01-01

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

Promoting energy efficiency investments with risk management decision tools

International Nuclear Information System (INIS)

Jackson, Jerry

2010-01-01

This paper reviews current capital budgeting practices and their impact on energy efficiency investments. The prevalent use of short payback 'rule-of-thumb' requirements to screen efficiency projects for risk is shown to bias investment choices towards 'sure bet' investments bypassing many profitable efficiency investment options. A risk management investment strategy is presented as an alternative to risk avoidance practices applied with payback thresholds. The financial industry risk management tool Value-at-Risk is described and extended to provide an Energy-Budgets-at-Risk or EBaR risk management analysis to convey more accurate energy efficiency investment risk information. The paper concludes with recommendations to expand the use of Value-at-Risk-type energy efficiency analysis.

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

Directory of Open Access Journals (Sweden)

Christoph Heesen

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

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

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

Kim, Taekyoung; Xiong, Shuping

2017-03-01

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

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

Science.gov (United States)

Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

2017-03-01

To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely

Development of risk assessment tool for foundry workers.

Science.gov (United States)

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

2008-01-01

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

Software Tool Implementing the Fuzzy AHP Method in Ecological Risk Assessment

Directory of Open Access Journals (Sweden)

Radionovs Andrejs

2017-12-01

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

Risk analysis as a decision tool

International Nuclear Information System (INIS)

Yadigaroglu, G.; Chakraborty, S.

1985-01-01

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

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

Science.gov (United States)

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

2016-05-01

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

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

NARCIS (Netherlands)

Kraker, H. de; Douwes, M.

2008-01-01

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

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

International Nuclear Information System (INIS)

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

2000-12-01

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

Standardised risk analysis as a communication tool

International Nuclear Information System (INIS)

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

1998-01-01

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

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

Science.gov (United States)

Kulp, S. A.; Strauss, B.

2015-12-01

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

Risk management: A tool for improving nuclear power plant performance

International Nuclear Information System (INIS)

2001-04-01

This technical document on risk management as a tool for improving nuclear power plant (NPP) operations is part of an ongoing project on management of NPP operations in a competitive environment. The overall objective of this project is to assist the management of operating organizations and NPPs in identifying and implementing appropriate measures to remain competitive in a rapidly changing business environment. Other reports developed through this project have identified overall strategies and techniques that NPP operating organization managers can use to succeed in more competitive energy markets. For example, in IAEA-TECDOC-1123, Strategies for Competitive Nuclear Power Plants, one of the most important strategies identified was integrated risk management. This publication provides a recommended structure for risk management along with examples of how NPP operating organizations are using this tool to help them integrate safety, operational and economic related risks in a changing business environment

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

Directory of Open Access Journals (Sweden)

Iordanis Eleftheriadis

2017-03-01

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

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

LENUS (Irish Health Repository)

Khan, MI

2017-01-01

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

Bayesian network as a modelling tool for risk management in agriculture

DEFF Research Database (Denmark)

Rasmussen, Svend; Madsen, Anders Læsø; Lund, Mogens

The importance of risk management increases as farmers become more exposed to risk. But risk management is a difficult topic because income risk is the result of the complex interaction of multiple risk factors combined with the effect of an increasing array of possible risk management tools. In ......, and that it has the ability to link uncertainty from different external sources to budget figures and to quantify risk at the farm level....

Integrating Risk Analyses and Tools at the DOE Hanford Site

International Nuclear Information System (INIS)

LOBER, R.W.

2002-01-01

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

Chemical Risk Assessment Screening Tool of a Global Chemical Company

OpenAIRE

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

2018-01-01

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

Multi-Hazard Advanced Seismic Probabilistic Risk Assessment Tools and Applications

International Nuclear Information System (INIS)

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

2016-01-01

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

Multi-Hazard Advanced Seismic Probabilistic Risk Assessment Tools and Applications

Energy Technology Data Exchange (ETDEWEB)

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

2016-09-01

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

Risk Informed Design Using Integrated Vehicle Rapid Assessment Tools

Data.gov (United States)

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2013-11-01

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

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

Science.gov (United States)

Park, Seong-Hi

2018-01-01

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

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

Science.gov (United States)

Renfro, Mindy Oxman; Fehrer, Steven

2011-01-01

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

New Tools and Methods for Assessing Risk-Management Strategies

National Research Council Canada - National Science Library

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

2004-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-07-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Directory of Open Access Journals (Sweden)

Teja Voruganti

2015-09-01

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

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

Science.gov (United States)

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

2018-03-05

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

The comparative risk assessment framework and tools (CRAFT)

Science.gov (United States)

Southern Research Station. USDA Forest Service

2010-01-01

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

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

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2016-11-01

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

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

Directory of Open Access Journals (Sweden)

Sharon Levy

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

Nutritional Risk in Emergency-2017: A New Simplified Proposal for a Nutrition Screening Tool.

Science.gov (United States)

Marcadenti, Aline; Mendes, Larissa Loures; Rabito, Estela Iraci; Fink, Jaqueline da Silva; Silva, Flávia Moraes

2018-03-13

There are many nutrition screening tools currently being applied in hospitals to identify risk of malnutrition. However, multivariate statistical models are not usually employed to take into account the importance of each variable included in the instrument's development. To develop and evaluate the concurrent and predictive validities of a new screening tool of nutrition risk. A prospective cohort study was developed, in which 4 nutrition screening tools were applied to all patients. Length of stay in hospital and mortality were considered to test the predictive validity, and the concurrent validity was tested by comparing the Nuritional Risk in Emergency (NRE)-2017 to the other tools. A total of 748 patients were included. The final NRE-2017 score was composed of 6 questions (advanced age, metabolic stress of the disease, decreased appetite, changing of food consistency, unintentional weight loss, and muscle mass loss) with answers yes or no. The prevalence of nutrition risk was 50.7% and 38.8% considering the cutoff points 1.0 and 1.5, respectively. The NRE-2017 showed a satisfactory power to indentify risk of malnutrition (area under the curve >0.790 for all analyses). According to the NRE-2017, patients at risk of malnutrition have twice as high relative risk of a very long hospital stay. The hazard ratio for mortality was 2.78 (1.03-7.49) when the cutoff adopted by the NRE-2017 was 1.5 points. NRE-2017 is a new, easy-to-apply nutrition screening tool which uses 6 bi-categoric features to detect the risk of malnutrition, and it presented a good concurrent and predictive validity. © 2018 American Society for Parenteral and Enteral Nutrition.

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

Science.gov (United States)

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

2010-01-01

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

A risk-based decision-aiding tool for waste disposal

International Nuclear Information System (INIS)

Weiner, R.F.; Reiser, A.S.; Elcock, C.G.; Nevins, S.

1997-01-01

N-CART (the National Spent Nuclear Fuel Program Cost Analysis and Risk Tool) is being developed to aid in low-risk, cost-effective, timely management of radioactive waste and spent nuclear fuel, and can therefore be used in management of mixed waste. N-CART provides evaluation of multiple alternatives and presents the consequences of proposed waste management activities in a clear and concise format. N-CART's decision-aiding analyses include comparisons and sensitivity analyses of multiple alternatives and allows the user to perform quick turn-around open-quotes what ifclose quotes studies to investigate various scenarios. Uncertainties in data (such as cost and schedule of various activities) are represented as distributions. N-CART centralizes documentation of the bases of program alternatives and program decisions, thereby supporting responses to stakeholders concerns. The initial N-CART design considers regulatory requirements, costs, and schedules for alternative courses of action. The final design will include risks (public health, occupational, economic, scheduling), economic benefits, and the impacts of secondary waste generation. An optimization tool is being incorporated that allows the user to specify the relative importance of cost, time risks, and other bases for decisions. The N-CART prototype can be used to compare the costs and schedules of disposal alternatives for mixed low-level radioactive waste (MLLW) and greater-than-Class-C (GTCC) waste, as well as spent nuclear fuel (SNF) and related scrap material

Medical simulation: a tool for recognition of and response to risk

International Nuclear Information System (INIS)

Ruddy, Richard M.; Deffner Patterson, Mary

2008-01-01

The use of simulation and team training has become an excellent tool to reduce errors in high-risk industry such as the commercial airlines and in the nuclear energy field. The health care industry has begun to use similar tools to improve the outcome of high-risk areas where events are relatively rare but where practice with a tactical team can significantly reduce the chance of bad outcome. There are two parts to this review: first, we review the rationale of why simulation is a key element in improving our error rate, and second, we describe specific tools that have great use at the clinical bedside for improving the care of patients. These cross different (i.e. medical and surgical) specialties and practices within specialties in the health care setting. Tools described will include the pinch, brief/debriefing, read-backs, call-outs, dynamic skepticism, assertive statements, two-challenge rules, checklists and step back (hold points). Examples will assist the clinician in practical daily use to improve their bedside care of children. (orig.)

Medical simulation: a tool for recognition of and response to risk.

Science.gov (United States)

Ruddy, Richard M; Patterson, Mary Deffner

2008-11-01

The use of simulation and team training has become an excellent tool to reduce errors in high-risk industry such as the commercial airlines and in the nuclear energy field. The health care industry has begun to use similar tools to improve the outcome of high-risk areas where events are relatively rare but where practice with a tactical team can significantly reduce the chance of bad outcome. There are two parts to this review: first, we review the rationale of why simulation is a key element in improving our error rate, and second, we describe specific tools that have great use at the clinical bedside for improving the care of patients. These cross different (i.e. medical and surgical) specialties and practices within specialties in the health care setting. Tools described will include the pinch, brief/debriefing, read-backs, call-outs, dynamic skepticism, assertive statements, two-challenge rules, checklists and step back (hold points). Examples will assist the clinician in practical daily use to improve their bedside care of children.

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

Science.gov (United States)

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

2017-11-01

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

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

Science.gov (United States)

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

2016-03-01

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

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

Science.gov (United States)

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

2018-03-06

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

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

Science.gov (United States)

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

2013-09-01

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

A generic rabies risk assessment tool to support surveillance.

Science.gov (United States)

Ward, Michael P; Hernández-Jover, Marta

2015-06-01

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

Validation and inter-rater reliability of a three item falls risk screening tool

Directory of Open Access Journals (Sweden)

Catherine Maree Said

2017-11-01

Full Text Available Abstract Background Falls screening tools are routinely used in hospital settings and the psychometric properties of tools should be examined in the setting in which they are used. The aim of this study was to explore the concurrent and predictive validity of the Austin Health Falls Risk Screening Tool (AHFRST, compared with The Northern Hospital Modified St Thomas’s Risk Assessment Tool (TNH-STRATIFY, and the inter-rater reliability of the AHFRST. Methods A research physiotherapist used the AHFRST and TNH-STRATIFY to classify 130 participants admitted to Austin Health (five acute wards, n = 115 two subacute wards n = 15; median length of stay 6 days IQR 3–12 as ‘High’ or ‘Low’ falls risk. The AHFRST was also completed by nursing staff on patient admission. Falls data was collected from the hospital incident reporting system. Results Six falls occurred during the study period (fall rate of 4.6 falls per 1000 bed days. There was substantial agreement between the AHFRST and the TNH-STRATIFY (Kappa = 0.68, 95% CI 0.52–0.78. Both tools had poor predictive validity, with low specificity (AHFRST 46.0%, 95% CI 37.0–55.1; TNH-STRATIFY 34.7%, 95% CI 26.4–43.7 and positive predictive values (AHFRST 5.6%, 95% CI 1.6–13.8; TNH-STRATIFY 6.9%, 95% CI 2.6–14.4. The AHFRST showed moderate inter-rater reliability (Kappa = 0.54, 95% CI = 0.36–0.67, p < 0.001 although 18 patients did not have the AHFRST completed by nursing staff. Conclusions There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification. However, both tools demonstrated limited predictive validity in the Austin Health population. The results highlight the importance of evaluating the validity of falls screening tools, and the clinical utility of these tools should be reconsidered.

Water Distribution System Risk Tool for Investment Planning (WaterRF Report 4332)

Science.gov (United States)

Product Description/Abstract The product consists of the Pipe Risk Screening Tool (PRST), and a report on the development and use of the tool. The PRST is a software-based screening aid to identify and rank candidate pipes for actions that range from active monitoring (including...

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

International Nuclear Information System (INIS)

Yotsumoto, Hiroki; Yoshida, Kikuo; Genchi, Hiroshi

2011-01-01

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

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

Science.gov (United States)

Zhang, Junhong; Wang, Min; Liu, Yu

2016-10-01

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

Tools and Methods for Risk Management in Multi-Site Engineering Projects

Science.gov (United States)

Zhou, Mingwei; Nemes, Laszlo; Reidsema, Carl; Ahmed, Ammar; Kayis, Berman

In today's highly global business environment, engineering and manufacturing projects often involve two or more geographically dispersed units or departments, research centers or companies. This paper attempts to identify the requirements for risk management in a multi-site engineering project environment, and presents a review of the state-of-the-art tools and methods that can be used to manage risks in multi-site engineering projects. This leads to the development of a risk management roadmap, which will underpin the design and implementation of an intelligent risk mapping system.

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

DEFF Research Database (Denmark)

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

2011-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-07-01

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

THE FINANCIAL TOOLS FOR COVER POLITICAL RISKS IN PROJECT FINANCE

Directory of Open Access Journals (Sweden)

S. Naumenkova

2016-10-01

Full Text Available This article examines the risk-mitigation in public-private partnership. Today Ukraine is ranked as "CRT-5 country" and has high levels of economic and political risk. Political risk grows steadily because of financial and political instability in Ukraine. We conclude that investors continue to rank political risk as a key obstacle to long-term investing. The tools for cover many types of political risks such as war, terrorism, civil disturbance, breach of contract, export or operating license cancellation, currency inconvertibility and transfer restriction, change of laws and regulations etc. are described by authors. We focus on the advantages of World Bank Group Guarantee products. The guarantee instruments of the three WBG institutions for cover political risks under different circumstances are the most suitable for public-private partnership in Ukraine. In this article the political risk-mitigation with IBRD Partial Risk Guarantee put forward by authors for PPP projects in Ukraine.

Network Analysis with SiLK

Science.gov (United States)

2015-01-06

Carnegie Mellon University rwcut Default Display By default • sIP , sPort • dIP, dPort • protocol • packets, bytes • flags • sTime, eTime, duration...TCP/IP SOCKET IP address: 10.0.0.1 L4 protocol : TCP High-numbered ephemeral port # TCP/IP SOCKET IP address: 203.0.113.1 L4 protocol : TCP Low-numbered...Fields found to be useful in analysis: • source address, destination address • source port, destination port (Internet Control Message Protocol

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

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Abdulhakeem Al-Rawahi

2015-09-01

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

A prognostic tool to identify adolescents at high risk of becoming daily smokers

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Paradis Gilles

2011-08-01

Full Text Available Abstract Background The American Academy of Pediatrics advocates that pediatricians should be involved in tobacco counseling and has developed guidelines for counseling. We present a prognostic tool for use by health care practitioners in both clinical and non-clinical settings, to identify adolescents at risk of becoming daily smokers. Methods Data were drawn from the Nicotine Dependence in Teens (NDIT Study, a prospective investigation of 1293 adolescents, initially aged 12-13 years, recruited in 10 secondary schools in Montreal, Canada in 1999. Questionnaires were administered every three months for five years. The prognostic tool was developed using estimated coefficients from multivariable logistic models. Model overfitting was corrected using bootstrap cross-validation. Goodness-of-fit and predictive ability of the models were assessed by R2, the c-statistic, and the Hosmer-Lemeshow test. Results The 1-year and 2-year probability of initiating daily smoking was a joint function of seven individual characteristics: age; ever smoked; ever felt like you needed a cigarette; parent(s smoke; sibling(s smoke; friend(s smoke; and ever drank alcohol. The models were characterized by reasonably good fit and predictive ability. They were transformed into user-friendly tables such that the risk of daily smoking can be easily computed by summing points for responses to each item. The prognostic tool is also available on-line at http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php. Conclusions The prognostic tool to identify youth at high risk of daily smoking may eventually be an important component of a comprehensive tobacco control system.

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

Science.gov (United States)

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

2017-10-10

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

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

Science.gov (United States)

Campbell, Martin; McCue, Michael

2013-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

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

2017-08-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2013-01-01

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

[Use of hypertext as information and training tools in the prevention of occupational risk].

Science.gov (United States)

Franco, G

1998-01-01

Modern medical education is based on a variety of teaching techniques, by means of which individuals learn most effectively. The availability of the new technologies together with the diffusion of personal computers is favouring the spreading of the use of hypertexts through the World Wide Web. This contribution describes 2 hypertexts ("Human Activities and Health Risk"; "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine") and the prototype "Virtual Hospital". Assuming that prevention of health risks is based upon their knowledge, they have been created with the aim of providing users with problem-oriented tools, whose retorical aspects (content, information organization, user interface) are analysed. The "Human Activities and Health Risk" deals with the description of working activities and allows user to recognize health risks. The "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine" embodies a case report containing the clustered information about the patient and the library including educational material (risk factors, symptoms and signs, organ system diseases, jobs, occupational risk factors, environment related diseases. The "Virtual Hospital" has been conceived assuming that an appropriate information can change workers' behaviour in hospital, where health risks can be often underevaluated. It consists of a variety of structured and unstructured information, which can be browsed by users, allowing the discovery of links and providing the awareness of the semantic relationship between related information elements (including environment, instruments, drugs, job analysis, situations at risk for health, preventive means). The "Virtual Hospital" aims making the understanding of the working situations at risk easier and more interesting, stimulating the awareness of the relationship between jobs and risks.

Evaluation of a visual risk communication tool: effects on knowledge and perception of blood transfusion risk.

Science.gov (United States)

Lee, D H; Mehta, M D

2003-06-01

Effective risk communication in transfusion medicine is important for health-care consumers, but understanding the numerical magnitude of risks can be difficult. The objective of this study was to determine the effect of a visual risk communication tool on the knowledge and perception of transfusion risk. Laypeople were randomly assigned to receive transfusion risk information with either a written or a visual presentation format for communicating and comparing the probabilities of transfusion risks relative to other hazards. Knowledge of transfusion risk was ascertained with a multiple-choice quiz and risk perception was ascertained by psychometric scaling and principal components analysis. Two-hundred subjects were recruited and randomly assigned. Risk communication with both written and visual presentation formats increased knowledge of transfusion risk and decreased the perceived dread and severity of transfusion risk. Neither format changed the perceived knowledge and control of transfusion risk, nor the perceived benefit of transfusion. No differences in knowledge or risk perception outcomes were detected between the groups randomly assigned to written or visual presentation formats. Risk communication that incorporates risk comparisons in either written or visual presentation formats can improve knowledge and reduce the perception of transfusion risk in laypeople.

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

Science.gov (United States)

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

Does flood risk information held within at risk population always have a positive impact? An evaluation of the effects of French regulatory tools in Orleans

Directory of Open Access Journals (Sweden)

Jadot Julien

2016-01-01

Full Text Available French law on major risk preventive information for population setup the objective to make the citizen able to act for his own safety and to participate through his behaviour to the civil security. To reach this objective, the policymakers developed 4 regulatory tools that have to be implemented by the local authorities. These 4 tools do not meet the success factors of risk communication measures aiming at inducing behavioural adaptation to face risks. This, added to the fact that people who die in the last floods events in France lost their lives due to either a lack of knowledge of the risk or to a risk taking behaviour, led us to question the impact of the preventive information regulatory tools. For the needs of our study we developed a risk perception and behaviour scale, helping us to classify the people of our sample. Our evaluation in Orléans shows that very few people know the regulatory tools and that their impact is quite low, far from the policymakers’ expectations. This highlight the real necessity to innovate in the field of flood risk communication.

Perioperative Respiratory Adverse Events in Pediatric Ambulatory Anesthesia: Development and Validation of a Risk Prediction Tool.

Science.gov (United States)

Subramanyam, Rajeev; Yeramaneni, Samrat; Hossain, Mohamed Monir; Anneken, Amy M; Varughese, Anna M

2016-05-01

Perioperative respiratory adverse events (PRAEs) are the most common cause of serious adverse events in children receiving anesthesia. Our primary aim of this study was to develop and validate a risk prediction tool for the occurrence of PRAE from the onset of anesthesia induction until discharge from the postanesthesia care unit in children younger than 18 years undergoing elective ambulatory anesthesia for surgery and radiology. The incidence of PRAE was studied. We analyzed data from 19,059 patients from our department's quality improvement database. The predictor variables were age, sex, ASA physical status, morbid obesity, preexisting pulmonary disorder, preexisting neurologic disorder, and location of ambulatory anesthesia (surgery or radiology). Composite PRAE was defined as the presence of any 1 of the following events: intraoperative bronchospasm, intraoperative laryngospasm, postoperative apnea, postoperative laryngospasm, postoperative bronchospasm, or postoperative prolonged oxygen requirement. Development and validation of the risk prediction tool for PRAE were performed using a split sampling technique to split the database into 2 independent cohorts based on the year when the patient received ambulatory anesthesia for surgery and radiology using logistic regression. A risk score was developed based on the regression coefficients from the validation tool. The performance of the risk prediction tool was assessed by using tests of discrimination and calibration. The overall incidence of composite PRAE was 2.8%. The derivation cohort included 8904 patients, and the validation cohort included 10,155 patients. The risk of PRAE was 3.9% in the development cohort and 1.8% in the validation cohort. Age ≤ 3 years (versus >3 years), ASA physical status II or III (versus ASA physical status I), morbid obesity, preexisting pulmonary disorder, and surgery (versus radiology) significantly predicted the occurrence of PRAE in a multivariable logistic regression

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

Science.gov (United States)

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

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Pierpaolo Palumbo

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

Operation and evaluation of online risk communication assistant tool, 'ORCAT'

International Nuclear Information System (INIS)

Kimura, Hiroshi; Katsumura, Soichiro; Furuta, Kazuo; Matsumura, Kenichi; Tanaka, Hiroshi

2005-01-01

Risk communication about the high-level radioactive waste (HLW) disposal is necessary for public acceptance of HLW disposal program. Online Risk Communication Assistant Tool (ORCAT) system is developed in order to support risk communication for high-level radioactive disposal on World Wide Web. We have carried out two test operations of ORCAT system. First test operation is carried out from Jun. 26 to Feb. 13, 2003. After the first operation, we improved the ORCAT system, and carried out the second test operation from Dec. 4 to 22, 2004. In the second test operation, 20 participants replayed the questionnaire about usability of ORCAT system. In consequence, we found that the ORCAT system remains what need to refine, but is evaluated useful to the risk communication about the HLW disposal. (author)

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

Science.gov (United States)

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

2018-04-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Brown Emma

2016-01-01

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

Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

Science.gov (United States)

Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung; Kim, Soon-Kyung

2015-10-01

Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.

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

Science.gov (United States)

Tonini, Roberto; Selva, Jacopo

2013-04-01

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

A cloud based tool for knowledge exchange on local scale flood risk.

Science.gov (United States)

Wilkinson, M E; Mackay, E; Quinn, P F; Stutter, M; Beven, K J; MacLeod, C J A; Macklin, M G; Elkhatib, Y; Percy, B; Vitolo, C; Haygarth, P M

2015-09-15

There is an emerging and urgent need for new approaches for the management of environmental challenges such as flood hazard in the broad context of sustainability. This requires a new way of working which bridges disciplines and organisations, and that breaks down science-culture boundaries. With this, there is growing recognition that the appropriate involvement of local communities in catchment management decisions can result in multiple benefits. However, new tools are required to connect organisations and communities. The growth of cloud based technologies offers a novel way to facilitate this process of exchange of information in environmental science and management; however, stakeholders need to be engaged with as part of the development process from the beginning rather than being presented with a final product at the end. Here we present the development of a pilot Local Environmental Virtual Observatory Flooding Tool. The aim was to develop a cloud based learning platform for stakeholders, bringing together fragmented data, models and visualisation tools that will enable these stakeholders to make scientifically informed environmental management decisions at the local scale. It has been developed by engaging with different stakeholder groups in three catchment case studies in the UK and a panel of national experts in relevant topic areas. However, these case study catchments are typical of many northern latitude catchments. The tool was designed to communicate flood risk in locally impacted communities whilst engaging with landowners/farmers about the risk of runoff from the farmed landscape. It has been developed iteratively to reflect the needs, interests and capabilities of a wide range of stakeholders. The pilot tool combines cloud based services, local catchment datasets, a hydrological model and bespoke visualisation tools to explore real time hydrometric data and the impact of flood risk caused by future land use changes. The novel aspects of the

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

Science.gov (United States)

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

2017-03-03

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

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

Science.gov (United States)

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

2018-01-05

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

A review of decision support, risk communication and patient information tools for thrombolytic treatment in acute stroke: lessons for tool developers.

Science.gov (United States)

Flynn, Darren; Ford, Gary A; Stobbart, Lynne; Rodgers, Helen; Murtagh, Madeleine J; Thomson, Richard G

2013-06-18

Tools to support clinical or patient decision-making in the treatment/management of a health condition are used in a range of clinical settings for numerous preference-sensitive healthcare decisions. Their impact in clinical practice is largely dependent on their quality across a range of domains. We critically analysed currently available tools to support decision making or patient understanding in the treatment of acute ischaemic stroke with intravenous thrombolysis, as an exemplar to provide clinicians/researchers with practical guidance on development, evaluation and implementation of such tools for other preference-sensitive treatment options/decisions in different clinical contexts. Tools were identified from bibliographic databases, Internet searches and a survey of UK and North American stroke networks. Two reviewers critically analysed tools to establish: information on benefits/risks of thrombolysis included in tools, and the methods used to convey probabilistic information (verbal descriptors, numerical and graphical); adherence to guidance on presenting outcome probabilities (IPDASi probabilities items) and information content (Picker Institute Checklist); readability (Fog Index); and the extent that tools had comprehensive development processes. Nine tools of 26 identified included information on a full range of benefits/risks of thrombolysis. Verbal descriptors, frequencies and percentages were used to convey probabilistic information in 20, 19 and 18 tools respectively, whilst nine used graphical methods. Shortcomings in presentation of outcome probabilities (e.g. omitting outcomes without treatment) were identified. Patient information tools had an aggregate median Fog index score of 10. None of the tools had comprehensive development processes. Tools to support decision making or patient understanding in the treatment of acute stroke with thrombolysis have been sub-optimally developed. Development of tools should utilise mixed methods and

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

Science.gov (United States)

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

2018-05-01

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

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

NARCIS (Netherlands)

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

2002-01-01

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

Effectiveness of Weather Derivatives as a Risk Management Tool in Food Retail: The Case of Croatia

Directory of Open Access Journals (Sweden)

Ivana Štulec

2017-01-01

Full Text Available Non-catastrophic weather risk is gaining importance as climate change becomes more pronounced and economic crisis forces companies to strengthen their cost control. Recent literature proposes weather derivatives as flexible weather risk mitigating tools. Only a handful of studies analysed the feasibility of weather derivatives in industries other than agriculture and energy. The purpose of this paper is to review available weather risk management solutions in retail, present weather derivatives as non-catastrophic weather risk management tools, empirically demonstrate the process of designing weather derivatives and assess their effectiveness as risk mitigating tools in retail. Empirical analysis is performed on beverage sales in 60 large food stores in Croatia, and performance of monthly temperature put options during the summer season is examined. For weather sensitivity analysis of sales, the method of panel regression was used. Results show that weather has a statistically significant effect on beverage sales and that weather derivatives prove to be effective in beverage sales uncertainty reduction. Their effectiveness differs between covered periods and cities.

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

OpenAIRE

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

2015-01-01

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

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

Science.gov (United States)

Aguilar, Michael L.

2013-01-01

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

Interactive Decision-Support Tool for Risk-Based Radiation Therapy Plan Comparison for Hodgkin Lymphoma

DEFF Research Database (Denmark)

Brodin, N. Patrik; Maraldo, Maja V.; Aznar, Marianne C.

2014-01-01

PURPOSE: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). METHODS AND MATERIALS...... and a volumetric modulated arc therapy plan for a patient with mediastinal HL. CONCLUSION: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options....... of dose-response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan...

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

Science.gov (United States)

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

2016-03-01

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

In silico tools to aid risk assessment of endocrine disrupting chemicals

International Nuclear Information System (INIS)

Jacobs, M.N.

2004-01-01

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

Risk Prioritization Tool to Identify the Public Health Risks of Wildlife Trade: The Case of Rodents from Latin America.

Science.gov (United States)

Bueno, I; Smith, K M; Sampedro, F; Machalaba, C C; Karesh, W B; Travis, D A

2016-06-01

Wildlife trade (both formal and informal) is a potential driver of disease introduction and emergence. Legislative proposals aim to prevent these risks by banning wildlife imports, and creating 'white lists' of species that are cleared for importation. These approaches pose economic harm to the pet industry, and place substantial burden on importers and/or federal agencies to provide proof of low risk for importation of individual species. As a feasibility study, a risk prioritization tool was developed to rank the pathogens found in rodent species imported from Latin America into the United States with the highest risk of zoonotic consequence in the United States. Four formally traded species and 16 zoonotic pathogens were identified. Risk scores were based on the likelihood of pathogen release and human exposure, and the severity of the disease (consequences). Based on the methodology applied, three pathogens (Mycobacterium microti, Giardia spp. and Francisella tularensis) in one species (Cavia porcellus) were ranked as highest concern. The goal of this study was to present a methodological approach by which preliminary management resources can be allocated to the identified high-concern pathogen-species combinations when warranted. This tool can be expanded to other taxa and geographic locations to inform policy surrounding the wildlife trade. © 2015 Blackwell Verlag GmbH.

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

Science.gov (United States)

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

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

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

Science.gov (United States)

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

2016-10-01

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

Development of the Sydney Falls Risk Screening Tool in brain injury rehabilitation: A multisite prospective cohort study.

Science.gov (United States)

McKechnie, Duncan; Fisher, Murray J; Pryor, Julie; Bonser, Melissa; Jesus, Jhoven De

2018-03-01

To develop a falls risk screening tool (FRST) sensitive to the traumatic brain injury rehabilitation population. Falls are the most frequently recorded patient safety incident within the hospital context. The inpatient traumatic brain injury rehabilitation population is one particular population that has been identified as at high risk of falls. However, no FRST has been developed for this patient population. Consequently in the traumatic brain injury rehabilitation population, there is the real possibility that nurses are using falls risk screening tools that have a poor clinical utility. Multisite prospective cohort study. Univariate and multiple logistic regression modelling techniques (backward elimination, elastic net and hierarchical) were used to examine each variable's association with patients who fell. The resulting FRST's clinical validity was examined. Of the 140 patients in the study, 41 (29%) fell. Through multiple logistic regression modelling, 11 variables were identified as predictors for falls. Using hierarchical logistic regression, five of these were identified for inclusion in the resulting falls risk screening tool: prescribed mobility aid (such as, wheelchair or frame), a fall since admission to hospital, impulsive behaviour, impaired orientation and bladder and/or bowel incontinence. The resulting FRST has good clinical validity (sensitivity = 0.9; specificity = 0.62; area under the curve = 0.87; Youden index = 0.54). The tool was significantly more accurate (p = .037 on DeLong test) in discriminating fallers from nonfallers than the Ontario Modified STRATIFY FRST. A FRST has been developed using a comprehensive statistical framework, and evidence has been provided of this tool's clinical validity. The developed tool, the Sydney Falls Risk Screening Tool, should be considered for use in brain injury rehabilitation populations. © 2017 John Wiley & Sons Ltd.

Web-based GIS: the vector-borne disease airline importation risk (VBD-AIR) tool.

Science.gov (United States)

Huang, Zhuojie; Das, Anirrudha; Qiu, Youliang; Tatem, Andrew J

2012-08-14

Over the past century, the size and complexity of the air travel network has increased dramatically. Nowadays, there are 29.6 million scheduled flights per year and around 2.7 billion passengers are transported annually. The rapid expansion of the network increasingly connects regions of endemic vector-borne disease with the rest of the world, resulting in challenges to health systems worldwide in terms of vector-borne pathogen importation and disease vector invasion events. Here we describe the development of a user-friendly Web-based GIS tool: the Vector-Borne Disease Airline Importation Risk Tool (VBD-AIR), to help better define the roles of airports and airlines in the transmission and spread of vector-borne diseases. Spatial datasets on modeled global disease and vector distributions, as well as climatic and air network traffic data were assembled. These were combined to derive relative risk metrics via air travel for imported infections, imported vectors and onward transmission, and incorporated into a three-tier server architecture in a Model-View-Controller framework with distributed GIS components. A user-friendly web-portal was built that enables dynamic querying of the spatial databases to provide relevant information. The VBD-AIR tool constructed enables the user to explore the interrelationships among modeled global distributions of vector-borne infectious diseases (malaria. dengue, yellow fever and chikungunya) and international air service routes to quantify seasonally changing risks of vector and vector-borne disease importation and spread by air travel, forming an evidence base to help plan mitigation strategies. The VBD-AIR tool is available at http://www.vbd-air.com. VBD-AIR supports a data flow that generates analytical results from disparate but complementary datasets into an organized cartographical presentation on a web map for the assessment of vector-borne disease movements on the air travel network. The framework built provides a flexible

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

Directory of Open Access Journals (Sweden)

hadi hojati

2018-04-01

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

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

International Nuclear Information System (INIS)

Zandbergen, P.

1995-01-01

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

A screening tool for the risk of disability retirement due to musculoskeletal disorders.

Science.gov (United States)

Shiri, Rahman; Heliövaara, Markku; Ahola, Kirsi; Kaila-Kangas, Leena; Haukka, Eija; Kausto, Johanna; Saastamoinen, Peppiina; Leino-Arjas, Päivi; Lallukka, Tea

2018-01-01

Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676) and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gönen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of 3 or higher out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.

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

Directory of Open Access Journals (Sweden)

Zhelnova Christina Vladimirovna

2015-05-01

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

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

Science.gov (United States)

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

2011-01-01

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

BIBLIOGRAPHIC STUDY IN RISK MANAGEMENT AIMED TO IDENTIFY MORE REFERENCED TOOLS, METHODS AND RELATIONSHIPS

Directory of Open Access Journals (Sweden)

Alamir Costa Louro

2015-06-01

Full Text Available The objective of this paper is to identify and discuss trends in tools and methods used in project risk management and its relationship to other matters, using current scientific articles. The focus isn´t in understanding how they work in technical terms, but think about the possibilities of deepening in academic studies, including making several suggestions for future research. Adjacent to the article there is a discussion about an alleged "one best way" imperative normativity approach. It was answered the following research questions: what subjects and theories are related to project risk management tools and methods? The first contribution is related to the importance of the academic Chris Chapman as an author who has more published and also more referenced in the survey. There are several contributions on various subjects such as: the perception of the existence of many conceptual papers; papers about construction industry, problematization of contracts according to agency theory, IT and ERPs issues. Other contributions came from the bibliometric method that brings lot of consolidated information about terms, topics, authors, references, periods and, of course, methods and tools about Project Risk Management.

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

International Nuclear Information System (INIS)

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

1991-09-01

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

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

Science.gov (United States)

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

2014-12-13

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

Practical aspects of the use of FMEA tool in clinical laboratory risk management

Directory of Open Access Journals (Sweden)

Maria Elizabete Mendes

2013-06-01

Full Text Available INTRODUCTION: This paper presents the failure modes and effects analysis (FMEA tool in a clinical laboratory through the introduction of new technology for blood gas and serum ionized calcium in multi-parameter analyzers such as Point of Care Testing (POCT. OBJECTIVE: To present FMEA as a tool for risk managing and improvement with the introduction of new technologies in a public laboratory. METHODS: The change of multiparameter gas analyzer type POCT was defined and described as a process. Subsequently, the criteria were presented to the risk assessment and its quantification. We studied the failure modes that might occur in this process. We established three action plans involving improvements to be made in the technological change. FMEA was applied in two stages: at the beginning of the project and after the implementation of the proposed measures. RESULTS: The first plan involved administrative measures related to the bidding process; the second preventive action involved the possibility of which supplier would win the bid by studying the efficiency of the analyzer and its impact on productivity; the third set of actions was directed to improvements in the relationship with the clinical staff in order to minimize occasional complaints. The last actions referred to employing new employees to meet the growing demand. CONCLUSION: FMEA proved to be a reliable tool for performance improvement, which proactively identifies, prioritizes and mitigates patient risks.

RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

Energy Technology Data Exchange (ETDEWEB)

William W. Weiss

2000-06-30

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

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

Science.gov (United States)

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

2009-04-01

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

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

Science.gov (United States)

Stephen, Cook; Benjamin, Longo-Mbenza

2013-01-01

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

A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals.

Science.gov (United States)

Kang, Li; Chen, Xiaoyu; Han, Peipei; Ma, Yixuan; Jia, Liye; Fu, Liyuan; Yu, Hairui; Wang, Lu; Hou, Lin; Yu, Xing; An, Zongyang; Wang, Xuetong; Li, Lu; Zhang, Yuanyuan; Zhao, Peng; Guo, Qi

2018-01-22

The objective of this study was to determine falls risk profiles to derive a falls risk prediction score and establish a simple and practical clinical screening tool for Chinese community-dwelling elderly individuals. This was a prospective cohort study (n = 619) among adults aged 60 years and older. Falls were ascertained at a 1-year follow-up appointment. Sociodemographic information, medical history, and physical performance data were collected. The mean age was 67.4 years; 57.7% were women. Female sex (odds ratios [ORs] 1.82; 95% confidence interval [95% CI] 1.17-2.82), diabetes (OR 2.13; 95% CI 1.13-3.98), a Timed Up and Go Test (TUGT) ≥10.49 seconds (OR 1.51; 95% CI 1.23-1.94), a history of falls (OR 3.15; 95% CI 1.72-5.79), and depression (Geriatric Depression Scale [GDS] ≥11, OR 2.51; 95% CI 1.36-4.63) were the strongest predictors. These predictors were used to establish a risk score. The area under the curve of the score was 0.748. From a clinical point of view, the most appropriate cutoff value was 7 (97.5% specificity, 70.7% positive predictive value, and 83.6% negative predictive value). For this cutoff, the fraction correctly classified was 82.5%. A cutoff score of 7 derived from a risk assessment tool using four risk factors (gender, falls history, diabetes, and depression) and the TUGT may be used in Chinese community-dwelling elderly individuals as an initial step to screen those at low risk for falls.

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

DEFF Research Database (Denmark)

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

2015-01-01

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

A new tool for risk analysis and assessment in petrochemical plants

Directory of Open Access Journals (Sweden)

El-Arkam Mechhoud

2016-09-01

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

CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas

Science.gov (United States)

Tanguy, M.; Chokmani, K.; Bernier, M.; Poulin, J.

2013-12-01

When a flood affects an urban area, the managers and services responsible for public safety need precise and real time information on the localization of the flooded areas, on the submersion heights in those areas, but also on the vulnerability of people exposed to this hazard. Such information is essential for an effective crisis management. Despite a growing interest in this topic over the last 15 years, the development of flood risk assessment tools mainly focused on quantitative modeling of the monetary damages caused by floods to residential buildings or to critical infrastructures. Little attention was paid to the vulnerability of people exposed to flooding but also to the effects of the failure or destruction of critical infrastructures and residential building on people health and security during the disaster. Moreover, these models do not integrate the dynamic features of the flood (extent, submersion heights) and the evolution of human vulnerability in the same mapping tool. Thus, an accurate and precise evaluation of human risk induced by urban flooding is hardly feasible using such models. This study presents CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas, which fills the actual needs in terms of flood risk evaluation and management. This innovative tool integrates a methodology of flood hazard mapping that simulates, for a given discharge, the associated water level, and subsequently determines the extent of the flooded area and the submersion heights at each point of the flooded area, using a DEM. The dynamics of human vulnerability is then mapped at the household level, according to the characteristics of the flood hazard. Three key components of human vulnerability have been identified and are integrated to CADYRI: 1, the intrinsic vulnerability of the population, estimated by specific socio-economic indicators; 2, the vulnerability of buildings, assessed by their structural features; 3, the vulnerability of

Characterization of Apps and Other e-Tools for Medication Use: Insights Into Possible Benefits and Risks.

Science.gov (United States)

van Kerkhof, Linda Wilhelmina Maria; van der Laar, Catharina Walthera Egbertha; de Jong, Charlie; Weda, Marjolein; Hegger, Ingrid

2016-04-06

In the past years, an enormous increase in the number of available health-related applications (apps) has occurred, from approximately 5800 in 2011 to over 23,000 in 2013, in the iTunes store. However, little is still known regarding the use, possible effectiveness, and risks of these applications. In this study, we focused on apps and other e-tools related to medicine use. A large subset of the general population uses medicines and might benefit from tools that aid in the use of medicine. The aim of the present study was to gain more insight into the characteristics, possible risks, and possible benefits of health apps and e-tools related to medication use. We first made an inventory of apps and other e-tools for medication use (n=116). Tools were coded by two independent researchers, based on the information available in the app stores and websites. Subsequently, for one type of often downloaded apps (aimed at people with diabetes), we investigated users' experiences using an online questionnaire. Results of the inventory show that many apps for medication use are available and that they mainly offer simple functionalities. In line with this, the most experienced benefit by users of apps for regulating blood glucose levels in the online questionnaire was "information quick and conveniently available". Other often experienced benefits were improving health and self-reliance. Results of the inventory show that a minority of the apps for medication use has potentially high risks and for many of the apps it is unclear whether and how personal data are stored. In contrast, online questionnaire among users of apps for blood glucose regulation indicates that they hardly ever experience problems or doubts considering reliability and/or privacy. Although, respondents do mention to experience disadvantages of use due to incomplete apps and apps with poor ease of use. Respondents not using app(s) indicate that they might use them in the future if reliability of the apps and

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

Science.gov (United States)

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

2015-02-18

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

Risk Communication as a Tool for Training Apprentice Welders: A Study about Risk Perception and Occupational Accidents

Science.gov (United States)

Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; Rocha, Laurelize Pereira; de Almeida, Marlise Capa Verde; Severo, Luana de Oliveira; Borges, Anelise Miritz; Vaz, Joana Cezar; Turik, Claudia

2012-01-01

The present study has aimed to identify the perceptions of apprentice welders about physical, chemical, biological, and physiological risk factors to which they are exposed; identify types of occupational accidents involving apprentice welders; and report the development of a socioenvironmental education intervention as a tool for risk communication for apprentice welders. A quantitative study was performed with 161 apprentice welders in Southern Brazil in 2011. Data collection was performed via structured interviews with the apprentice welders about risk perception, occupational accidents, and time experienced in welding. The data were analyzed using SPSS 19.0. The participants identified the following risk types: physical (96.9%), chemical (95%), physiological (86.3%), and biological (51.5%). In this sample, 39.7% of apprentice welders reported occupational accidents and 27.3% reported burning. The inferential analysis showed that the frequency of risk perception factors increases with the length of experience, and apprentice welders who have experienced accidents during welding activity perceive a higher amount of risk factors than those who have never experienced them. It is concluded that apprentice welders perceive risks and that they tend to relate risks with the occurrence of occupational accidents as an indicator of the dangerous nature of their activity. PMID:23326211

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

Science.gov (United States)

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

2011-04-01

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

Application of the CO2-PENS risk analysis tool to the Rock Springs Uplift, Wyoming

Science.gov (United States)

Stauffer, P.H.; Pawar, R.J.; Surdam, R.C.; Jiao, Z.; Deng, H.; Lettelier, B.C.; Viswanathan, H.S.; Sanzo, D.L.; Keating, G.N.

2011-01-01

We describe preliminary application of the CO2-PENS performance and risk analysis tool to a planned geologic CO2 sequestration demonstration project in the Rock Springs Uplift (RSU), located in south western Wyoming. We use data from the RSU to populate CO2-PENS, an evolving system-level modeling tool developed at Los Alamos National Laboratory. This tool has been designed to generate performance and risk assessment calculations for the geologic sequestration of carbon dioxide. Our approach follows Systems Analysis logic and includes estimates of uncertainty in model parameters and Monte-Carlo simulations that lead to probabilistic results. Probabilistic results provide decision makers with a range in the likelihood of different outcomes. Herein we present results from a newly implemented approach in CO 2-PENS that captures site-specific spatially coherent details such as topography on the reservoir/cap-rock interface, changes in saturation and pressure during injection, and dip on overlying aquifers that may be impacted by leakage upward through wellbores and faults. We present simulations of CO 2 injection under different uncertainty distributions for hypothetical leaking wells and faults. Although results are preliminary and to be used only for demonstration of the approach, future results of the risk analysis will form the basis for a discussion on methods to reduce uncertainty in the risk calculations. Additionally, we present ideas on using the model to help locate monitoring equipment to detect potential leaks. By maintaining site-specific details in the CO2-PENS analysis we provide a tool that allows more logical presentations to stakeholders in the region. ?? 2011 Published by Elsevier Ltd.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-07-01

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

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

Science.gov (United States)

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

2012-06-01

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

SafetyBarrierManager, a software tool to perform risk analysis using ARAMIS's principles

DEFF Research Database (Denmark)

Duijm, Nijs Jan

2017-01-01

of the ARAMIS project, Risø National Laboratory started developing a tool that could implement these methodologies, leading to SafetyBarrierManager. The tool is based on the principles of “safety‐barrier diagrams”, which are very similar to “bowties”, with the possibility of performing quantitative analysis......The ARAMIS project resulted in a number of methodologies, dealing with among others: the development of standard fault trees and “bowties”; the identification and classification of safety barriers; and including the quality of safety management into the quantified risk assessment. After conclusion....... The tool allows constructing comprehensive fault trees, event trees and safety‐barrier diagrams. The tool implements the ARAMIS idea of a set of safety barrier types, to which a number of safety management issues can be linked. By rating the quality of these management issues, the operational probability...

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

Science.gov (United States)

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

2018-01-01

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

Knowledge and tools formalization in the accidental risks domain (DRA-35) Ω-13 Boilover

International Nuclear Information System (INIS)

Patej, S.

2003-03-01

Since 2000 the Ministry of the environment is financing a studies and researches program, called since 2003 ''formalization of the knowledge and tools in the domain of the major risks'' DRA-35. The aim of this program is to realize a document formalizing the INERIS expertise in the domain of the accidental risks: the physical phenomenon implied in the accidents, the risks analysis and control, the methodological aspects for the realization of regulations. This report presents the study of the boilover physical phenomenon. (A.L.B.)

Social media as a useful tool in food risk and benefit communication? A strategic orientation approach

NARCIS (Netherlands)

Rutsaert, P.; Pieniak, Z.; Regan, A.; McConnon, A.; Kuttschreuter, M.; Lores, M.; Lozano, N.; Guzzon, A.; Santare, D; Verbeke, W.

2014-01-01

Although considerable progress has been made in understanding the determinants of risk perception and in identifying the necessary components of effective food risk and benefit communication, this has not been matched with the development of efficient and appropriate communication tools. Little work

Identification of seniors at risk (ISAR) screening tool in the emergency department: implementation using the plan-do-study-act model and validation results.

Science.gov (United States)

Asomaning, Nana; Loftus, Carla

2014-07-01

To better meet the needs of older adults in the emergency department, Senior Friendly care processes, such as high-risk screening are recommended. The identification of Seniors at Risk (ISAR) tool is a 6-item validated screening tool for identifying elderly patients at risk of the adverse outcomes post-ED visit. This paper describes the implementation of the tool in the Mount Sinai Hospital emergency department using a Plan-Do-Study-Act model; and demonstrates whether the tool predicts adverse outcomes. An observational study tracked tool implementation. A retrospective chart audit was completed to collect data about elderly ED patients during 2 time periods in 2010 and 2011. Data analysis compared the characteristics of patients with positive and negative screening tool results. The identification of Seniors at Risk tool was completed for 51.6% of eligible patients, with 61.2% of patients having a positive result. Patients with positive screening results were more likely to be over age 79 (P = .003); be admitted to hospital (P Risk tool was challenged by problematic compliance with tool completion. Strategies to address this included tool adaptation; and providing staff with knowledge of ED and inpatient geriatric resources and feedback on completion rates. Positive screening results predicted adverse outcomes in elderly Mount Sinai Hospital ED patients. © 2014. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2009-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

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

2015-04-29

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Benefits, challenges, and best practices for involving audiences in the development of interactive coastal risk communication tools: Professional communicators' experiences

Science.gov (United States)

Stephens, S. H.; DeLorme, D.

2017-12-01

To make scientific information useful and usable to audiences, communicators must understand audience needs, expectations, and future applications. This presentation synthesizes benefits, challenges, and best practices resulting from a qualitative social science interview study of nine professionals on their experiences developing interactive visualization tools for communicating about coastal environmental risks. Online interactive risk visualization tools, such as flooding maps, are used to provide scientific information about the impacts of coastal hazards. These tools have a wide range of audiences and purposes, including time-sensitive emergency communication, infrastructure and natural resource planning, and simply starting a community conversation about risks. Thus, the science, purposes, and audiences of these tools require a multifaceted communication strategy. In order to make these tools useable and accepted by their audiences, many professional development teams solicit target end-user input or incorporate formal user-centered design into the development process. This presentation will share results of seven interviews with developers of U.S. interactive coastal risk communication tools, ranging from state-level to international in scope. Specific techniques and procedures for audience input that were used in these projects will be discussed, including ad-hoc conversations with users, iterative usability testing with project stakeholder groups, and other participatory mechanisms. The presentation will then focus on benefits, challenges, and recommendations for best practice that the interviewees disclosed about including audiences in their development projects. Presentation attendees will gain an understanding of different procedures and techniques that professionals employ to involve end-users in risk tool development projects, as well as important considerations and recommendations for effectively involving audiences in science communication design.

Survey on the use of configuration risk and safety management tools at nuclear power plants. Final report

International Nuclear Information System (INIS)

Fleming, K.N.; Read, J.W.; Dagan, W.J.; Bidwell, D.A.

1998-09-01

In order to provide input to Electricite de France's (EDF) evaluation of the use of configuration safety and risk management tools in the French plants and to collect information to guide the EPRI efforts to provide useful tools for the EPRI member utilities and international partners, a joint effort to survey US and selected non-US nuclear power stations was conducted. This survey examined the use of various approaches, techniques, and software tools that are being used to evaluate the safety and risk aspects of plant configuration changes and configuration changes during plant outages as well as during power operation. The use of these tools has increased in recent years as a result of efforts to optimize plant maintenance programs, improve plant safety, and increase plant reliability and availability. This report provides the results of the survey of 37 organizations covering 54 nuclear plant sites and 97 reactor units

Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

Science.gov (United States)

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

2016-08-29

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Decision support in addiction: The development of an e-health tool to assess and prevent risk of fatal overdose. The ORION Project.

Science.gov (United States)

Baldacchino, A; Crocamo, C; Humphris, G; Neufeind, J; Frisher, M; Scherbaum, N; Carrà, G

2016-09-01

The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. In this article, we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore, its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Polovina Snežana

2015-01-01

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

Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

Science.gov (United States)

Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

2015-06-01

Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

Risk management as a modern sustainable development of the enterprise management tool

Directory of Open Access Journals (Sweden)

Aikhel K.V.

2017-01-01

Full Text Available Actively embedding in the international market processes, domestic industrial enterprises improve their management tools to create competitive structures. Spread one of the modern approaches to Business Engineering defines risk management as the starting point of building processes of the company. Adapting the method of analyzing hierarchies for quantitative risk assessment will increase the efficiency for the implementation of the new management approach, taking into account the existing time limits and the initial data, which in turn will ensure the stability of enterprises operations in the face of uncertainty. From the point of view of prospect of development, stability of the modern enterprises is also reflection of their competitiveness.

Risk management tools from the traditional energy industry to wind energy projects

International Nuclear Information System (INIS)

Randall, G.; Marks, R.

2010-01-01

Risk-based analysis techniques are used to quantify and prioritize a wide variety of problems within the traditional fossil fuel and nuclear power industries. This poster presentation evaluated some of the risk analysis tools and methods used by the energy industry to quantify and manage wind energy development risks. A comprehensive risk-based approach for identifying the probability and consequences of potential concerns was presented for a sample wind energy project. The process determined objectives in relation to the project's net present value. Contributing domains included the energy production, prices, and operating costs of the project. Decision criteria used to evaluate the desirability of the wind project were then developed. Monte Carlo simulations were the used to aggregate individual risks into an overall total. The contribution of each element to the decision objective was calculated separately. The element outputs were than combined into a measure of aggregate risk exposure. Aggregate results were used to calculate the decision criteria. The decision objective was to determine if the energy cost was less than the avoided cost of other project options. The study showed that the approach can allow decision-makers to mitigate risks. However, the results are dependent on the quality of the input data. tabs., figs.

A long-term risk management tool for electricity markets using swarm intelligence

International Nuclear Information System (INIS)

Azevedo, F.; Vale, Z.A.; Khodr, H.M.; Oliveira, P.B. Moura

2010-01-01

This paper addresses the optimal involvement in derivatives electricity markets of a power producer to hedge against the pool price volatility. To achieve this aim, a swarm intelligence meta-heuristic optimization technique for long-term risk management tool is proposed. This tool investigates the long-term opportunities for risk hedging available for electric power producers through the use of contracts with physical (spot and forward contracts) and financial (options contracts) settlement. The producer risk preference is formulated as a utility function (U) expressing the trade-off between the expectation and the variance of the return. Variance of return and the expectation are based on a forecasted scenario interval determined by a long-term price range forecasting model. This model also makes use of particle swarm optimization (PSO) to find the best parameters allow to achieve better forecasting results. On the other hand, the price estimation depends on load forecasting. This work also presents a regressive long-term load forecast model that make use of PSO to find the best parameters as well as in price estimation. The PSO technique performance has been evaluated by comparison with a Genetic Algorithm (GA) based approach. A case study is presented and the results are discussed taking into account the real price and load historical data from mainland Spanish electricity market demonstrating the effectiveness of the methodology handling this type of problems. Finally, conclusions are dully drawn. (author)

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

International Nuclear Information System (INIS)

Itoi, Tatsuya

2015-01-01

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

Social media as a useful tool in food risk and benefit communication? A strategic orientation approach

OpenAIRE

Verbeke, W.; Santare, D.; Guzzon, A.; Lozano, N.; Lores, M.; Kuttschreuter, M.; McConnon, Á.; Regan, Á.; Pieniak, Z.; Rutsaert, P.

2014-01-01

10.1016/j.foodpol.2014.02.003 Although considerable progress has been made in understanding the determinants of risk perception and in identifying the necessary components of effective food risk and benefit communication, this has not been matched with the development of efficient and appropriate communication tools. Little work has been done examining the implications of the explosion of new media and web technologies, which may offer potential for improving food risk and benefit communi...

A risk measurement tool for an underground electricity distribution system considering the consequences and uncertainties of manhole events

International Nuclear Information System (INIS)

Garcez, Thalles Vitelli; Teixeira de Almeida, Adiel

2014-01-01

This paper explores a risk measure of underground vaults that considers the consequences of arc faults. The increasing use of underground systems, together with the aging of networks, the lack of maintenance and interference from other (third party) underground systems nearby have caused many accidents in urban areas, thus endangering human life. The involvement of a large number (hundreds or thousands) of underground vaults with different characteristics, the lack of historical data on modes of failure, the rarity of the occurrence of some faults, the magnitude of their consequences and the involvement of a complex environment surrounding the hazard zone make risk management even more complex and uncertain. Furthermore, given that the (monetary, time, staff, etc.) resources of an electrical power company are limited and scarce, it is necessary to use decision-making tools that aggregate the consequences and the uncertainties to assess the risks jointly with the preference structure of the company, thus solving the problem more realistically. Therefore, this paper puts forward the use of an additional risk analysis for manhole events in underground electrical distribution networks with a view to its being used as a decision aid tool in risk management. As an illustration of the use of the risk measurement tool proposed, a numerical application is presented. The result rather than showing a ranking of underground vaults, gives a measure of the risk used that can show the decision-maker (DM) how much better one group of alternatives (formed by alternatives with quite similar risk values) is than other groups, based on the DM’s attitude to risk and grounded on the axiomatic structure of utility theory. - Highlights: • The paper proposes a risk measure of underground vaults for manhole events. • It makes risk analysis in underground electrical distribution networks. • It makes more than show a risk ranking of underground vaults. • It can show to the DM how

Viability qPCR, a new tool for Legionella risk management.

Science.gov (United States)

Lizana, X; López, A; Benito, S; Agustí, G; Ríos, M; Piqué, N; Marqués, A M; Codony, F

2017-11-01

Viability quantitative Polymerase Chain Reaction (v-qPCR) is a recent analytical approach for only detecting live microorganisms by DNA amplification-based methods This approach is based on the use of a reagent that irreversibly fixes dead cells DNA. In this study, we evaluate the utility of v-qPCR versus culture method for Legionellosis risk management. The present study was performed using 116 real samples. Water samples were simultaneously analysed by culture, v-qPCR and qPCR methods. Results were compared by means of a non-parametric test. In 11.6% of samples using both methods (culture method and v-qPCR) results were positive, in 50.0% of samples both methods gave rise to negative results. As expected, equivalence between methods was not observed in all cases, as in 32.1% of samples positive results were obtained by v-qPCR and all of them gave rise to negative results by culture. Only in 6.3% of samples, with very low Legionella levels, was culture positive and v-qPCR negative. In 3.5% of samples, overgrowth of other bacteria did not allow performing the culture. When comparing both methods, significant differences between culture and v-qPCR were in the samples belonging to the cooling towers-evaporative condensers group. The v-qPCR method detected greater presence and obtained higher concentrations of Legionella spp. (p<0.001). Otherwise, no significant differences between methods were found in the rest of the groups. The v-qPCR method can be used as a quick tool to evaluate Legionellosis risk, especially in cooling towers-evaporative condensers, where this technique can detect higher levels than culture. The combined interpretation of PCR results along with the ratio of live cells is proposed as a tool for understanding the sample context and estimating the Legionellosis risk potential according to 4 levels of hierarchy. Copyright © 2017 Elsevier GmbH. All rights reserved.

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

International Nuclear Information System (INIS)

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

2010-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-10-15

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

The KnowRISK project: Tools and strategies for risk communication and learning

Science.gov (United States)

Musacchio, Gemma; Amaral Ferreira, Mónica; Falsaperla, Susanna; Piangiamore, Giovanna Lucia; Pino, Nicola Alessandro; Solarino, Stefano; Crescimbene, Massimo; Eva, Elena; Reitano, Danilo; Þorvaldsdottir, Solveig; Sousa Silva, Delta; Rupakhety, Rajesh; Sousa Oliveira, Carlos

2016-04-01

Damage of non-structural elements of buildings (i.e. partitions, ceilings, cladding, electrical and mechanical systems and furniture) is known to cause injuries and human losses. Also it has a significant impact on earthquake resilience and is yet being worldwide underestimated. The project KnowRISK (Know your city, Reduce seISmic risK through non-structural elements) is financed by the European Commission to develop prevention measures that may reduce non-structural damage in urban areas. Pilot areas of the project are within the three European participating countries, namely Portugal, Iceland and Italy. They were chosen because they are prone to damage level 2 and 3 (EMS-98, European Macroseismic Scale) that typically affects non-structural elements. We will develop and test a risk communication strategy taking into account the needs of households and schools, putting into practice a portfolio of best practice to reduce the most common non-structural vulnerabilities. We will target our actions to different societal groups, considering their cultural background and social vulnerabilities, and implement a participatory approach that will promote engagement and interaction between the scientific community, practitioners and citizens to foster knowledge on everyone's own neighborhoods, resilience and vulnerability. A Practical Guide for citizens will highlight that low-cost actions can be implemented to increase safety of households, meant as being the places where the most vulnerable societal groups, including children and elderly people, spend much of their time. Since our actions towards communication will include education, we will define tools that allow a clear and direct understanding of elements exposed to risk. Schools will be one of our target societal groups and their central role played at the community level will ensure spreading and strengthening of the communication process. Schools are often located in old or re-adapted buildings, formerly used for

Risk analysis for dengue suitability in Africa using the ArcGIS predictive analysis tools (PA tools).

Science.gov (United States)

Attaway, David F; Jacobsen, Kathryn H; Falconer, Allan; Manca, Germana; Waters, Nigel M

2016-06-01

Risk maps identifying suitable locations for infection transmission are important for public health planning. Data on dengue infection rates are not readily available in most places where the disease is known to occur. A newly available add-in to Esri's ArcGIS software package, the ArcGIS Predictive Analysis Toolset (PA Tools), was used to identify locations within Africa with environmental characteristics likely to be suitable for transmission of dengue virus. A more accurate, robust, and localized (1 km × 1 km) dengue risk map for Africa was created based on bioclimatic layers, elevation data, high-resolution population data, and other environmental factors that a search of the peer-reviewed literature showed to be associated with dengue risk. Variables related to temperature, precipitation, elevation, and population density were identified as good predictors of dengue suitability. Areas of high dengue suitability occur primarily within West Africa and parts of Central Africa and East Africa, but even in these regions the suitability is not homogenous. This risk mapping technique for an infection transmitted by Aedes mosquitoes draws on entomological, epidemiological, and geographic data. The method could be applied to other infectious diseases (such as Zika) in order to provide new insights for public health officials and others making decisions about where to increase disease surveillance activities and implement infection prevention and control efforts. The ability to map threats to human and animal health is important for tracking vectorborne and other emerging infectious diseases and modeling the likely impacts of climate change. Copyright © 2016 Elsevier B.V. All rights reserved.

A novel tool for user-friendly estimation of natural, diagnostic and professional radiation risk: Radio-Risk software

International Nuclear Information System (INIS)

Carpeggiani, Clara; Paterni, Marco; Caramella, Davide; Vano, Eliseo; Semelka, Richard C.; Picano, Eugenio

2012-01-01

Background: Awareness of radiological risk is low among doctors and patients. An educational/decision tool that considers each patient’ s cumulative lifetime radiation exposure would facilitate provider–patient communication. Aim: The purpose of this work was to develop user-friendly software for simple estimation and communication of radiological risk to patients and doctors as a part of the SUIT-Heart (Stop Useless Imaging Testing in Heart disease) Project of the Tuscany Region. Methods: We developed a novel software program (PC-platform, Windows OS fully downloadable at (http://suit-heart.ifc.cnr.it)) considering reference dose estimates from American Heart Association Radiological Imaging 2009 guidelines and UK Royal College of Radiology 2007 guidelines. Cancer age and gender-weighted risk were derived from Biological Effects of Ionising Radiation VII Committee, 2006. Results: With simple input functions (demographics, age, gender) the user selects from a predetermined menu variables relating to natural (e.g., airplane flights and geo-tracked background exposure), professional (e.g., cath lab workers) and medical (e.g., CT, cardiac scintigraphy, coronary stenting) sources. The program provides a simple numeric (cumulative effective dose in milliSievert, mSv, and equivalent number of chest X-rays) and graphic (cumulative temporal trends of exposure, cancer cases out of 100 exposed persons) display. Conclusions: A simple software program allows straightforward estimation of cumulative dose (in multiples of chest X-rays) and risk (in extra % lifetime cancer risk), with simple numbers quantifying lifetime extra cancer risk. Pictorial display of radiation risk may be valuable for increasing radiological awareness in cardiologists.

A novel tool for user-friendly estimation of natural, diagnostic and professional radiation risk: Radio-Risk software

Energy Technology Data Exchange (ETDEWEB)

Carpeggiani, Clara; Paterni, Marco [CNR, Institute of Clinical Physiology (Italy); Caramella, Davide [Radiology Department, Pisa University, Pisa (Italy); Vano, Eliseo [San Carlos Hospital, Radiology Department, Complutense University, Madrid (Spain); Semelka, Richard C. [University of North Carolina, Chapel Hill, NC (United States); Picano, Eugenio, E-mail: picano@ifc.cnr.it [CNR, Institute of Clinical Physiology (Italy)

2012-11-15

Background: Awareness of radiological risk is low among doctors and patients. An educational/decision tool that considers each patient' s cumulative lifetime radiation exposure would facilitate provider-patient communication. Aim: The purpose of this work was to develop user-friendly software for simple estimation and communication of radiological risk to patients and doctors as a part of the SUIT-Heart (Stop Useless Imaging Testing in Heart disease) Project of the Tuscany Region. Methods: We developed a novel software program (PC-platform, Windows OS fully downloadable at (http://suit-heart.ifc.cnr.it)) considering reference dose estimates from American Heart Association Radiological Imaging 2009 guidelines and UK Royal College of Radiology 2007 guidelines. Cancer age and gender-weighted risk were derived from Biological Effects of Ionising Radiation VII Committee, 2006. Results: With simple input functions (demographics, age, gender) the user selects from a predetermined menu variables relating to natural (e.g., airplane flights and geo-tracked background exposure), professional (e.g., cath lab workers) and medical (e.g., CT, cardiac scintigraphy, coronary stenting) sources. The program provides a simple numeric (cumulative effective dose in milliSievert, mSv, and equivalent number of chest X-rays) and graphic (cumulative temporal trends of exposure, cancer cases out of 100 exposed persons) display. Conclusions: A simple software program allows straightforward estimation of cumulative dose (in multiples of chest X-rays) and risk (in extra % lifetime cancer risk), with simple numbers quantifying lifetime extra cancer risk. Pictorial display of radiation risk may be valuable for increasing radiological awareness in cardiologists.

The risk of bias in systematic reviews tool showed fair reliability and good construct validity.

Science.gov (United States)

Bühn, Stefanie; Mathes, Tim; Prengel, Peggy; Wegewitz, Uta; Ostermann, Thomas; Robens, Sibylle; Pieper, Dawid

2017-11-01

There is a movement from generic quality checklists toward a more domain-based approach in critical appraisal tools. This study aimed to report on a first experience with the newly developed risk of bias in systematic reviews (ROBIS) tool and compare it with A Measurement Tool to Assess Systematic Reviews (AMSTAR), that is, the most common used tool to assess methodological quality of systematic reviews while assessing validity, reliability, and applicability. Validation study with four reviewers based on 16 systematic reviews in the field of occupational health. Interrater reliability (IRR) of all four raters was highest for domain 2 (Fleiss' kappa κ = 0.56) and lowest for domain 4 (κ = 0.04). For ROBIS, median IRR was κ = 0.52 (range 0.13-0.88) for the experienced pair of raters compared to κ = 0.32 (range 0.12-0.76) for the less experienced pair of raters. The percentage of "yes" scores of each review of ROBIS ratings was strongly correlated with the AMSTAR ratings (r s  = 0.76; P = 0.01). ROBIS has fair reliability and good construct validity to assess the risk of bias in systematic reviews. More validation studies are needed to investigate reliability and applicability, in particular. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Daniele Franchi

2011-02-01

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

The Pros and Cons of Using Joint Ventures as a Tool to Mitigate Political Risks in Developing Countries

Directory of Open Access Journals (Sweden)

Violeta Iftinchi

2018-03-01

Full Text Available As part of their political risk management strategy, multinational corporations (MNCs can use joint ventures as a tool to reduce their exposure to political risks in international activities. The aim of this article is to present the main benefits for MNCs in using joint ventures with a local partner to mitigate political risks in developing countries and to put forward three risks that MNCs have to consider when choosing the local partner (the risk of opportunistic expropriation, the risk associated with transferring of intellectual property rights and reputational risk.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2013-12-01

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

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

Science.gov (United States)

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

2017-09-01

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

Work Ability Index as Tool to Identify Workers at Risk of Premature Work Exit

NARCIS (Netherlands)

Roelen, Corne A. M.; Heymans, Martijn W.; Twisk, Jos W. R.; van der Klink, Jac J. L.; Groothoff, Johan W.; van Rhenen, Willem

2014-01-01

Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

Work ability index as tool to identify workers at risk of premature work exit

NARCIS (Netherlands)

Roelen, C.A.M.; Heymans, M.W.; Twisk, J.W.R.; van der Klink, J.J.L.; Groothoff, J.W.; van Rhenen, W.

2014-01-01

Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

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

Science.gov (United States)

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

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

Predictive validity of the identification of seniors at risk screening tool in a German emergency department setting.

Science.gov (United States)

Singler, Katrin; Heppner, Hans Jürgen; Skutetzky, Andreas; Sieber, Cornel; Christ, Michael; Thiem, Ulrich

2014-01-01

The identification of patients at high risk for adverse outcomes [death, unplanned readmission to emergency department (ED)/hospital, functional decline] plays an important role in emergency medicine. The Identification of Seniors at Risk (ISAR) instrument is one of the most commonly used and best-validated screening tools. As to the authors' knowledge so far there are no data on any screening tool for the identification of older patients at risk for a negative outcome in Germany. To evaluate the validity of the ISAR screening tool in a German ED. This was a prospective single-center observational cohort study in an ED of an urban university-affiliated hospital. Participants were 520 patients aged ≥75 years consecutively admitted to the ED. The German version of the ISAR screening tool was administered directly after triage of the patients. Follow-up telephone interviews to assess outcome variables were conducted 28 and 180 days after the index visit in the ED. The primary end point was death from any cause or hospitalization or recurrent ED visit or change of residency into a long-term care facility on day 28 after the index ED visit. The mean age ± SD was 82.8 ± 5.0 years. According to ISAR, 425 patients (81.7%) scored ≥2 points, and 315 patients (60.5%) scored ≥3 points. The combined primary end point was observed in 250 of 520 patients (48.1%) on day 28 and in 260 patients (50.0%) on day 180. Using a continuous ISAR score the area under the curve on day 28 was 0.621 (95% confidence interval, CI 0.573-0.669) and 0.661 (95% CI 0.615-0.708) on day 180, respectively. The German version of the ISAR screening tool acceptably identified elderly patients in the ED with an increased risk of a negative outcome. Using the cutoff ≥3 points instead of ≥2 points yielded better overall results.

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

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

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

International Nuclear Information System (INIS)

Diller, S.

1998-01-01

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

A clinical risk stratification tool for predicting treatment resistance in major depressive disorder.

Science.gov (United States)

Perlis, Roy H

2013-07-01

Early identification of depressed individuals at high risk for treatment resistance could be helpful in selecting optimal setting and intensity of care. At present, validated tools to facilitate this risk stratification are rarely used in psychiatric practice. Data were drawn from the first two treatment levels of a multicenter antidepressant effectiveness study in major depressive disorder, the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) cohort. This cohort was divided into training, testing, and validation subsets. Only clinical or sociodemographic variables available by or readily amenable to self-report were considered. Multivariate models were developed to discriminate individuals reaching remission with a first or second pharmacological treatment trial from those not reaching remission despite two trials. A logistic regression model achieved an area under the receiver operating characteristic curve exceeding .71 in training, testing, and validation cohorts and maintained good calibration across cohorts. Performance of three alternative models with machine learning approaches--a naïve Bayes classifier and a support vector machine, and a random forest model--was less consistent. Similar performance was observed between more and less severe depression, men and women, and primary versus specialty care sites. A web-based calculator was developed that implements this tool and provides graphical estimates of risk. Risk for treatment resistance among outpatients with major depressive disorder can be estimated with a simple model incorporating baseline sociodemographic and clinical features. Future studies should examine the performance of this model in other clinical populations and its utility in treatment selection or clinical trial design. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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

OpenAIRE

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

2016-01-01

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

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

Science.gov (United States)

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

2012-04-01

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

The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

Science.gov (United States)

Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

2011-12-01

Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

Degree of Agreement between Cardiovascular Risk Stratification Tools.

Science.gov (United States)

Garcia, Guilherme Thomé; Stamm, Ana Maria Nunes de Faria; Rosa, Ariel Córdova; Marasciulo, Antônio Carlos; Marasciulo, Rodrigo Conill; Battistella, Cristian; Remor, Alexandre Augusto de Costa

2017-05-01

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Brazil, and primary prevention care may be guided by risk stratification tools. The Framingham (FRS) and QRISK-2 (QRS) risk scores estimate 10-year overall cardiovascular risk in asymptomatic individuals, but the instrument of choice may lead to different therapeutic strategies. To evaluate the degree of agreement between FRS and QRS in 10-year overall cardiovascular risk stratification in disease-free individuals. Cross-sectional, observational, descriptive and analytical study in a convenience sample of 74 individuals attending the outpatient care service of a university hospital in Brazil between January 2014 and January 2015. After application of FRS and QRS, patients were classified in low/moderate risk (Brasil, e a prevenção primária pode ser direcionada com ferramentas que estratificam o risco. Os escores de Framingham (ERF) e QRISK-2 (ERQ) estimam o risco cardiovascular (RCV) global em 10 anos em indivíduos assintomáticos, mas a escolha do instrumento pode implicar em terapêuticas distintas. Observar o grau de concordância entre o ERF e o ERQ, na estratificação do risco cardiovascular global em 10 anos, nos indivíduos livres da doença. Estudo transversal, observacional, descritivo e analítico, com uma amostra de conveniência de 74 indivíduos, atendidos em um ambulatório de ensino de um hospital universitário brasileiro, no sul do país, de janeiro de 2014 a janeiro de 2015. O ERF e o ERQ foram aplicados nos pacientes, que foram classificados em baixo/moderado (superior no ERF que no ERQ (33,7% vs 21,6%), sendo identificado efeito sinérgico do gênero masculino com hipertensão arterial sistêmica nas duas ferramentas, e com faixa etária geriátrica no ERQ (p < 0,05) nesse estrato de risco. O índice de concordância Kappa entre os dois escores foi igual a 0,519 (IC95% = 0,386-0,652; p < 0,001). Houve concordância moderada entre o ERF e o ERQ, na estimativa de

The development of a screening tool for the early identification of risk for suicidal behavior among students in a developing country.

Science.gov (United States)

Vawda, Naseema B M; Milburn, Norweeta G; Steyn, Renier; Zhang, Muyu

2017-05-01

Adolescent suicidal behavior is a public health concern in South Africa. The purpose of this article is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behavior. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behavior was developed using a 4-phase approach. Twelve factors for high-risk suicidal behavior were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behavior to mental health services for treatment. This screening tool is based on factors that were identified as being associated with suicidal behavior from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behavior, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The I.P.S.N. barometer on the risk perception and the safety, a tool of opinion follow up on the risks in France

International Nuclear Information System (INIS)

Charron, S.; Mansoux, H.

2001-01-01

The risk perception by the public is one of the policy elements of management, information, communication on the nuclear. the I.P.S.N. is working since 1977 on the psycho-social aspects of the risk. It makes inquiries about public opinion, attitudes, credibility of diffused information. The results of these polls are gathered in the I.P.S.N. barometer of the risk and safety perception and constitutes an unique tool in France by the number of data and their follow up in time. (N.C.)

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

DEFF Research Database (Denmark)

Chambon, Julie Claire Claudia

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

Using Numerical Models in the Development of Software Tools for Risk Management of Accidents with Oil and Inert Spills

Science.gov (United States)

Fernandes, R.; Leitão, P. C.; Braunschweig, F.; Lourenço, F.; Galvão, P.; Neves, R.

2012-04-01

The increasing ship traffic and maritime transport of dangerous substances make it more difficult to significantly reduce the environmental, economic and social risks posed by potential spills, although the security rules are becoming more restrictive (ships with double hull, etc.) and the surveillance systems are becoming more developed (VTS, AIS). In fact, the problematic associated to spills is and will always be a main topic: spill events are continuously happening, most of them unknown for the general public because of their small scale impact, but with some of them (in a much smaller number) becoming authentic media phenomena in this information era, due to their large dimensions and environmental and social-economic impacts on ecosystems and local communities, and also due to some spectacular or shocking pictures generated. Hence, the adverse consequences posed by these type of accidents, increase the preoccupation of avoiding them in the future, or minimize their impacts, using not only surveillance and monitoring tools, but also increasing the capacity to predict the fate and behaviour of bodies, objects, or substances in the following hours after the accident - numerical models can have now a leading role in operational oceanography applied to safety and pollution response in the ocean because of their predictive potential. Search and rescue operation, oil, inert (ship debris, or floating containers), and HNS (hazardous and noxious substances) spills risk analysis are the main areas where models can be used. Model applications have been widely used in emergency or planning issues associated to pollution risks, and contingency and mitigation measures. Before a spill, in the planning stage, modelling simulations are used in environmental impact studies, or risk maps, using historical data, reference situations, and typical scenarios. After a spill, the use of fast and simple modelling applications allow to understand the fate and behaviour of the spilt

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

OpenAIRE

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

2017-01-01

Introduction The burden of disease from dementia is a growing global concern as incidence increases dramatically with age, and average life expectancy has been increasing around the world. Planning for an ageing population requires reliable projections of dementia prevalence; however, existing population projections are simple and have poor predictive accuracy. The Dementia Population Risk Tool (DemPoRT) will predict incidence of dementia in the population setting using multivariable modellin...

SMART: A Propositional Logic-Based Trade Analysis and Risk Assessment Tool for a Complex Mission

Science.gov (United States)

Ono, Masahiro; Nicholas, Austin; Alibay, Farah; Parrish, Joseph

2015-01-01

This paper introduces a new trade analysis software called the Space Mission Architecture and Risk Analysis Tool (SMART). This tool supports a high-level system trade study on a complex mission, such as a potential Mars Sample Return (MSR) mission, in an intuitive and quantitative manner. In a complex mission, a common approach to increase the probability of success is to have redundancy and prepare backups. Quantitatively evaluating the utility of adding redundancy to a system is important but not straightforward, particularly when the failure of parallel subsystems are correlated.

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

Science.gov (United States)

Baruffini, Mirko

2010-05-01

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

The Climate-Agriculture-Modeling and Decision Tool (CAMDT) for Climate Risk Management in Agriculture

Science.gov (United States)

Ines, A. V. M.; Han, E.; Baethgen, W.

2017-12-01

Advances in seasonal climate forecasts (SCFs) during the past decades have brought great potential to improve agricultural climate risk managements associated with inter-annual climate variability. In spite of popular uses of crop simulation models in addressing climate risk problems, the models cannot readily take seasonal climate predictions issued in the format of tercile probabilities of most likely rainfall categories (i.e, below-, near- and above-normal). When a skillful SCF is linked with the crop simulation models, the informative climate information can be further translated into actionable agronomic terms and thus better support strategic and tactical decisions. In other words, crop modeling connected with a given SCF allows to simulate "what-if" scenarios with different crop choices or management practices and better inform the decision makers. In this paper, we present a decision support tool, called CAMDT (Climate Agriculture Modeling and Decision Tool), which seamlessly integrates probabilistic SCFs to DSSAT-CSM-Rice model to guide decision-makers in adopting appropriate crop and agricultural water management practices for given climatic conditions. The CAMDT has a functionality to disaggregate a probabilistic SCF into daily weather realizations (either a parametric or non-parametric disaggregation method) and to run DSSAT-CSM-Rice with the disaggregated weather realizations. The convenient graphical user-interface allows easy implementation of several "what-if" scenarios for non-technical users and visualize the results of the scenario runs. In addition, the CAMDT also translates crop model outputs to economic terms once the user provides expected crop price and cost. The CAMDT is a practical tool for real-world applications, specifically for agricultural climate risk management in the Bicol region, Philippines, having a great flexibility for being adapted to other crops or regions in the world. CAMDT GitHub: https://github.com/Agro-Climate/CAMDT

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

Science.gov (United States)

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

2012-01-01

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

The VeTOOLS Project: an example of how to strengthen collaboration between scientists and Civil Protections in disaster risk reduction

Science.gov (United States)

Marti, Joan; Bartolini, Stefania; Becerril, Laura

2016-04-01

VeTOOLS is a project funded by the European Commission's Humanitarian Aid and Civil Protection department (ECHO), and aims at creating an integrated software platform specially designed to assess and manage volcanic risk. The project facilitates interaction and cooperation between scientists and Civil Protection Agencies in order to share, unify, and exchange procedures, methodologies and technologies to effectively reduce the impacts of volcanic disasters. The project aims at 1) improving and developing volcanic risk assessment and management capacities in active volcanic regions; 2) developing universal methodologies, scenario definitions, response strategies and alert protocols to cope with the full range of volcanic threats; 4) improving quantitative methods and tools for vulnerability and risk assessment; and 5) defining thresholds and protocols for civil protection. With these objectives, the VeTOOLS project points to two of the Sendai Framework resolutions for implementing it: i) Provide guidance on methodologies and standards for risk assessments, disaster risk modelling and the use of data; ii) Promote and support the availability and application of science and technology to decision-making, and offers a good example on how a close collaboration between science and civil protection is an effective way to contribute to DRR. European Commission ECHO Grant SI2.695524

Ranking Tool Created for Medicinal Plants at Risk of Being Overharvested in the Wild

Directory of Open Access Journals (Sweden)

Lisa Marie Castle

2014-05-01

Full Text Available We developed an adaptable, transparent tool that can be used to quantify and compare vulnerability to overharvest for wild collected medicinal plants. Subsequently, we are creating a list of the most threatened medicinal plants in temperate North America. The new tool scores species according to their life history, the effects of harvest, their abundance and range, habitat, and demand. The resulting rankings, based on explicit criteria rather than expert opinion, will make it easier to discuss areas of vulnerability and set conservation priorities. Here we present scores for 40 species assessed using the At-Risk Tool and discuss the traits that led to different scores for six example species: echinacea (Echinacea angustifolia DC. Asteraceae, peyote (Lophophora williamsii (Lem. ex Salm-Dyck J.M. Coult. Cactaceae, sandalwood (Santalum spp. L. Santalaceae, stinging nettle (Urtica dioica L. Urticaceae, American ginseng (Panax quinquefolius L. Araliaceae and mayapple (Podophyllum peltatum L. Berberidaceae.

Thyroid Cancer Risk Assessment Tool

Science.gov (United States)

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

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

Science.gov (United States)

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

2009-01-01

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

Social dataset analysis and mapping tools for Risk Perception: resilience, people preparation and communication tools

Science.gov (United States)

Peters-Guarin, Graciela; Garcia, Carolina; Frigerio, Simone

2010-05-01

Perception has been identified as resource and part of the resilience of a community to disasters. Risk perception, if present, may determine the potential damage a household or community experience. Different levels of risk perception and preparedness can influence directly people's susceptibility and the way they might react in case of an emergency caused by natural hazards. In spite of the profuse literature about risk perception, works to spatially portray this feature are really scarce. The spatial relationship to danger or hazard is being recognised as an important factor of the risk equation; it can be used as a powerful tool either for better knowledge or for operational reasons (e.g. management of preventive information). Risk perception and people's awareness when displayed in a spatial format can be useful for several actors in the risk management arena. Local authorities and civil protection can better address educational activities to increase the preparation of particularly vulnerable groups of clusters of households within a community. It can also be useful for the emergency personal in order to optimally direct the actions in case of an emergency. In the framework of the Marie Curie Research Project, a Community Based Early Warning System (CBEWS) it's been developed in the Mountain Community Valtellina of Tirano, northern Italy. This community has been continuously exposed to different mass movements and floods, in particular, a large event in 1987 which affected a large portion of the valley and left 58 dead. The actual emergency plan for the study area is composed by a real time, highly detailed, decision support system. This emergency plan contains detailed instructions for the rapid deployment of civil protection and other emergency personal in case of emergency, for risk scenarios previously defined. Especially in case of a large event, where timely reaction is crucial for reducing casualties, it is important for those in charge of emergency

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

Science.gov (United States)

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

2017-12-01

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

The third experiment of operation and evaluation of online risk communication assistant tool, 'ORCAT'

International Nuclear Information System (INIS)

Katsumura, Soichiro; Kimura, Hiroshi; Furuta, Kazuo; Tanaka, Hiroshi

2006-01-01

Risk communication about the high-level radioactive waste (HLW) disposal is necessary for public acceptance of HLW disposal program. Online Risk Communication Assistant Tool (ORCAT) system is developed in order to support risk communication for HLW disposal on World Wide Web. We have been evaluating ORCAT system. After two test operations, we carried out the third test operation from Aug. 29 to Dec. 12, 2005. In the third test operation, 100 participants answered the questionnaires about the attitude change and knowledge. We classified the participants into two groups by the analysis on the number of login a week, and analyzed the change of the amount of subjective and objective knowledge. In the result of analysis on knowledge, the increase of amount of subjective knowledge doesn't always carried the increase of amount of objective knowledge. On the whole we found that the ORCAT system is evaluated useful to the risk communication about the HLW disposal. (author)

An ensemble model of QSAR tools for regulatory risk assessment.

Science.gov (United States)

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

2016-01-01

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

Self-Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST).

Science.gov (United States)

Sandhu, Amindeep; Mosli, Mahmoud; Yan, Brian; Wu, Thomas; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Beaton, Melanie; Rahman, Adam

2016-05-01

Malnutrition is common in patients with inflammatory bowel disease (IBD) and is associated with poor outcomes. Our aim is to determine if patient self-administered malnutrition screening using the malnutrition universal screening tool (MUST) is reliable by comparing patient scores with those derived from the healthcare practitioner (HCP), the gold standard. We conducted a prospective validation study at a tertiary Canadian academic center that included 154 adult outpatients with IBD. All patients with IBD completed a self-administered nutrition screening assessment using the MUST score followed by an independent MUST assessment performed by HCPs. The main outcome measure was chance-corrected agreement (κ) of malnutrition risk categorization. For patient-administered MUST, the chance-corrected agreement κ (95% confidence interval [CI]) was 0.83 (0.74-0.92) when comparing low-risk and combined medium- and high-risk patients with HCP screening. Weighted κ analysis comparing all 3 risks groups yielded a κ (95% CI) of 0.85 (0.77-0.93) between patient and HCP screening. All patients were able to screen themselves. Overall, 96% of patients reported the MUST questionnaire as either very easy or easy to understand and to complete. Self-administered nutrition screening in outpatients with IBD is valid using the MUST screening tool and is easy to use. If adopted, this tool will increase utilization of malnutrition screening in hectic outpatient clinic settings and will help HCPs determine which patients require additional nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

A GIS-based tool for bioaccumulation risk analysis and its application to study polychlorinated biphenyls in the Great Lakes

Directory of Open Access Journals (Sweden)

Fernanda P. Maciel

2018-01-01

Full Text Available This paper presents a GIS-based tool named Arc-BEST (Bioaccumulation Evaluation Screening Tool to perform spatially distributed bioaccumulation risk analyses. Estimating bioaccumulation risk is important to help predict potentially adverse effects from contaminants on ecosystems and human health, which are key factors in the development of sound public policy. Arc-BEST is based on the BEST model in the U.S. Army Corps of Engineers BRAMS (Bioaccumulation Risk Assessment Modeling System software, released in 2012. It predicts concentration of concern contaminants in predators’ tissues from concentrations in organisms at the bottom of the food chain, and corresponding bioaccumulation factors. Additionally, it estimates carcinogenic and non-carcinogenic risks for humans that consume those species. The greatest contribution of Arc-BEST is that it enables the automated use of digital spatial data sets, which improves model creation speed, analysis and visualization of results, and comparison and cross-referencing with other geographic datasets. Furthermore, the model was improved to consider up to four trophic levels. The code is written in Python and is open-source. In this work Arc-BEST is used as part of a screening-level risk assessment process in order to identify hot spots where further studies and monitoring should be performed to ensure humans and ecosystems health. The tool is successfully applied to a case study in the Laurentian Great Lakes, where long-term effects of polychlorinated biphenyls (PCBs is performed, based on measured concentrations in zebra mussels (Dreissena polymorpha, and local bioaccumulation factors from previous studies. Zebra mussels have a great filtration capacity and high bioconcentration rates, increasing the bioavailability of contaminants for predator species. PCBs concentrations in different-level predators are predicted. Furthermore, health risks for humans that consume sport fish are estimated for various

The Sydney Triage to Admission Risk Tool (START): A prospective validation study.

Science.gov (United States)

Ebker-White, Anja A; Bein, Kendall J; Dinh, Michael M

2018-02-08

The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. This was a prospective validation study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was patient disposition (discharge or inpatient admission) from the ED. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUC ROC) for START scores as well as START score in combination with other variables such as frailty, general practitioner referral, overcrowding and major medical comorbidities. There were 894 patients analysed during the study period. The START score when applied to the data had AUC ROC of 0.80 (95% CI 0.77-0.83). The inclusion of other clinical variables identified at triage did not improve the overall performance of the model with an AUC ROC of 0.81 (95% CI 0.78-0.84) in the present study. The overall performance of the START tool with respect to model discrimination and accuracy has been prospectively validated. Further clinical trials are required to test the clinical effectiveness of the tool in improving patient flow and overall ED performance. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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

Science.gov (United States)

Siebert, A. C.

2009-04-01

earth, and an extensive location database makes searching easy. The knowledge modules for historical catastrophes, megacities and change processes can be linked with each other and displayed on the maps. Completely new is the integration of the topic of climate change: various depictions of climate effects and projections show in which regions of the world risk situations have to be reckoned with in future. Thanks to its comprehensive information, the globe is an important tool for identifying risk locations worldwide and evaluating them from a geoscientific perspective. Thus, the transparency of insurance portfolios can be increased and legal requirements can be met. Munich Re's multi-discipline Geo Risks team combines a wealth of global experience and contacts. Clients benefit from a first-class natural hazard consultancy service and valuable support for introducing and implementing geographical information technology systems. The team can also provide the knowledge and technology to help clients plan and set up in-house solutions tailored to different classes of business in this innovative field of underwriting. With the new DVD "Globe of Natural Hazards" risk managers, scientists, lecturers and the public have access to Munich Re's natural hazard knowledge. The Globe of Natural Hazards is a natural hazard risk management tool that is easy to use and understand. Earth's exposure to extreme natural hazards will continue to increase. To overcome these challenges the insurance industry will need accurate and competent information.

Development of an attrition risk prediction tool.

Science.gov (United States)

Fowler, John; Norrie, Peter

To review lecturers' and students' perceptions of the factors that may lead to attrition from pre-registration nursing and midwifery programmes and to identify ways to reduce the impact of such factors on the student's experience. Comparable attrition rates for nursing and midwifery students across various universities are difficult to monitor accurately; however, estimates that there is approximately a 25% national attrition rate are not uncommon. The financial and human implications of this are significant and worthy of investigation. A study was carried out in one medium-sized UK school of nursing and midwifery, aimed at identifying perceived factors associated with attrition and retention. Thirty-five lecturers were interviewed individually; 605 students completed a questionnaire, and of these, 10 were individually interviewed. Attrition data kept by the student service department were reviewed. Data were collected over an 18-month period in 2007-2008. Regression analysis of the student data identified eight significant predictors. Four of these were 'positive' factors in that they aided student retention and four were 'negative' in that they were associated with students' thoughts of resigning. Student attrition and retention is multifactorial, and, as such, needs to be managed holistically. One aspect of this management could be an attrition risk prediction tool.

Association between the Family Nutrition and Physical Activity screening tool and cardiovascular disease risk factors in 10-year old children

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Yee, Kimbo Edward

Purpose. To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess the obesogenic family environment and behaviors, with cardiovascular disease (CVD) risk factors in 10-year old children. Methods. One hundred nineteen children were assessed for body mass index (BMI), percent body fat (%BF), waist circumference (WC), total cholesterol, HDL-cholesterol, and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and WC. The FNPA survey was completed by parents. The associations between the FNPA score and individual CVD risk factors and the continuous CVD risk score were examined using correlation analyses. Results. Approximately 35% of the sample were overweight (19%) or obese (16%). The mean FNPA score was 24.6 +/- 2.5 (range 18 to 29). Significant correlations were found between the FNPA score and WC (r = -.35, pChildren from a high-risk, obesogenic family environment as indicated with a lower FNPA score have a higher CVD risk factor profile than children from a low-risk family environment.

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

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Kyyrö, J; Sahlström, L; Lyytikäinen, T

2017-12-01

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

TCF7L2 variant genotypes and type 2 diabetes risk in Brazil: significant association, but not a significant tool for risk stratification in the general population

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Mill JG

2008-12-01

Full Text Available Abstract Background Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population. Methods We genotyped the single nucleotide polymorphisms (SNP rs7903146 of the TCF7L2 gene in 560 patients with known coronary disease enrolled in the MASS II (Medicine, Angioplasty, or Surgery Study Trial and in 1,449 residents of Vitoria, in Southeast Brazil. The associations of this gene variant to diabetes risk and metabolic characteristics in these two different populations were analyzed. To access the potential benefit of using this marker for diabetes risk prediction in the general population we analyzed the impact of this genetic variant on a validated diabetes risk prediction tool based on clinical characteristics developed for the Brazilian general population. Results SNP rs7903146 of the TCF7L2 gene was significantly associated with type 2 diabetes in the MASS-II population (OR = 1.57 per T allele, p = 0.0032, confirming, in the Brazilian population, previous reports of the literature. Addition of this polymorphism to an established clinical risk prediction score did not increased model accuracy (both area under ROC curve equal to 0.776. Conclusion TCF7L2 rs7903146 T allele is associated with a 1.57 increased risk for type 2 diabetes in a Brazilian cohort of patients with known coronary heart disease. However, the inclusion of this polymorphism in a risk prediction tool developed for the general population resulted in no improvement of performance. This is the first study, to our knowledge, that has confirmed this recent association in a South American population and adds to the great consistency of this finding in studies around the world

Pre-counseling education for low literacy women at risk of Hereditary Breast and Ovarian Cancer (HBOC): patient experiences using the Cancer Risk Education Intervention Tool (CREdIT).

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Joseph, Galen; Beattie, Mary S; Lee, Robin; Braithwaite, Dejana; Wilcox, Carolina; Metrikin, Maya; Lamvik, Kate; Luce, Judith

2010-10-01

The Cancer Risk Education Intervention Tool (CREdIT) is a computer-based (non-interactive) slide presentation designed to educate low-literacy, and ethnically and racially diverse public hospital patients at risk of Hereditary Breast and Ovarian Cancer (HBOC) about genetics. To qualitatively evaluate participants' experience with and perceptions of a genetic education program as an adjunct to genetic counseling, we conducted direct observations of the intervention, semi-structured in person interviews with 11 women who viewed CREdIT, and post-counseling questionnaires with the two participating genetic counselors. Five themes emerged from the analysis of interviews: (1) genetic counseling and testing for breast/ovarian cancer was a new concept; (2) CREdIT's story format was particularly appealing; (3) changes in participants' perceived risk for breast cancer varied; (4) some misunderstandings about individual risk and heredity persisted after CREdIT and counseling; (5) the context for viewing CREdIT shaped responses to the presentation. Observations demonstrated ways to make the information provided in CREdIT and by genetic counselors more consistent. In a post-session counselor questionnaire, counselors' rating of the patient's preparedness before the session was significantly higher for patients who viewed CREdIT prior to their appointments than for other patients. This novel educational tool fills a gap in HBOC education by tailoring information to women of lower literacy and diverse ethnic/racial backgrounds. The tool was well received by interview participants and counselors alike. Further study is needed to examine the varied effects of CREdIT on risk perception. In addition, the implementation of CREdIT in diverse clinical settings and the cultural adaptation of CREdIT to specific populations reflect important areas for future work.

Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

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Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

2015-01-01

The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

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

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

How many holes is too many? A prototype tool for estimating mosquito entry risk into damaged bed nets.

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Sutcliffe, James; Ji, Xin; Yin, Shaoman

2017-08-01

Insecticide-treated bed nets (ITNs) have played an integral role in malaria reduction but how insecticide depletion and accumulating physical damage affect ITN performance is poorly understood. More accurate methods are needed to assess damage to bed nets so that they can be designed, deployed and replaced optimally. Video recordings of female Anopheles gambiae in near approach (1-½ cm) to occupied untreated rectangular bed nets in a laboratory study were used to quantify the amount of mosquito activity (appearances over time) around different parts of the net, the per-appearance probability of a mosquito coming close to holes of different sizes (hole encounter) and the per-encounter probability of mosquitoes passing through holes of different sizes (hole passage). Appearance frequency on different parts of the net reflected previously reported patterns: the area of the net under greatest mosquito pressure was the roof, followed by the bottom 30 cm of the sides, followed by the 30 cm area immediately above this, followed by the upper two-thirds of the sides. The ratio of activity in these areas was (respectively) 250:33:5:1. Per-appearance probability of hole encounter on all parts of the net was strongly predicted by a factor combining hole perimeter and area. Per-encounter probability of hole passage, in turn, was strongly predicted by hole width. For a given width, there was a 20% greater risk of passage through holes on the roof than holes on the sides. Appearance, encounter and passage predictors correspond to various mosquito behaviours that have previously been described and are combined into a prototype mosquito entry risk tool that predicts mosquito entry rates for nets with various amounts of damage. Scenarios that use the entry risk tool to test the recommendations of the WHOPES proportionate hole index (pHI) suggest that the pHI hole size categories and failure to account for hole location likely sometimes lead to incorrect conclusions about net

The Prevalence of Malnutrition and Effectiveness of STRONGkids Tool in the Identification of Malnutrition Risks among Pediatric Surgical Patients

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Çiğdem Ulukaya Durakbaşa

2014-12-01

Full Text Available Background: High prevalence of malnutrition along with the risk for the development of malnutrition in hospitalised children has been reported. However, this problem remains largely unrecognised by healthcare workers. Aims: To determine the prevalence of malnutrition and effectiveness of STRONGkids nutritional risk screening (NRS tool in the identification of malnutrition risk among pediatric surgical patients. Study Design: Cross-sectional study. Methods: A total of 494 pediatric surgical patients (median age 59 months, 75.8% males were included in this prospective study conducted over 3 months. SD-scores 60 months (13.4 vs. 6.6%, p=0.012. Chronic malnutrition was identified in 23 (4.6% of patients with no significant difference between age groups. There were 7 (1.4% children with coexistent acute and chronic malnutrition. The STRONGkids tool revealed that 35.7% of patients were either in the moderate or high risk group for malnutrition. Malnutrition, as revealed by anthropometric measurements, was more likely in the presence of gastrointestinal (26.9%, p=0.004 and inguinoscrotal/penile surgery (4.0%, p=0.031, co-morbidities affecting nutritional status (p<0.001 and inpatient admissions (p=0.014. Among patients categorized as low risk for malnutrition, there were more outpatients than inpatients (89.3 vs. 10.7%, p<0.001 and more elective surgery cases than emergency surgery cases (93.4 vs. 6.6%, p<0.001. Conclusion: Providing data on the prevalence of malnutrition and risk of malnutrition in a prospectively recruited group of hospitalised pediatric surgical patients, the data acquired in the present study emphasise the need to raise clinician’s awareness about the importance of nutritional status assessment among hospitalised pediatric patients and the benefits of identifying patients at the risk of nutritional depletion before malnutrition occurs. Our findings support the use of the STRONGkids tool among pediatric surgical patients to

Prospective validation of American Diabetes Association risk tool for predicting pre-diabetes and diabetes in Taiwan-Taichung community health study.

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Chia-Ing Li

Full Text Available BACKGROUND: A simple diabetes risk tool that does not require laboratory tests would be beneficial in screening individuals at higher risk. Few studies have evaluated the ability of these tools to identify new cases of pre-diabetes. This study aimed to assess the ability of the American Diabetes Association Risk Tool (ADART to predict the 3-year incidence of pre-diabetes and diabetes in Taiwanese. METHODS: This was a 3-year prospective study of 1021 residents with normoglycemia at baseline, gathered from a random sample of residents aged 40-88 years in a metropolitan city in Taiwan. The areas under the curve (AUCs of three models were compared: ADART only, ADART plus lifestyle behaviors at baseline, and ADART plus lifestyle behaviors and biomarkers at baseline. The performance of ADART was compared with that of 16 tools that had been reported in the literature. RESULTS: The AUCs and their 95% confidence intervals (CIs were 0.60 (0.54-0.66 for men and 0.72 (0.66-0.77 for women in model 1; 0.62 (0.56-0.68 for men and 0.74 (0.68-0.80 for women in model 2; and 0.64 (0.58-0.71 for men and 0.75 (0.69-0.80 for women in model 3. The AUCs of these three models were all above 0.7 in women, but not in men. No significant difference in either women or men (p = 0.268 and 0.156, respectively was observed in the AUC of these three models. Compared to 16 tools published in the literature, ADART had the second largest AUC in both men and women. CONCLUSIONS: ADART is a good screening tool for predicting the three-year incidence of pre-diabetes and diabetes in females of a Taiwanese population. The performance of ADART in men was similar to the results with other tools published in the literature. Its performance was one of the best among the tools reported in the literature.

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

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Shiva Mortazavi

2017-01-01

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

Identifying the Risk Areas and Urban Growth by ArcGIS-Tools

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Omar Hamdy

2016-10-01

Full Text Available Abouelreesh is one of the most at risk areas in Aswan, Egypt, which suffers from storms, poor drainage, and flash flooding. These phenomena affect the urban areas and cause a lot of damage to buildings and infrastructure. Moreover, the potential for the further realization of dangerous situations increased when the urban areas of Abouelreesh extended towards the risk areas. In an effort to ameliorate the danger, two key issues for urban growth management were studied, namely: (i estimations regarding the pace of urban sprawl, and (ii the identification of urban areas located in regions that would be affected by flash floods. Analyzing these phenomena require a lot of data in order to obtain good results, but in our case, the official data or field data was limited so we tried to obtain it by accessing two kinds of free sources of satellite data. First, we used Arc GIS tools to analyze (digital elevation model (DEM files in order to study the watershed and better identify the risk area. Second, we studied historical imagery in Google Earth to determine the age of each urban block. The urban growth rate in the risk areas had risen to 63.31% in 2001. Urban growth in the case study area had been influenced by house sizes, because most people were looking to live in bigger houses. The aforementioned problem can be observed by considering the increasing average house sizes from 2001 until 2013, where, especially in risky areas, the average of house sizes had grown from 223 m2 in 2001 to 318 m2 in 2013. The findings from this study would be useful to urban planners and government officials in helping them to make informed decisions on urban development to benefit the community, especially those living in areas at risk from flash flooding from heavy rain events.

Using incident response trees as a tool for risk management of online financial services.

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Gorton, Dan

2014-09-01

The article introduces the use of probabilistic risk assessment for modeling the incident response process of online financial services. The main contribution is the creation of incident response trees, using event tree analysis, which provides us with a visual tool and a systematic way to estimate the probability of a successful incident response process against the currently known risk landscape, making it possible to measure the balance between front-end and back-end security measures. The model is presented using an illustrative example, and is then applied to the incident response process of a Swedish bank. Access to relevant data is verified and the applicability and usability of the proposed model is verified using one year of historical data. Potential advantages and possible shortcomings are discussed, referring to both the design phase and the operational phase, and future work is presented. © 2014 Society for Risk Analysis.

Screening in toddlers and preschoolers at risk for autism spectrum disorder: Evaluating a novel mobile-health screening tool.

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Kanne, Stephen M; Carpenter, Laura Arnstein; Warren, Zachary

2018-05-07

There are many available tools with varying levels of accuracy designed to screen for Autism Spectrum Disorder (ASD) in young children, both in the general population and specifically among those referred for developmental concerns. With burgeoning waitlists for comprehensive diagnostic ASD assessments, finding accurate methods and tools for advancing diagnostic triage becomes increasingly important. The current study compares the efficacy of four oft used paper and pencil measures, the Modified Checklist for Autism in Toddlers Revised with Follow-up, the Social Responsiveness Scale, Second Edition, and the Social Communication Questionnaire, and the Child Behavior Checklist to a novel mobile-health screening tool developed by Cognoa, Inc. (Cognoa) in a group of children 18-72 months of age. The Cognoa tool may have potential benefits as it integrates a series of parent-report questions with remote clinical ratings of brief video segments uploaded via parent's smartphones to calculate level of ASD risk. Participants were referred to one of three tertiary care diagnostic centers for ASD-related concerns (n = 230) and received a best estimate ASD diagnosis. Analysis and comparison of psychometric properties indicated potential advantages for Cognoa within this clinical sample across age ranges not often covered by another single measure/tool. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. With the wait times getting longer for comprehensive Autism Spectrum Disorder (ASD) diagnostic assessments, it is becoming increasingly important to find accurate tools to screen for ASD. The current study compares four screening measures that have been in use for some time to a novel mobile-health screening tool, called Cognoa. The Cognoa tool is novel because it integrates parent-report questions with clinical ratings of brief video segments uploaded via parent's smartphones to calculate ASD risk. Two hundred thirty children who

Engagement in the Overdose RIsk InfOrmatioN (ORION) e-Health Tool for Opioid Overdose Prevention and Self-Efficacy: A Preliminary Study.

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Carrà, Giuseppe; Crocamo, Cristina; Humphris, Gerald; Tabacchi, Tommaso; Bartoli, Francesco; Neufeind, Julia; Scherbaum, Norbert; Baldacchino, Alexander

2017-12-01

Increasing awareness of, and information about, overdose risk is an appropriate approach in risk reduction. e-Health technology in substance use disorders is an opportunity to support behavioral changes related to public health concerns. The present study aimed to evaluate the short-term impact of an innovative e-health psychoeducational software, the Overdose RIsk InfOrmatioN (ORION) tool. The ORION programme provided relevant information to opioid-dependent individuals about the risk of suffering a drug overdose as a result of high risky and dysfunctional behaviors. Seven aggregate risk factors were identified through a systematic review and their outputs included in a risk estimation model. We recruited 194 opioid-dependent treatment-seeking individuals from the United Kingdom, Germany, Italy, and Denmark. All participants were given at study entry, and after their use of the software, the General Self-Efficacy (GSE) Scale. We found comparable pre- and post-ORION administration mean GSE scores (SD), 28.49 (5.50) and 28.32 (5.90), respectively (p = 0.297). However, there was an inverse correlation between the number of risk factors and reported levels of self-efficacy (p ORION was able to identify individuals who are most in need of reducing their modifiable risk factors with appropriate interventions. However, a one-shot e-health tool cannot influence complex domains such as self-efficacy unless this is used with other effective interventions. Nonetheless, the ORION tool is unique in its style and content of delivery, that is translating risks combination into a clear estimation, and will need further development such as (a) integration in smartphone-based e-health apps and (b) testing in other high-risk populations.

Minimizing Collision Risk Between Migrating Raptors and Marine Wind Farms: Development of a Spatial Planning Tool

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Baisner, Anette Jægerfeldt; Andersen, Jonas Lembcke; Findsen, Anders; Yde Granath, Simon Wilhelm; Madsen, Karin Ølgaard; Desholm, Mark

2010-11-01

An increased focus on renewable energy has led to the planning and construction of marine wind farms in Europe. Since several terrestrial studies indicate that raptors are especially susceptible to wind turbine related mortality, a Spatial Planning Tool is needed so that wind farms can be sited, in an optimal way, to minimize risk of collisions. Here we use measurements of body mass, wingspan and wing area of eight European raptor species, to calculate their Best Glide Ratio (BGR). The BGR was used to construct a linear equation, which, by the use of initial take-off altitude, could be used to calculate a Theoretical Maximum Distance (TMD) from the coast, attained by these soaring-gliding raptor species. If the nearest turbine, of future marine wind farms, is placed farther away from the coast than the estimated TMD, the collision risk between the turbine blades and these gliding raptors will be minimized. The tool was demonstrated in a case study at the Rødsand II wind farm in Denmark. Data on raptor migration altitude were gathered by radar. From the TMD attained by registered soaring-gliding raptors in the area, we concluded that the Rødsand II wind farm is not sited ideally, from an ornithological point of view, as potentially all three registered species are at risk of gliding through the area swept by the turbine rotor blades, and thereby at risk of colliding with the wind turbines.

Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools

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Van Baalen, Mary; Mason, Sara S.; Taiym, Wafa; Wear, Mary L.; Moynihan, Shannan; Alexander, David; Hart, Steve; Tarver, William

2014-01-01

Prior to 2010, several ISS crewmembers returned from spaceflight with changes to their vision, ranging from a mild hyperopic shift to frank disc edema. As a result, NASA expanded clinical vision testing to include more comprehensive medical imaging, including Optical Coherence Tomography and 3 Tesla Brain and Orbit MRIs. The Space and Clinical Operations (SCO) Division developed a clinical practice guideline that classified individuals based on their symptoms and diagnoses to facilitate clinical care. For the purposes of clinical surveillance, this classification was applied retrospectively to all crewmembers who had sufficient testing for classification. This classification is also a tool that has been leveraged for researchers to identify potential risk factors. In March 2014, driven in part by a more comprehensive understanding of the imaging data and increased imaging capability on orbit, the SCO Division revised their clinical care guidance to outline in-flight care and increase post-flight follow up. The new clinical guidance does not include a classification scheme

Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID).

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Pourasghar, Faramarz; Tabrizi, Jafar Sadegh; Yarifard, Khadijeh

2016-04-01

Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients' medication orders. The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare.

Operational tools to build a multicriteria territorial risk scale with multiple stakeholders

International Nuclear Information System (INIS)

Cailloux, Olivier; Mayag, Brice; Meyer, Patrick; Mousseau, Vincent

2013-01-01

Evaluating and comparing the threats and vulnerabilities associated with territorial zones according to multiple criteria (industrial activity, population, etc.) can be a time-consuming task and often requires the participation of several stakeholders. Rather than a direct evaluation of these zones, building a risk assessment scale and using it in a formal procedure permits to automate the assessment and therefore to apply it in a repeated way and in large-scale contexts and, provided the chosen procedure and scale are accepted, to make it objective. One of the main difficulties of building such a formal evaluation procedure is to account for the multiple decision makers' preferences. The procedure used in this article, ELECTRE TRI, uses the performances of each territorial zone on multiple criteria, together with preferential parameters from multiple decision makers, to qualitatively assess their associated risk level. We also present operational tools in order to implement such a procedure in practice, and show their use on a detailed example

Use of a functional movement screening tool to determine injury risk in female collegiate athletes.

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Chorba, Rita S; Chorba, David J; Bouillon, Lucinda E; Overmyer, Corey A; Landis, James A

2010-06-01

Athletes often utilize compensatory movement strategies to achieve high performance. However, these inefficient movement strategies may reinforce poor biomechanical movement patterns during typical activities, resulting in injury. This study sought to determine if compensatory movement patterns predispose female collegiate athletes to injury, and if a functional movement screening (FMS™) tool can be used to predict injuries in this population. Scores on the FMS™, comprised of seven movement tests, were calculated for 38 NCAA Division II female collegiate athletes before the start of their respective fall and winter sport seasons (soccer, volleyball, and basketball). Seven athletes reported a previous history of anterior cruciate ligament reconstruction (ACLR). Injuries sustained while participating in sport activities were recorded throughout the seasons. The mean FMS™ score and standard deviation for all subjects was 14.3±1.77 (maximum score of 21). Eighteen injuries (17 lower extremity, 1 lower back) were recorded during this study. A score of 14/21 or less was significantly associated with injury (P=0.0496). Sixty-nine percent of athletes scoring 14 or less sustained an injury. Odds ratios were 3.85 with inclusion of all subjects, and 4.58 with exclusion of ACLR subjects. Sensitivity and specificity were 0.58 and 0.74 for all subjects, respectively. A significant correlation was found between low-scoring athletes and injury (P=0.0214, r=0.76). A score of 14 or less on the FMS™ tool resulted in a 4-fold increase in risk of lower extremity injury in female collegiate athletes participating in fall and winter sports. The screening tool was able to predict injury in female athletes without a history of major musculoskeletal injury such as ACLR. Compensatory fundamental movement patterns can increase the risk of injury in female collegiate athletes, and can be identified by using a functional movement screening tool.

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

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N.G. Vygovska

2017-12-01

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

The safety monitor and RCM workstation as complementary tools in risk based maintenance optimization

International Nuclear Information System (INIS)

Rawson, P.D.

2000-01-01

Reliability Centred Maintenance (RCM) represents a proven technique for rendering maintenance activities safer, more effective, and less expensive, in terms of systems unavailability and resource management. However, it is believed that RCM can be enhanced by the additional consideration of operational plant risk. This paper discusses how two computer-based tools, i.e., the RCM Workstation and the Safety Monitor, can complement each other in helping to create a living preventive maintenance strategy. (author)

Conceptual Aspects in the Modeling of Logistical Risk of the Networked Information Economy with the Use of Tools of Natural Computing

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Vitlinskyy Valdemar V.

2016-11-01

Full Text Available Information and communication tools and technologies are rapidly changing daily lives of people and business processes in economic activity primarily in the field of logistics. In particular, the innovative nature of these transformations leads to the emergence of new logistical risks, changing the essence of the existing ones, which needs to be taken into account in the management of logistics systems at various levels. Besides, the problem of Big Data has become increasingly urgent, which, on the one hand, can improve the validity of making managerial decisions, on the other hand — they (Big Data require modern tools for their production, processing and analysis. As such tools there can be used methods and models of natural computing. In the paper the basics of ant and bee algorithms, the particle swarm method, artificial immune systems are summarized; the possibilities of their application in the modeling of various types of logistical risk are demonstrated, the formalization of the problem of risk modeling with the use of an artificial immune system being given as a conditional example.

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

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Ling, Lisa

2014-01-01

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

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

Science.gov (United States)

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

2011-10-01

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

Poster - 30: Use of a Hazard-Risk Analysis for development of a new eye immobilization tool for treatment of choroidal melanoma

International Nuclear Information System (INIS)

Prooijen, Monique van; Breen, Stephen

2016-01-01

Purpose: Our treatment for choroidal melanoma utilizes the GTC frame. The patient looks at a small LED to stabilize target position. The LED is attached to a metal arm attached to the GTC frame. A camera on the arm allows therapists to monitor patient compliance. To move to mask-based immobilization we need a new LED/camera attachment mechanism. We used a Hazard-Risk Analysis (HRA) to guide the design of the new tool. Method: A pre-clinical model was built with input from therapy and machine shop personnel. It consisted of an aluminum frame placed in aluminum guide posts attached to the couch top. Further development was guided by the Department of Defense Standard Practice - System Safety hazard risk analysis technique. Results: An Orfit mask was selected because it allowed access to indexes on the couch top which assist with setup reproducibility. The first HRA table was created considering mechanical failure modes of the device. Discussions with operators and manufacturers identified other failure modes and solutions. HRA directed the design towards a safe clinical device. Conclusion: A new immobilization tool has been designed using hazard-risk analysis which resulted in an easier-to-use and safer tool compared to the initial design. The remaining risks are all low probability events and not dissimilar from those currently faced with the GTC setup. Given the gains in ease of use for therapists and patients as well as the lower costs for the hospital, we will implement this new tool.

Poster - 30: Use of a Hazard-Risk Analysis for development of a new eye immobilization tool for treatment of choroidal melanoma

Energy Technology Data Exchange (ETDEWEB)

Prooijen, Monique van; Breen, Stephen [Princess Margaret Cancer Centre, Princess Margaret Hospital-UHN (Canada)

2016-08-15

Purpose: Our treatment for choroidal melanoma utilizes the GTC frame. The patient looks at a small LED to stabilize target position. The LED is attached to a metal arm attached to the GTC frame. A camera on the arm allows therapists to monitor patient compliance. To move to mask-based immobilization we need a new LED/camera attachment mechanism. We used a Hazard-Risk Analysis (HRA) to guide the design of the new tool. Method: A pre-clinical model was built with input from therapy and machine shop personnel. It consisted of an aluminum frame placed in aluminum guide posts attached to the couch top. Further development was guided by the Department of Defense Standard Practice - System Safety hazard risk analysis technique. Results: An Orfit mask was selected because it allowed access to indexes on the couch top which assist with setup reproducibility. The first HRA table was created considering mechanical failure modes of the device. Discussions with operators and manufacturers identified other failure modes and solutions. HRA directed the design towards a safe clinical device. Conclusion: A new immobilization tool has been designed using hazard-risk analysis which resulted in an easier-to-use and safer tool compared to the initial design. The remaining risks are all low probability events and not dissimilar from those currently faced with the GTC setup. Given the gains in ease of use for therapists and patients as well as the lower costs for the hospital, we will implement this new tool.

An Interactive Risk Detection Tool to Aid Decision-Making in Global Mangrove Restoration

Science.gov (United States)

Goldberg, L.; Lagomasino, D.

2017-12-01

Mangrove ecosystems hold high ecological and economic value in coastal communities worldwide; detecting potential regions of mangrove stress is therefore critical to strategic planning of forest and coastal resources. In order to address the need for a unified risk management system for mangrove loss, a Risk Evaluation for MAngroves Portal (REMaP) was developed to identify the locations and causes of mangrove degradation worldwide, as well as project future areas of stress or loss. Long-term Earth observations from LANDSAT, MODIS, and TRMM were used in identifying regions with low, medium, and high vulnerability. Regions were categorized by vulnerability level based upon disturbance metrics in NDVI, land surface temperature, and precipitation using designated thresholds. Natural risks such as erosion and degradation were also evaluated through an analysis of NDVI time series trends from calendar year 1984 to 2017. Future trends in ecosystem vulnerability and resiliency were modeled using IPCC climate scenarios. Risk maps for anthropogenic-based disturbances such as urbanization and the expansion of agriculture and aquaculture through rice, rubber, shrimp, and oil palm farming were also included. The natural and anthropogenic risk factors evaluated were then aggregated to generate a cumulative estimate for total mangrove vulnerability in each region. This interactive modeling tool can aid decision-making on the regional, national, and international levels on an ongoing basis to continuously identify areas best suited for mangrove restoration measures, assisting governments and local communities in addressing a wide range of Sustainable Development Goals for coastal areas.

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

Science.gov (United States)

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

2011-01-01

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

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

Science.gov (United States)

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

2015-08-01

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

Quality assurance tool for organ at risk delineation in radiation therapy using a parametric statistical approach.

Science.gov (United States)

Hui, Cheukkai B; Nourzadeh, Hamidreza; Watkins, William T; Trifiletti, Daniel M; Alonso, Clayton E; Dutta, Sunil W; Siebers, Jeffrey V

2018-02-26

To develop a quality assurance (QA) tool that identifies inaccurate organ at risk (OAR) delineations. The QA tool computed volumetric features from prior OAR delineation data from 73 thoracic patients to construct a reference database. All volumetric features of the OAR delineation are computed in three-dimensional space. Volumetric features of a new OAR are compared with respect to those in the reference database to discern delineation outliers. A multicriteria outlier detection system warns users of specific delineation outliers based on combinations of deviant features. Fifteen independent experimental sets including automatic, propagated, and clinically approved manual delineation sets were used for verification. The verification OARs included manipulations to mimic common errors. Three experts reviewed the experimental sets to identify and classify errors, first without; and then 1 week after with the QA tool. In the cohort of manual delineations with manual manipulations, the QA tool detected 94% of the mimicked errors. Overall, it detected 37% of the minor and 85% of the major errors. The QA tool improved reviewer error detection sensitivity from 61% to 68% for minor errors (P = 0.17), and from 78% to 87% for major errors (P = 0.02). The QA tool assists users to detect potential delineation errors. QA tool integration into clinical procedures may reduce the frequency of inaccurate OAR delineation, and potentially improve safety and quality of radiation treatment planning. © 2018 American Association of Physicists in Medicine.

CONSIDERATIONS IN RISK COMMUNICATION: A DIGEST OF RISK COMMUNICATION AS A RISK MANAGEMENT TOOL

Science.gov (United States)

Risk communication is the process of informing people about hazards. Like all communication, communicating risk is a two-way exchange in which you inform the target community about possible hazards, but also gather information about those affected by the risk. The purpose of risk...

Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults

Science.gov (United States)

Aronow, Harriet Udin; Borenstein, Jeff; Haus, Flora; Braunstein, Glenn D.; Bolton, Linda Burnes

2014-01-01

Older patients are vulnerable to adverse hospital events related to frailty. SPICES, a common screening protocol to identify risk factors in older patients, alerts nurses to initiate care plans to reduce the probability of patient harm. However, there is little published validating the association between SPICES and measures of frailty and adverse outcomes. This paper used data from a prospective cohort study on frailty among 174 older adult inpatients to validate SPICES. Almost all patients met one or more SPICES criteria. The sum of SPICES was significantly correlated with age and other well-validated assessments for vulnerability, comorbid conditions, and depression. Individuals meeting two or more SPICES criteria had a risk of adverse hospital events three times greater than individuals with either no or one criterion. Results suggest that as a screening tool used within 24 hours of admission, SPICES is both valid and predictive of adverse events. PMID:24876954

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

International Nuclear Information System (INIS)

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

2011-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-05-15

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

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

Science.gov (United States)

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

2017-03-28

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

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

Science.gov (United States)

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

2012-01-01

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

Yield gap mapping as a support tool for risk management in agriculture

Science.gov (United States)

Lahlou, Ouiam; Imani, Yasmina; Slimani, Imane; Van Wart, Justin; Yang, Haishun

2016-04-01

The increasing frequency and magnitude of droughts in Morocco and the mounting losses from extended droughts in the agricultural sector emphasized the need to develop reliable and timely tools to manage drought and to mitigate resulting catastrophic damage. In 2011, Morocco launched a cereals multi-risk insurance with drought as the most threatening and the most frequent hazard in the country. However, and in order to assess the gap and to implement the more suitable compensation, it is essential to quantify the potential yield in each area. In collaboration with the University of Nebraska-Lincoln, a study is carried out in Morocco and aims to determine the yield potentials and the yield gaps in the different agro-climatic zones of the country. It fits into the large project: Global Yield Gap and Water Productivity Atlas: http://www.yieldgap.org/. The yield gap (Yg) is the magnitude and difference between crop yield potential (Yp) or water limited yield potential (Yw) and actual yields, reached by farmers. World Food Studies (WOFOST), which is a Crop simulation mechanistic model, has been used for this purpose. Prior to simulations, reliable information about actual yields, weather data, crop management data and soil data have been collected in 7 Moroccan buffer zones considered, each, within a circle of 100 km around a weather station point, homogenously spread across the country and where cereals are widely grown. The model calibration was also carried out using WOFOST default varieties data. The map-based results represent a robust tool, not only for drought insurance organization, but for agricultural and agricultural risk management. Moreover, accurate and geospatially granular estimates of Yg and Yw will allow to focus on regions with largest unexploited yield gaps and greatest potential to close them, and consequently to improve food security in the country.

STUDY ON IMPACT OF SALINE WATER INUNDATION ON FRESHWATER AQUACULTURE IN SUNDARBAN USING RISK ANALYSIS TOOLS

Directory of Open Access Journals (Sweden)

B.K Chand

2012-11-01

Full Text Available The impact of saline water inundation on freshwater aquaculture was evaluated through risk assessment tools. Fishponds in low-lying areas of Sagar and Basanti block are prone to saline water flooding. Respondents of Sagar block considered events like cyclone and coastal flooding as extreme risk; erratic monsoon, storm surge and land erosion as high risk; temperature rise, sea level rise, hot & extended summer and precipitation as medium risk. Likewise, in Basanti block the respondents rated cyclone as extreme risk; erratic monsoon, storm surge as high risk; temperature rise, hot & extended summer, land erosion, and precipitation as medium risk; coastal flooding and sea level rise as low risk. Fish farmers of Sagar block classified the consequences of saline water flooding like breach of pond embankment and mass mortality of fishes as extreme risk; escape of existing fish stock and diseases as high risk; entry of unwanted species, retardation of growth and deterioration of water quality as medium risk; and damage of pond environment as low risk. Farmers of Basanti block categorised breach of pond dyke, mass mortality of fishes and entry of unwanted species as extreme risk; escape of fish and diseases as high risk; retardation of growth as medium risk; deterioration of water quality and damage of pond environment as low risk. To reduce the threats against saline water ingression, farmers are taking some coping measures like increase in pond dyke height; repair and strengthening of dyke; plantation on dyke; dewatering and addition of fresh water; application of chemicals/ lime/ dung; addition of tree branches in pond for hide outs etc.

Visualization tools for insurance risk processes

OpenAIRE

Krzysztof Burnecki; Rafal Weron

2006-01-01

This chapter develops on risk processes which, perhaps, are most suitable for computer visualization of all insurance objects. At the same time, risk processes are basic instruments for any non-life actuary – they are vital for calculating the amount of loss that an insurance company may incur.

Development of funding project risk management tools.

Science.gov (United States)

2013-11-01

Funding project risk management is a process for identifying, assessing, and prioritizing project funding risks. To plan to : minimize or eliminate the impact of negative events, one must identify what projects have higher risk to respond to potentia...

The role of records management as a tool to identify risks in the public sector in South Africa

Directory of Open Access Journals (Sweden)

Mpho Ngoepe

2014-06-01

Objectives: The study utilised the King III report on corporate governance in South Africa as a framework to investigate the role of records management in identifying risks in the public sector, with a view to entrench the synergy between records management and risk management. Method: Quantitative data were collected through questionnaires distributed to records managers, risk managers and auditors in governmental bodies in South Africa. Provisions of the King III report, guided the research objectives. Results: Even though the study established that there is a reciprocal relationship between risk identification and records management, most governmental bodies in South Africa lack records management and risk-mitigating frameworks or strategy. Furthermore, records management did not feature in most governmental bodies’ risk registers. It has been established that most governmental bodies have established risk committees that do not include records management practitioners. In most governmental bodies, risk management resides within internal audit functions. Conclusion: The study concludes by arguing that a strong records management regime can be one of an organisation’s primary tools in identifying risks and implementing proper risk management. Therefore, records management should be integrated with risk management processes for organisations to benefit from the synergy.

Measurement of biofilm thickness. An effective Legionella risk assessment tool

Energy Technology Data Exchange (ETDEWEB)

Foret, Christophe [BKG France, Arnage (France); Martemianov, Serguei [Poitiers Univ. (FR). Lab. of Thermal Study (LET); Moscow Univ. (Russian Federation). Frumkin Inst. of Physical Chemistry and Electrochemistry; Hater, Wolfgang [BK Giulini GmbH, Duesseldorf (Germany); Merlet, Nicole; Chaussec, Guenole; Tribollet, Bernard

2010-02-15

The best way to prevent the risk of bacterial growth in water systems is to monitor and control the microorganisms (biofilm) attached to pipe walls. Three years of laboratory research led two Centre National de Recherche Scientifique (French National Center for Scientific Research) teams (UMR 6008 and UPR 15) to develop a tool designed to determine the average biofilm thickness. The average biofilm thickness measurements carried out on pilot plants fed with natural water were sufficiently accurate and sensitive to monitor the formation and development of biofilm in a water system and to determine the efficiency of the applied treatments. The implementation of appropriate treatments (type and dose of the treatment product) leads to a significant reduction in or even complete removal of the porous layer on the material surface. A reduction of the attached biomass, measured by the sensor, is connected to a decrease in the density of the bacterial attached to the material (viable flora in the plate count agar environment). (orig.)

US EPA Office of Research and Development Community-Focused Exposure and Risk Screening Tool (C-FERST) Air web mapping service

Data.gov (United States)

U.S. Environmental Protection Agency — This map service displays all air-related layers used in the USEPA Community/Tribal-Focused Exposure and Risk Screening Tool (C/T-FERST) mapping application...

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

International Nuclear Information System (INIS)

Bashamkova, I

2010-01-01

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

Development and validation of fall risk screening tools for use in residential aged care facilities.

Science.gov (United States)

Delbaere, Kim; Close, Jacqueline C T; Menz, Hylton B; Cumming, Robert G; Cameron, Ian D; Sambrook, Philip N; March, Lyn M; Lord, Stephen R

2008-08-18

To develop screening tools for predicting falls in nursing home and intermediate-care hostel residents who can and cannot stand unaided. Prospective cohort study in residential aged care facilities in northern Sydney, New South Wales, June 1999-June 2003. 2005 people aged 65-104 years (mean +/- SD, 85.7+/-7.1 years). Demographic, health, and physical function assessment measures; number of falls over a 6-month period; validity of the screening models. Ability to stand unaided was identified as a significant event modifier for falls. In people who could stand unaided, having either poor balance or two of three other risk factors (previous falls, nursing home residence, and urinary incontinence) increased the risk of falling in the next 6 months threefold (sensitivity, 73%; specificity, 55%). In people who could not stand unaided, having any one of three risk factors (previous falls, hostel residence, and using nine or more medications) increased the risk of falling twofold (sensitivity, 87%; specificity, 29%). These two screening models are useful for identifying older people living in residential aged care facilities who are at increased risk of falls. The screens are easy to administer and contain items that are routinely collected in residential aged care facilities in Australia.

Work Ability Index as tool to identify workers at risk of premature work exit.

Science.gov (United States)

Roelen, Corné A M; Heymans, Martijn W; Twisk, Jos W R; van der Klink, Jac J L; Groothoff, Johan W; van Rhenen, Willem

2014-12-01

To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at baseline and reported their work status (employed, unemployed, disability pension, or retired) after mean 2.3 years of follow-up. Associations between WAI scores and work status were investigated by multinomial logistic regression analysis. The ability of the WAI to discriminate between workers at high and low risk of premature work exit was analyzed by the area (AUC) under the receiver operating characteristic curve. 9,530 (83 %) construction workers had complete data for analysis. At follow-up, 336 (4 %) workers reported disability pension, 125 (1 %) unemployment, and 255 (3 %) retirement. WAI scores were prospectively associated with the risk of disability pension at follow-up, but not with the risk of unemployment and early retirement. The WAI showed fair discrimination to identify workers at risk of disability pension [AUC = 0.74; 95 % confidence interval (CI) 0.70-0.77]. The discriminative ability decreased with age from AUC = 0.78 in workers aged 30-39 years to AUC = 0.69 in workers ≥50 years of age. Discrimination failed for unemployment (AUC = 0.51; 95 % CI 0.47-0.55) and early retirement (AUC = 0.58; 95 % CI 0.53-0.61). The WAI can be used to identify construction workers <50 years of age at increased risk of disability pension and invite them for preventive interventions.

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

Science.gov (United States)

Higgs, Stephanie; McMullan, Caroline

2016-04-01

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

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

Science.gov (United States)

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

2016-02-01

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

Integrated Monitoring and Modeling of Carbon Dioxide Leakage Risk Using Remote Sensing, Ground-Based Monitoring, Atmospheric Models and Risk-Indexing Tools

Science.gov (United States)

Burton, E. A.; Pickles, W. L.; Gouveia, F. J.; Bogen, K. T.; Rau, G. H.; Friedmann, J.

2006-12-01

estimating its associated risk, spatially and temporally. This requires integration of subsurface, surface and atmospheric data and models. To date, we have developed techniques to map risk based on predicted atmospheric plumes and GIS/MT (meteorologic- topographic) risk-indexing tools. This methodology was derived from study of large CO2 releases from an abandoned well penetrating a natural CO2 reservoir at Crystal Geyser, Utah. This integrated approach will provide a powerful tool to screen for high-risk zones at proposed sequestration sites, to design and optimize surface networks for site monitoring and/or to guide setting science-based regulatory compliance requirements for monitoring sequestration sites, as well as to target critical areas for first responders should a catastrophic-release event occur. This work was performed under the auspices of the U.S. Dept. of Energy by University of California, Lawrence Livermore National Laboratory under Contract W-7405-Eng-48.

A European Commission software tool for radon risk calculation and evaluation of countermeasures

Energy Technology Data Exchange (ETDEWEB)

Degrange, J.P.; Levy, F.P. [CEPN, Fontenay-aux-Roses Cedex (France); Birchall, A.; Haylock, R.; Marsh, J.; Muirhead, C. [National Radiological Protection Board, Chilton (United Kingdom); Janssens, A. [European Commission, DG XI (Luxembourg)

2000-05-01

through the successive use of a dosimetric model (NRPB, 1998) and a somatic effects model (BEIR V, 1990) based on the follow-up of lung cancers in Hiroshima and Nagasaki population. In both cases, the modifying effect of tobacco consumption on the risk is adjusted for. The principal risk indicators calculated by the software are the whole life mortality risk and loss of life expectancy. Additionally, all the intermediate results are available. A system of monetary value of human life allows also to identify the most cost-effective countermeasure. This software could play a role in general training, the provision of information to the public and in investigating the effect on risk of different dose reduction strategies. Finally, its sensitivity analysis capabilities and its database system together with its user friendly configuration capabilities should make it an easy to use tool for the risk evaluation experts of various countries to perform useful calculations, appropriate to their situations with regard to local radon and smoking patterns. (author)

A European Commission software tool for radon risk calculation and evaluation of countermeasures

International Nuclear Information System (INIS)

Degrange, J.P.; Levy, F.P.; Birchall, A.; Haylock, R.; Marsh, J.; Muirhead, C.; Janssens, A.

2000-01-01

through the successive use of a dosimetric model (NRPB, 1998) and a somatic effects model (BEIR V, 1990) based on the follow-up of lung cancers in Hiroshima and Nagasaki population. In both cases, the modifying effect of tobacco consumption on the risk is adjusted for. The principal risk indicators calculated by the software are the whole life mortality risk and loss of life expectancy. Additionally, all the intermediate results are available. A system of monetary value of human life allows also to identify the most cost-effective countermeasure. This software could play a role in general training, the provision of information to the public and in investigating the effect on risk of different dose reduction strategies. Finally, its sensitivity analysis capabilities and its database system together with its user friendly configuration capabilities should make it an easy to use tool for the risk evaluation experts of various countries to perform useful calculations, appropriate to their situations with regard to local radon and smoking patterns. (author)

Proceedings of the Atlantic climate change 2008 conference : risk, responses and tools for action

International Nuclear Information System (INIS)

2008-01-01

This conference provided a forum for members of the private and public sector, as well as researchers and industry leaders to discuss methods of preventing and adapting to climate change in the Maritime provinces. Presentations at the conference evaluated a range of options, opportunities, and potential outcomes from strategies for reducing environmental impacts and improving energy efficiency in the region. Topics discussed at the conference included adaptation tools; carbon markets; resource management; corporate and public policy; and risk assessment and decision-making processes. The conference was divided into the following 5 sessions: (1) land use planning and adaptation, (2) fish, farms and forests, (3) climate science and modelling, (4) energy policy for mitigation and sustainability, and (5) tools for adaptation and infrastructure. A workshop discussing the use of LIDAR in decision-making processes was also held. The conference featured 11 presentations, of which 3 have been catalogued separately for inclusion in this database. tabs., figs.

"Best Case/Worst Case": Training Surgeons to Use a Novel Communication Tool for High-Risk Acute Surgical Problems.

Science.gov (United States)

Kruser, Jacqueline M; Taylor, Lauren J; Campbell, Toby C; Zelenski, Amy; Johnson, Sara K; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Kwekkeboom, Kris L; Schwarze, Margaret L

2017-04-01

Older adults often have surgery in the months preceding death, which can initiate postoperative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. The objective of this study was to evaluate a structured training program designed to teach surgeons how to use BC/WC. Twenty-five surgeons from one tertiary care hospital completed a two-hour training session followed by individual coaching. We audio-recorded surgeons using BC/WC with standardized patients and 20 hospitalized patients. Hospitalized patients and their families participated in an open-ended interview 30 to 120 days after enrollment. We used a checklist of 11 BC/WC elements to measure tool fidelity and surgeons completed the Practitioner Opinion Survey to measure acceptability of the tool. We used qualitative analysis to evaluate variability in tool content and to characterize patient and family perceptions of the tool. Surgeons completed a median of 10 of 11 BC/WC elements with both standardized and hospitalized patients (range 5-11). We found moderate variability in presentation of treatment options and description of outcomes. Three months after training, 79% of surgeons reported BC/WC is better than their usual approach and 71% endorsed active use of BC/WC in clinical practice. Patients and families found that BC/WC established expectations, provided clarity, and facilitated deliberation. Surgeons can learn to use BC/WC with older patients considering acute high-risk surgical interventions. Surgeons, patients, and family members endorse BC/WC as a strategy to support complex decision making. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

Directory of Open Access Journals (Sweden)

Vanoh D

2016-05-01

Full Text Available Divya Vanoh,1 Suzana Shahar,1 Razali Rosdinom,2 Normah Che Din,3 Hanis Mastura Yahya,4 Azahadi Omar5 1Dietetic Programme, Centre of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2Department of Psychiatry, University Kebangsaan Medical Centre, Kuala Lumpur, Malaysia; 3Health Psychology Programme, 4Nutrition Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 5Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia Background and aim: Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS. Methodology: A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC, sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic

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.

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

Science.gov (United States)

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

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Cyrille P Launay

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

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

Science.gov (United States)

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

2015-01-01

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

Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

Science.gov (United States)

Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

2013-04-01

The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

Mechanisms, Prediction, and Prevention of ACL Injuries: Cut Risk With Three Sharpened and Validated Tools

Science.gov (United States)

Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.

2017-01-01

Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195

The KnowRISK project: Tools and strategies to reduce non-structural damage

Science.gov (United States)

Sousa Oliveira, Carlos; Lopes, Mário; Mota de Sá, Francisco; Amaral Ferreia, Mónica; Candeias, Paulo; Campos Costa, Alfredo; Rupakhety, Rajesh; Meroni, Fabrizio; Azzaro, Raffaele; D'Amico, Salvatore; Langer, Horst; Musacchio, Gemma; Sousa Silva, Delta; Falsaperla, Susanna; Scarfì, Luciano; Tusa, Giuseppina; Tuvé, Tiziana

2016-04-01

The project KnowRISK (Know your city, Reduce seISmic risK through non-structural elements) is financed by the European Commission to develop prevention measures that may reduce non-structural damage in urban areas. Pilot areas of the project are within the three European participating countries, namely Portugal, Iceland and Italy. Non-structural components of a building include all those components that are not part of the structural system, more specifically the architectural, mechanical, electrical, and plumbing systems, as well as furniture, fixtures, equipment, and contents. Windows, partitions, granite veneer, piping, ceilings, air conditioning ducts and equipment, elevators, computer and hospital equipment, file cabinets, and retail merchandise are all examples of non-structural components that are vulnerable to earthquake damage. We will use the experience gained during past earthquakes, which struck in particular Iceland, Italy and Portugal (Azores). Securing the non-structural elements improves the safety during an earthquake and saves lives. This paper aims at identifying non-structural seismic protection measures in the pilot areas and to develop a portfolio of good practices for the most common and serious non-structural vulnerabilities. This systematic identification and the portfolio will be achieved through a "cross-knowledge" strategy based on previous researches, evidence of non-structural damage in past earthquakes. Shake table tests of a group of non-structural elements will be performed. These tests will be filmed and, jointly with portfolio, will serve as didactic supporting tools to be used in workshops with building construction stakeholders and in risk communication activities. A Practical Guide for non-structural risk reduction will be specifically prepared for citizens on the basis of the outputs of the project, taking into account the local culture and needs of each participating country.

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

Science.gov (United States)

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

2013-08-01

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

Engineering and Ingenuity, Tools and Technologies (1)

DEFF Research Database (Denmark)

Jensen, Jørgen Juncher; Ravn, Erik Sonne; Guarin, Luis

2007-01-01

Risk-based ship design demands advanced tools to predict the safety performance of a given design. Such tools have been developed or refined in the SAFEDOR project covering • Fast and accurate flooding prediction • Probabilistic assessment of the strength of ship structures • Probabilistic...... assessment of intact stability • Prevention of collision and grounding events • Prevention of fire and explosion events Various procedures have been used to derive the tools: Bayesian network, artificial neural networks, CFD calculations, non-linear time domain calculations and reliability models...... with tools for fast and reliable evaluation of various risks associated with failure of the ship or its subsystems and able to evaluate the effect of various risk-control options. Examples will be given within prevention of collision, grounding and fire events....

A two-question tool to assess the risk of repeated falls in the elderly.

Directory of Open Access Journals (Sweden)

Alejandro Rodríguez-Molinero

Full Text Available Older adults' perception of their own risk of fall has never been included into screening tools. The goal of this study was to evaluate the predictive validity of questions on subjects' self-perception of their own risk of fall.This prospective study was conducted on a probabilistic sample of 772 Spanish community-dwelling older adults, who were followed-up for a one year period. At a baseline visit, subjects were asked about their recent history of falls (question 1: "Have you fallen in the last 6 months?", as well as on their perception of their own risk of fall by using two questions (question 2: "Do you think you may fall in the next few months?" possible answers: yes/no; question 3: "What is the probability that you fall in the next few months?" possible answers: low/intermediate/high. The follow-up consisted of quarterly telephone calls, where the number of falls occurred in that period was recorded.A short questionnaire built with questions 1 and 3 showed 70% sensitivity (95% CI: 56%-84%, 72% specificity (95% CI: 68%-76% and 0.74 area under the ROC curve (95% CI: 0.66-0.82 for prediction of repeated falls in the subsequent year.The estimation of one's own risk of fall has predictive validity for the occurrence of repeated falls in older adults. A short questionnaire including a question on perception of one's own risk of fall and a question on the recent history of falls had good predictive validity.

A two-question tool to assess the risk of repeated falls in the elderly.

Science.gov (United States)

Rodríguez-Molinero, Alejandro; Gálvez-Barrón, César; Narvaiza, Leire; Miñarro, Antonio; Ruiz, Jorge; Valldosera, Esther; Gonzalo, Natalia; Ng, Thalia; Sanguino, María Jesús; Yuste, Antonio

2017-01-01

Older adults' perception of their own risk of fall has never been included into screening tools. The goal of this study was to evaluate the predictive validity of questions on subjects' self-perception of their own risk of fall. This prospective study was conducted on a probabilistic sample of 772 Spanish community-dwelling older adults, who were followed-up for a one year period. At a baseline visit, subjects were asked about their recent history of falls (question 1: "Have you fallen in the last 6 months?"), as well as on their perception of their own risk of fall by using two questions (question 2: "Do you think you may fall in the next few months?" possible answers: yes/no; question 3: "What is the probability that you fall in the next few months?" possible answers: low/intermediate/high). The follow-up consisted of quarterly telephone calls, where the number of falls occurred in that period was recorded. A short questionnaire built with questions 1 and 3 showed 70% sensitivity (95% CI: 56%-84%), 72% specificity (95% CI: 68%-76%) and 0.74 area under the ROC curve (95% CI: 0.66-0.82) for prediction of repeated falls in the subsequent year. The estimation of one's own risk of fall has predictive validity for the occurrence of repeated falls in older adults. A short questionnaire including a question on perception of one's own risk of fall and a question on the recent history of falls had good predictive validity.

Equivalence Testing as a Tool for Fatigue Risk Management in Aviation.

Science.gov (United States)

Wu, Lora J; Gander, Philippa H; van den Berg, Margo; Signal, T Leigh

2018-04-01

Many civilian aviation regulators favor evidence-based strategies that go beyond hours-of-service approaches for managing fatigue risk. Several countries now allow operations to be flown outside of flight and duty hour limitations, provided airlines demonstrate an alternative method of compliance that yields safety levels "at least equivalent to" the prescriptive regulations. Here we discuss equivalence testing in occupational fatigue risk management. We present suggested ratios/margins of practical equivalence when comparing operations inside and outside of prescriptive regulations for two common aviation safety performance indicators: total in-flight sleep duration and psychomotor vigilance task reaction speed. Suggested levels of practical equivalence, based on expertise coupled with evidence from field and laboratory studies, are ≤ 30 min in-flight sleep and ± 15% of reference response speed. Equivalence testing is illustrated in analyses of a within-subjects field study during an out-and-back long-range trip. During both sectors of their trip, 41 pilots were monitored via actigraphy, sleep diary, and top of descent psychomotor vigilance task. Pilots were assigned to take rest breaks in a standard lie-flat bunk on one sector and in a bunk tapered 9 from hip to foot on the other sector. Total in-flight sleep duration (134 ± 53 vs. 135 ± 55 min) and mean reaction speed at top of descent (3.94 ± 0.58 vs. 3.77 ± 0.58) were equivalent after rest in the full vs. tapered bunk. Equivalence testing is a complimentary statistical approach to difference testing when comparing levels of fatigue and performance in occupational settings and can be applied in transportation policy decision making.Wu LJ, Gander PH, van den Berg M, Signal TL. Equivalence testing as a tool for fatigue risk management in aviation. Aerosp Med Hum Perform. 2018; 89(4):383-388.

Risk factors for neurocognitive impairment in HIV-infected patients and comparison of different screening tools

Directory of Open Access Journals (Sweden)

Elisa Moreira de Souza

Full Text Available HIV-associated neurocognitive disorder (HAND is relatively frequent among HIV-infected patients and is often underdiagnosed. Assessment of HAND in daily clinical practice is challenging and different tools have been proposed. Objective : To evaluate risk factors and compare different screening tools for neurocognitive impairment in HIV-infected patients. Methods : HIV-infected patients were evaluated using the International HIV-Dementia Scale (IHDS, Mini-Mental State Examination (MMSE and a neurocognitive self-perception questionnaire recommended by the European AIDS Clinical Society. Sociodemographic, clinical and laboratory data were obtained through chart review and patient interview. Results : Among the 63 patients included, low performance on the IHDS was observed in 54.0% and IHDS score was inversely associated with age (OR 0.13; 95%CI [0.02-0.67]. Regarding cognitive self-perception, 63.5% of patients reported no impairment on the three domains covered by the questionnaire. Among those patients self-reporting no problems, 42.1% had low performance on the IHDS. None of the patients scored below the education-adjusted cut-off on the MMSE. Conclusion : IHDS scores suggestive of HAND were observed in more than half of the patients and lower scores were found among older patients. There was low agreement between the different tools, suggesting that the MMSE may be inadequate for assessing HAND. The self-assessment questionnaire had low sensitivity and might not be useful as a screening tool.

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

Science.gov (United States)

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

2017-03-01

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

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

Science.gov (United States)

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

2013-01-01

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

Occupational health management: an audit tool.

Science.gov (United States)

Shelmerdine, L; Williams, N

2003-03-01

Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

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

Energy Technology Data Exchange (ETDEWEB)

Dan Kieki

2008-09-30

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

Go Play Outside! Effects of a risk-reframing tool on mothers' tolerance for, and parenting practices associated with, children's risky play: study protocol for a randomized controlled trial.

Science.gov (United States)

Brussoni, Mariana; Ishikawa, Takuro; Han, Christina; Pike, Ian; Bundy, Anita; Faulkner, Guy; Mâsse, Louise C

2018-03-07

Children's risky play is associated with a variety of positive developmental, physical and mental health outcomes, including greater physical activity, self-confidence and risk-management skills. Children's opportunities for risky play have eroded over time, limited by parents' fears and beliefs about risk, particularly among mothers. We developed a digital tool and in-person Risk-reframing (RR) workshop to reframe parents' perceptions of risk and change parenting behaviours. The purpose of this paper is to describe our RR intervention, rationale and protocol for a randomised controlled trial to examine whether it leads to increases in mothers' tolerance of risk in play and goal attainment relating to promoting their child's opportunities for risky play. We use a randomised controlled trial design and will recruit a total of 501 mothers of children aged 6-12 years. The RR digital tool is designed for a one-time visit and includes three chapters of self-reflection and experiential learning tasks. The RR in-person tool is a 2-h facilitated workshop in which participants are guided through discussion of the same tasks contained within the digital tool. The control condition consists of reading the Position Statement on Active Outdoor Play. Primary outcome is increased tolerance of risk in play, as measured by the Tolerance of Risk in Play Scale. Secondary outcome is self-reported attainment of a behaviour-change goal that participants set for themselves. We will test the hypothesis that there will be differences between the experimental and control conditions with respect to tolerance of risk in play using mixed-effects models. We will test the hypothesis that there will be differences between the experimental and control conditions with respect to goal attainment using logistic regression. The results of this trial will have important implications for facilitating the widespread change in parents' risk perception that is necessary for promoting broad societal

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

Science.gov (United States)

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

2012-08-15

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

How well does the Post-fire Erosion Risk Management Tool (ERMiT) really work?

Science.gov (United States)

Robichaud, Peter; Elliot, William; Lewis, Sarah; Miller, Mary Ellen

2016-04-01

The decision of where, when, and how to apply the most effective postfire erosion mitigation treatments requires land managers to assess the risk of damaging runoff and erosion events occurring after a fire. The Erosion Risk Management Tool (ERMiT) was developed to assist post fire assessment teams identify high erosion risk areas and effectiveness of various mitigation treatments to reduce that risk. ERMiT is a web-based application that uses the Water Erosion Prediction Project (WEPP) technology to estimate erosion, in probabilistic terms, on burned and recovering forest, range, and chaparral lands with and without the application of mitigation treatments. User inputs are processed by ERMiT to combine rain event variability with spatial and temporal variabilities of hillslope burn severity and soil properties which are then used as WEPP inputs. Since 2007, the model has been used in making hundreds of land management decisions in the US and elsewhere. We use eight published field study sites in the Western US to compare ERMiT predictions to observed hillslope erosion rates. Most sites experience only a few rainfall events that produced runoff and sediment except for a California site with a Mediterranean climate. When hillslope erosion occurred, significant correlations occurred between the observed hillslope erosion and those predicted by ERMiT. Significant correlation occurred for most mitigation treatments as well as the five recovery years. These model validation results suggest reasonable estimates of probabilistic post-fire hillslope sediment delivery when compared to observation.

iTunes song-gifting is a low-cost, efficient recruitment tool to engage high-risk MSM in internet research.

Science.gov (United States)

Holland, Christine M; Ritchie, Natalie D; Du Bois, Steve N

2015-10-01

This brief report describes methodology and results of a novel, efficient, and low-cost recruitment tool to engage high-risk MSM in online research. We developed an incentivization protocol using iTunes song-gifting to encourage participation of high-risk MSM in an Internet-based survey of HIV status, childhood sexual abuse, and adult behavior and functioning. Our recruitment methodology yielded 489 participants in 4.5 months at a total incentive cost of $1.43USD per participant. The sample comprised a critically high-risk group of MSM, including 71.0 % who reported recent condomless anal intercourse. We offer a "how-to" guide to aid future investigators in using iTunes song-gifting incentives.

The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

Science.gov (United States)

Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

2012-01-01

In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

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

Science.gov (United States)

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

2015-01-01

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

Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).

Science.gov (United States)

Htun, N C; Ishikawa-Takata, K; Kuroda, A; Tanaka, T; Kikutani, T; Obuchi, S P; Hirano, H; Iijima, K

2016-02-01

Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations. This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II. The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people. Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST). These results indicate that the NRST is a

Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain

Directory of Open Access Journals (Sweden)

Solà Sílvia

2011-01-01

Full Text Available Abstract Background Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age. Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years. Methods/Design To assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site. Discussion Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to

DEBRISK, a Tool for Re-Entry Risk Analysis

Science.gov (United States)

Omaly, P.; Spel, M.

2012-01-01

An act of French parliament, adopted in 2008, imposes satellite constructors to evaluate the end-of-life operations in order to assure the risk mitigation of their satellites. One important element in this evaluation is the estimation of the mass and impact energy of the satellite debris after atmospheric re-entry. For this purpose, CNES has developed the tool DEBRISK which allows the operator to simulate the re-entry phase and to study the demise altitudes or impact energy of the individual fragments of the original satellite. DEBRISK is based on the so called object based approach. Using this approach, a breakup altitude is assumed where the satellite disintegrates due to the pressure loads. This altitude is typically around 78 km. After breakup, the satellite structure is modelled by a parent-child approach, where each child has its birth criterion. In the simplest approach the child is born after demise of the parent object. This could be the case of an object A containing an object B which is in the interior of object A and thus not exposed to the atmosphere. Each object is defined by: - its shape, attitude and dimensions, - the material along with their physical properties - the state and velocity vectors. The shape, attitude and dimensions define the aerodynamic drag of the object which is input to the 3DOF trajectory modelling. The aerodynamic mass used in the equation of motion is defined as the sum of the object's own mass and the mass of the object's offspring. A new born object inherits the state vector of the parent object. The shape, attitude and dimensions also define the heating rates experienced by the object. The heating rate is integrated in time up to the point where the melting temperature is reached. The mass of melted material is computed from the excess heat and the material properties. After each step the amount of ablated material is determined using the lumped mass approach and is peeled off from the object, updating mass and shape of the

US EPA Office of Research and Development Community-Focused Exposure and Risk Screening Tool (C-FERST) Air Pollutants 2011 web mapping service

Data.gov (United States)

U.S. Environmental Protection Agency — This map service displays all air-related layers used in the USEPA Community/Tribal-Focused Exposure and Risk Screening Tool (C/T-FERST) mapping application...

Taking the Risk Out of Risk Assessment

Science.gov (United States)

2005-01-01

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

Climate Risk Management and Decision Support Tools for the Agriculture Sector in Lao PDR, Bangladesh, and Indonesia

Science.gov (United States)

Allis, E. C.; Greene, A. M.; Cousin, R.

2014-12-01

We describe a comprehensive project for developing climate information and decision support / climate risk management tools in Lao PDR, Bangladesh and Indonesia. Mechanisms are developed for bringing the benefits of these tools to both policy makers and poor rural farmers, with the goal of enabling better management, at the farm level, of the risks associated with climate variability and change. The project comprises several interwoven threads, differentially applied in the different study regions. These include data management and quality control, development of seasonal forecast capabilities, use of dynamic cropping calendars and climate advisories, the development of longer-term climate information for both past and future and a weather index insurance component. Stakeholder engagement and capacity building served as reinforcing and complementary elements to all components. In this talk we will provide a project overview, show how the various components fit together and describe some lessons learned in this attempt to promote the uptake of actionable climate information from farmer to policy level. The applied research project was led by the International Research Institute for Climate and Society (IRI) at Columbia University with funding from the International Fund for Agriculture Development (IFAD) and in close collaboration with our regional partners at the Centre for Climate Risk and Opportunity Management in Southeast Asia Pacific (at Bogor Agricultural University in Indonesia), Indonesia's National Agency for Meteorology, Climatology and Geophysics (BMKG), Lao PDR's National Agriculture and Forestry Research Institute (NAFRI), Laotian Department of Meteorology and Hydrology (DMH), WorldFish Center, Bangladesh Meteorology Department (BMD), and CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS).

ORGANIZATIONAL RISK COMMUNICATION

Science.gov (United States)

Ris communication tools in organizations differs in several ways from many of tools and techniques developed for public meetings. The traditional view of risk communication seeks to manage the public outrage ssociated with site-based issues. Organizational risk communication seek...

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

Science.gov (United States)

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

2016-12-01

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

The Environmental Virtual Observatory (EVO) local exemplar: A cloud based local landscape learning visualisation tool for communicating flood risk to catchment stakeholders

Science.gov (United States)

Wilkinson, Mark; Beven, Keith; Brewer, Paul; El-khatib, Yehia; Gemmell, Alastair; Haygarth, Phil; Mackay, Ellie; Macklin, Mark; Marshall, Keith; Quinn, Paul; Stutter, Marc; Thomas, Nicola; Vitolo, Claudia

2013-04-01

Today's world is dominated by a wide range of informatics tools that are readily available to a wide range of stakeholders. There is growing recognition that the appropriate involvement of local communities in land and water management decisions can result in multiple environmental, economic and social benefits. Therefore, local stakeholder groups are increasingly being asked to participate in decision making alongside policy makers, government agencies and scientists. As such, addressing flooding issues requires new ways of engaging with the catchment and its inhabitants at a local level. To support this, new tools and approaches are required. The growth of cloud based technologies offers new novel ways to facilitate this process of exchange of information in earth sciences. The Environmental Virtual Observatory Pilot project (EVOp) is a new initiative from the UK Natural Environment Research Council (NERC) designed to deliver proof of concept for new tools and approaches to support the challenges as outlined above (http://www.evo-uk.org/). The long term vision of the Environmental Virtual Observatory is to: • Make environmental data more visible and accessible to a wide range of potential users including public good applications; • Provide tools to facilitate the integrated analysis of data, greater access to added knowledge and expert analysis and visualisation of the results; • Develop new, added-value knowledge from public and private sector data assets to help tackle environmental challenges. As part of the EVO pilot, an interactive cloud based tool has been developed with local stakeholders. The Local Landscape Visualisation Tool attempts to communicate flood risk in local impacted communities. The tool has been developed iteratively to reflect the needs, interests and capabilities of a wide range of stakeholders. This tool (assessable via a web portal) combines numerous cloud based tools and services, local catchment datasets, hydrological models and

Construct validity of the Heart Failure Screening Tool (Heart-FaST) to identify heart failure patients at risk of poor self-care: Rasch analysis.

Science.gov (United States)

Reynolds, Nicholas A; Ski, Chantal F; McEvedy, Samantha M; Thompson, David R; Cameron, Jan

2018-02-14

The aim of this study was to psychometrically evaluate the Heart Failure Screening Tool (Heart-FaST) via: (1) examination of internal construct validity; (2) testing of scale function in accordance with design; and (3) recommendation for change/s, if items are not well adjusted, to improve psychometric credential. Self-care is vital to the management of heart failure. The Heart-FaST may provide a prospective assessment of risk, regarding the likelihood that patients with heart failure will engage in self-care. Psychometric validation of the Heart-FaST using Rasch analysis. The Heart-FaST was administered to 135 patients (median age = 68, IQR = 59-78 years; 105 males) enrolled in a multidisciplinary heart failure management program. The Heart-FaST is a nurse-administered tool for screening patients with HF at risk of poor self-care. A Rasch analysis of responses was conducted which tested data against Rasch model expectations, including whether items serve as unbiased, non-redundant indicators of risk and measure a single construct and that rating scales operate as intended. The results showed that data met Rasch model expectations after rescoring or deleting items due to poor discrimination, disordered thresholds, differential item functioning, or response dependence. There was no evidence of multidimensionality which supports the use of total scores from Heart-FaST as indicators of risk. Aggregate scores from this modified screening tool rank heart failure patients according to their "risk of poor self-care" demonstrating that the Heart-FaST items constitute a meaningful scale to identify heart failure patients at risk of poor engagement in heart failure self-care. © 2018 John Wiley & Sons Ltd.

NGNP Risk Management Database: A Model for Managing Risk

International Nuclear Information System (INIS)

Collins, John

2009-01-01

To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft(reg s ign) Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool's design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

Safe motherhood : severe acute maternal morbidity: risk factors in the Netherlands and validation of the WHO Maternal Near Miss tool

NARCIS (Netherlands)

Witteveen, T.

2016-01-01

Using the results from a two-year nationwide prospective study, this thesis shows numerous (risk) factors associated with severe acute maternal morbidity (SAMM) in the Netherlands and validates the WHO Maternal Near Miss (MNM) tool to detect and monitor SAMM worldwide. The ratio behind the different

The validity of three fall risk screening tools in an acute geriatric inpatient population.

Science.gov (United States)

Latt, Mark Dominic; Loh, K Florence; Ge, Ludi; Hepworth, Annie

2016-09-01

We examined the validity of the Ontario Modified STRATIFY (OM) (St Thomas's Risk Assessment Tool in Falling Elderly Inpatients), The Northern Hospital Modified STRATIFY (TNH) and STRATIFY in predicting falls in an acute aged care unit. Data were collected prospectively from 217 people presenting consecutively and falls identified during hospitalisation. Sensitivities of OM (80.0, 95% confidence interval (CI) 58.4 to 91.9%), TNH (85, CI 64.0 to 94.8%) and STRATIFY (80.0, CI 58.4 to 91.0%) were similar. The STRATIFY had higher specificity (61.4, CI 54.5 to 67.9%) than OM (37.1, CI 30.6 to 44.0%) and TNH (51.3, CI 44.3 to 58.2%). Accuracy (percentage of patients correctly classified as 'faller' or 'non-faller') was higher using STRATIFY (63.1, CI 56.5 to 69.3%) and TNH (54.4, CI 47.8 to 61.0%) than with OM (41.0, CI 34.7 to 47.7%, P patients at high risk of falls. © 2016 AJA Inc.

How can we use the radioecological sensitivity concept as a tool for risk management?

International Nuclear Information System (INIS)

Mercat-Rommens, C.; Renaud, P.

2004-01-01

The consequences for the man and the environment of the discharges of nuclear facilities depend on the importance and the nature of the discharges, but also on the environment which receives them. Thus, the impact of a pollution, which is expressed in term of toxicity, risk or economic consequences, varies according to the characteristics of the environment and the use of this environment by the man. The radioecological sensitivity can be defined as the response of the environment to a radioactive pollution. For a determined discharge, the higher is the response, the more sensitive is the environment. If all the ecosystems appear sensitive, their sensitivity does not concern the same criteria and it is currently difficult to compare these criteria between them. The idea of the SENSIB project is to create a standardized tool which makes it possible to represent and to compare with the same scale the sensitivity of various ecosystems. The SENSIB project aims to develop both a methodology to calculate sensitivity indexes and a radioecological sensitivity scale usable for risk management. (orig.)

Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S Primary Care Setting.

Science.gov (United States)

Suri, Pradeep; Delaney, Kristin; Rundell, Sean D; Cherkin, Daniel C

2018-04-03

To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care. Secondary analysis of data from participants receiving usual care in a randomized clinical trial. Primary care clinics. Adults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included. Not applicable. The original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up. The STarT Back risk group was a significant predictor of persistent disabling back pain (PSTarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States. Published by Elsevier Inc.

A semi-quantitative model for risk appreciation and risk weighing

DEFF Research Database (Denmark)

Bos, Peter M.J.; Boon, Polly E.; van der Voet, Hilko

2009-01-01

Risk managers need detailed information on (1) the type of effect, (2) the size (severity) of the expected effect(s) and (3) the fraction of the population at risk to decide on well-balanced risk reduction measures. A previously developed integrated probabilistic risk assessment (IPRA) model...... provides quantitative information on these three parameters. A semi-quantitative tool is presented that combines information on these parameters into easy-readable charts that will facilitate risk evaluations of exposure situations and decisions on risk reduction measures. This tool is based on a concept...... detailed information on the estimated health impact in a given exposure situation. These graphs will facilitate the discussions on appropriate risk reduction measures to be taken....

Smoking cessation: the potential role of risk assessment tools as motivational triggers.

Science.gov (United States)

Young, Robert P; Hopkins, Raewyn J; Smith, Melinda; Hogarth, D Kyle

2010-01-01

Smoking is the most important and preventable cause of morbidity and premature mortality in developed and developing countries. To date, efforts to reduce the burden of smoking have focused on non-personalised strategies. Anxiety about ill health, especially lung cancer and emphysema, is the foremost concern for smokers and a major reason for quitting. Recent efforts in cessation management focus on behaviour change and pharmacotherapy. The '3 Ts' (tension, trigger, treatment) model of behaviour change proposes that at any one time a smoker experiences varying degrees of motivational tension, which in the presence of a trigger may initiate or enhance quitting. Smokers' optimistic bias (ie, denial of one's own vulnerability) sustains continued smoking, while increasing motivational tension (eg, illness) favours quitting. The 1 year quit rates achieved when smokers encounter a life threatening event, such as a heart attack or lung cancer, are as much as 50-60%. Utilising tests of lung function and/or genetic susceptibility personalises the risk and have been reported to achieve 1 year quit rates of 25%. This is comparable to quit rates achieved among healthy motivated smokers using smoking cessation drug therapy. In this paper we review existing evidence and propose that identifying those smokers at increased risk of an adverse smoking related disease may be a useful motivational tool, and enhance existing public health strategies directed at smoking cessation.

Proposal on How To Conduct a Biopharmaceutical Process Failure Mode and Effect Analysis (FMEA) as a Risk Assessment Tool.

Science.gov (United States)

Zimmermann, Hartmut F; Hentschel, Norbert

2011-01-01

With the publication of the quality guideline ICH Q9 "Quality Risk Management" by the International Conference on Harmonization, risk management has already become a standard requirement during the life cycle of a pharmaceutical product. Failure mode and effect analysis (FMEA) is a powerful risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to biopharmaceutical processes brings about some difficulties. The proposal presented here is intended to serve as a brief but nevertheless comprehensive and detailed guideline on how to conduct a biopharmaceutical process FMEA. It includes a detailed 1-to-10-scale FMEA rating table for occurrence, severity, and detectability of failures that has been especially designed for typical biopharmaceutical processes. The application for such a biopharmaceutical process FMEA is widespread. It can be useful whenever a biopharmaceutical manufacturing process is developed or scaled-up, or when it is transferred to a different manufacturing site. It may also be conducted during substantial optimization of an existing process or the development of a second-generation process. According to their resulting risk ratings, process parameters can be ranked for importance and important variables for process development, characterization, or validation can be identified. Health authorities around the world ask pharmaceutical companies to manage risk during development and manufacturing of pharmaceuticals. The so-called failure mode and effect analysis (FMEA) is an established risk analysis tool that has been used for decades in mechanical and electrical industries. However, the adaptation of the FMEA methodology to pharmaceutical processes that use modern biotechnology (biopharmaceutical processes) brings about some difficulties, because those biopharmaceutical processes differ from processes in mechanical and electrical industries. The proposal presented here

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

Science.gov (United States)

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

2015-01-01

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

User's Guide and Metadata to Coastal Biodiversity Risk Analysis Tool (CBRAT): Framework for the Systemization of Life History and Biogeographic Information

Science.gov (United States)

ABSTRACTUser’s Guide & Metadata to Coastal Biodiversity Risk Analysis Tool (CBRAT): Framework for the Systemization of Life History and Biogeographic Information(EPA/601/B-15/001, 2015, 123 pages)Henry Lee II, U.S. EPA, Western Ecology DivisionKatharine Marko, U.S. EPA,...

Climate-Agriculture-Modeling and Decision Tool for Disease (CAMDT-Disease) for seasonal climate forecast-based crop disease risk management in agriculture

Science.gov (United States)

Kim, K. H.; Lee, S.; Han, E.; Ines, A. V. M.

2017-12-01

Climate-Agriculture-Modeling and Decision Tool (CAMDT) is a decision support system (DSS) tool that aims to facilitate translations of probabilistic seasonal climate forecasts (SCF) to crop responses such as yield and water stress. Since CAMDT is a software framework connecting different models and algorithms with SCF information, it can be easily customized for different types of agriculture models. In this study, we replaced the DSSAT-CSM-Rice model originally incorporated in CAMDT with a generic epidemiological model, EPIRICE, to generate a seasonal pest outlook. The resulting CAMDT-Disease generates potential risks for selected fungal, viral, and bacterial diseases of rice over the next months by translating SCFs into agriculturally-relevant risk information. The integrated modeling procedure of CAMDT-Disease first disaggregates a given SCF using temporal downscaling methods (predictWTD or FResampler1), runs EPIRICE with the downscaled weather inputs, and finally visualizes the EPIRICE outputs as disease risk compared to that of the previous year and the 30-year-climatological average. In addition, the easy-to-use graphical user interface adopted from CAMDT allows users to simulate "what-if" scenarios of disease risks over different planting dates with given SCFs. Our future work includes the simulation of the effect of crop disease on yields through the disease simulation models with the DSSAT-CSM-Rice model, as disease remains one of the most critical yield-reducing factors in the field.

Lessons from the pandemic: the need for new tools for risk and outbreak communication.

Science.gov (United States)

Abraham, Thomas

2011-10-17

The influenza pandemic of 2009 revealed shortcomings in the existing guidelines for risk and outbreak communication. Concepts such as building trust proved hard to achieve in practice, whereas other issues such as communicating through the internet and coping with the political fallout of disease outbreaks are not dealt with in existing guidelines. This article surveys the current guidelines and makes recommendations for additional tools and guidelines to be developed in four areas: integrating long-term behavior change models with outbreak communications; research to develop a better understanding of communicating through the internet; research to understand how to use communications to build trust; and developing guidelines and principles to understand the political nature of disease outbreaks.

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

Science.gov (United States)

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

2011-01-01

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

Quantitative tools for addressing hospital readmissions

Directory of Open Access Journals (Sweden)

Lagoe Ronald J

2012-11-01

Full Text Available Abstract Background Increased interest in health care cost containment is focusing attention on reduction of hospital readmissions. Major payors have already developed financial penalties for providers that generate excess readmissions. This subject has benefitted from the development of resources such as the Potentially Preventable Readmissions software. This process has encouraged hospitals to renew efforts to improve these outcomes. The aim of this study was to describe quantitative tools such as definitions, risk estimation, and tracking of patients for reducing hospital readmissions. Findings This study employed the Potentially Preventable Readmissions software to develop quantitative tools for addressing hospital readmissions. These tools included two definitions of readmissions that support identification and management of patients. They also included analytical approaches for estimation of the risk of readmission for individual patients by age, discharge status of the initial admission, and severity of illness. They also included patient specific spreadsheets for tracking of target populations and for evaluation of the impact of interventions. Conclusions The study demonstrated that quantitative tools including the development of definitions of readmissions, estimation of the risk of readmission, and patient specific spreadsheets could contribute to the improvement of patient outcomes in hospitals.

Comparison of different screening tools (FRAX®, OST, ORAI, OSIRIS, SCORE and age alone) to identify women with increased risk of fracture. A population-based prospective study

DEFF Research Database (Denmark)

Rubin, Katrine Hass; Abrahamsen, Bo; Friis-Holmberg, Teresa

2013-01-01

PURPOSE: To compare the power of FRAX® without bone mineral density (BMD) and simpler screening tools (OST, ORAI, OSIRIS, SCORE and age alone) in predicting fractures. METHODS: This study was a prospective, population-based study performed in Denmark comprising 3614 women aged 40-90years, who...... returned a questionnaire concerning items on risk factors for osteoporosis. Fracture risk was calculated using the different screening tools (FRAX®, OST, ORAI, OSIRIS and SCORE) for each woman. The women were followed using the Danish National Register registering new major osteoporotic fractures during 3......years, counting only the first fracture per person. Area under the receiver operating characteristic curve (ROC) and statistics and Harrell's index were calculated. Agreement between the tools was calculated by kappa statistics. RESULTS: A total of 4% of the women experienced a new major osteoporotic...

Development of a simple tool to predict the risk of postpartum diabetes in women with gestational diabetes mellitus.

Science.gov (United States)

Köhler, M; Ziegler, A G; Beyerlein, A

2016-06-01

Women with gestational diabetes mellitus (GDM) have an increased risk of diabetes postpartum. We developed a score to predict the long-term risk of postpartum diabetes using clinical and anamnestic variables recorded during or shortly after delivery. Data from 257 GDM women who were prospectively followed for diabetes outcome over 20 years of follow-up were used to develop and validate the risk score. Participants were divided into training and test sets. The risk score was calculated using Lasso Cox regression and divided into four risk categories, and its prediction performance was assessed in the test set. Postpartum diabetes developed in 110 women. The computed training set risk score of 5 × body mass index in early pregnancy (per kg/m(2)) + 132 if GDM was treated with insulin (otherwise 0) + 44 if the woman had a family history of diabetes (otherwise 0) - 35 if the woman lactated (otherwise 0) had R (2) values of 0.23, 0.25, and 0.33 at 5, 10, and 15 years postpartum, respectively, and a C-Index of 0.75. Application of the risk score in the test set resulted in observed risk of postpartum diabetes at 5 years of 11 % for low risk scores ≤140, 29 % for scores 141-220, 64 % for scores 221-300, and 80 % for scores >300. The derived risk score is easy to calculate, allows accurate prediction of GDM-related postpartum diabetes, and may thus be a useful prediction tool for clinicians and general practitioners.

Nuclear power plant risk assembly and decomposition for risk management

International Nuclear Information System (INIS)

Iden, D.C.

1985-01-01

The state-of-the-art method for analyzing the risk from nuclear power plants is probabilistic risk assessment (PRA). The intermediate results of a PRA are first assembled to quantify the risk from operating a nuclear power plant in the form of (1) core damage (or core melt) frequency, (2) plant damage state frequencies, (3) release category frequencies, and (4) the frequency of exceeding specific levels of offsite consequences. Once the overall PRA results have been quantified, the next step is to decompose those results into the individual contributors to each of the four forms of risk in some rank order. The way in which the PRA model is set up to assemble and decompose the plant risk determines the ease and usefulness of the PRA model as a risk management tool for evaluating perturbations to the PRA model. These perturbations can take the form of technical specification changes, hardware modifications, procedural changes, etc. The matrix formalism developed by Dr. Stan Kaplan for risk assembly and decomposition represents a significant breakthrough in making the PRA model an effective risk management tool. The key to understanding the matrix formalism and making it a useful tool for managing nuclear power plant risk is the structure of the PRA model. PRA risk model structure and decomposition of the risk results are discussed with the Seabrook PRA as an example

Human System Risk Management - Tools of our Trade

Science.gov (United States)

Ott, C. Mark

2009-01-01

The risk of infectious disease to select individuals has historically been difficult to predict in either spaceflight or on Earth with health care efforts relying on broad-based prevention and post-infection treatment. Over the past 10 years, quantitative microbial risk assessment evaluations have evolved to formalize the assessment process and quantify the risk. This process of hazard identification, exposure assessment, dose-response assessment, and risk characterization has been applied by the water and food safety industries to address the public health impacts associated with the occurrence of and human exposure to pathogens in water and food for the development of preventive strategies for microbial disease. NASA is currently investigating the feasibility of using these techniques to better understand the risks to astronauts and refine their microbiological requirements. To assess these techniques, NASA began an evaluation of the potable water system on the International Space Station to determine how the microbial risk from water consumption during flight differed from terrestrial sources, such as municipal water systems. The ultimate goal of this work is to optimize microbial requirements which would minimize unnecessary cargo and use of crew time, while still protecting the health of the crew. Successful demonstration of this risk assessment framework with the water system holds the potential to maximize the use of available resources during spaceflight missions and facilitate investigations into the evaluation of other routes of infection, such as through the spaceflight foods system.

Evaluation of flood hazard maps in print and web mapping services as information tools in flood risk communication

Science.gov (United States)

Hagemeier-Klose, M.; Wagner, K.

2009-04-01

Flood risk communication with the general public and the population at risk is getting increasingly important for flood risk management, especially as a precautionary measure. This is also underlined by the EU Flood Directive. The flood related authorities therefore have to develop adjusted information tools which meet the demands of different user groups. This article presents the formative evaluation of flood hazard maps and web mapping services according to the specific requirements and needs of the general public using the dynamic-transactional approach as a theoretical framework. The evaluation was done by a mixture of different methods; an analysis of existing tools, a creative workshop with experts and laymen and an online survey. The currently existing flood hazard maps or web mapping services or web GIS still lack a good balance between simplicity and complexity with adequate readability and usability for the public. Well designed and associative maps (e.g. using blue colours for water depths) which can be compared with past local flood events and which can create empathy in viewers, can help to raise awareness, to heighten the activity and knowledge level or can lead to further information seeking. Concerning web mapping services, a linkage between general flood information like flood extents of different scenarios and corresponding water depths and real time information like gauge levels is an important demand by users. Gauge levels of these scenarios are easier to understand than the scientifically correct return periods or annualities. The recently developed Bavarian web mapping service tries to integrate these requirements.

Evaluation of flood hazard maps in print and web mapping services as information tools in flood risk communication

Directory of Open Access Journals (Sweden)

M. Hagemeier-Klose

2009-04-01

Full Text Available Flood risk communication with the general public and the population at risk is getting increasingly important for flood risk management, especially as a precautionary measure. This is also underlined by the EU Flood Directive. The flood related authorities therefore have to develop adjusted information tools which meet the demands of different user groups. This article presents the formative evaluation of flood hazard maps and web mapping services according to the specific requirements and needs of the general public using the dynamic-transactional approach as a theoretical framework. The evaluation was done by a mixture of different methods; an analysis of existing tools, a creative workshop with experts and laymen and an online survey.

The currently existing flood hazard maps or web mapping services or web GIS still lack a good balance between simplicity and complexity with adequate readability and usability for the public. Well designed and associative maps (e.g. using blue colours for water depths which can be compared with past local flood events and which can create empathy in viewers, can help to raise awareness, to heighten the activity and knowledge level or can lead to further information seeking. Concerning web mapping services, a linkage between general flood information like flood extents of different scenarios and corresponding water depths and real time information like gauge levels is an important demand by users. Gauge levels of these scenarios are easier to understand than the scientifically correct return periods or annualities. The recently developed Bavarian web mapping service tries to integrate these requirements.

Probability concepts in quality risk management.

Science.gov (United States)

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as

DengueTools: innovative tools and strategies for the surveillance and control of dengue.

Science.gov (United States)

Wilder-Smith, Annelies; Renhorn, Karl-Erik; Tissera, Hasitha; Abu Bakar, Sazaly; Alphey, Luke; Kittayapong, Pattamaporn; Lindsay, Steve; Logan, James; Hatz, Christoph; Reiter, Paul; Rocklöv, Joacim; Byass, Peter; Louis, Valérie R; Tozan, Yesim; Massad, Eduardo; Tenorio, Antonio; Lagneau, Christophe; L'Ambert, Grégory; Brooks, David; Wegerdt, Johannah; Gubler, Duane

2012-01-01

Dengue fever is a mosquito-borne viral disease estimated to cause about 230 million infections worldwide every year, of which 25,000 are fatal. Global incidence has risen rapidly in recent decades with some 3.6 billion people, over half of the world's population, now at risk, mainly in urban centres of the tropics and subtropics. Demographic and societal changes, in particular urbanization, globalization, and increased international travel, are major contributors to the rise in incidence and geographic expansion of dengue infections. Major research gaps continue to hamper the control of dengue. The European Commission launched a call under the 7th Framework Programme with the title of 'Comprehensive control of Dengue fever under changing climatic conditions'. Fourteen partners from several countries in Europe, Asia, and South America formed a consortium named 'DengueTools' to respond to the call to achieve better diagnosis, surveillance, prevention, and predictive models and improve our understanding of the spread of dengue to previously uninfected regions (including Europe) in the context of globalization and climate change.The consortium comprises 12 work packages to address a set of research questions in three areas:Research area 1: Develop a comprehensive early warning and surveillance system that has predictive capability for epidemic dengue and benefits from novel tools for laboratory diagnosis and vector monitoring.Research area 2: Develop novel strategies to prevent dengue in children.Research area 3: Understand and predict the risk of global spread of dengue, in particular the risk of introduction and establishment in Europe, within the context of parameters of vectorial capacity, global mobility, and climate change.In this paper, we report on the rationale and specific study objectives of 'DengueTools'. DengueTools is funded under the Health theme of the Seventh Framework Programme of the European Community, Grant Agreement Number: 282589 Dengue Tools.

A unified framework for evaluating the risk of re-identification of text de-identification tools.

Science.gov (United States)

Scaiano, Martin; Middleton, Grant; Arbuckle, Luk; Kolhatkar, Varada; Peyton, Liam; Dowling, Moira; Gipson, Debbie S; El Emam, Khaled

2016-10-01

It has become regular practice to de-identify unstructured medical text for use in research using automatic methods, the goal of which is to remove patient identifying information to minimize re-identification risk. The metrics commonly used to determine if these systems are performing well do not accurately reflect the risk of a patient being re-identified. We therefore developed a framework for measuring the risk of re-identification associated with textual data releases. We apply the proposed evaluation framework to a data set from the University of Michigan Medical School. Our risk assessment results are then compared with those that would be obtained using a typical contemporary micro-average evaluation of recall in order to illustrate the difference between the proposed evaluation framework and the current baseline method. We demonstrate how this framework compares against common measures of the re-identification risk associated with an automated text de-identification process. For the probability of re-identification using our evaluation framework we obtained a mean value for direct identifiers of 0.0074 and a mean value for quasi-identifiers of 0.0022. The 95% confidence interval for these estimates were below the relevant thresholds. The threshold for direct identifier risk was based on previously used approaches in the literature. The threshold for quasi-identifiers was determined based on the context of the data release following commonly used de-identification criteria for structured data. Our framework attempts to correct for poorly distributed evaluation corpora, accounts for the data release context, and avoids the often optimistic assumptions that are made using the more traditional evaluation approach. It therefore provides a more realistic estimate of the true probability of re-identification. This framework should be used as a basis for computing re-identification risk in order to more realistically evaluate future text de-identification tools

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

NARCIS (Netherlands)

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

2016-01-01

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

Experiences of Playscan: Interviews with users of a responsible gambling tool

Directory of Open Access Journals (Sweden)

David Forsström

2017-06-01

Full Text Available Online gambling, encompassing a wide variety of activities and around-the-clock access, can be a potential risk factor for gamblers who tend to gamble excessively. Yet, the advent of online gambling has enabled responsible gambling (RG features that may help individuals to limit their gambling behaviour. One of these features is RG tools that track gamblers' behaviour, performs risk assessments and provides advice to gamblers. This study investigated users' views and experiences of the RG tool Playscan from a qualitative perspective using a semi-structured interview. The tool performs a risk assessment on a three-step scale (low, medium and high risk. Users from every risk category were included. Twenty interviews were carried out and analysed using thematic analysis. Two main themes with associated sub-themes were identified: “Usage of Playscan and the gambling site” and “Experiences of Playscan”. Important experiences in the sub-themes were lack of feedback from the tool and confusion when signing up to use Playscan. These experiences counteracted positive attitudes that should have promoted usage of the tool. Providing more feedback directly to users is a suggested solution to increase usage of the RG tool.

The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad.

Science.gov (United States)

Melin, Anna; Tornberg, Asa B; Skouby, Sven; Faber, Jens; Ritz, Christian; Sjödin, Anders; Sundgot-Borgen, Jorunn

2014-04-01

Low energy availability (EA) in female athletes with or without an eating disorder (ED) increases the risk of oligomenorrhoea/functional hypothalamic amenorrhoea and impaired bone health, a syndrome called the female athlete triad (Triad). There are validated psychometric instruments developed to detect disordered eating behaviour (DE), but no validated screening tool to detect persistent low EA and Triad conditions, with or without DE/ED, is available. The aim of this observational study was to develop and test a screening tool designed to identify female athletes at risk for the Triad. Female athletes (n=84) with 18-39 years of age and training ≥5 times/week filled out the Low Energy Availability in Females Questionnaire (LEAF-Q), which comprised questions regarding injuries and gastrointestinal and reproductive function. Reliability and internal consistency were evaluated in a subsample of female dancers and endurance athletes (n=37). Discriminant as well as concurrent validity was evaluated by testing self-reported data against measured current EA, menstrual function and bone health in endurance athletes from sports such as long distance running and triathlon (n=45). The 25-item LEAF-Q produced an acceptable sensitivity (78%) and specificity (90%) in order to correctly classify current EA and/or reproductive function and/or bone health. The LEAF-Q is brief and easy to administer, and relevant as a complement to existing validated DE screening instruments, when screening female athletes at risk for the Triad, in order to enable early detection and intervention.

Tool wear and breakage monitoring in machining

International Nuclear Information System (INIS)

Madl, J.

1992-01-01

Risk minimization of metal cutting operations is one of the main problems of metal cutting technology. This paper describes some aspects in monitoring and control of machining processes. Tool monitoring is the fokus of machining process monitoring. Tool breakage and tool life recognition are the main problems of tool monitoring. All problems of this type of monitoring have not yet been fully solved. (orig.)

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

Science.gov (United States)

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

2014-10-01

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

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

Directory of Open Access Journals (Sweden)

Eva Maya Puspita

2017-01-01

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

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

Science.gov (United States)

van der Put, Claudia E

2014-06-01

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

Assessing Bleeding Risk in Patients Taking Anticoagulants

Science.gov (United States)

Shoeb, Marwa; Fang, Margaret C.

2013-01-01

Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism. Although highly effective, they are also associated with significant bleeding risks. Numerous individual clinical factors have been linked to an increased risk of hemorrhage, including older age, anemia, and renal disease. To help quantify hemorrhage risk for individual patients, a number of clinical risk prediction tools have been developed. These risk prediction tools differ in how they were derived and how they identify and weight individual risk factors. At present, their ability to effective predict anticoagulant-associated hemorrhage remains modest. Use of risk prediction tools to estimate bleeding in clinical practice is most influential when applied to patients at the lower spectrum of thromboembolic risk, when the risk of hemorrhage will more strongly affect clinical decisions about anticoagulation. Using risk tools may also help counsel and inform patients about their potential risk for hemorrhage while on anticoagulants, and can identify patients who might benefit from more careful management of anticoagulation. PMID:23479259

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

Science.gov (United States)

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

2018-03-01

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

A web-based personalized risk communication and decision-making tool for women with dense breasts: Design and methods of a randomized controlled trial within an integrated health care system.

Science.gov (United States)

Knerr, Sarah; Wernli, Karen J; Leppig, Kathleen; Ehrlich, Kelly; Graham, Amanda L; Farrell, David; Evans, Chalanda; Luta, George; Schwartz, Marc D; O'Neill, Suzanne C

2017-05-01

Mammographic breast density is one of the strongest risk factors for breast cancer after age and family history. Mandatory breast density disclosure policies are increasing nationally without clear guidance on how to communicate density status to women. Coupling density disclosure with personalized risk counseling and decision support through a web-based tool may be an effective way to allow women to make informed, values-consistent risk management decisions without increasing distress. This paper describes the design and methods of Engaged, a prospective, randomized controlled trial examining the effect of online personalized risk counseling and decision support on risk management decisions in women with dense breasts and increased breast cancer risk. The trial is embedded in a large integrated health care system in the Pacific Northwest. A total of 1250 female health plan members aged 40-69 with a recent negative screening mammogram who are at increased risk for interval cancer based on their 5-year breast cancer risk and BI-RADS® breast density will be randomly assigned to access either a personalized web-based counseling and decision support tool or standard educational content. Primary outcomes will be assessed using electronic health record data (i.e., chemoprevention and breast MRI utilization) and telephone surveys (i.e., distress) at baseline, six weeks, and twelve months. Engaged will provide evidence about whether a web-based personalized risk counseling and decision support tool is an effective method for communicating with women about breast density and risk management. An effective intervention could be disseminated with minimal clinical burden to align with density disclosure mandates. Clinical Trials Registration Number:NCT03029286. Copyright © 2017 Elsevier Inc. All rights reserved.

Analyse the risks of ad hoc programming in web development and develop a metrics of appropriate tools

OpenAIRE

Gubhaju, Manish; Al-Sherbaz, Ali

2013-01-01

Today the World Wide Web has become one of the most powerful tools for business promotion and social networking. As the use of websites and web applications to promote the businesses has increased drastically over the past few years, the complexity of managing them and protecting them from security threats has become a complicated task for the organizations. On the other hand, most of the web projects are at risk and less secure due to lack of quality programming. Although there are plenty of...

Pneumonia risks in bedridden patients receiving oral care and their screening tool: Malnutrition and urinary tract infection-induced inflammation.

Science.gov (United States)

Matsusaka, Kaoru; Kawakami, Genichiro; Kamekawa, Hatsumi; Momma, Haruki; Nagatomi, Ryoichi; Itoh, Jun; Yamaya, Mutsuo

2018-05-01

Pneumonia develops in bedridden patients even when they are receiving oral care. However, the pneumonia risk in bedridden patients remains unclear, and no screening tool has been developed to assess this risk by using daily hospital data. We retrospectively examined pneumonia risk factors by analyzing the records of 102 bedridden patients receiving oral care. Body mass index, peripheral blood hemoglobin, and serum concentrations of total protein, albumin, total cholesterol and uric acid in the pneumonia group (n = 51; mean age 73.4 years) were lower than those in the non-pneumonia group (n = 51; mean age 68.1 years). In the univariate analysis, body mass index; leukocytosis; high C-reactive protein; low levels of hemoglobin, total protein and albumin (bedridden patient pneumonia risk (BPPR) score using these two risk factors to assess pneumonia risk. We applied scores of zero (0) or one (1) according to the absence or presence of the two risk factors and summed the scores in each patient. The proportion of pneumonia patients increased with increasing BPPR score when the patients were divided into three groups - low, moderate and high risk - according to the BPPR score (0, 1 or 2, respectively). Malnutrition, urinary tract infection-induced inflammation and anemia were associated with pneumonia in bedridden patients. BPPR scoring might be useful for assessing pneumonia risk and managing affected patients. Geriatr Gerontol Int 2018; 18: 714-722. © 2018 Japan Geriatrics Society.

Identification of high-risk cutaneous melanoma tumors is improved when combining the online American Joint Committee on Cancer Individualized Melanoma Patient Outcome Prediction Tool with a 31-gene expression profile-based classification.

Science.gov (United States)

Ferris, Laura K; Farberg, Aaron S; Middlebrook, Brooke; Johnson, Clare E; Lassen, Natalie; Oelschlager, Kristen M; Maetzold, Derek J; Cook, Robert W; Rigel, Darrell S; Gerami, Pedram

2017-05-01

A significant proportion of patients with American Joint Committee on Cancer (AJCC)-defined early-stage cutaneous melanoma have disease recurrence and die. A 31-gene expression profile (GEP) that accurately assesses metastatic risk associated with primary cutaneous melanomas has been described. We sought to compare accuracy of the GEP in combination with risk determined using the web-based AJCC Individualized Melanoma Patient Outcome Prediction Tool. GEP results from 205 stage I/II cutaneous melanomas with sufficient clinical data for prognostication using the AJCC tool were classified as low (class 1) or high (class 2) risk. Two 5-year overall survival cutoffs (AJCC 79% and 68%), reflecting survival for patients with stage IIA or IIB disease, respectively, were assigned for binary AJCC risk. Cox univariate analysis revealed significant risk classification of distant metastasis-free and overall survival (hazard ratio range 3.2-9.4, P risk by GEP but low risk by AJCC. Specimens reflect tertiary care center referrals; more effective therapies have been approved for clinical use after accrual. The GEP provides valuable prognostic information and improves identification of high-risk melanomas when used together with the AJCC online prediction tool. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Risk and cognition

CERN Document Server

Faucher, Colette

2015-01-01

This book presents recent research using cognitive science to apprehend risk situations and elaborate new organizations, new systems and new methodological tools in response. The book demonstrates the reasons, advantages and implications of the association of the concepts of cognition and risk. It is shown that this association has strong consequences on how to apprehend critical situations that emerge  within various activity domains, and how to elaborate responses to these critical situations.. The following topics are covered by the book: ·     Influence of the culture in risk management, ·     Influence of the risk communication in risk management, ·     User-centred design to improve risk situation management, ·     Designing new tools to assist risk situation management, ·     Risk prevention in industrial activities.

The development of a 3-d risk matrix for qualitative maintenance risk management

International Nuclear Information System (INIS)

Hsu, Pi-Lin; Lo, Chung-Kung

2009-01-01

The 3-D Risk Matrix is a web-based tool, developed by the Institute of Nuclear Energy research (INER), to assist plant personnel for qualitative assessment of operational risks inherent with scheduling of system/component maintenance and testing. This paper focuses on a software development for a three-dimensional risk matrix which serves as a sub-function embedded in the Maintenance Rule (MR) risk management tool used by the Taiwan's nuclear power plants. The color in any field of the matrix directly corresponds to the risk condition level of the related plant maintenance configuration. It also informs the operators via graphical interface of the remaining hours before reaching to the potentially more significant risk level. In the 3-D Risk Matrix, the risk levels can be quickly determined since the conditional Core Damage Frequency (CDF) and Large Early Release Frequency (LERF) for each expected and allowed out-of-service sub-systems or trains combination is pre-calculated by INERISKEN. The 3-D Risk Matrix will play an important role to enhance the MR risk management tool during the on-line maintenances in Taiwan's nuclear power plants

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

Science.gov (United States)

Chin, Kok-Yong

2017-09-01

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

Hedging tools and cross market applications

International Nuclear Information System (INIS)

Schlenker, C.

1997-01-01

The nature of the basic tools of the market - put, call, and swap - their various combinations and how they are used in various market transactions were explained. The role and effect of the use of these tools on prices, price fluctuations and risks were outlined. Predictions for the future for producers (reduced use of price optimization and its replacement by price diversification strategies, realignment of risk management tools to be in accord with the changed marketing techniques), and for end users (focus on managing short term fluctuations in input costs, short-term price fixing, more frequent utilization of traditional option strategies and spread options), were summarized. For the electricity market in particular, the prominence of gas-fired generation units as options on the spread between gas and electricity, providing opportunities for outperformance options was predicted

Tools for plant safety engineer

International Nuclear Information System (INIS)

Fabic, S.

1996-01-01

This paper contains: - review of tools for monitoring plant safety equipment reliability and readiness, before and accident (performance indicators for monitoring the risk and reliability performance and for determining when degraded performance alert levels are achieved) - brief reviews of tools for use during an accident: Emergency Operating Procedures (EOPs), Emergency Response Data System (ERDS), Reactor Safety Assessment System (RSAS), Computerized Accident Management Support

Development and validation of a tool for identifying women with low bone mineral density and low-impact fractures: the São Paulo Osteoporosis Risk Index (SAPORI).

Science.gov (United States)

Pinheiro, M M; Reis Neto, E T; Machado, F S; Omura, F; Szejnfeld, J; Szejnfeld, V L

2012-04-01

The performance of the São Paulo Osteoporosis Risk Index (SAPORI) was tested in 1,915 women from the original cohort, São Paulo Osteoporosis Study (SAPOS) (N = 4332). This new tool was able to identify women with low bone density (spine and hip) and low-impact fracture, with an area under the receiving operator curve (ROC) of 0.831, 0.724, and 0.689, respectively. A number of studies have demonstrated the clinical relevance of risk factors for identifying individuals at risk of fracture (Fx) and osteoporosis (OP). The SAPOS is an epidemiological study for the assessment of risk factors for Fx and low bone density in women from the community of the metropolitan area of São Paulo, Brazil. The aim of the present study was to develop and validate a tool for identifying women at higher risk for OP and low-impact Fx. A total of 4,332 pre-, peri-, and postmenopausal women were analyzed through a questionnaire addressing risk factors for OP and Fx. All of them performed bone densitometry at the lumbar spine and proximal femur (DPX NT, GE-Lunar). Following the identification of the main risk factors for OP and Fx through multivariate and logistic regression, respectively, the SAPORI was designed and subsequently validated on a second cohort of 1,915 women from the metropolitan community of São Paulo. The performance of this tool was assessed through ROC analysis. The main and significant risk factors associated with low bone density and low-impact Fx were low body weight, advanced age, Caucasian ethnicity, family history of hip Fx, current smoking, and chronic use of glucocorticosteroids. Hormonal replacement therapy and regular physical activity in the previous year played a protective role (p < 0.05). After the statistical adjustments, the SAPORI was able to identify women with low bone density (T-score ≤ -2 standard deviations) in the femur, with 91.4% sensitivity, 52% specificity, and an area under the ROC of 0.831 (p < 0.001). At the lumbar spine

Environmental modeling and health risk analysis (ACTS/RISK)

National Research Council Canada - National Science Library

Aral, M. M

2010-01-01

... presents a review of the topics of exposure and health risk analysis. The Analytical Contaminant Transport Analysis System (ACTS) and Health RISK Analysis (RISK) software tools are an integral part of the book and provide computational platforms for all the models discussed herein. The most recent versions of these two softwa...

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

Science.gov (United States)

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

2008-08-01

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

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

Science.gov (United States)

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

2016-12-01

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

Three Points Approach (3PA) for urban flood risk management: A tool to support climate change adaptation through transdisciplinarity and multifunctionality

DEFF Research Database (Denmark)

Fratini, Chiara; Geldof, Govert Daan; Kluck, J.

2012-01-01

Urban flood risk is increasing as a consequence of climate change and growing impervious surfaces. Increasing complexity of the urban context, gradual loss of tacit knowledge and decreasing social awareness are at the same time leading to inadequate choices with respect to urban flood risk...... management (UFRM). The European Flood Risk Directive emphasises the need for non-structural measures aimed at urban resilience and social preparedness. The Three Points Approach (3PA) provides a structure facilitating the decision making processes dealing with UFRM. It helps to accept the complexity...... water managers and operators an efficient communication tool and thinking system, which helps to reduce complexity to a level suitable when organising strategy plans for UFRM and urban adaptation to climate change....

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

Science.gov (United States)

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

2013-03-01

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

Comparison of occupational exposure assessment tools and concepts for nanomaterials

DEFF Research Database (Denmark)

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

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

Earthworms and in vitro physiologically-based extraction tests: complementary tools for a holistic approach towards understanding risk at arsenic-contaminated sites.

Science.gov (United States)

Button, Mark; Watts, Michael J; Cave, Mark R; Harrington, Chris F; Jenkin, Gawen T

2009-04-01

The relationship of the total arsenic content of a soil and its bioaccumulation by earthworms (Lumbricus rubellus and Dendrodrilus rubidus) to the arsenic fraction bioaccessible to humans, measured using an in vitro physiologically-based extraction test (PBET), was investigated. Soil and earthworm samples were collected at 24 sites at the former arsenic mine at the Devon Great Consols (DGC) in southwest England (UK), along with an uncontaminated site in Nottingham, UK, for comparison. Analysis of soil and earthworm total arsenic via inductively coupled plasma mass spectrometry (ICP-MS) was performed following a mixed acid digestion. Arsenic concentrations in the soil were elevated (204-9,025 mg kg(-1)) at DGC. The arsenic bioaccumulation factor (BAF) for both earthworm species was found to correlate positively with the human bioaccessible fraction (HBF), although the correlation was only significant (P earthworms as complementary tools is explored as a holistic and multidisciplinary approach towards understanding risk at contaminated sites. Arsenic resistant earthworm species such as the L. rubellus populations at DGC are presented as a valuable tool for understanding risk at highly contaminated sites.

Predicting recidivism among adult male child pornography offenders: Development of the Child Pornography Offender Risk Tool (CPORT).

Science.gov (United States)

Seto, Michael C; Eke, Angela W

2015-08-01

In this study, we developed a structured risk checklist, the Child Pornography Offender Risk Tool (CPORT), to predict any sexual recidivism among adult male offenders with a conviction for child pornography offenses. We identified predictors of sexual recidivism using a 5-year fixed follow-up analysis from a police case file sample of 266 adult male child pornography offenders in the community after their index offense. In our 5-year follow-up, 29% committed a new offense, and 11% committed a new sexual offense, with 3% committing a new contact sexual offense against a child and 9% committing a new child pornography offense. The CPORT items comprised younger offender age, any prior criminal history, any contact sexual offending, any failure on conditional release, indication of sexual interest in child pornography material or prepubescent or pubescent children, more boy than girl content in child pornography, and more boy than girl content in other child depictions. The CPORT was significantly associated with any sexual recidivism, with moderate predictive accuracy, and thus has promise in the risk assessment of adult male child pornography offenders with further cross-validation. (c) 2015 APA, all rights reserved).

Increasing fall risk awareness using wearables: A fall risk awareness protocol.

Science.gov (United States)

Danielsen, Asbjørn; Olofsen, Hans; Bremdal, Bernt Arild

2016-10-01

Each year about a third of elderly aged 65 or older experience a fall. Many of these falls may have been avoided if fall risk assessment and prevention tools where available in a daily living situation. We identify what kind of information is relevant for doing fall risk assessment and prevention using wearable sensors in a daily living environment by investigating current research, distinguishing between prospective and context-aware fall risk assessment and prevention. Based on our findings, we propose a fall risk awareness protocol as a fall prevention tool integrating both wearables and ambient sensing technology into a single platform. Copyright © 2016. Published by Elsevier Inc.

Risk management for engineering projects procedures, methods and tools

CERN Document Server

Munier, Nolberto

2014-01-01

Many people see risk in engineering projects as an imprecise and nebulous problem - something that exists, is feared and is impossible to deal with. Nothing could be further from the truth. While risk is certainly ubiquitous, sometimes difficult to detect, and cannot always be completely avoided, it can generally be mitigated, reduced or prevented through timely analysis and action.   This book covers the entire process of risk management by providing methodologies for determining the sources of project risk, and once threats have been identified, managing them through:   ·         identification and assessment (probability, relative importance, variables, risk breakdown structure, etc.) ·         implementation of measures for their prevention, reduction or mitigation ·         evaluation of impacts and quantification of risks ·         establishment of control measures   It also considers sensitivity analysis to determine the influence of uncertain parameters values ...

COASTAL INVERTEBRATES AND FISHES: HOW WILL THEY BE AFFECTED BY CHANGING ENVIRONMENTAL CONDITIONS- INCORPORATING CLIMATE SCENARIOS INTO THE COASTAL BIODIVERSITY RISK ANALYSIS TOOL (CBRAT)

Science.gov (United States)

The Coastal Biodiversity Risk Analysis Tool (CBRAT) is a public website that functions as an ecoinformatics platform to synthesize biogeographical distributions, abundances, life history attributes, and environmental tolerances for near-coastal invertebrates and fishes on a broad...

[Medication reconciliation errors according to patient risk and type of physician prescriber identified by prescribing tool used].

Science.gov (United States)

Bilbao Gómez-Martino, Cristina; Nieto Sánchez, Ángel; Fernández Pérez, Cristina; Borrego Hernando, Mª Isabel; Martín-Sánchez, Francisco Javier

2017-01-01

To study the frequency of medication reconciliation errors (MREs) in hospitalized patients and explore the profiles of patients at greater risk. To compare the rates of errors in prescriptions written by emergency physicians and ward physicians, who each used a different prescribing tool. Prospective cross-sectional study of a convenience sample of patients admitted to medical, geriatric, and oncology wards over a period of 6 months. A pharmacist undertook the medication reconciliation report, and data were analyzed for possible associations with risk factors or prescriber type (emergency vs ward physician). A total of 148 patients were studied. Emergency physicians had prescribed for 68 (45.9%) and ward physicians for 80 (54.1%). A total of 303 MREs were detected; 113 (76.4%) patients had at least 1 error. No statistically significant differences were found between prescriber types. Factors that conferred risk for a medication error were use polypharmacy (odds ratio [OR], 3.4; 95% CI, 1.2-9.0; P=.016) and multiple chronic conditions in patients under the age of 80 years (OR, 3.9; 95% CI, 1.1-14.7; P=.039). The incidence of MREs is high regardless of whether the prescriber is an emergency or ward physician. The patients who are most at risk are those taking several medications and those under the age of 80 years who have multiple chronic conditions.