WorldWideScience

Sample records for risk tool dport

  1. Dutch Risk Assessment tools

    NARCIS (Netherlands)

    Venema, A.

    2015-01-01

    The ‘Risico- Inventarisatie- en Evaluatie-instrumenten’ is the name for the Dutch risk assessment (RA) tools. A RA tool can be used to perform a risk assessment including an evaluation of the identified risks. These tools were among the first online risk assessment tools developed in Europe. The

  2. Colorectal Cancer Risk Assessment Tool

    Science.gov (United States)

    ... 11/12/2014 Risk Calculator About the Tool Colorectal Cancer Risk Factors Download SAS and Gauss Code Page ... Rectal Cancer: Prevention, Genetics, Causes Tests to Detect Colorectal Cancer and Polyps Cancer Risk Prediction Resources Update November ...

  3. Tools for Microbiological risk assessment

    DEFF Research Database (Denmark)

    Bassett, john; Nauta, Maarten; Lindqvist, Roland

    can increase the understanding of microbiological risks in foods. It is timely to inform food safety professionals about the availability and utility of MRA tools. Therefore, the focus of this report is to aid the food safety manager by providing a concise summary of the tools available for the MRA......Microbiological Risk Assessment (MRA) has emerged as a comprehensive and systematic approach for addressing the risk of pathogens in specific foods and/or processes. At government level, MRA is increasingly recognised as a structured and objective approach to understand the level of risk in a given...... food/pathogen scenario. Tools developed so far support qualitative and quantitative assessments of the risk that a food pathogen poses to a particular population. Risk can be expressed as absolute numbers or as relative (ranked) risks. The food industry is beginning to appreciate that the tools for MRA...

  4. Metal Vapor Arcing Risk Assessment Tool

    Science.gov (United States)

    Hill, Monika C.; Leidecker, Henning W.

    2010-01-01

    The Tin Whisker Metal Vapor Arcing Risk Assessment Tool has been designed to evaluate the risk of metal vapor arcing and to help facilitate a decision toward a researched risk disposition. Users can evaluate a system without having to open up the hardware. This process allows for investigating components at risk rather than spending time and money analyzing every component. The tool points to a risk level and provides direction for appropriate action and documentation.

  5. 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.

  6. Liquidity risk charges as a macroprudential tool

    NARCIS (Netherlands)

    Perotti, E.; Suarez, J.

    2009-01-01

    Liquidity risk charges were proposed in February 2009 as a new macro-prudential tool to discourage systemic risk creation by banks. A new CEPR Policy Insight refines this proposal in order to clarify challenging issues surrounding the implementation of liquidity risk charges.

  7. Development of computerized risk management tool

    International Nuclear Information System (INIS)

    Kil Yoo Kim; Mee Jung Hwang; Seung Cheol Jang; Sang Hoon Han; Tae Woon Kim

    1997-01-01

    The author describes the kinds of efforts for the development of computerized risk management tool; (1) development of a risk monitor, Risk Monster, (2) improvement of McFarm (Missing Cutsets Finding Algorithm for Risk Monitor) and finally (3) development of reliability database management system, KwDBMan. Risk Monster supports for plant operators and maintenance schedulers to monitor plant risk and to avoid high peak risk by rearranging maintenance work schedule. Improved McFarm significantly improved calculation speed of Risk Monster for the cases of supporting system OOS (Out Of Service). KwDBMan manages event data, generic data and CCF (Common Cause Failure) data to support Risk Monster as well as PSA tool, KIRAP (KAERI Integrated Reliability Analysis Package)

  8. Risk indicators as a tool for risk control

    International Nuclear Information System (INIS)

    Oien, K.

    2001-01-01

    This paper presents a general methodology for the establishment of risk indicators that can be used as a tool for risk control during operation of offshore petroleum installations. The risk indicators established are based on the platform specific quantitative risk analysis (QRA). The general methodology is evaluated against comparable approaches both in offshore and nuclear industry. There are two distinct features of this methodology. The first is that it is truly risk-based with the intention of covering the total risk picture. The second is that the identification of the risk factors contributing most to the total risk is based on realistic changes of each factor assessed by the platform personnel, not a theoretically assumed change. The set of risk indicators for one specific installation is presented along with test results

  9. Development of configuration risk management tool

    International Nuclear Information System (INIS)

    Masuda, Takahiro; Doi, Eiji

    2003-01-01

    Tokyo Electric Power Company (referred to as TEPCO hereinafter), and other Japanese utilities as well, have been trying to improve the capacity factor of their Nuclear Power Plants (NPPs) through modernization of Operation and Maintenance strategy. TEPCO intends to apply risk information to O and M field with maintaining or even improving both safety and production efficiency. Under these situations, TEPCO with some BWR utilities started to develop a Configuration Risk Management (CRM) tool that can estimate risk in various plant conditions due to configuration changes during outage. Moreover, we also intend to apply CRM to on-line maintenance (OLM) in the near future. This tool can calculate the Core Damage Frequency (CDF) according to given plant condition, such as SSCs availability, decay heat level and the inventory of coolant in both outage state and full-power operation. From deterministic viewpoint, whether certain configuration meet the related requirements of Technical Specifications. User-friendly interface is one of the important features of this tool because this enables the site engineers with little experience in PSA to quantify and utilize the risk information by this tool. (author)

  10. 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)

  11. 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

  12. RISK COMMUNICATION IN ACTION: THE TOOLS OF MESSAGE MAPPING

    Science.gov (United States)

    Risk Communication in Action: The Tools of Message Mapping, is a workbook designed to guide risk communicators in crisis situations. The first part of this workbook will review general guidelines for risk communication. The second part will focus on one of the most robust tools o...

  13. 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.

  14. Dairy farmer use of price risk management tools.

    Science.gov (United States)

    Wolf, C A

    2012-07-01

    Volatility in milk and feed prices can adversely affect dairy farm profitability. Many risk management tools are available for use by US dairy farmers. This research uses surveys of Michigan dairy farmers to examine the extent to which price risk management tools have been used, the farm and operator characteristics that explain the use of these tools, and reasons farmers have not used these tools. A 1999 survey was used to benchmark the degree to which dairy producers had used milk and feed price risk management instruments to compare with 2011 use rates. The surveys collected information about the farm characteristics such as herd size, farmland operated, business organization, and solvency position. Farm operator characteristics collected include age, education, and experience. Dairy farmer use of both milk and feed price risk management tools increased between 1999 and 2011. In 2011, herd size was positively related to the use of milk price risk management tools, whereas farms organized as a sole proprietorship were less likely to use them. Also in 2011, herd size and land operated were positively related to feed price risk management tools, whereas operator age was negatively related. Reasons why farmers had not used price risk management tools included basis risk, cost, lack of management time, cooperative membership, and lack of understanding. Conclusions include the need for educational programming on price risk management tools and a broader exploration of dairy farm risk management programs. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. 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...

  16. Suicide Risk Screening Tools and the Youth Population.

    Science.gov (United States)

    Patterson, Sharon

    2016-08-01

    The use of suicide risk screening tools is a critical component of a comprehensive approach to suicide risk assessment. Since nurses frequently spend more time with patients than any other healthcare professional, they are in key positions to detect and prevent suicidal behavior in youth. To inform nurses about suicide risk screening tools for the youth population. Suicide risk screening tools are research-based standardized instruments that are used to identify people who may be at risk for suicide. A literature search was performed using the Athabasca University Library Resource, the databases of the Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, and Google Scholar. Nurses are cautioned to utilize suicide risk screening tools as only part of the suicide risk assessment in youth populations and avoid the danger of relying on tools that may result in a blind application of evidence to the detriment of clinical experience and judgement. © 2016 Wiley Periodicals, Inc.

  17. 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)

  18. RISK IDENTIFICATION TOOLS – POLISH MSMES COMPANIES PRACTICES

    Directory of Open Access Journals (Sweden)

    Iwona Gorzeń-Mitka

    2013-07-01

    Full Text Available The purpose of this study is to present risk identification tools in Polish micro, small and medium-sized enterprises (MSMEs. Risk identification is a key element of the risk management process in companies. Correctly fitting risk identification tools affect the accuracy of management decisions. The result of research is to identify the leading risk identification tools used by MSMEs. The study was conducted in 2010-2012 using a mixed survey-monographic method and questionnaires. The qualitative data were obtained during the study.

  19. 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

  20. Analysis of Alternatives for Risk Assessment Methodologies and Tools

    Energy Technology Data Exchange (ETDEWEB)

    Nachtigal, Noel M. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). System Analytics; Fruetel, Julia A. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Gleason, Nathaniel J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Helms, Jovana [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Imbro, Dennis Raymond [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis; Sumner, Matthew C. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Systems Research and Analysis

    2013-10-01

    The purpose of this document is to provide a basic overview and understanding of risk assessment methodologies and tools from the literature and to assess the suitability of these methodologies and tools for cyber risk assessment. Sandia National Laboratories (SNL) performed this review in support of risk modeling activities performed for the Stakeholder Engagement and Cyber Infrastructure Resilience (SECIR) division of the Department of Homeland Security (DHS) Office of Cybersecurity and Communications (CS&C). The set of methodologies and tools covered in this document is not intended to be exhaustive; instead, it focuses on those that are commonly used in the risk assessment community. The classification of methodologies and tools was performed by a group of analysts with experience in risk analysis and cybersecurity, and the resulting analysis of alternatives has been tailored to address the needs of a cyber risk assessment.

  1. 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.

  2. Risk assessment: tools, techniques, and their applications

    National Research Council Canada - National Science Library

    Ostrom, Lee T; Wilhelmsen, Cheryl A

    2012-01-01

    .... The central task of the risk assessor is predicting the success of a project. This includes isolating the entire spectrum of adverse events that can derail a project or threaten the health and safety of individuals, organizations, and the environment...

  3. Draught risk index tool for building energy simulations

    DEFF Research Database (Denmark)

    Vorre, Mette Havgaard; Jensen, Rasmus Lund; Nielsen, Peter V.

    2014-01-01

    Flow elements combined with a building energy simulation tool can be used to indicate areas and periods when there is a risk of draught in a room. The study tests this concept by making a tool for post-processing of data from building energy simulations. The objective is to show indications...... of draught risk during a whole year, giving building designers a tool for the design stage of a building. The tool uses simple one-at-a-time calculations of flow elements and assesses the uncertainty of the result by counting the number of overlapping flow elements. The calculation time is low, making...... it usable in the early design stage to optimise the building layout. The tool provides an overview of the general draught pattern over a period, e.g. a whole year, and of how often there is a draught risk....

  4. 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...

  5. 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...

  6. Updating risk prediction tools: a case study in prostate cancer.

    Science.gov (United States)

    Ankerst, Donna P; Koniarski, Tim; Liang, Yuanyuan; Leach, Robin J; Feng, Ziding; Sanda, Martin G; Partin, Alan W; Chan, Daniel W; Kagan, Jacob; Sokoll, Lori; Wei, John T; Thompson, Ian M

    2012-01-01

    Online risk prediction tools for common cancers are now easily accessible and widely used by patients and doctors for informed decision-making concerning screening and diagnosis. A practical problem is as cancer research moves forward and new biomarkers and risk factors are discovered, there is a need to update the risk algorithms to include them. Typically, the new markers and risk factors cannot be retrospectively measured on the same study participants used to develop the original prediction tool, necessitating the merging of a separate study of different participants, which may be much smaller in sample size and of a different design. Validation of the updated tool on a third independent data set is warranted before the updated tool can go online. This article reports on the application of Bayes rule for updating risk prediction tools to include a set of biomarkers measured in an external study to the original study used to develop the risk prediction tool. The procedure is illustrated in the context of updating the online Prostate Cancer Prevention Trial Risk Calculator to incorporate the new markers %freePSA and [-2]proPSA measured on an external case-control study performed in Texas, U.S.. Recent state-of-the art methods in validation of risk prediction tools and evaluation of the improvement of updated to original tools are implemented using an external validation set provided by the U.S. Early Detection Research Network. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. 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...

  8. Using risk based tools in emergency response

    International Nuclear Information System (INIS)

    Dixon, B.W.; Ferns, K.G.

    1987-01-01

    Probabilistic Risk Assessment (PRA) techniques are used by the nuclear industry to model the potential response of a reactor subjected to unusual conditions. The knowledge contained in these models can aid in emergency response decision making. This paper presents requirements for a PRA based emergency response support system to date. A brief discussion of published work provides background for a detailed description of recent developments. A rapid deep assessment capability for specific portions of full plant models is presented. The program uses a screening rule base to control search space expansion in a combinational algorithm

  9. 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.

  10. 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.

  11. 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.

  12. PROJECT MANAGER SKILLS, RISK MANAGEMENT TOOLS

    Directory of Open Access Journals (Sweden)

    Vladut Iacob

    2013-12-01

    Full Text Available Although the projects are different from each other there are many common things that contribute to their success. Looked overall, the success of a project is the result of a multitude of factors. This person is considered the "engine" of the project. The man who makes the action set for the achievement of project objectives to be brought to an end. The project manager must have the technical knowledge and economic diverse. He should be able to choose a team and lead. You must be tenacious, combative, to know how to communicate both within the team and beyond. In a word, the project manager must have an impressive stock of knowledge, skills and abilities and appreciate as Peter Drucker, to "exist for the organization. To be its servant. Any management who forget this will only cause damage to the organization. "This study will focus on highlighting the skills of the project manager and their role in managing difficult situations or risk.

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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...

  19. Application of Risk Assessment Tools in the Continuous Risk Management (CRM) Process

    Science.gov (United States)

    Ray, Paul S.

    2002-01-01

    Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) is currently implementing the Continuous Risk Management (CRM) Program developed by the Carnegie Mellon University and recommended by NASA as the Risk Management (RM) implementation approach. The four most frequently used risk assessment tools in the center are: (a) Failure Modes and Effects Analysis (FMEA), Hazard Analysis (HA), Fault Tree Analysis (FTA), and Probabilistic Risk Analysis (PRA). There are some guidelines for selecting the type of risk assessment tools during the project formulation phase of a project, but there is not enough guidance as to how to apply these tools in the Continuous Risk Management process (CRM). But the ways the safety and risk assessment tools are used make a significant difference in the effectiveness in the risk management function. Decisions regarding, what events are to be included in the analysis, to what level of details should the analysis be continued, make significant difference in the effectiveness of risk management program. Tools of risk analysis also depends on the phase of a project e.g. at the initial phase of a project, when not much data are available on hardware, standard FMEA cannot be applied; instead a functional FMEA may be appropriate. This study attempted to provide some directives to alleviate the difficulty in applying FTA, PRA, and FMEA in the CRM process. Hazard Analysis was not included in the scope of the study due to the short duration of the summer research project.

  20. Providing access to risk prediction tools via the HL7 XML-formatted risk web service.

    Science.gov (United States)

    Chipman, Jonathan; Drohan, Brian; Blackford, Amanda; Parmigiani, Giovanni; Hughes, Kevin; Bosinoff, Phil

    2013-07-01

    Cancer risk prediction tools provide valuable information to clinicians but remain computationally challenging. Many clinics find that CaGene or HughesRiskApps fit their needs for easy- and ready-to-use software to obtain cancer risks; however, these resources may not fit all clinics' needs. The HughesRiskApps Group and BayesMendel Lab therefore developed a web service, called "Risk Service", which may be integrated into any client software to quickly obtain standardized and up-to-date risk predictions for BayesMendel tools (BRCAPRO, MMRpro, PancPRO, and MelaPRO), the Tyrer-Cuzick IBIS Breast Cancer Risk Evaluation Tool, and the Colorectal Cancer Risk Assessment Tool. Software clients that can convert their local structured data into the HL7 XML-formatted family and clinical patient history (Pedigree model) may integrate with the Risk Service. The Risk Service uses Apache Tomcat and Apache Axis2 technologies to provide an all Java web service. The software client sends HL7 XML information containing anonymized family and clinical history to a Dana-Farber Cancer Institute (DFCI) server, where it is parsed, interpreted, and processed by multiple risk tools. The Risk Service then formats the results into an HL7 style message and returns the risk predictions to the originating software client. Upon consent, users may allow DFCI to maintain the data for future research. The Risk Service implementation is exemplified through HughesRiskApps. The Risk Service broadens the availability of valuable, up-to-date cancer risk tools and allows clinics and researchers to integrate risk prediction tools into their own software interface designed for their needs. Each software package can collect risk data using its own interface, and display the results using its own interface, while using a central, up-to-date risk calculator. This allows users to choose from multiple interfaces while always getting the latest risk calculations. Consenting users contribute their data for future

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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...

  6. 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)

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. Risk monitor - a tool for operational safety assessment risk monitor - user's manual

    International Nuclear Information System (INIS)

    Hari Prasad, M.; Vinod, Gopika; Saraf, R.K.; Ghosh, A.K.

    2006-06-01

    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 optimize 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 the step by step procedure for the user.to interact with the software. This software can be used with the PSA model of any Nuclear Power Plant. (author)

  15. Selecting a risk-based tool to aid in decision making

    Energy Technology Data Exchange (ETDEWEB)

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  16. 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

  17. 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...

  18. 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

  19. Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools

    Science.gov (United States)

    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

  20. 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)

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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...

  12. 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.

  13. 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.

  14. 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.)

  15. 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....

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. Operational Risk Assesement Tools for Quality Management in Banking Services

    OpenAIRE

    Dima, Alina Mihaela

    2009-01-01

    Among all the different types of risks that can affect financial companies, the operational risk can be the most devastating and the most difficult to anticipate. The management of operational risk is a key component of financial and risk management discipline that drives net income results, 2capital management and customer satisfaction. The present paper contains a statistical analysis in order to determine the number of operational errors as quality based services determinants, depending on...

  2. 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…

  3. 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.

  4. 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…

  5. Quantitative risk assessment: an emerging tool for emerging foodborne pathogens.

    OpenAIRE

    Lammerding, A. M.; Paoli, G. M.

    1997-01-01

    New challenges to the safety of the food supply require new strategies for evaluating and managing food safety risks. Changes in pathogens, food preparation, distribution, and consumption, and population immunity have the potential to adversely affect human health. Risk assessment offers a framework for predicting the impact of changes and trends on the provision of safe food. Risk assessment models facilitate the evaluation of active or passive changes in how foods are produced, processed, d...

  6. Risk management plans as a tool for proactive pharmacovigilance

    DEFF Research Database (Denmark)

    Vermeer, N S; Duijnhoven, R G; Straus, S M J M

    2014-01-01

    Risk Management Plans (RMPs) have become a cornerstone in the pharmacovigilance of new drugs in Europe. The RMP was introduced in 2005 to support a proactive approach in gaining knowledge on safety concerns through early planning of pharmacovigilance activities. However, the rate at which...... of uncertainties, suggests that opportunities for optimization exist while ensuring feasible and risk-proportionate pharmacovigilance planning....

  7. NanoRisk - A Conceptual Decision Support Tool for Nanomaterials

    DEFF Research Database (Denmark)

    Hansen, Steffen Foss; Baun, Anders; Alstrup Jensen, K.

    2011-01-01

    Only a few risk assessment methodologies and approaches are useful for assessing the risk for professional end-users, consumers and the environment. We have developed a generic framework (NanoRiskCat) that can be used by companies and risk assessors to categorize nanomaterials considering existing...... environmental, health and safety information and known uncertainties. In NanoRiskCat’s simplest form, the final evaluation outcome for a specific nanomaterial in a given application will be communicated in the form of a short title (e.g. TiO2 in sunscreen) describing the use of the nanomaterial. This short...... to the exposure and hazard potential are green , yellow corresponding to none, possible, expected and unknown, respectively. The exposure potential was evaluated based on 1) the location of the nanomaterial and 2) a judgment of the potential of nanomaterial exposure based on the description and explanation...

  8. 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.

  9. 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.

  10. Application of Risk Monitor MAREas tool in operation and maintenance

    International Nuclear Information System (INIS)

    Carretero, J. A.; Fuentes, I.

    2004-01-01

    From the very beginning and ongoing application objective of the Probabilistic Safety Assessment (PSA) was to develop Monitors. Their development was contingent on the PSA model computing capacity of the computer tools. the availability of effective tools, as well as the requirements of the Consejo de Seguridad Nuclear to apply the Maintenance Rule, have driven their implementation in Spain. The MARE application of Empresarios Agrupados presented herein has been developed for that purpose and has been implemented in Almaraz NPP. This article describes the process followed and experience in using it. (Author)

  11. 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.

  12. 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

  13. Semantic Mediation Tool for Risk Reduction, Phase I

    Data.gov (United States)

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

  14. Enhanced clinical pharmacy service targeting tools: risk-predictive algorithms.

    Science.gov (United States)

    El Hajji, Feras W D; Scullin, Claire; Scott, Michael G; McElnay, James C

    2015-04-01

    This study aimed to determine the value of using a mix of clinical pharmacy data and routine hospital admission spell data in the development of predictive algorithms. Exploration of risk factors in hospitalized patients, together with the targeting strategies devised, will enable the prioritization of clinical pharmacy services to optimize patient outcomes. Predictive algorithms were developed using a number of detailed steps using a 75% sample of integrated medicines management (IMM) patients, and validated using the remaining 25%. IMM patients receive targeted clinical pharmacy input throughout their hospital stay. The algorithms were applied to the validation sample, and predicted risk probability was generated for each patient from the coefficients. Risk threshold for the algorithms were determined by identifying the cut-off points of risk scores at which the algorithm would have the highest discriminative performance. Clinical pharmacy staffing levels were obtained from the pharmacy department staffing database. Numbers of previous emergency admissions and admission medicines together with age-adjusted co-morbidity and diuretic receipt formed a 12-month post-discharge and/or readmission risk algorithm. Age-adjusted co-morbidity proved to be the best index to predict mortality. Increased numbers of clinical pharmacy staff at ward level was correlated with a reduction in risk-adjusted mortality index (RAMI). Algorithms created were valid in predicting risk of in-hospital and post-discharge mortality and risk of hospital readmission 3, 6 and 12 months post-discharge. The provision of ward-based clinical pharmacy services is a key component to reducing RAMI and enabling the full benefits of pharmacy input to patient care to be realized. © 2014 John Wiley & Sons, Ltd.

  15. 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 ...

  16. Human factors questionnaire as a tool for risk assessment

    International Nuclear Information System (INIS)

    Santos, Isaac J.A.L.; Grecco, Claudio H.S.; Carvalho, Paulo V.R.; Mol, Antonio C.A.; Oliveira, Mauro V.; Augusto, Silas C.

    2009-01-01

    The human factors engineering (HFE) as a discipline, and as a process, seeks to discover and to apply knowledge about human capabilities and limitations to system and equipment design, ensuring that the system design, human tasks and work environment are compatible with the sensory, perceptual, cognitive and physical attributes of the personnel who operates systems and equipment. Risk significance considers the magnitude of the consequences (loss of life, material damage, environmental degradation) and the frequency of occurrence of a particular adverse event. The questionnaire design was based on the following definitions: the score and the classification of the nuclear safety risk. The principal benefit of applying an approach based on the risk significance in the development of the questionnaire is to ensure the identification and evaluation of the features of the projects, related to human factors, which affect the nuclear safety risk, the human actions and the safety of the nuclear plant systems. The human factors questionnaire developed in this study will provide valuable support for risk assessment, making possible the identification of design problems that can influence the evaluation of the nuclear safety risk. (author)

  17. 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...

  18. 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

  19. Prognostic factors in follicular lymphoma: new tools to personalize risk.

    Science.gov (United States)

    Casulo, Carla

    2016-12-02

    Follicular lymphoma (FL) is the most common indolent lymphoma, and it has a long median overall survival (OS). However, the recent discovery of clinical and biological prognostic biomarkers in FL is shedding light on FL heterogeneity and the need for a precise and risk-stratified individual approach at diagnosis and relapse. Many FL patients who are asymptomatic with indolent disease can be vulnerable to the toxicity, emotional distress, and financial burden of overtreatment. Yet a subset of FL patients develop chemoresistance to standard chemoimmunotherapy, experience transformation to aggressive lymphoma and rapid progression, and represent the population most in need of novel therapies and curative approaches. Novel biomarkers that incorporate both clinical and genetic determinants of poor risk are being developed with the hope of identifying high-risk patients at diagnosis in order to offer biologically rational targeted therapies. © 2016 by The American Society of Hematology. All rights reserved.

  20. 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.

  1. 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

  2. Stress Testing as a Tool of Bank Risk Management

    Directory of Open Access Journals (Sweden)

    Antonyuk Oksana I.

    2013-12-01

    Full Text Available The goal of the article is development of theoretical, methodological and practical recommendations on the use of stress testing by Ukrainian commercial banks. Stress testing is defined as a part of bank risk management on the basis of scientific studies of domestic and foreign scientists. The article marks the essence of the bank stress testing and identifies its role in the structure of banks’ risk management in Ukraine. It considers goals of conducting stress testing in banking institutions. It identifies main aspects and specific features of conducting stress testing of bank risks. It characterises main advantages and shortcomings of use of stress testing in the modern bank risk management. It generalises the world and European approaches to the methods of conducting stress testing in commercial banks in comparison with the Ukrainian methodical recommendations. It shows that results of stress testing have practical value, since they help to preliminary assess influence of potentially negative events upon the state of the loan portfolio of the bank and make relevant managerial decisions.

  3. CoCo design as a risk preventive tool

    NARCIS (Netherlands)

    Perotti, E.; Flannery, M.

    2011-01-01

    Contingent Convertible (CoCo) bonds have been suggested as a way to ensure that banks keep aside enough capital to help them through financial crises. This column proposes a market-triggered CoCo buffer to maintain risk incentives during periods of high leverage. It argues that this will also

  4. Risk Reduction with a Fuzzy Expert Exploration Tool

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-10-24

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

  5. Choice of corporate risk management tools under moral hazard

    Czech Academy of Sciences Publication Activity Database

    Bena, Jan

    -, č. 298 (2006), s. 1-43 ISSN 1211-3298 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:AV0Z70850503 Keywords : risk management * corporate insurance * moral hazard Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp298.pdf

  6. Choice of corporate risk management tools under moral hazard

    Czech Academy of Sciences Publication Activity Database

    Bena, Jan

    -, č. 566 (2006), s. 1-41 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:AV0Z70850503 Keywords : risk management * corporate insurance * moral hazard Subject RIV: AH - Economics http://fmg.lse.ac.uk/publications/searchdetail.php?pubid=1&wsid=1&wpdid=800

  7. 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

  8. 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

  9. 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.

  10. PORTFOLIO INSURANCE INVESTMENT STRATEGIES: A RISK-MANAGEMENT TOOL

    Directory of Open Access Journals (Sweden)

    Elma Agic-Sabeta

    2017-06-01

    Full Text Available Unsystemic risks in financial markets may be reduced through diversification. Systemic risks relate to the overall economy, cannot be influenced by a single company, and require special attention. Empirical research on return distributions in the long-term shows that investing under the assumption of normal distribution of returns may be dangerous. The main objectives of this article are to describe portfolio insurance strategies and investigate their advantages and disadvantages. Furthermore, their use in financial markets in both developed and emerging markets is explored, with special consideration placed on southeast European markets. Theoretical models are reviewed, including recent research articles in the field. The results are analyzed, summarized, and presented in the form of tables and graphs. The main finding of the article is identification of strategies that could be used in southeast Europe. It concludes that implementation of portfolio insurance strategies by asset managers may reduce financial risks in southeast European markets if implementation is done professionally and, simultaneously, it is monitored during the entire investment horizon.

  11. 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...

  12. 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.

  13. Risk analysis tools for force protection and infrastructure/asset protection

    International Nuclear Information System (INIS)

    Jaeger, C.D.; Duggan, R.A.; Paulus, W.K.

    1998-01-01

    The Security Systems and Technology Center at Sandia National Laboratories has for many years been involved in the development and use of vulnerability assessment and risk analysis tools. In particular, two of these tools, ASSESS and JTS, have been used extensively for Department of Energy facilities. Increasingly, Sandia has been called upon to evaluate critical assets and infrastructures, support DoD force protection activities and assist in the protection of facilities from terrorist attacks using weapons of mass destruction. Sandia is involved in many different activities related to security and force protection and is expanding its capabilities by developing new risk analysis tools to support a variety of users. One tool, in the very early stages of development, is EnSURE, Engineered Surety Using the Risk Equation. EnSURE addresses all of the risk equation and integrates the many components into a single, tool-supported process to help determine the most cost-effective ways to reduce risk. This paper will briefly discuss some of these risk analysis tools within the EnSURE framework

  14. 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

  15. 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.

  16. Social media as a risk communication tool following Typhoon Haiyan

    Directory of Open Access Journals (Sweden)

    Christine Tiffany Cool

    2015-11-01

    Full Text Available Problem: In the aftermath of Typhoon Haiyan, the World Health Organization (WHO Representative Office in the Philippines had no social media presence to share timely, relevant public health information. Context: Risk communication is essential to emergency management for public health message dissemination. As social media sites, such as Facebook, are popular in the Philippines, these were adopted for risk communication during the response to Haiyan. Action and outcome: The WHO Representative Office in the Philippines established Facebook, Twitter and Instagram accounts. Thirty days after these social medial channels were established, a gradual increase in followers was observed. Facebook saw the largest increase in followers which occurred as posted content gradually evolved from general public health information to more pro-active public health intervention and preparedness messaging. This included information on key health interventions encouraging followers to adopt protective behaviours to mitigate public health threats that frequently occur after a disaster. Lessons learnt: During the response to Haiyan, creating a social media presence, raising a follower base and developing meaningful messages and content was possible. This event underscored the importance of building a social media strategy in non-emergency times and supported the value of developing public health messages and content that both educates and interests the general public.

  17. Development tools for risk implementation of entrepreneurship infrastructure

    Directory of Open Access Journals (Sweden)

    Rustam Ilkamovich Malikov

    2013-12-01

    Full Text Available In the present article, we consider the organizational, economic and institutional aspects of the implementation of infrastructure projects in the Russian Federation. The main objective of the work is to try to organize the parameters of the national economy on the criteria of quality and availability of infrastructure for domestic business. According to the authors, an effective solution to the problem of modernization of infrastructure businesses in the regions may be the result of interaction between the state, the public and businesses to achieve the consolidation of their joint efforts. However, inadequate institutional and legal framework for the interaction of the institutions of government and business can be a significant barrier to the implementation of infrastructure projects to ensure economic activities of businesses. For this reason it is necessary to increase the loyalty and mutual benefit relationship of relevant government agencies and commercial organizations to develop the infrastructure of the complex in the context of meeting the mutual expectations of the parties at all stages of interaction. With the use of fuzzy set theory researchers presented a risk assessment model for infrastructure projects. The use of the model will allow for the participation of the rationale business structure in the formation of infrastructure resources to meet emerging potential benefits in the prevailing levels of risk.

  18. Social media as a risk communication tool following Typhoon Haiyan.

    Science.gov (United States)

    Cool, Christine Tiffany; Claravall, Marie Chantal; Hall, Julie Lyn; Taketani, Keisuke; Zepeda, John Paul; Gehner, Monika; Lawe-Davies, Olivia

    2015-01-01

    In the aftermath of Typhoon Haiyan, the World Health Organization (WHO) Representative Office in the Philippines had no social media presence to share timely, relevant public health information. Risk communication is essential to emergency management for public health message dissemination. As social media sites, such as Facebook, are popular in the Philippines, these were adopted for risk communication during the response to Haiyan. The WHO Representative Office in the Philippines established Facebook, Twitter and Instagram accounts. Thirty days after these social medial channels were established, a gradual increase in followers was observed. Facebook saw the largest increase in followers which occurred as posted content gradually evolved from general public health information to more pro-active public health intervention and preparedness messaging. This included information on key health interventions encouraging followers to adopt protective behaviours to mitigate public health threats that frequently occur after a disaster. During the response to Haiyan, creating a social media presence, raising a follower base and developing meaningful messages and content was possible. This event underscored the importance of building a social media strategy in non-emergency times and supported the value of developing public health messages and content that both educates and interests the general public.

  19. Tensit - a simulation tool for migration, risk and dose calculations

    International Nuclear Information System (INIS)

    Jones, J.; Kautsky, U.; Vahlund, C.F.

    2004-01-01

    During the next years the Swedish Nuclear Fuel and Waste Management Co (SKB) performs site investigations for a future repository of spent nuclear fuel. The repository will be situated in crystalline rock at a depth of approximately 500 m. Novel methods based on systems and landscape ecology are developed to understand the interacting mechanisms and finally, to model radionuclide migration in the biosphere using site specific data. These models and methods are later used as part of the overall safety assessment for the repository where also migration in the near field and in the bedrock is considered. In the present paper, a newly developed probabilistic simulation package, TENSIT, is presented. The package is based on pre-existing codes (Matlab, Simulink and the probabilistic engine-at-risk) and is capable of performing radionuclide migration calculations both for the repository and the biosphere. Hence, a platform independent, transparent (well documented and intuitive on a model scale), thoroughly supported, efficient and user friendly (graphical interface for the modeler) code can be developed at a fairly low cost. Comparisons with other codes used for compartment based biosphere modelling and the PSACOIN Level 1B exercise shows on a good agreement on the application scale. Moreover, by basing the package on continuously maintained, pre-existing codes, potential risks associated with a less spread software may be avoided. In addition to the compartment based models based on transfer factors, TENSIT is also able to handle the more complex ecosystem models (based on flow of carbon and nutrients) either separately or in combination with the compartment models. Within the project, biosphere migration calculations have been performed using TENSIT for a watershed in the Forsmark area (one of the studied sites). In this simulation, data from the ongoing site investigation program has been used to define the based model. (author)

  20. 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...

  1. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. 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.)

  9. [Conflict matrix : Risk management tool in the operating room].

    Science.gov (United States)

    Andel, D; Markstaller, K; Andel, H

    2017-05-01

    In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts. We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR. The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 0-9. By aggregating the response data, an overview of the conflict matrix within this OR section was created. No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between 0 and 6. Estimation of the escalation levels differed widely within one category, showing a range of up to 6 (out of 6) levels. The presented assessment using a conflict matrix is a simple and cost-effective method to assess the conflict landscape, especially in multidisciplinary environments, such as OR management. The chance of conflict prevention or the early recognition of existing conflicts represents an enormous potential for cost and risk saving and might have positive long-term effects by building a culture of conflict prevention at the workplace and a positive influence on interdisciplinary cooperation in this working environment.

  10. 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)

  11. 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.

  12. 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.

  13. 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.

  14. 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)

  15. 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)

  16. 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.

  17. 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.

  18. [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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. Risk factor: a tool for risk administration; Fator de risco: uma ferramenta para gestao de risco

    Energy Technology Data Exchange (ETDEWEB)

    Ferraco Junior, Darcy; Bobsin, Marco Aurelio; Araujo, Mirian Peres de; Cabral, Simone Dias [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The risk management has been processing in an evolutionary form through the years. Derived from military development, nowadays it encircles the industries and constitutes in one of the administration elements of large and medium corporations. At the Centro de Pesquisas Leopoldo Miguez de Mello (CENPES) the matter of risk management has passed through an expressive change with the implementation of the raising of aspects and impacts (LAI) and the utilization of the risk factor as indicator of the risk administration in the managements of the research center. (author)

  10. 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.

  11. 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.

  12. 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)

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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. 

  19. 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

  20. 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

  1. 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

  2. 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....

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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...

  8. 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

  9. 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.

  10. 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.)

  11. 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

  12. 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...

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. 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...

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. Health risks maps. Modelling of air quality as a tool to map health risks

    International Nuclear Information System (INIS)

    Van Doorn, R.; Hegger, C.

    2000-01-01

    Environmental departments consider geographical maps with information on air quality as the final product of a complicated process of measuring, modelling and presentation. Municipal health departments consider such maps a useful starting point to solve the problem whether air pollution causes health risks for citizens. The answer to this question cannot be reduced to checking if threshold limit values are exceeded. Based on the results of measurements and modelling of concentrations of nitrogen dioxide in air, the health significance of air pollution caused by nitrogen dioxide is illuminated. A proposal is presented to map health risks of air pollution by using the results of measurements and modelling of air pollution. 7 refs

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. SOCIAL MEDIA RISK ANALYSIS: HOW TO USE ACCEPTED RISK ASSESSMENT TOOLS TO ANALYZE SOCIAL MEDIA RISKS IN MILITARY ORGANIZATIONS

    Science.gov (United States)

    2017-06-01

    Commanders may see value in utilizing the schools of thought to understand how each one influences their judgment of social media risks. For instance...school may represent a view that employs social media to influence the decision-making and behavior of adversaries. Each school of thought differs...the risk further, or accept the risk and move on to the next threat event. Social Media Schools of Thought. Each school of thought may influence

  13. 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.)

  14. 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.

  15. 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)

  16. 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.

  17. 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…

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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)

  7. 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.

  8. 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.)

  9. 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.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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)

  17. 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)

  18. 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

  19. 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

  20. 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

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

    Science.gov (United States)

    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.

  2. 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.

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

    Science.gov (United States)

    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.

  4. 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).

  5. 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.

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

    Science.gov (United States)

    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.

  7. 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.

  8. 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)

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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

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

    Science.gov (United States)

    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.

  19. 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

  20. 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

  1. 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)

  2. 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)

  3. 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

  4. 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

  5. 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.

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

    Science.gov (United States)

    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...

  7. 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.

  8. 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.

  9. 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)

  10. 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

  11. 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.

  12. 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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Identifying the Risk Areas and Urban Growth by ArcGIS-Tools

    Directory of Open Access Journals (Sweden)

    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.

  1. [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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. [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

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

    Science.gov (United States)

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

    2017-10-24

    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 modelling techniques and will be used to project dementia prevalence. The derivation cohort will consist of elderly Ontario respondents of the Canadian Community Health Survey (CCHS) (2001, 2003, 2005 and 2007; 18 764 males and 25 288 females). Prespecified predictors include sociodemographic, general health, behavioural, functional and health condition variables. Incident dementia will be identified through individual linkage of survey respondents to population-level administrative healthcare databases (1797 and 3281 events, and 117 795 and 166 573 person-years of follow-up, for males and females, respectively, until 31 March 2014). Using time of first dementia capture as the primary outcome and death as a competing risk, sex-specific proportional hazards regression models will be estimated. The 2008/2009 CCHS survey will be used for validation (approximately 4600 males and 6300 females). Overall calibration and discrimination will be assessed as well as calibration within predefined subgroups of importance to clinicians and policy makers. Research ethics approval has been granted by the Ottawa Health Science Network Research Ethics Board. DemPoRT results will be submitted for publication in peer-review journals and presented at scientific meetings. The algorithm will be assessable online for both population and individual uses. ClinicalTrials.gov NCT03155815, pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  9. 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.

  10. 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.

  11. Developing tools for the safety specification in risk management plans: lessons learned from a pilot project.

    Science.gov (United States)

    Cooper, Andrew J P; Lettis, Sally; Chapman, Charlotte L; Evans, Stephen J W; Waller, Patrick C; Shakir, Saad; Payvandi, Nassrin; Murray, Alison B

    2008-05-01

    Following the adoption of the ICH E2E guideline, risk management plans (RMP) defining the cumulative safety experience and identifying limitations in safety information are now required for marketing authorisation applications (MAA). A collaborative research project was conducted to gain experience with tools for presenting and evaluating data in the safety specification. This paper presents those tools found to be useful and the lessons learned from their use. Archive data from a successful MAA were utilised. Methods were assessed for demonstrating the extent of clinical safety experience, evaluating the sensitivity of the clinical trial data to detect treatment differences and identifying safety signals from adverse event and laboratory data to define the extent of safety knowledge with the drug. The extent of clinical safety experience was demonstrated by plots of patient exposure over time. Adverse event data were presented using dot plots, which display the percentages of patients with the events of interest, the odds ratio, and 95% confidence interval. Power and confidence interval plots were utilised for evaluating the sensitivity of the clinical database to detect treatment differences. Box and whisker plots were used to display laboratory data. This project enabled us to identify new evidence-based methods for presenting and evaluating clinical safety data. These methods represent an advance in the way safety data from clinical trials can be analysed and presented. This project emphasises the importance of early and comprehensive planning of the safety package, including evaluation of the use of epidemiology data.

  12. 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.

  13. 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.

  14. An Online Tool for Nurse Triage to Evaluate Risk for Acute Coronary Syndrome at Emergency Department

    Directory of Open Access Journals (Sweden)

    Yuwares Sittichanbuncha

    2015-01-01

    Full Text Available Background. To differentiate acute coronary syndrome (ACS from other causes in patients presenting with chest pain at the emergency department (ED is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital. Methods. We retrospectively enrolled consecutive patients who were identified as ACS at risk patients by the ED nurse triage. Patients were categorized as ACS and non-ACS group by the final diagnosis. Multivariate logistic analysis was used to predict factors associated with ACS. An online model predictive of ACS for the ED nurse triage was constructed. Results. There were 175 patients who met the study criteria. Of those, 28 patients (16.0% were diagnosed with ACS. Patients with diabetes, patients with previous history of CAD, and those who had at least one character of ACS chest pain were independently associated with having ACS by multivariate logistic regression. The adjusted odds ratios (95% confidence interval were 4.220 (1.445, 12.327, 3.333 (1.040, 10.684, and 12.539 (3.876, 40.567, respectively. Conclusions. The effectiveness of the ED nurse triage for ACS was 16%. The online tool is available for the ED triage nurse to evaluate risk of ACS in individuals.

  15. 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.)

  16. 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.

  17. Development and pilot feasibility study of a health information technology tool to calculate mortality risk for patients with asymptomatic carotid stenosis: the Carotid Risk Assessment Tool (CARAT)

    OpenAIRE

    Faerber, Adrienne E; Horvath, Rebecca; Stillman, Carey; O?Connell, Melissa L; Hamilton, Amy L; Newhall, Karina A; Likosky, Donald S; Goodney, Philip P

    2015-01-01

    Background Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians? ability to recommend optimal treatments based on an individual?s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assess...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. Development and validation of the FRAGIRE tool for assessment an older person's risk for frailty.

    Science.gov (United States)

    Vernerey, Dewi; Anota, Amelie; Vandel, Pierre; Paget-Bailly, Sophie; Dion, Michele; Bailly, Vanessa; Bonin, Marie; Pozet, Astrid; Foubert, Audrey; Benetkiewicz, Magdalena; Manckoundia, Patrick; Bonnetain, Franck

    2016-11-17

    Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults. A prospective multicenter recruitment of the elderly patients was undertaken in France. The subjects were classified into financially-helped group (FH, with financial assistance) and non-financially helped group (NFH, without any financial assistance), considering FH subjects are more frail than the NFH group and thus representing an acceptable surrogate population for frailty. Psychometric properties of the FRAGIRE grid were assessed including discrimination between the FH and NFH groups. Items reduction was made according to statistical analyses and experts' point of view. The association between items response and tests with "help requested status" was assessed in univariate and multivariate unconditional logistic regression analyses and a prognostic score to become frail was finally proposed for each subject. Between May 2013 and July 2013, 385 subjects were included: 338 (88%) in the FH group and 47 (12%) in the NFH group. The initial FRAGIRE grid included 65 items. After conducting the item selection, the final grid of the FRAGIRE was reduced to 19 items. The final grid showed fair discrimination ability to predict frailty (area under the curve (AUC) = 0.85) and good calibration (Hosmer-Lemeshow P-value = 0.580), reflecting a good agreement between the prediction by the final model and actual observation. The Cronbach's alpha for the developed tool scored as high as 0.69 (95% Confidence Interval: 0.64 to 0.74). The final prognostic score was excellent, with an AUC of 0

  11. Remote Sensing as a Landscape Epidemiologic Tool to Identify Villages at High Risk for Malaria Transmission

    Science.gov (United States)

    Beck, Louisa R.; Rodriquez, Mario H.; Dister, Sheri W.; Rodriquez, Americo D.; Rejmankova, Eliska; Ulloa, Armando; Meza, Rosa A.; Roberts, Donald R.; Paris, Jack F.; Spanner, Michael A.; hide

    1994-01-01

    A landscape approach using remote sensing and Geographic Information System (GIS) technologies was developed to discriminate between villages at high and low risk for malaria transmission, as defined by adult Anopheles albimanus abundance. Satellite data for an area in southern Chiapas, Mexico were digitally processed to generate a map of landscape elements. The GIS processes were used to determine the proportion of mapped landscape elements surrounding 40 villages where An. albimanus data had been collected. The relationships between vector abundance and landscape element proportions were investigated using stepwise discriminant analysis and stepwise linear regression. Both analyses indicated that the most important landscape elements in terms of explaining vector abundance were transitional swamp and unmanaged pasture. Discriminant functions generated for these two elements were able to correctly distinguish between villages with high ind low vector abundance, with an overall accuracy of 90%. Regression results found both transitional swamp and unmanaged pasture proportions to be predictive of vector abundance during the mid-to-late wet season. This approach, which integrates remotely sensed data and GIS capabilities to identify villages with high vector-human contact risk, provides a promising tool for malaria surveillance programs that depend on labor-intensive field techniques. This is particularly relevant in areas where the lack of accurate surveillance capabilities may result in no malaria control action when, in fact, directed action is necessary. In general, this landscape approach could be applied to other vector-borne diseases in areas where: 1. the landscape elements critical to vector survival are known and 2. these elements can be detected at remote sensing scales.

  12. Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management

    Science.gov (United States)

    Piette, John D.; List, Justin; Rana, Gurpreet K.; Townsend, Whitney; Striplin, Dana; Heisler, Michele

    2016-01-01

    We examined evidence on whether mobile health (mHealth) tools, including Interactive Voice Response (IVR) calls, short message service (SMS) or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and grey literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries (LMICs). IVR and SMS interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. IVR and SMS-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multi-modal interventions including web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in more than 30 LMICs, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients’ unique and changing needs. PMID:26596977

  13. Modified STOP-Bang Tool for Stratifying Obstructive Sleep Apnea Risk in Adolescent Children.

    Directory of Open Access Journals (Sweden)

    Daniel Combs

    Full Text Available Obstructive sleep apnea (OSA is prevalent in children and diagnostic polysomnography is costly and not readily available in all areas. We developed a pediatric modification of a commonly used adult clinical prediction tool for stratifying the risk of OSA and the need for polysomnography.A total of 312 children (age 9-17 years from phase 2 of the Tucson Children's Assessment of Sleep Apnea cohort study, with complete anthropomorphic data, parent questionnaires, and home polysomnograms were included. An adolescent modification of STOP-Bang (teen STOP-Bang was developed and included snoring, tired, observed apnea, blood pressure ≥ 95th percentile, BMI > 95th percentile, academic problems, neck circumference >95th percentile for age, and male gender. An apnea-hypopnea index ≥ 1.5 events/hour was considered diagnostic of OSA.Receiver Operator Characteristic (ROC curves for parent-reported STOP-Bang scores were generated for teenage and pre-teen children. A STOP-Bang score of < 3 in teenagers was associated with a negative predictive value of 0.96. ROC curves were also generated based upon child-reported sexual maturity rating (SMR; n = 291. The ability of teen STOP-Bang to discriminate the presence or absence of OSA as measured by the AUC for children with SMR ≥ 4 (0.83; 95%CI 0.71-0.95 was better than children with SMR < 4 (0.63; 95%CI 0.46-0.81; p = 0.048.In community dwelling adolescents, teen STOP-Bang may be useful in stratifying the risk of OSA.

  14. Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

    Science.gov (United States)

    Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

    2015-11-24

    We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs

  15. 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

  16. 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.

  17. 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...

  18. Genetic Stratification in Myeloid Diseases: From Risk Assessment to Clinical Decision Support Tool

    Directory of Open Access Journals (Sweden)

    Yishai Ofran

    2014-10-01

    Full Text Available Genetic aberrations have become a dominant factor in the stratification of myeloid malignancies. Cytogenetic and a few mutation studies are the backbone of risk assessment models of myeloid malignancies which are a major consideration in clinical decisions, especially patient assignment for allogeneic stem cell transplantation. Progress in our understanding of the genetic basis of the pathogenesis of myeloid malignancies and the growing capabilities of mass sequencing may add new roles for the clinical usage of genetic data. A few recently identified mutations recognized to be associated with specific diseases or clinical scenarios may soon become part of the diagnostic criteria of such conditions. Mutational studies may also advance our capabilities for a more efficient patient selection process, assigning the most effective therapy at the best timing for each patient. The clinical utility of genetic data is anticipated to advance further with the adoption of deep sequencing and next-generation sequencing techniques. We herein suggest some future potential applications of sequential genetic data to identify pending deteriorations at time points which are the best for aggressive interventions such as allogeneic stem cell transplantation. Genetics is moving from being mostly a prognostic factor to becoming a multitasking decision support tool for hematologists. Physicians must pay attention to advances in molecular hematology as it will soon be accessible and influential for most of our patients.

  19. Identifying areas under potential risk of illegal construction and demolition waste dumping using GIS tools.

    Science.gov (United States)

    Seror, Nissim; Portnov, Boris A

    2018-05-01

    Construction and demolition (C&D) waste, dumped illegally in ravines and open areas, contaminates soil and can cause underground water pollution and forests fires. Yet, effective monitoring of illegal C&D waste dumping and enforcing legislation against the offenders are often a difficult task due to the large size of geographic areas that need to be monitored, and limited human and financial resources available to environmental law enforcement agencies. In this study, we use Geographic Information System (GIS) tools and geo-statistical modelling to identify the areas under potentially elevated risk of illegal C&D waste dumping in the Haifa district of Israel. As our analysis shows, locational factors, significantly associated with the accumulated amount of waste in the existing illegal C&D waste sites, include: distance to the nearest main road, depth of the ravine present at the site (pwaste dumping for future monitoring. As we suggest, the proposed approach may be useful for environmental law enforcement authorities, by helping them to focus on specific sites for inspection, save resources, and act against the offenders more efficiently. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Development and psychometric evaluation of a cardiovascular risk and disease management knowledge assessment tool.

    Science.gov (United States)

    Rosneck, James S; Hughes, Joel; Gunstad, John; Josephson, Richard; Noe, Donald A; Waechter, Donna

    2014-01-01

    This article describes the systematic construction and psychometric analysis of a knowledge assessment instrument for phase II cardiac rehabilitation (CR) patients measuring risk modification disease management knowledge and behavioral outcomes derived from national standards relevant to secondary prevention and management of cardiovascular disease. First, using adult curriculum based on disease-specific learning outcomes and competencies, a systematic test item development process was completed by clinical staff. Second, a panel of educational and clinical experts used an iterative process to identify test content domain and arrive at consensus in selecting items meeting criteria. Third, the resulting 31-question instrument, the Cardiac Knowledge Assessment Tool (CKAT), was piloted in CR patients to ensure use of application. Validity and reliability analyses were performed on 3638 adults before test administrations with additional focused analyses on 1999 individuals completing both pretreatment and posttreatment administrations within 6 months. Evidence of CKAT content validity was substantiated, with 85% agreement among content experts. Evidence of construct validity was demonstrated via factor analysis identifying key underlying factors. Estimates of internal consistency, for example, Cronbach's α = .852 and Spearman-Brown split-half reliability = 0.817 on pretesting, support test reliability. Item analysis, using point biserial correlation, measured relationships between performance on single items and total score (P knowledge instrument specifically designed for an adult CR population was systematically developed and tested in a large representative patient population, satisfying psychometric parameters, including validity and reliability.

  1. 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.

  2. 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.

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

    NARCIS (Netherlands)

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

    Background: Several malnutrition screening tools have been advocated for use in pediatric inpatients. Objective: 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

  4. 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.)

  5. Tool Weighs Benefits, Risks of Raloxifene or Tamoxifen to Prevent Breast Cancer

    Science.gov (United States)

    Researchers have developed a benefit-risk index to help guide decisions on whether postmenopausal women at increased risk of developing breast cancer should take raloxifene or tamoxifen to reduce that risk.

  6. 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

  7. COMSY - A software tool for PLIM + PLEX with integrated risk-informed approaches

    International Nuclear Information System (INIS)

    Zander, A.; Nopper, H.; Roessner, R.

    2004-01-01

    The majority of mechanical components and structures in a thermal power plant are designed to experience a service life which is far above the intended design life. In most cases, only a small percentage of mechanical components are subject to significant degradation which may affect the integrity or the function of the component. If plant life extension (PLEX) is considered as an option, a plant specific PLIM strategy needs to be developed. One of the most important tasks of such a PLIM strategy is to identify those components which (i) are relevant for the safety and/or availability of the plant and (ii) experience elevated degradation due to their operating and design conditions. For these components special life management strategies need to be established to reliably monitor their condition. FRAMATOME ANP GmbH has developed the software tool COMSY, which is designed to efficiently support a plant-wide lifetime management strategy for static mechanical components, providing the basis for plant life extension (PLEX) activities. The objective is the economical and safe operation of power plants over their design lifetime - and beyond. The tool provides the capability to establish a program guided technical documentation of the plant by utilizing a virtual plant data model. The software integrates engineering analysis functions and comprehensive material libraries to perform a lifetime analysis for various degradation mechanisms typically experienced in power plants (e.g. flow-accelerated corrosion, intergranular stress corrosion cracking, strain-induced cracking, material fatigue, cavitation erosion, droplet impingement erosion, pitting, etc.). A risk-based prioritization serves to focus inspection activities on safety or availability relevant locations, where a degradation potential exists. Trending functions support the comparison of the as-measured condition with the predicted progress of degradation while making allowance for measurement tolerances. The

  8. 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

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

    Science.gov (United States)

    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.

  10. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics.

    Science.gov (United States)

    Baral, Stefan; Logie, Carmen H; Grosso, Ashley; Wirtz, Andrea L; Beyrer, Chris

    2013-05-17

    Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These factors are representative of social, economic, organizational and political inequities. Associated with an improved understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages. Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is often far more actionable than characterizing individual-level risks. We propose a modified social ecological model (MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM. The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic studies has traditionally been on

  11. 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.

  12. Value at Risk as a Diagnostic Tool for Corporates: The Airline Industry

    NARCIS (Netherlands)

    W.G.P.M. Hallerbach (Winfried); A.J. Menkveld (Bert)

    1999-01-01

    textabstractIn recent years the Value at Risk (VaR) concept for measuring downside risk has been widely studied. VaR basically is a summary statistic that quantifies the exposure of an asset or portfolio to market risk, or the risk that a position declines in value with adverse market price changes.

  13. A decision support tool to prioritize risk management options for contaminated sites.

    Science.gov (United States)

    Sorvari, Jaana; Seppälä, Jyri

    2010-03-15

    The decisions on risk management (RM) of contaminated sites in Finland have typically been driven by practical factors such as time and money. However, RM is a multifaceted task that generally involves several additional determinants, e.g. performance and environmental effects of remediation methods, psychological and social factors. Therefore, we adopted a multi-criteria decision analysis approach and developed a decision support tool (DST) that is viable in decision-making in such a complex situation. The basic components of the DST are based on the Dutch REC system. However, our DST is more case-specific and allows the consideration of the type, magnitude and scale of contamination, land use, environmental conditions and socio-cultural aspects (e.g. loss of cultural heritage, image aspects). The construction of the DST was started by structuring the decision problem using a value tree. Based on this work we adopted the Multi-Attribute Value Theory (MAVT) for data aggregation. The final DST was demonstrated by two model sites for which the RM alternatives and site-specific data were created on the basis of factual remediation projects and by interviewing experts. The demonstration of the DST was carried out in a workshop where representatives of different stakeholders were requested to rank and weight the decision criteria involved. To get information on the consistency of the ranking of the RM alternatives, we used different weighting techniques (ratio estimation and pair-wise weighting) and alternative ways to treat individual respondents' weights in calculating the preference scores for each RM alternative. These dissimilar approaches resulted in some differences in the preference order of the RM alternatives. The demonstration showed that attention has to be paid to the proper description of the site, the principles of the procedure and the decision criteria. Nevertheless, the procedure proved to enable efficient communication between different stakeholders

  14. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio.

    Science.gov (United States)

    Spencer, Timothy R; Mahoney, Keegan J

    2017-11-01

    In vascular access practices, the internal vessel size is considered important, and a catheter to vessel ratio (CVR) is recommended to assist clinicians in selecting the most appropriate-sized device for the vessel. In 2016, new practice recommendations stated that the CVR can increase from 33 to 45% of the vessels diameter. There has been evidence on larger diameter catheters and increased thrombosis risk in recent literature, while insufficient information established on what relationship to vessel size is appropriate for any intra-vascular device. Earlier references to clinical standards and guidelines did not clearly address vessel size in relation to the area consumed or external catheter diameter. The aim of this manuscript is to present catheter-related thrombosis evidence and develop a standardized process of ultrasound-guided vessel assessment, integrating CVR, Virchow's triad phenomenon and vessel health and preservation strategies, empowering an evidence-based approach to device placement. Through review, calculation and assessment on the areas of the 33 and 45% rule, a preliminary clinical tool was developed to assist clinicians make cognizant decisions when placing intravascular devices relating to target vessel size, focusing on potential reduction in catheter-related thrombosis. Increasing the understanding and utilization of CVRs will lead to a safer, more consistent approach to device placement, with potential thrombosis reduction strategies. The future of evidence-based data relies on the clinician to capture accurate vessel measurements and device-related outcomes. This will lead to a more dependable data pool, driving the relationship of catheter-related thrombosis and vascular assessment.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Overtopping hazards to port activities: Application of a new methodology to risk management (POrt Risk MAnagement Tool)

    International Nuclear Information System (INIS)

    Alises, Ana; Molina, Rafael; Gómez, Rebeca; Pery, Pascual; Castillo, Carmen

    2014-01-01

    In the past 20 years, the need of ports to serve a fleet whose dimensions are continuously increasing due to economies of scale, has derived on a port infrastructures growth with a trend to look for greater drafts at deeper waters and therefore the protection structures built in the last years have been increasingly exposed to severer maritime climate action. Consequently, overtopping phenomenon has been identified as a potential risk factor able to cause structural damages and operative failure modes to vulnerable economic activities located at these port facilities. Port activities must be developed ensuring operative and safety conditions what imply reducing uncertainties of overtopping phenomena by using prediction methods which may allow overtopping risk management. This paper provides a risk assessment methodology which is integrated into an overtopping risk management framework to cope with safety problems in port exploitation. Overtopping risk value is measured by combining probability of occurrence of an undesirable event together with its consequences, estimated in terms of costs or delays and given in base of the vulnerability of the affected port system. The development of this methodology is described and finally applied to a real case study what seems to reinforce the validity of the proposed method to overtopping risk assessment. - Highlights: • Infrastructure risk assessment involves both probabilistic and economic techniques. • Risk equation is posed by the combination of probability, vulnerability and cost. • Port infrastructures' vulnerability level depends on climate agents' action. • Economic value of natural hazards consequences is linked with vulnerability level. • Project planning process should be done taking into account the project's risk distribution

  1. Early detection of communication delays with the PEDS tools in at-risk South African infants

    Directory of Open Access Journals (Sweden)

    Jeannie van der Linde

    2016-04-01

    Method: A comparative study design evaluated the accuracy of the PEDS tools to detect communication delays, using an internationally accepted diagnostic assessment tool, the Rossetti Infant-Toddler Language Scale (RITLS. A convenience sample of 201 infants was selected at primary healthcare clinics. Results: Expressive and receptive language sensitivity scores were low across all three screens(ranging between 14% and 44%. The PEDS tools had high sensitivity (71% and specificity (73% ratings for the receptive and expressive language and socio-emotional domain in combination. Conclusion: In the sample population, the PEDS tools did not accurately detect receptive and expressive language delays; however, communication delays in general were identified. Future research determining accuracy of the PEDS, PEDS-Developmental Milestones and PEDS tools for children aged 2–5 years in detecting communication delays should be prioritised.

  2. Predicting risk and outcomes for frail older adults: an umbrella review of frailty screening tools

    Science.gov (United States)

    Apóstolo, João; Cooke, Richard; Bobrowicz-Campos, Elzbieta; Santana, Silvina; Marcucci, Maura; Cano, Antonio; Vollenbroek-Hutten, Miriam; Germini, Federico; Holland, Carol

    2017-01-01

    EXECUTIVE SUMMARY Background A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. Objectives To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. Inclusion criteria Population Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals. Index test Available frailty measures in older adults. Reference test Cardiovascular Health Study phenotype model, the Canadian Study of Health and Aging cumulative deficit model, Comprehensive Geriatric Assessment or other reference tests. Diagnosis of interest Frailty defined as an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Types of studies Quantitative systematic reviews. Search strategy A three-step search strategy was utilized to find systematic reviews, available in English, published between January 2001 and October 2015. Methodological quality Assessed by two independent reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Data extraction Two independent reviewers extracted data using the standardized data extraction tool designed for umbrella reviews. Data synthesis Data were only presented in a narrative form due to the heterogeneity of included reviews. Results Five reviews with a total of 227,381 participants were included in this umbrella review. Two reviews focused on reliability, validity and diagnostic accuracy; two examined predictive ability for adverse health outcomes; and one investigated validity, diagnostic accuracy and predictive ability. In total, 26 questionnaires and brief assessments and eight frailty

  3. Development and application of a geospatial wildfire exposure and risk calculation tool

    Science.gov (United States)

    Matthew P. Thompson; Jessica R. Haas; Julie W. Gilbertson-Day; Joe H. Scott; Paul Langowski; Elise Bowne; David E. Calkin

    2015-01-01

    Applying wildfire risk assessment models can inform investments in loss mitigation and landscape restoration, and can be used to monitor spatiotemporal trends in risk. Assessing wildfire risk entails the integration of fire modeling outputs, maps of highly valued resources and assets (HVRAs), characterization of fire effects, and articulation of relative importance...

  4. 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

  5. Quantifying the geopolitical dimension of energy risks: A tool for energy modelling and planning

    International Nuclear Information System (INIS)

    Muñoz, Beatriz; García-Verdugo, Javier; San-Martín, Enrique

    2015-01-01

    Energy risk and security are topical issues in energy analysis and policy. However, the quantitative analysis of energy risk presents significant methodological difficulties, especially when dealing with certain of its more qualitative dimensions. The aim of this paper is to quantitatively estimate the geopolitical risk of energy supply with the help of a multivariate statistical technique, factor analysis. Four partial energy risk factors were computed for 122 countries, which were subsequently aggregated to form the composite GESRI (Geopolitical Energy Supply Risk Index). The results demonstrate that advanced economies present a lower level of geopolitical energy risk, especially countries with energy resources, while less-developed countries register higher levels of risk regardless of their energy production. Although this indicator is computed for countries, it can be aggregated for regions or corridors, and it could also be applied to model and scenario building. The different uses of the GESRI could eventually lead to practical implications in the energy policy field, as well as in the energy planning and energy management areas. - Highlights: • We quantitatively estimate the multidimensional geopolitical risk of energy supply. • Factor analysis was used to reveal energy risk, a variable not directly observable. • Advanced economies with energy resources present the lowest level of energy risk. • Less-developed countries obtain high risk values even when they are energy producers. • The proposed index can be used for energy planning and energy management purposes

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

    Directory of Open Access Journals (Sweden)

    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

  7. 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

  8. 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.

  9. Company project: "Evaluation of the quality of medical records as a tool of clinical risk management"

    OpenAIRE

    Anna Santa Guzzo; Mario Tecca; Enrico Marinelli; Claudio Bontempi; Caterina Palazzo; Paolo Ursillo; Giuseppe Ferro; Anna Miani; Annunziata Salvati; Stefania Catanzaro; Massimiliano Chiarini; Domenica Vittoria Colamesta; Domenico Cacchio; Patrizia Sposato; Anna Maria Lombardi

    2017-01-01

    Introduction: The medical record was defined by the Italian Ministry of Health in 1992 as "the information tool designed to record all relevant demographic and clinical information on a patient during a single hospitalization episode". Retrospective analysis of medical records is a tool for selecting direct and indirect indicators of critical issues (organizational, management, technical and professional issues). The project’s purpose being the promotion of an evaluation and self-evaluation ...

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

    Science.gov (United States)

    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

  11. Coronary Artery Calcium Screening: Does it Perform Better than Other Cardiovascular Risk Stratification Tools?

    Directory of Open Access Journals (Sweden)

    Irfan Zeb

    2015-03-01

    Full Text Available Coronary artery calcium (CAC has been advocated as one of the strongest cardiovascular risk prediction markers. It performs better across a wide range of Framingham risk categories (6%–10% and 10%–20% 10-year risk categories and also helps in reclassifying the risk of these subjects into either higher or lower risk categories based on CAC scores. It also performs better among population subgroups where Framingham risk score does not perform well, especially young subjects, women, family history of premature coronary artery disease and ethnic differences in coronary risk. The absence of CAC is also associated with excellent prognosis, with 10-year event rate of 1%. Studies have also compared with other commonly used markers of cardiovascular disease risk such as Carotid intima-media thickness and highly sensitive C-reactive protein. CAC also performs better compared with carotid intima-media thickness and highly sensitive C-reactive protein in prediction of coronary heart disease and cardiovascular disease events. CAC scans are associated with relatively low radiation exposure (0.9–1.1 mSv and provide information that can be used not only for risk stratification but also can be used to track the progression of atherosclerosis and the effects of statins.

  12. 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.

  13. 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.

  14. 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.

  15. Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Johansen Taber KA

    2015-01-01

    Full Text Available Katherine A Johansen Taber, Barry D DickinsonDepartment of Science and Biotechnology, American Medical Association, Chicago, IL, USAAbstract: Type 2 diabetes (T2D is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.Keywords: diabetes, genomic, risk prediction, management

  16. Integration of risk and benefit analysis - The window of benefit as a new tool?

    NARCIS (Netherlands)

    Palou, A.; Pico, C.; Keijer, J.

    2009-01-01

    Foods and food components can have positive and/or negative effects on our health, resulting in benefits and risks. At present these are evaluated in largely separated trajectories. In view of assessment, management, and communication, we here propose and argue for an integrated evaluation of risk

  17. 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.

  18. 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

  19. 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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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

  2. "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.

  3. 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.

  4. 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.

  5. A software tool integrated risk assessment of spent fuel transpotation and storage

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Mi Rae; Almomani, Belal; Ham, Jae Hyun; Kang, Hyun Gook [Dept. of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Christian, Robby [Dept. of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy (Korea, Republic of); Kim, Bo Gyung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Lee, Sang Hoon [Dept. of Mechanical and Automotive Engineering, Keimyung University, Daegu (Korea, Republic of)

    2017-06-15

    When temporary spent fuel storage pools at nuclear power plants reach their capacity limit, the spent fuel must be moved to an alternative storage facility. However, radioactive materials must be handled and stored carefully to avoid severe consequences to the environment. In this study, the risks of three potential accident scenarios (i.e., maritime transportation, an aircraft crashing into an interim storage facility, and on-site transportation) associated with the spent fuel transportation process were analyzed using a probabilistic approach. For each scenario, the probabilities and the consequences were calculated separately to assess the risks: the probabilities were calculated using existing data and statistical models, and the consequences were calculated using computation models. Risk assessment software was developed to conveniently integrate the three scenarios. The risks were analyzed using the developed software according to the shipment route, building characteristics, and spent fuel handling environment. As a result of the risk analysis with varying accident conditions, transportation and storage strategies with relatively low risk were developed for regulators and licensees. The focus of this study was the risk assessment methodology; however, the applied model and input data have some uncertainties. Further research to reduce these uncertainties will improve the accuracy of this mode.

  6. A software tool integrated risk assessment of spent fuel transpotation and storage

    International Nuclear Information System (INIS)

    Yun, Mi Rae; Almomani, Belal; Ham, Jae Hyun; Kang, Hyun Gook; Christian, Robby; Kim, Bo Gyung; Lee, Sang Hoon

    2017-01-01

    When temporary spent fuel storage pools at nuclear power plants reach their capacity limit, the spent fuel must be moved to an alternative storage facility. However, radioactive materials must be handled and stored carefully to avoid severe consequences to the environment. In this study, the risks of three potential accident scenarios (i.e., maritime transportation, an aircraft crashing into an interim storage facility, and on-site transportation) associated with the spent fuel transportation process were analyzed using a probabilistic approach. For each scenario, the probabilities and the consequences were calculated separately to assess the risks: the probabilities were calculated using existing data and statistical models, and the consequences were calculated using computation models. Risk assessment software was developed to conveniently integrate the three scenarios. The risks were analyzed using the developed software according to the shipment route, building characteristics, and spent fuel handling environment. As a result of the risk analysis with varying accident conditions, transportation and storage strategies with relatively low risk were developed for regulators and licensees. The focus of this study was the risk assessment methodology; however, the applied model and input data have some uncertainties. Further research to reduce these uncertainties will improve the accuracy of this mode

  7. 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.

  8. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials

    DEFF Research Database (Denmark)

    Jørgensen, L; Paludan-Müller, A. S.; Laursen, David

    2016-01-01

    the tool is applied to both Cochrane and non-Cochrane systematic reviews. Methods: A review of published comments (searches in PubMed, The Cochrane Methodology Register and Google Scholar) and an observational study (100 Cochrane and 100 non-Cochrane reviews from 2014). Results: Our review included 68...

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

    Science.gov (United States)

    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

  10. 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.

  11. Application of modeling tools for risk assessment of engineered nanomaterials in aquatic systems

    CSIR Research Space (South Africa)

    Ondiaka, M

    2012-04-01

    Full Text Available Globally, engineered nanomaterials (ENMs) are increasingly being used in nanoproducts to improve their performance. The multi-stage lifecycle of ENMs increases their potential risk profiles to different environmental systems, for example, due...

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

    DEFF Research Database (Denmark)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela

    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...... 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...

  13. Eliciting affect via immersive virtual reality: a tool for adolescent risk reduction.

    Science.gov (United States)

    Hadley, Wendy; Houck, Christopher D; Barker, David H; Garcia, Abbe Marrs; Spitalnick, Josh S; Curtis, Virginia; Roye, Scott; Brown, Larry K

    2014-04-01

    A virtual reality environment (VRE) was designed to expose participants to substance use and sexual risk-taking cues to examine the utility of VR in eliciting adolescent physiological arousal. 42 adolescents (55% male) with a mean age of 14.54 years (SD = 1.13) participated. Physiological arousal was examined through heart rate (HR), respiratory sinus arrhythmia (RSA), and self-reported somatic arousal. A within-subject design (neutral VRE, VR party, and neutral VRE) was utilized to examine changes in arousal. The VR party demonstrated an increase in physiological arousal relative to a neutral VRE. Examination of individual segments of the party (e.g., orientation, substance use, and sexual risk) demonstrated that HR was significantly elevated across all segments, whereas only the orientation and sexual risk segments demonstrated significant impact on RSA. This study provides preliminary evidence that VREs can be used to generate physiological arousal in response to substance use and sexual risk cues.

  14. Mitigating Corporate Water Risk: Financial Market Tools and Supply Management Strategies

    Directory of Open Access Journals (Sweden)

    Wendy M. Larson

    2012-10-01

    Full Text Available A decision framework for business water-risk response is proposed that considers financial instruments and supply management strategies. Based on available and emergent programmes, companies in the agricultural, commodities, and energy sectors may choose to hedge against financial risks by purchasing futures contracts or insurance products. These strategies address financial impacts such as revenue protection due to scarcity and disruption of direct operations or in the supply chain, but they do not directly serve to maintain available supplies to continue production. In contrast, companies can undertake actions in the watershed to enhance supply reliability and/or they can reduce demand to mitigate risk. Intermediate strategies such as purchasing of water rights or water trading involving financial transactions change the allocation of water but do not reduce overall watershed demand or increase water supply. The financial services industry is playing an increasingly important role, by considering how water risks impact decision making on corporate growth and market valuation, corporate creditworthiness, and bond rating. Risk assessment informed by Conditional Value-at-Risk (CVaR measures is described, and the role of the financial services industry is characterised. A corporate decision framework is discussed in the context of water resources management strategies under complex uncertainties.

  15. 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

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

    Science.gov (United States)

    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.

  17. Risk

    Science.gov (United States)

    Barshi, Immanuel

    2016-01-01

    Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

  18. The System Cost Model: A tool for life cycle cost and risk analysis

    International Nuclear Information System (INIS)

    Hsu, K.; Lundeen, A.; Shropshire, D.; Sherick, M.

    1996-01-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors began development of the System Cost Model (SCM) application. The SCM estimates life cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, and transuranic waste. The SCM uses parametric cost functions to estimate life cycle costs for various treatment, storage, and disposal modules which reflect planned and existing waste management facilities at DOE installations. In addition, SCM can model new TSD facilities based on capacity needs over the program life cycle. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction, operations and maintenance, and decommissioning these waste management facilities. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. A complement to the SCM is the System Cost Model-Risk (SCM-R) model, which provides relative Environmental, Safety, and Health (ES and H) risk information. A relative ES and H risk basis has been developed and applied by LITCO at the INEL. The risk basis is now being automated in the SCM-R to facilitate rapid risk analysis of system alternatives. The added risk functionality will allow combined cost and risk evaluation of EM alternatives

  19. 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.

  20. 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.

  1. 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.

  2. ORRION: A specific information sharing tool to (rebuild a “flood risk culture” in the Rhine Graben (France - Germany

    Directory of Open Access Journals (Sweden)

    Martin Brice

    2016-01-01

    Full Text Available When is led a prevention initiative concerning flood risk, the recall of old events allows just as much to act as pedagogy to legitimize the initiative. So as it is written in the information leaflet on the “Plan de Prévention des Risques d’Inondation” (PPRI:«Alsace did not know any more exceptional floods since 1910. In almost a century, the flood risk thus naturally faded of our memory”. A paradoxical assertion because the floods of 1910 are not taken into account for risk mapping. Only the recent floods (1983, 1990 are used as benchmarks. We were able to show [1] that, although legitimate as reference events, the floods of 1910 and many others had become manifestly underestimated for multiple reasons connected to the history of Alsace, or due to disorganization of the archives. Worse, these riks unawareness is shared by all the actors, causing problems of acceptance of the risk and their management, and an additional vulnerability in terms of population behavior before, during and after the crises. This is the reason why an online participative database (ORRION has been created. the objective of this database is to inform and to share the information about floods history, in the particular context of a cross-border territory (France, Germany, Switzerland. This tool has been immediately involved into risks prevention actions (PAPI, PPRI.

  3. RAVEN AS A TOOL FOR DYNAMIC PROBABILISTIC RISK ASSESSMENT: SOFTWARE OVERVIEW

    Energy Technology Data Exchange (ETDEWEB)

    Alfonsi Andrea; Mandelli Diego; Rabiti Cristian; Joshua Cogliati; Robert Kinoshita

    2013-05-01

    RAVEN is a software tool under development at the Idaho National Laboratory (INL) that acts as the control logic driver and post-processing tool for the newly developed Thermo-Hydraylic code RELAP- 7. The scope of this paper is to show the software structure of RAVEN and its utilization in connection with RELAP-7. A short overview of the mathematical framework behind the code is presented along with its main capabilities such as on-line controlling/monitoring and Monte-Carlo sampling. A demo of a Station Black Out PRA analysis of a simplified Pressurized Water Reactor (PWR) model is shown in order to demonstrate the Monte-Carlo and clustering capabilities.

  4. Environmental risk index: A tool to assess the safety of dams for leachate

    International Nuclear Information System (INIS)

    Colomer Mendoza, Francisco J.; Gallardo Izquierdo, Antonio

    2009-01-01

    Dams for leachate store very toxic substances that contain a large amount of organic material and, probably, heavy metals; they therefore constitute an important threat to the environment. Existing models of environmental risk assessment for landfills do not take into consideration the specific risk that leachate dams may represent for the environment. In this paper a methodology to improve the environmental safety is presented according to the parameters used in their construction and management. In order to do that, the following characteristics of the dam must be known: (1) geotechnical stability, (2) erosion of downstream slope, (3) type of sealing of the dam, (4) overtopping probability, (5) volume of leachate stored inside the dam and (6) pollution load of leachate. Once these parameters have been calculated, they are transformed by means of rating curves into homogeneous units, so as to make it possible to operate between them. From the study and analysis of these parameters an environmental risk index for a dam for leachate can be calculated. If the environmental risk index exceeds an established value then it involves a dam for leachate with high environmental risk, therefore preventive measures in its design, construction and management would be necessary

  5. Tool for evaluation compliance standards and expectations in occupational risk prevention by collaborating companies

    International Nuclear Information System (INIS)

    Duran Perez, A.; Gomez Pardo, M. A.; Cao Tejero, R.; Millan Verdejo, J. A.; Blas Perez, P.

    2013-01-01

    Within the framework of a single security in ANAV, in our Action Plan on prevention, we consider it essential to include workers from ECCE working for and by ANAV in compliance with standards and expectations both in the accounts of the incidents. With this system is intended to standardize a set of observed deviations report and a tool for measuring the degree of compliance, allowing to monitor the evolution of each company and the effectiveness of prevention plan.

  6. Numerical tool for tsunami risk assessment in the southern coast of Dominican Republic

    Science.gov (United States)

    Macias Sanchez, J.; Llorente Isidro, M.; Ortega, S.; Gonzalez Vida, J. M., Sr.; Castro, M. J.

    2016-12-01

    The southern coast of Dominican Republic is a very populated region, with several important cities including Santo Domingo, its capital. Important activities are rooted in the southern coast including tourism, industry, commercial ports, and, energy facilities, among others. According to historical reports, it has been impacted by big earthquakes accompanied by tsunamis as in Azua in 1751 and recently Pedernales in 2010, but their sources are not clearly identified. The aim of the present work is to develop a numerical tool to simulate the impact in the southern coast of the Dominican Republic of tsunamis generated in the Caribbean Sea. This tool, based on the Tsunami-HySEA model from EDANYA group (University of Malaga, Spain), could be used in the framework of a Tsunami Early Warning Systems due the very short computing times when only propagation is computed or it could be used to assess inundation impact, computing inundation with a initial 5 meter resolution. Numerical results corresponding to three theoretical sources are used to test the numerical tool.

  7. DESIGN OF LIVESTOCK MANAGEMENT TOOL FOR CLIMATE CHANGE RISK IN MONGOLIA

    Directory of Open Access Journals (Sweden)

    A. Oba

    2012-08-01

    Nevertheless it needs to consider about management, we have to research information about each management under different conditions of each area in all Mongolia. Thus, it needs to survey livestock management workflows of regional administration and GIS data about rangeland areas and their attributes in order to evaluate their nomadic life and their livestock objectively. It is essential to use some tools that have the function of processing the spatial data. It could cover wide areas and have different abilities for spatial relations. To solve this problem; we analyzed management workflows of herder and regional administration working in Mongolia, and designed a hierarchical structure of tables and data layers with the relational database. With this structure, we developed the structure of a WebGIS tool on the Adobe Flex platform for livestock management visually. It will be also useful for them to improve the accountability of activities. This system is a versatile WebGIS tool which can interact with various spatial scales.

  8. 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

  9. Bayesian network as a modelling tool for risk management in agriculture

    DEFF Research Database (Denmark)

    Rasmussen, Svend; Madsen, Anders L.; Lund, Mogens

    . In this paper we use Bayesian networks as an integrated modelling approach for representing uncertainty and analysing risk management in agriculture. It is shown how historical farm account data may be efficiently used to estimate conditional probabilities, which are the core elements in Bayesian network models....... We further show how the Bayesian network model RiBay is used for stochastic simulation of farm income, and we demonstrate how RiBay can be used to simulate risk management at the farm level. It is concluded that the key strength of a Bayesian network is the transparency of assumptions......, and that it has the ability to link uncertainty from different external sources to budget figures and to quantify risk at the farm level....

  10. Information and communication technologies, a tool for risk prevention and accident management on sea ice

    Directory of Open Access Journals (Sweden)

    Elise Lépy

    2015-06-01

    Full Text Available Marine ice melting topic is a repetitive phenomenon in alarmist speeches on climate change. The present positive evolution of air temperatures has in all probability many impacts on the environment and more or less directly on societies. Face to the temperature elevation, the ice pack is undergone to an important temporal variability of ice growth and melting. Human populations can be exposed to meteorological and ice hazards engendering a societal risk. The purpose of this paper is to better understand how ICT get integrated into the risk question through the example of the Bay of Bothnia in the northern extremity of the Baltic Sea. The study deals with the way that Finnish society, advanced in the ICT field, faces to new technology use in risk prevention and accident management on sea ice.

  11. Use of a Computerized Tool (ORAM) to Help Manage Outage Safety and Risk at NPP Krsko

    International Nuclear Information System (INIS)

    Spiler, J.; Basic, I.; Vrbanic, I.; Fifnja, I.; Kastelan, M.; Dagan, W. J.; Shanley, L. B.; Naum, T. J.

    1998-01-01

    Outage Risk Assessment and Management (ORAM) is a computerized methodology developed by the U.S. Electric Power Research Institute (EPRI) to help Nuclear Power Plant personnel manage the risk and safety associated with refueling and forced plant outages. Today, over 60 plants including NPP Krsko are using ORAM during the preparation and performance of plant outages. In fact, many plants are attributing much of the reductions in the duration of refueling outages to the use of ORAM. The success of the ORAM methodology is the capability to provide plant and management personnel with understandable results from both deterministic evaluations of plant safety and quantitative risk assessments. The Nuklearna Elektrarna Krsko (NEK) use of ORAM involves both of these approaches. The deterministic portion of ORAM is used to model the NPP Krsko Shutdown Technical Specifications and administrative considerations. The probabilistic portion of ORAM uses industry and NEK specific initiating events and other risk elements pertaining to shutdown to derive a quantitative risk assessment for various end states, including core damage and RCS boiling. This paper expands on the value of each approach and demonstrates the benefits of combining these elements in the decision-making process. Another key advantage of ORAM is the ability to apply the methodology to specific outages. Since no outage is identical, this provides tremendous benefits to plant personnel for managing the safety and risk of a particular outage. ORAM does this ba organizing all of the various plant configurations and equipment unavailability windows into numerous plant states. Furthermore, ORAM evaluations can be a utomated b y interfacing with outage scheduling software programs such as Primavera. For each plant state, the deterministic and the probabilistic logic evaluations are applied. This paper will demonstrate the ORAM evaluation for an actual NPP Krsko outage. (author)

  12. Destination Networks as a Tool for Minimizing the Risk and Improving the Performance of a Destination

    Directory of Open Access Journals (Sweden)

    Holešinská Andrea

    2015-12-01

    Full Text Available The management of a tourist destination in the form of networks is considered to be one of the possible approaches to destination governance structures. The concept of destination governance is based on the cooperation between actors from the public and private sectors. It is known that public–private relationships built on trust, joint risk taking and based on informal structures have a positive impact on the level of growth at a tourist destination. The aim of this paper is to quantify to what extent each of the determinants of the DMO success participate in the total destination performance, and thus point out the factors of a potential risk.

  13. Tool-based Risk Assessment of Cloud Infrastructures as Socio-Technical Systems

    DEFF Research Database (Denmark)

    Nidd, Michael; Ivanova, Marieta Georgieva; Probst, Christian W.

    2015-01-01

    Assessing risk in cloud infrastructures is difficult. Typical cloud infrastructures contain potentially thousands of nodes that are highly interconnected and dynamic. Another important component is the set of human actors who get access to data and computing infrastructure. The cloud infrastructure...... exercise for cloud infrastructures using the socio-technical model developed in the TRESPASS project; after showing how to model typical components of a cloud infrastructure, we show how attacks are identified on this model and discuss their connection to risk assessment. The technical part of the model...... is extracted automatically from the configuration of the cloud infrastructure, which is especially important for systems so dynamic and complex....

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

    DEFF Research Database (Denmark)

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela

    2013-01-01

    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......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...... and number of sick-listing days were related (Kruskal-Wallis, p

  15. 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

  16. 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...

  17. The Stroke RiskometerTM App: Validation of a data collection tool and stroke risk predictor

    NARCIS (Netherlands)

    P. Parmar (Priya); R. Krishnamurthi (Rita); M.A. Ikram (Arfan); A. Hofman (Albert); S.S. Mirza (Saira); Y. Varakin (Yury); M. Kravchenko (Michael); M. Piradov (Michael); A.G. Thrift (Amanda G.); B. Norrving (Bo); W. Wang (Wenzhi); D.K. Mandal (Dipes Kumar); S. Barker-Collo (Suzanne); R. Sahathevan (Ramesh); S.M. Davis (Stephen); G. Saposnik (Gustavo); M. Kivipelto (Miia); S. Sindi (Shireen); S.R. Bornstein (Stefan); M. Giroud (Maurice); Y. Béjot (Yannick); M. Brainin (Michael); R. Poulton (Richie); K.M.V. Narayan (K. M. Venkat); M. Correia (Manuel); A. Freire (António); Y. Kokubo (Yoshihiro); D. Wiebers (David); F.K.F. Mensah (Fane ); N.F. Bindhim (Nasser); P.A. Barber (P. Alan); N.G. Pandian (Natesa); G.J. Hankey (Graeme); M.M. Mehndiratta (Man Mohan); S. Azhagammal (Shobhana); N.M. Ibrahim (Norlinah Mohd); M. Abbott (Max); E. Rush (Elaine); P. Hume (Patria); T. Hussein (Tasleem); R. Bhattacharjee (Rohit); M. Purohit (Mitali); V.L. Feigin (V.)

    2015-01-01

    textabstractBackground: The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the 'mass' approach), the 'high risk' approach aims to identify

  18. The Identification of Seniors at Risk screening tool is useful for predicting acute readmissions

    DEFF Research Database (Denmark)

    Rosted, Elizabeth; Schultz, Martin; Dynesen, Helle

    2014-01-01

    . Patients ≥ 65 years treated during a 14-day period were included. Their mean age was 78 years. Screening with the Identification of Seniors at Risk (ISAR) was performed (n = 198) by the Mobile Geriatric Team (MGT). The patients' medical journals were assessed retrospectively by the SG to determine any need...

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

    NARCIS (Netherlands)

    Brug, F. van de

    2009-01-01

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

  20. MATILDA: A Military Laser Range Safety Tool Based on Probabilistic Risk Assessment (PRA) Techniques

    Science.gov (United States)

    2014-08-01

    3 2.1 UK Need for a PRA-Based Approach ............................................................... 3 2.2 A Risk-Based Approach to...Figure 6: MATILDA Coordinate Transformations ....................................................... 22  Figure 7: Geocentric and MICS Coordinates...Star-Shaped Condition ................................................................................. 27  Figure 11: Points of Closest Approach

  1. Multiple regression as a preventive tool for determining the risk of Legionella spp.

    Directory of Open Access Journals (Sweden)

    Enrique Gea-Izquierdo

    2012-04-01

    Full Text Available To determine the interrelationship between health & hygiene conditions for prevention of legionellosis, the compositionof materials used in water distribution systems, the water origin and Legionella pneumophila risk. Material and methods. Include adescriptive study and multiple regression analysis on a sample of golf course sprinkler irrigation systems (n=31 pertaining to hotelslocated on the Costa del Sol (Malaga, Spain. The study was carried out in 2009. Results. Presented a significant lineal relation, withall the independent variables contributing significantly (p<0.05 to the model’s fit. The relationship between water type and the risk ofLegionella, as well as the material composition and the latter, is lineal and positive. In contrast, the relationship between health-hygieneconditions and Legionella risk is lineal and negative. Conclusion. The characterization of Legionella pneumophila concentration, asdefined by the risk in water and through use of the predictive method, can contribute to the consideration of new influence variables inthe development of the agent, resulting in improved control and prevention of the disease.

  2. Risk Assessment as an Environmental Management Tool: Considerations for Freshwater Wetlands

    Science.gov (United States)

    A. Dennis Lemly

    1997-01-01

    This paper presents a foundation for improving the risk assessment process for freshwater wetlands. Integrating wetland science, i.e., use of an ecosystem-based approach, is the key concept. Each biotic and abiotic wetland component should be identified and its contribution to ecosystem functions and societal values determined when deciding whether a stressor poses an...

  3. Environmental risk assessment using the Persian version of the Home Falls And Screening Tool (HOME FAST in Iranian elderly

    Directory of Open Access Journals (Sweden)

    Bahareh Maghfouri

    2013-05-01

    Full Text Available Introduction: One of the common problems among older people is falling. Falling inside the houses and streets makes up a large incidence between Iranian elderly, then the effort to identify environmental factors at home and home modification can reduce falls and injury in the elderly. The aim of this study is identifying elderly at risk of fall with using screening tool (HOME FAST and define reliability of this tool.Material and Methods: As a reliability, through the health housing of the town councils in five geographical regions of Tehran, 60 old person were selected. Participants aged 60 to 65 years and the HOME FAST tool was used in the two stages (inter rater and test-retest.Results: Test-retest reliability in the study showed that agreement between the items is over than 0.8, which shows very good reliability. The results showed that the relative of the each item in the Agreement between the domain is 1 - 0.65, which shows moderate to high reliability. And the results in this study showed that agreement between the items in Inter rater reliability is over than 0.8, which shows the level of reliability is very good. Also it showed that the relative of the each item in the agreement between the domain is 1 - 0.01, which shows poor to high reliability.Conclusion: This study shows that the reliability of the HOME FAST is high. The findings of these comments have been expected that the test objectives were appropriate to prevent falls and the tools showed acceptable reliability, then this test can be used as a tool for to professionals.

  4. Multi-site risk-based project planning, optimization, sequencing, & budgeting process and tool for the integrated facility disposition project

    International Nuclear Information System (INIS)

    Nelson, J.G.; Castillo, C.; Huntsman, J.; Killoy, S.; Lucek, H.; Marks, T.C.

    2011-01-01

    Faced with the Department of Energy (DOE) Complex Transformation, National Nuclear Security Administration (NNSA) was tasked with developing an integrated plan for the decommissioning of over 400 facilities and 300 environmental remediation units, as well as the many reconfiguration and modernization projects at the Oak Ridge National Laboratory (ORNL) and Y-12 Complex. Manual scheduling of remediation activities is time-consuming and inherently introduces bias of the scheduler or organization into the process. Clearly a well-defined process, quantitative risk-based tool was needed to develop an objective, unbiased baseline sequence and schedule with a sound technical foundation for the Integrated Facility Disposition Project (IFDP). Faced with limited available data, innovation was needed to extrapolate intelligent relative data for key risk parameters based on known data elements. The IFDP Supermodel was customized and expanded to provide this capability for conceptual planning of diverse project portfolios and multiple sites. (author)

  5. Development of an integrated e-health tool for people with, or at high risk of, cardiovascular disease: The Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) web application.

    Science.gov (United States)

    Neubeck, Lis; Coorey, Genevieve; Peiris, David; Mulley, John; Heeley, Emma; Hersch, Fred; Redfern, Julie

    2016-12-01

    Cardiovascular disease is the leading killer globally and secondary prevention substantially reduces risk. Uptake of, and adherence to, face-to-face preventive programs is often low. Alternative models of care are exploiting the prominence of technology in daily life to facilitate lifestyle behavior change. To inform the development of a web-based application integrated with the primary care electronic health record, we undertook a collaborative user-centered design process to develop a consumer-focused e-health tool for cardiovascular disease risk reduction. A four-phase iterative process involved ten multidisciplinary clinicians and academics (primary care physician, nurses and allied health professionals), two design consultants, one graphic designer, three software developers and fourteen proposed end-users. This 18-month process involved, (1) defining the target audience and needs, (2) pilot testing and refinement, (3) software development including validation and testing the algorithm, (4) user acceptance testing and beta testing. From this process, researchers were able to better understand end-user needs and preferences, thereby improving and enriching the increasingly detailed system designs and prototypes for a mobile responsive web application. We reviewed 14 relevant applications/websites and sixteen observational and interventional studies to derive a set of core components and ideal features for the system. These included the need for interactivity, visual appeal, credible health information, virtual rewards, and emotional and physical support. The features identified as essential were: (i) both mobile and web-enabled 'apps', (ii) an emphasis on medication management, (iii) a strong psychosocial support component. Subsequent workshops (n=6; 2×1.5h) informed the development of functionality and lo-fidelity sketches of application interfaces. These ideas were next tested in consumer focus groups (n=9; 3×1.5h). Specifications for the application were

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. 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...

  9. 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...

  10. 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...

  11. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods

    Directory of Open Access Journals (Sweden)

    Grossi Enzo

    2006-05-01

    Full Text Available Abstract Background In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years Discussion The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. Summary The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

  12. [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.

  13. 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.

  14. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods.

    Science.gov (United States)

    Grossi, Enzo

    2006-05-03

    In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

  15. Groundwater vulnerability and risk mapping using GIS, modeling and a fuzzy logic tool.

    Science.gov (United States)

    Nobre, R C M; Rotunno Filho, O C; Mansur, W J; Nobre, M M M; Cosenza, C A N

    2007-12-07

    A groundwater vulnerability and risk mapping assessment, based on a source-pathway-receptor approach, is presented for an urban coastal aquifer in northeastern Brazil. A modified version of the DRASTIC methodology was used to map the intrinsic and specific groundwater vulnerability of a 292 km(2) study area. A fuzzy hierarchy methodology was adopted to evaluate the potential contaminant source index, including diffuse and point sources. Numerical modeling was performed for delineation of well capture zones, using MODFLOW and MODPATH. The integration of these elements provided the mechanism to assess groundwater pollution risks and identify areas that must be prioritized in terms of groundwater monitoring and restriction on use. A groundwater quality index based on nitrate and chloride concentrations was calculated, which had a positive correlation with the specific vulnerability index.

  16. Physiologically Based Toxicokinetic Modelling as a Tool to Support Risk Assessment: Three Case Studies

    Directory of Open Access Journals (Sweden)

    Hans Mielke

    2012-01-01

    Full Text Available In this contribution we present three case studies of physiologically based toxicokinetic (PBTK modelling in regulatory risk assessment. (1 Age-dependent lower enzyme expression in the newborn leads to bisphenol A (BPA blood levels which are near the levels of the tolerated daily intake (TDI at the oral exposure as calculated by EFSA. (2 Dermal exposure of BPA by receipts, car park tickets, and so forth, contribute to the exposure towards BPA. However, at the present levels of dermal exposure there is no risk for the adult. (3 Dermal exposure towards coumarin via cosmetic products leads to external exposures of two-fold the TDI. PBTK modeling helped to identify liver peak concentration as the metric for liver toxicity. After dermal exposure of twice the TDI, the liver peak concentration was lower than that present after oral exposure with the TDI dose. In the presented cases, PBTK modeling was useful to reach scientifically sound regulatory decisions.

  17. Critical infrastructures at risk: A need for a new conceptual approach and extended analytical tools

    International Nuclear Information System (INIS)

    Kroeger, Wolfgang

    2008-01-01

    Recent decades have witnessed on the one hand a much greater and tighter integration of goods or services supply systems and growing interconnectedness as well as changing organizational and operational factors, and on the other hand an increased social vulnerability in the face of accidental or intentional disruption. The work of the International Risk Governance Council (IRGC) in the field of critical infrastructures has focused on both the risks associated with five individual infrastructures and the issues associated with the increasing interdependence between them. This paper presents a selection of system weaknesses and a number of policy options that have been identified and highlights issues for further investigation and dialogue with stakeholders. Furthermore, the need to extend current modeling and simulation techniques in order to cope with the increasing system complexity is elaborated. An object-oriented, hybrid modeling approach promising to overcome some of the shortcomings of traditional methods is presented

  18. Developing a pipeline risk assessment tool for the upstream oil and gas industry

    Energy Technology Data Exchange (ETDEWEB)

    Paez, J.; Roy, A. [Talisman Energy Inc., Calgary, AB (Canada)

    2010-07-01

    This paper described an in-house pipeline risk assessment process developed by Talisman Energy. The semi-quantitative methodology was used to identify high-risk pipelines. The first phase of the methodology consisted of determining only the consequence of failures, while the second phase included a detailed, more traditional approach that considered consequences and the likelihood of failure. A mathematical algorithm was developed to generate a final consequence score between 0 and 4. The algorithm combined both public concern and environmental concern scores to form a base value for the health and safety score. A production score was then factored in to yield an overall consequence score. The algorithm yielded results consistent with real pipeline failure consequences. Phase 2 considered internal and external corrosion likelihood, historical likelihood, third party damage likelihood. and geotechnical likelihood. A cascading approach was to yield an overall likelihood score. Examples of the methodology were included. 9 refs., 1 tab., 6 figs.

  19. Green, Yellow, and Red risk perception in everyday life - a communication tool.

    Science.gov (United States)

    Stensgaard, A; DunnGalvin, A; Nielsen, D; Munch, M; Bindslev-Jensen, C

    2017-07-01

    Adolescents have the highest risk for food allergy-related fatalities. Our main aim was to investigate the level of risk in everyday social situations as perceived by adolescents/young adults with peanut allergy, their families, and their friends. The web-based 'Colours Of Risks' (COR) questionnaire was completed by 70 patients (aged 12-23 years), 103 mothers and fathers, 31 siblings (aged 12-26 years), and 42 friends (aged 12-24 years). COR deals with six main contexts (home, school/university, work, visiting/social activities, special occasions/parties, and vacations), each with 1-12 items. Response categories are green (I feel safe), yellow (I feel uncertain), or red (I feel everything is risky). There was a high level of agreement between participants in defining situations as safe, uncertain, or risky, but female patients and mothers rated fewer situations as safe compared to male patients and fathers. Being with close friends and family, and attending planned parties without alcohol were perceived as situations of low risk. While 94% of patients took an epinephrine auto-injector (EAI) into risky situations, only 65% took it into safe situations. In contrast to the close family, 31% of the friends did not know the patient had an EAI, and fewer knew how to administer the EAI. Young adults with peanut allergy face challenges when moving from the safe home with ready assistance if needed, to independence with unpredictable surroundings and less certain help. Perceived 'safe' situations may in fact be the riskiest, as patients often do not take the EAI with them. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Communication as a tool to modify the negative perception of radiation risk

    International Nuclear Information System (INIS)

    Alonso, L.; Prieto, D.; Sanchez, K.; Ferrer, N.; Arranz, L.

    2011-01-01

    The radiation risks are probably for historical reasons related to their military origin, the paradigm of subjectivity and its perception by the population has become increasingly of interest to those responsible for management and management of any applications of ionizing radiation. This interest is positive because the more you know, the better will the conditions to try to change attitudes and approaches to the problem, particularly from the point of view of communication with society.

  1. Evaluation of clinical risk factors for osteoporosis and applicability of the FRAX tool in Joinville City, Southern Brazil.

    Science.gov (United States)

    Silva, Dalisbor Marcelo Weber; Borba, Victoria Zeghbi Cochenski; Kanis, John A

    2017-12-09

    Clinical risk factors for fracture in Southern Brazil are similar to those used in Fracture Risk Assessment Tool (FRAX®). Age-dependent intervention thresholds had higher accuracy than a fixed cut-off point. Access to bone mineral density testing is wanted for a large part of the Brazilian population. The FRAX® has an option to calculate the risk of fracture without this costly evaluation but relies on the clinical risk factors (CRFs) identified in the source cohorts used to generate FRAX. The aims of this study were to determine whether the CRFs used in FRAX are also risk indicators for individuals in Southern Brazil and to evaluate possible intervention thresholds for treatment in Brazil. We determined the CRFs for hip fractures in women and men aged 50 years and more with a hip fracture and controls in Joinville, Southern Brazil (April 1, 2010, and March 31, 2012). For intervention thresholds, we determined the accuracy of using the fixed thresholds of National Osteoporosis Foundation (NOF), USA, compared with the age-dependent thresholds of the National Osteoporosis Guideline Group (NOGG), UK. CRFs that were significant for hip fracture were very similar to FRAX, apart from chronic obstructive pulmonary disease and malabsorptive intestinal disease. FRAX based on the NOGG and NOF models had an accuracy of 64.2 and 58.7%, respectively. CRFs used in FRAX® were similar to those in the Southern Brazil. The NOGG model seems to be more accurate to discriminate patients with increased fracture risk in this population compared to the NOF model, but not significantly.

  2. Assessment of food safety practices of food service food handlers (risk assessment data): testing a communication intervention (evaluation of tools).

    Science.gov (United States)

    Chapman, Benjamin; Eversley, Tiffany; Fillion, Katie; Maclaurin, Tanya; Powell, Douglas

    2010-06-01

    Globally, foodborne illness affects an estimated 30% of individuals annually. Meals prepared outside of the home are a risk factor for acquiring foodborne illness and have been implicated in up to 70% of traced outbreaks. The Centers for Disease Control and Prevention has called on food safety communicators to design new methods and messages aimed at increasing food safety risk-reduction practices from farm to fork. Food safety infosheets, a novel communication tool designed to appeal to food handlers and compel behavior change, were evaluated. Food safety infosheets were provided weekly to food handlers in working food service operations for 7 weeks. It was hypothesized that through the posting of food safety infosheets in highly visible locations, such as kitchen work areas and hand washing stations, that safe food handling behaviors of food service staff could be positively influenced. Using video observation, food handlers (n = 47) in eight food service operations were observed for a total of 348 h (pre- and postintervention combined). After the food safety infosheets were introduced, food handlers demonstrated a significant increase (6.7%, P < 0.05, 95% confidence interval) in mean hand washing attempts, and a significant reduction in indirect cross-contamination events (19.6%, P < 0.05, 95% confidence interval). Results of the research demonstrate that posting food safety infosheets is an effective intervention tool that positively influences the food safety behaviors of food handlers.

  3. 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.

  4. Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

    Science.gov (United States)

    Granata, Randy L; Hamilton, Karen

    2015-01-01

    Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

  5. 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.

  6. Hydro-biogeochemical phosphorus mobilization - evaluating a wetland restoration "P risk" assesment tool

    DEFF Research Database (Denmark)

    Kjærgaard, Charlotte; Forsmann, Ditte M.; Hoffmann, Carl Christian

    2012-01-01

    recognized as one of the most important mitigation options in obeying the quality goals of the European Water Framework Directive. While the nitrogen removal efficiency of restored wetlands is well accepted, the impact of wetland restoration on phosphorus (P) is less obvious. An increasing number...... of studies have called to the attention that wetland restoration on former agricultural soils may result in P release. Despite the high priority of wetland restoration there is a serious lack in understanding the fate of P following wetland restoration, and predictive model tools are highly needed....... Prediction of P dynamics in restored wetlands is extremely challenging because of the complex interactions and feedbacks between hydrology, hydrochemistry and sediment geochemistry. In the Danish Strategic Research project MONITECH, one of the major objectives was to investigate the possibility of developing...

  7. International multicenter tool to predict the risk of nonsentinel node metastases in breast cancer

    DEFF Research Database (Denmark)

    Meretoja, Tuomo J; Leidenius, Marjut H K; Heikkilä, Päivi S

    2012-01-01

    predicting nonsentinel node involvement were identified in logistic regression analysis. A multivariable predictive model was developed and validated by area under the receiver operating characteristics curve (AUC), first internally in 500 additional patients and then externally in 1068 patients from other...... centers. All statistical tests were two-sided. Results Nine tumor- and sentinel node-specific variables were identified as statistically significant factors predicting nonsentinel node involvement in logistic regression analysis. A resulting predictive model applied to the internal validation series...... resulted in an AUC of 0.714 (95% confidence interval [CI] = 0.665 to 0.763). For the external validation series, the AUC was 0.719 (95% CI = 0.689 to 0.750). The model was well calibrated in the external validation series. Conclusions We present a novel, international, multicenter, predictive tool...

  8. Stratifying Risk of Falls in Community-Dwelling Elderly Adults Through a Simple Tool

    Directory of Open Access Journals (Sweden)

    Schettino Ludmila

    2016-12-01

    Full Text Available Purpose. Falls are among the main disabling events for elderly adults and the identification of old people prone to falls enables the development of preventive and rehabilitative strategies. This study aimed to develop a simple tool, based on easily obtained variables (anthropometric measurements, motor performance tests and sociodemographic characteristics, to early identify community-dwelling old people prone to falls. Methods. The population-based household study was conducted among 316 elders (≥ 60 years old of both sexes, living in the urban area of Lafaiete Coutinho in Brazil. History of falls in the previous 12 months (dependent variable, sociodemographic characteristics, anthropometric measurements and motor performance tests results (explanatory variables were recorded, and a multivariate logistic regression was applied to identify the association between the explanatory variables and the history of falls. Fall probability for each elderly adult was calculated from the logistic regression parameters, and the predictive power of the final model and the cutoff for higher propensity to fall were evaluated on the basis of the receiver operating characteristic curve. Results. The prevalence of falls was 25.8% and the final model was influenced by the variables of sex (female and poor performance in the balance test. The estimated probability model predicted approximately 66.5% (95% CI, 61-72% of the falls. The sensitivity and specificity were 58 and 70%, respectively. Conclusions. We conclude that there is a high prevalence of falls among the studied elderly individuals, and the proposed method allowed to construct a simple tool for screening old adults prone to fall.

  9. Innovation and risk-averse firms: Options on carbon allowances as a hedging tool

    International Nuclear Information System (INIS)

    Szolgayová, Jana; Golub, Alexander; Fuss, Sabine

    2014-01-01

    In a regulated world where government seeks to decarbonize the energy sector, firms face both indirect and direct costs of emitting CO 2 . This study seeks to take the perspective of the firm, which needs to maximize profits implying minimization of (carbon) cost as well. In this study, the firm can compose the cost-optimal portfolio of (a) investing into carbon-saving technology, which is currently expensive, (b) investing into carbon-saving technology R and D and adopt this technology at a later point, (c) buying allowances per ton of emitted CO 2 in a carbon market (alternatively this could be formulated as a tax), and (d) buying offsets traded in the same market, which are based on reduced emissions from deforestation and degradation (REDD+). Uncertainties in the cost of carbon coming from a lack of commitment in policy-making leading to fluctuations in markets and uncertainty in the payoff of R and D activities could provide disincentives to incur large up-front sunk cost and raise the economic value of being flexible. We apply a real options approach with stochastic carbon-saving technology costs and stochastic CO 2 costs. Assuming that firms are risk-averse, they will not only value flexibility, but also risk reductions from diversification over the different (carbon mitigation) options. - Highlights: • We study the compliance problem of a private firm under both regulatory and technological uncertainty in an optimal control setting. • When firms are risk-averse, forest-backed offset options will be part of the compliance portfolio. • R and D creates valuable options on new technology

  10. California Levee Risk, Now and in the Future:Identifying Research and Tool Development Needs

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, R L; Hanemann, M; Farber, D

    2006-11-28

    The Center for Catastrophic Risk Management (CCRM) and the California Center for Environmental Law and Policy (CCELP) at UC Berkeley and the Lawrence Livermore National Laboratory (LLNL) joined together to cosponsor a workshop to define research requirements to mitigate the hazards facing the Sacramento-San Joaquin Delta Levee system. The Workshop was intended to provide a forum to (1) Report assessments of current vulnerabilities facing the levees, such as structural failure, seismic loading, flooding, terrorism; (2) Consider longer term challenges such as climate change, sea level rise; and (3) Define research requirements to fill gaps in knowledge and reduce uncertainties in hazard assessments.

  11. Risk-based evaluation tool for safety-related maintenance involving scaffolding

    International Nuclear Information System (INIS)

    Stevens, C.; Azizi, M.; Massman, M.

    1988-01-01

    The US Nuclear Regulatory Commission (NRC) has expressed a general concern that transient materials in and around safety systems at nuclear power plants represent a seismic safety hazard to the plant, in particular, the uncontrolled use of scaffolding during maintenance activities. Currently, most plants perform a seismic safety analysis for all uses of scaffolding near safety-related equipment to determine appropriate tie-down locations, scaffolding reinforcements, etc. This is both time-consuming and, for the most part, unnecessary. A workable engineering solution based on risk analysis techniques has been developed and is being used at the Palo Verde nuclear generating station (PVNGS)

  12. 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.

  13. 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).

  14. Balancing research and funding using value of information and portfolio tools for nanomaterial risk classification

    Science.gov (United States)

    Bates, Matthew E.; Keisler, Jeffrey M.; Zussblatt, Niels P.; Plourde, Kenton J.; Wender, Ben A.; Linkov, Igor

    2016-02-01

    Risk research for nanomaterials is currently prioritized by means of expert workshops and other deliberative processes. However, analytical techniques that quantify and compare alternative research investments are increasingly recommended. Here, we apply value of information and portfolio decision analysis—methods commonly applied in financial and operations management—to prioritize risk research for multiwalled carbon nanotubes and nanoparticulate silver and titanium dioxide. We modify the widely accepted CB Nanotool hazard evaluation framework, which combines nano- and bulk-material properties into a hazard score, to operate probabilistically with uncertain inputs. Literature is reviewed to develop uncertain estimates for each input parameter, and a Monte Carlo simulation is applied to assess how different research strategies can improve hazard classification. The relative cost of each research experiment is elicited from experts, which enables identification of efficient research portfolios—combinations of experiments that lead to the greatest improvement in hazard classification at the lowest cost. Nanoparticle shape, diameter, solubility and surface reactivity were most frequently identified within efficient portfolios in our results.

  15. Assessing Bioenergy Harvest Risks: Geospatially Explicit Tools for Maintaining Soil Productivity in Western US Forests

    Directory of Open Access Journals (Sweden)

    Deborah Page-Dumroese

    2011-09-01

    Full Text Available Biomass harvesting for energy production and forest health can impact the soil resource by altering inherent chemical, physical and biological properties. These impacts raise concern about damaging sensitive forest soils, even with the prospect of maintaining vigorous forest growth through biomass harvesting operations. Current forest biomass harvesting research concurs that harvest impacts to the soil resource are region- and site-specific, although generalized knowledge from decades of research can be incorporated into management activities. Based upon the most current forest harvesting research, we compiled information on harvest activities that decrease, maintain or increase soil-site productivity. We then developed a soil chemical and physical property risk assessment within a geographic information system for a timber producing region within the Northern Rocky Mountain ecoregion. Digital soil and geology databases were used to construct geospatially explicit best management practices to maintain or enhance soil-site productivity. The proposed risk assessments could aid in identifying resilient soils for forest land managers considering biomass operations, policy makers contemplating expansion of biomass harvesting and investors deliberating where to locate bioenergy conversion facilities.

  16. Polycyclic Aromatic Hydrocarbons (PAHs) and their Bioaccessibility in Meat: a Tool for Assessing Human Cancer Risk.

    Science.gov (United States)

    Hamidi, Elliyana Nadia; Hajeb, Parvaneh; Selamat, Jinap; Abdull Razis, Ahmad Faizal

    2016-01-01

    Polycyclic aromatic hydrocarbons (PAHs) are primarily formed as a result of thermal treatment of food, especially barbecuing or grilling. Contamination by PAHs is due to generation by direct pyrolysis of food nutrients and deposition from smoke produced through incomplete combustion of thermal agents. PAHs are ubiquitous compounds, well-known to be carcinogenic, which can reach the food in different ways. As an important human exposure pathway of contaminants, dietary intake of PAHs is of increasing concern for assessing cancer risk in the human body. In addition, the risks associated with consumption of barbecued meat may increase if consumers use cooking practices that enhance the concentrations of contaminants and their bioaccessibility. Since total PAHs always overestimate the actual amount that is available for absorption by the body, bioaccessibility of PAHs is to be preferred. Bioaccessibility of PAHs in food is the fraction of PAHs mobilized from food matrices during gastrointestinal digestion. An in vitro human digestion model was chosen for assessing the bioaccessibility of PAHs in food as it offers a simple, rapid, low cost alternative to human and animal studies; providing insights which may not be achievable in in vivo studies. Thus, this review aimed not only to provide an overview of general aspects of PAHs such as the formation, carcinogenicity, sources, occurrence, and factors affecting PAH concentrations, but also to enhance understanding of bioaccessibility assessment using an in vitro digestion model.

  17. MIC risk in the Halfdan oil export system quantified with a DNA-based diagnostic tool

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Jan; Rasmussen, Kim; Andersen, Kenneth [Maersk Oil (Denmark); Holmkvist, Lars [DTI Oil and Gas (Denmark)

    2011-07-01

    The paper presents the risk involved due to microbial influenced corrosion (MIC) using the halfdan oil export system. With growth of assets, scale and microbial fouling, corrosion and souring have increased. Some of the consequences to operators include, safety issues and loss of production. An example of the effects caused by MIC is the Valhall platform in the Norwegian sector, which was shut down for 80 days. Some of the factors causing bacterial growth and MIC are O2, CO2, and H2S, solids. Consideration of four objectives, corrosive products, microbiological activities, microbes, and spatially associating microbes is very important for diagnosing MIC. The objective of the halfdan study was to investigate the corrosion mechanism in the oil export spool section. Observations show severe pitting inside the pipelines. Suggestions for the operator, including the risk assessment of MIC, are given along with a summary of results. It can be concluded that there is a certain need in the industry to understand and act upon MIC.

  18. Relapse Risk Assessment for Schizophrenia Patients (RASP): A New Self-Report Screening Tool.

    Science.gov (United States)

    Velligan, Dawn; Carpenter, William; Waters, Heidi C; Gerlanc, Nicole M; Legacy, Susan N; Ruetsch, Charles

    2018-01-01

    The Relapse Assessment for Schizophrenia Patients (RASP) was developed as a six-question self-report screener that measures indicators of Increased Anxiety and Social Isolation to assess patient stability and predict imminent relapse. This paper describes the development and psychometric characteristics of the RASP. The RASP and Positive and Negative Syndrome Scale (PANSS) were administered to patients with schizophrenia (n=166) three separate times. Chart data were collected on a subsample of patients (n=81). Psychometric analyses of RASP included tests of reliability, construct validity, and concurrent validity of items. Factors from RASP were correlated with subscales from PANSS (sensitivity to change and criterion validity [agreement between RASP and evidence of relapse]). Test-retest reliability returned modest to strong agreement at the item level and strong agreement at the questionnaire level. RASP showed good item response curves and internal consistency for the total instrument and within each of the two subscales (Increased Anxiety and Social Isolation). RASP Total Score and subscales showed good concurrent validity when correlated with PANSS Total Score, Positive, Excitement, and Anxiety subscales. RASP correctly predicted relapse in 67% of cases, with good specificity and negative predictive power and acceptable positive predictive power and sensitivity. The reliability and validity data presented support the use of RASP in settings where addition of a brief self-report assessment of relapse risk among patients with schizophrenia may be of benefit. Ease of use and scoring, and the ability to administer without clinical supervision allows for routine administration and assessment of relapse risk.

  19. Proposal for the testing of a tool for assessing the risk of dehydration in the elderly patient.

    Science.gov (United States)

    Bulgarelli, Ketty

    2015-09-09

    Dehydration is now the most common fluid and electrolyte disorder in older people. Because it is often associated with high rates of morbidity and mortality, it requires careful control and prevention in the context of a thorough primary care. The main risk factor for dehydration was the low intake of water by mouth for several reasons, such as lack of autonomy, altered mental status, decreased sensation of thirst, social and environmental problems. To this may be added an increase in fluid loss caused by fever, vomiting, diarrhoea, bleeding etc., the use of diuretics or laxatives and the onset of diseases that induce an increase in the loss of urine (e.g. diabetes). This paper aims to locate a tool for assessing the risk among those reported in the literature that is easy to use for the nurse and to experiment with it on a sample of patients. An analysis of the literature showed the reliability of an instrument for assessing the risk of dehydration by the name of "Dehydration Risk Appraisal Checklist." In order to verify its usefulness in identifying the risk of dehydration, 2 groups of elderly persons at the OU Geriatrics and long-term care unit of the Azienda USL of Piacenza and the OU complex Geriatric Clinic of the University Hospital of Parma were investigated. Patients in both groups were assessed on admission by the assessment scale MNA (Mini Nutritional Assessment) and by the sheet of quantitative evaluation of the meal consumed. One group was considered as the "control group". Patients belonging to the other group, which was regarded as the "experimental group", in addition to the two above-mentioned instruments, were also assessed by the "Dehydration risk appraisal checklist". In both groups, the presence or absence of four indicators of dehydration measured at the time of and immediately before discharge was then detected. In the presence of each indicator of dehydration one point was awarded for a comprehensive evaluation. The data collected were

  20. ECONOMIC MECHANISMS OF POPULATION PROTECTION AGAINST PENSION RISKS AS A TOOL FOR SOCIO-ECONOMIC DEVELOPMENT OF THE REGION

    Directory of Open Access Journals (Sweden)

    Lyubov V. Grigoryeva

    2017-06-01

    Full Text Available The problem of finding effective economic instruments for socio-economic development of the regions has recently become of increasing relevance. Strengthening the regional differentiation, highlighting the leading and lagging regions, the lack of own resources in the regions has forced regional authorities to use new instruments of territorial development, in particular, economic mechanisms of protection against pension risks. The use of these mechanisms has a dual effect (economic and social, due to the attraction of the regions with additional financial resources in the form of “long money” and increasing the protection of citizens against pension risks (the increase in the level of pension payments. The analysis of the current use of economic mechanisms of protection against pension risks in the regions of the Southern Federal District helped to articulate key issues of their use, in particular, low pension literacy of the population, distrust towards specialized financial institutions, the investment policy of the regions does not take into account the possibility of attracting private pension funds into regional projects, and there is no mechanism to support regional National Pension Fund. Territorial analysis revealed the potential application of economic mechanisms to protect against pension risks in the regions of the Southern Federal District as a tool for socio-economic development, which is based on the existence of regional pension funds and insurance companies (providing services for pension insurance, as well as participation in private pension provision. The Krasnodar, Rostov and Volgograd regions have the highest potential among the regions of the Southern Federal District, as there already exist regional National Pension Fund, and the participation in private pension insurance is confirmed by the statistics of the contributions paid. The study of existing economic mechanisms to protect against pension risks will provide the

  1. Screening Tool to Determine Risk of Having Muscle Dysmorphia Symptoms in Men Who Engage in Weight Training at a Gym.

    Science.gov (United States)

    Palazón-Bru, Antonio; Rizo-Baeza, María M; Martínez-Segura, Asier; Folgado-de la Rosa, David M; Gil-Guillén, Vicente F; Cortés-Castell, Ernesto

    2018-03-01

    Although 2 screening tests exist for having a high risk of muscle dysmorphia (MD) symptoms, they both require a long time to apply. Accordingly, we proposed the construction, validation, and implementation of such a test in a mobile application using easy-to-measure factors associated with MD. Cross-sectional observational study. Gyms in Alicante (Spain) during 2013 to 2014. One hundred forty-one men who engaged in weight training. The variables are as follows: age, educational level, income, buys own food, physical activity per week, daily meals, importance of nutrition, special nutrition, guilt about dietary nonadherence, supplements, and body mass index (BMI). A points system was constructed through a binary logistic regression model to predict a high risk of MD symptoms by testing all possible combinations of secondary variables (5035). The system was validated using bootstrapping and implemented in a mobile application. High risk of having MD symptoms (Muscle Appearance Satisfaction Scale). Of the 141 participants, 45 had a high risk of MD symptoms [31.9%, 95% confidence interval (CI), 24.2%-39.6%]. The logistic regression model combination providing the largest area under the receiver operating characteristic curve (0.76) included the following: age [odds ratio (OR) = 0.90; 95% CI, 0.84-0.97, P = 0.007], guilt about dietary nonadherence (OR = 2.46; 95% CI, 1.06-5.73, P = 0.037), energy supplements (OR = 3.60; 95% CI, 1.54-8.44, P = 0.003), and BMI (OR = 1.33, 95% CI, 1.12-1.57, P < 0.001). The points system was validated through 1000 bootstrap samples. A quick, easy-to-use, 4-factor test that could serve as a screening tool for a high risk of MD symptoms has been constructed, validated, and implemented in a mobile application.

  2. 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

    Background 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. Methods 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. Results 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 (Prisk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients. PMID:25333271

  3. Risks of using social media as a marketing tool for small producers in a developing country

    Directory of Open Access Journals (Sweden)

    Makhitha, K. M.

    2016-12-01

    Full Text Available The aim of this secondary research is to determine the suitability of social media as an element of marketing communication for craft producers. Secondary research was used to determine the suitability of social media as an element of marketing communication for craft producers in an emerging country. The growth in the craft market is also associated with the rise in local interest in South African craft fuelled by trends towards ethnic, rustic, earthy styles and increasing national pride and the return of local values. The consulted secondary resources confirm that social media has the potential to help crafters to create better brand awareness, better relationships with customers, and increase sales via these mechanisms. However, the major challenge for craft producers to use social media as a communication tool will be limited resources and illiteracy. The research recommends that the South African government provide support in the form of a centralized marketing agency that uses social media to promote craft producers products

  4. Cross-cultural adaptation of the STRATIFY tool in detecting and predicting risk of falling.

    Science.gov (United States)

    Enríquez de Luna-Rodríguez, Margarita; Aranda-Gallardo, Marta; Canca-Sánchez, José Carlos; Vazquez-Blanco, M José; Moya-Suárez, Ana Belén; Morales-Asencio, José Miguel

    To adapt to Spanish language the STRATIFY tool for clinical use in the Spanish-speaking World. A multicenter, 2 care settings cross-sectional study cultural adaptation study in acute care hospitals and nursing homes was performed in Andalusia during 2014. The adaptation process was divided into 4 stages: translation, back-translation, equivalence between the 2 back-translations and piloting of the Spanish version, thus obtaining the final version. The validity of appearance, content validity and the time required to complete the scale were taken into account. For analysis, the median, central tendency and dispersion of scores, the interquartile range, and the interquartile deviation for the possible variability in responses it was calculated. Content validity measured by content validity index reached a profit of 1. For the validity aspect the clarity and comprehensibility of the questions were taken into account. Of the 5 questions of the instrument, 2 had a small disagreement solved with the introduction of an explanatory phrase to achieve conceptual equivalence. Median both questions were equal or superior to 5. The average time for completion of the scale was less than 3 minutes. The process of adaptation to Spanish of STRATIFY has led to a semantic version and culturally equivalent to the original for easy filling and understanding for use in the Spanish-speaking world. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Tool to manage Road Safety Deficiencies and risk of highway crashes

    Energy Technology Data Exchange (ETDEWEB)

    Lopez Maldonado, G.; Baena Ruiz, L.; Garach Morcillo, L.; Oña Lopez, J. de

    2016-07-01

    In order to facilitate the management of the results obtained in the project “Analysis of the relationship between Road Safety Deficiencies, crashes and hazardous sections” financed by Public Works Agency of the Regional Government of Andalusia (AOPJA) and led by the research group TRYSE from University of Granada, a safety management tool has been developed. This application allows safety managers to consult some factors affecting crashes on two-lane rural highways.The main aim of that project was to analyze the influence of some road deficiencies on crashes and hazardous sections in the Complementary Road Network of Andalusia. These deficiencies were defined in a checklist and were identified by a road inspection. Decision Trees (DTs), that are a data mining technique that allows the extraction of Decision Rules (DRs), were used. DRs revealed the relationship between road deficiencies and crashes.The application allows two different analyses. A specific analysis of the Complementary Road Network of Andalusia, in which, particular safety problems can be identified, and the location of roads with those problems can be obtained. A more general analysis in which some characteristics related to road safety can be selected in order to know the combination of factors contributing to traffic crashes. Safety problems are based on data from Complementary Road Network of Andalusia but results can be extrapolated to other rural highways in Spain. (Author)

  6. Environmental biodosimetry: a biologically relevant tool for ecological risk assessment and biomonitoring

    Energy Technology Data Exchange (ETDEWEB)

    Ulsh, B. E-mail: ulshb@mcmaster.ca; Hinton, T.G.; Congdon, J.D.; Dugan, L.C.; Whicker, F.W.; Bedford, J.S

    2003-07-01

    Biodosimetry, the estimation of received doses by determining the frequency of radiation-induced chromosome aberrations, is widely applied in humans acutely exposed as a result of accidents or for clinical purposes, but biodosimetric techniques have not been utilized in organisms chronically exposed to radionuclides in contaminated environments. The application of biodosimetry to environmental exposure scenarios could greatly improve the accuracy, and reduce the uncertainties, of ecological risk assessments and biomonitoring studies, because no assumptions are required regarding external exposure rates and the movement of organisms into and out of contaminated areas. Furthermore, unlike residue analyses of environmental media environmental biodosimetry provides a genetically relevant biomarker of cumulative lifetime exposure. Symmetrical chromosome translocations can impact reproductive success, and could therefore prove to be ecologically relevant as well. We describe our experience in studying aberrations in the yellow-bellied slider turtle as an example of environmental biodosimetry.

  7. Mesocosm soil ecological risk assessment tool for GMO 2nd tier studies

    DEFF Research Database (Denmark)

    D'Annibale, Alessandra; Maraldo, Kristine; Larsen, Thomas

    Ecological Risk Assessment (ERA) of GMO is basically identical to ERA of chemical substances, when it comes to assessing specific effects of the GMO plant material on the soil ecosystem. The tiered approach always includes the option of studying more complex but still realistic ecosystem level...... effects in 2nd tier caged experimental systems, cf. the new GMO ERA guidance: EFSA Journal 2010; 8(11):1879. We propose to perform a trophic structure analysis, TSA, and include the trophic structure as an ecological endpoint to gain more direct insight into the change in interactions between species, i.......e. the food-web structure, instead of relying only on the indirect evidence from population abundances. The approach was applied for effect assessment in the agro-ecosystem where we combined factors of elevated CO2, viz. global climate change, and GMO plant effects. A multi-species (Collembola, Acari...

  8. Hotspot health physics codes used as a tool for managing excess risk on radiological emergencies

    International Nuclear Information System (INIS)

    Andrade, Edson Ramos de; Alves, Nelson Mendes; Rocha, Joao B.T.; Cruz, Ivana B. Manica da; Santos, Greice F. Fey dos; Machado, Michel Mansur; Rossato, Veronica Venturini; Bauermann, Liliane Freitas

    2008-01-01

    This work is aimed to use the Hotspot Health Physics codes in acute mode in order to estimate the immediate radiological impact associated with high acute radiation doses, which is applied to special target organs such as lung, small intestine wall, and red bone marrow. Organic compounds such as Diphenyl Diselenide (C 6 H 5 Se 2 C 6 H 5 ) and Ebselen (C 13 H 9 NOSe), an antioxidants selenium containing compounds, were used over irradiated phospholipids extracted from chicken yolk eggs, in vitro in order to reduce lipo-peroxidation. Experimental data were measured by Thiobarbituric Acid Reactive Substance (TBARS) assay which is able to measure the production of oxidative stress in the sample. Experimental data were extrapolated and applied as a reduction factors over equations for cancer excess risk calculation from BEIR V, for helping the decisonmaking process on Radiological Emergency Scenarios. (author)

  9. Reducing developmental risk for emotional/behavioral problems: a randomized controlled trial examining the Tools for Getting Along curriculum.

    Science.gov (United States)

    Daunic, Ann P; Smith, Stephen W; Garvan, Cynthia W; Barber, Brian R; Becker, Mallory K; Peters, Christine D; Taylor, Gregory G; Van Loan, Christopher L; Li, Wei; Naranjo, Arlene H

    2012-04-01

    Researchers have demonstrated that cognitive-behavioral intervention strategies - such as social problem solving - provided in school settings can help ameliorate the developmental risk for emotional and behavioral difficulties. In this study, we report the results of a randomized controlled trial of Tools for Getting Along (TFGA), a social problem-solving universally delivered curriculum designed to reduce the developmental risk for serious emotional or behavioral problems among upper elementary grade students. We analyzed pre-intervention and post-intervention teacher-report and student self-report data from 14 schools, 87 classrooms, and a total of 1296 students using multilevel modeling. Results (effect sizes calculated using Hedges' g) indicated that students who were taught TFGA had a more positive approach to problem solving (g=.11) and a more rational problem-solving style (g=.16). Treated students with relatively poor baseline scores benefited from TFGA on (a) problem-solving knowledge (g=1.54); (b) teacher-rated executive functioning (g=.35 for Behavior Regulation and .32 for Metacognition), and proactive aggression (g=.20); and (c) self-reported trait anger (g=.17) and anger expression (g=.21). Thus, TFGA may reduce risk for emotional and behavioral difficulties by improving students' cognitive and emotional self-regulation and increasing their pro-social choices. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  10. 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).

  11. Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

    Science.gov (United States)

    Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

    2016-12-01

    A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

  12. The modified "Rockfall Hazard Rating System": a new tool for roads risk assessment

    Science.gov (United States)

    Budetta, P.

    2003-04-01

    This paper contains a modified method for the analysis of rockfall hazard along roads and motorways. The method is derived from that one developed by Pierson et alii at the Oregon State Highway Division. The Rockfall Hazard Rating System (RHRS) provides a rational way to make informed decisions on where and how to spend construction funds. An exponential scoring graph is used to represent the increase in hazard that is reflected in the nine categories forming the classification (slope height, ditch effectiveness, average vehicle risk, percent of decision site distance, roadway width, geological character, quantity of rockfall/event, climate and rock fall history). The resulting total score contains the essential elements regarding the evaluation of the consequences ("cost of failure"). In the modified method, the rating for the categories "ditch effectiveness", "decision sight distance", "rodway width", "geologic characteristic" and "climate and water circulation" have been rendered more easy and objective. The main modifications regard the introduction of the Romana's Slope Mass Rating improving the estimate of the geologic characteristics, of the volume of the potentially unstable blocks and underground water circulation. Other modifications regard the scoring determination for the categories "decision sight distance" and "road geometry". For these categories, the Italian National Council's standards (CNR) have been used. The method must be applied in both the traffic directions because the percentage of reduction in the "decision sight distance" greatly affects the results. An application of the method to a 2-km-long section of the Sorrentine road (n° 145) in Southern Italy was pointed out. A high traffic intensity affects the entire section of the road and rockfalls periodically cause casualties, as well as a large amount of damage and traffic interruptions. The method was applied on seven cross section traces of slopes adjacent to the Sorrentine road and the

  13. The analysis of risks at LPG depots: a tool for decision makers

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1993-10-01

    At the Tokyo congress of the World LPG Forum, Mr Patrick Mayras, Technical Director at Butagaz, presented a study on the probability of the occurrence of a major accident which this company has undertaken with Cremer Warner on its storage and filling site in Montereau, together with the key prevention principles which have resulted from this study and which have been applied to all their installations. The study shows that the probability of a BLEVE is 1 in a thousand million years per sphere or, for the 60 storage sites belonging to Butagaz, that the probability of a BLEVE in its installations is 1 every 16 million years. If every company in the profession had this level of standards on an international scale, the probability of a BLEVE occurring in the world would be, again according to Butagaz calculations, of the order of 1 every 100.000 years or, at a really conservative estimate, of the order of 1 every 10.000 years (based on: one storage site for 10.000 t sold/year). This report was received with a great deal of interest in Tokyo and it is certain that this probability-based approach will constitute hence-forth a reference both on a national and an international scale. As Mr Mayras underlined at the end of his presentation, although a zero risk does not exist, there is a socially acceptable risk which is used implicitly by governmental authorities for certain human or industrial activities for certain human or industrial activities which have an accident occurrence probability which is much higher than that run by LPG storage sites. Conversely, the determinist and calculated approach applied in France presents a high cost to society due to the freezing of all land around the sites. The probability-based approach, which can be systematized to all LPG professionals, could, therefore, allow for a relaxation of the constraints weighing on the environment of storage sites and could place LPG on an equal footing with other types of energy. (Abstract Truncated)

  14. Optimization method to determine mass transfer variables in a PWR crud deposition risk assessment tool

    International Nuclear Information System (INIS)

    Do, Chuong; Hussey, Dennis; Wells, Daniel M.; Epperson, Kenny

    2016-01-01

    Optimization numerical method was implemented to determine several mass transfer coefficients in a crud-induced power shift risk assessment code. The approach was to utilize a multilevel strategy that targets different model parameters that first changes the major order variables, mass transfer inputs, then calibrates the minor order variables, crud source terms, according to available plant data. In this manner, the mass transfer inputs are effectively simplified as 'dependent' on the crud source terms. Two optimization studies were performed using DAKOTA, a design and analysis toolkit, with the difference between the runs, being the number of model runs using BOA, allowed for adjusting the crud source terms, therefore, reducing the uncertainty with calibration. The result of the first case showed that the current best estimated values for the mass transfer coefficients, which were derived from first principle analysis, can be considered an optimized set. When the run limit of BOA was increased for the second case, an improvement in the prediction was obtained with the results deviating slightly from the best estimated values. (author)

  15. The MULTIMEDIA exposure model as a risk assessment tool at LUST sites

    International Nuclear Information System (INIS)

    Bowers, R.B.

    1994-01-01

    In the course of characterizing Leaking Underground Storage Tank (LUST) sites in the Commonwealth, Virginia Department of Environmental Quality (VDEQ) regulations section 6.5.A.2.b of VR-680-13-02, requires that a risk assessment be performed which must address, among other issues, aqueous phase contaminant exposure levels to critical receptors. often, during the course of conducting such an assessment, the aqueous phase contaminant plume has not yet intercepted the critical down gradient receptor. Thus, the determination of the maximum potential exposure level to this receptor can only be made through the use of an appropriate fate and transport model. This paper focuses on an application of the saturated zone module of the USEPA's MULTIMEDIA Exposure Assessment model. The case study presented involves a LUST site in the Commonwealth, in which four critical receptors of leaded gasoline contaminated groundwater were identified. These receptors included three residential water wells and an intermittent stream. At this particular site, the aqueous phase contaminant plume had not yet reached any of the receptors; and the MULTIMEDIA model was employed to predict the steady-state aqueous phase concentrations with very favorable results

  16. Inspection qualification as a tool to risk based ET ISI of VVER type SG tubes

    International Nuclear Information System (INIS)

    Horacek, L.

    2002-01-01

    A Pilot study on Eddy current inspection qualification of VVER 440 steam generator tubes, discussed in this paper, followed the ENIQ methodology principles and covered briefly the assumed scope of ET qualification, relevant elaborated qualification documents, known ISI limitations and a review of input information on component and defects determined for Eddy current inspection qualification of VVER 440 steam generator tubes. The information includes the fabrication of the test blocks with SG tube segments provided by intended defect simulations of realistic SCC type and basic data on the realistic SCC type defects manufacturing technology. Lessons learned from the development of manufacturing technology of SSC type of defects, regional blind tests, elaboration of the preliminary technical justification for Eddy current automated inspections, potential optimisation of inspection procedures, laboratory and practical open trials are summarised in the paper. The results of the Pilot study also especially in relation to POD curve being determined seem to be useful for practical operational ISI programme and Risk informed ISI decisions and the establishment of plugging criteria of VVER 440 and VVER 1000 type steam generator tubes. (orig.)

  17. 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.

  18. 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.

  19. Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass

    DEFF Research Database (Denmark)

    Håkansson, Fanny; Høgdall, Estrid V S; Nedergaard, Lotte

    2012-01-01

    Abstract Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI =200 are referred to tertiary gynecologic oncology...... the use of RMI =200 as a tool for preoperative identification of ovarian cancer at a tertiary center. Design. Prospective observational study. Setting. A tertiary center in Copenhagen, Denmark. Population. One thousand one hundred and fifty-nine women with pelvic mass. Methods. The RMI was calculated...... pelvic mass. Results. There were 778 women diagnosed with benign pelvic mass, while 251 had ovarian cancer and 74 had borderline ovarian tumor. Fifty-six women were diagnosed with other forms of cancer. Sensitivity and specificity for ovarian cancer vs. benign pelvic mass for RMI =200 were 92 and 82...

  20. Is monocyte HLA-DR expression monitoring a useful tool to predict the risk of secondary infection?

    Science.gov (United States)

    Lukaszewicz, A-C; Faivre, V; Payen, D

    2010-09-01

    Downregulation of the immune response is common among Intensive Care Unit (ICU) patients after an acute inflammatory injury, whether it was septic or not. Such a modification could be seen as an adaptation to attenuate the effects of the inflammatory storm on tissues, but it exposes the subject to the risk of nosocomial infection and impairs recovery processes. The intensity of immunity downregulation is difficult to characterize, since clinical presentation is silent and non-specific, which urges the use of tools for immune monitoring. This review focuses on the use of monocyte HLA-DR expression to detect immune hyporesponsiveness and to select the appropriate immunomodulating therapy, as well as the efficiency of this technique in controlling secondary infections.

  1. Use of an Integrated Tool for Interpretation of Blood Glucose Data Improves Correctness of Glycemic Risk Assessment in Individuals With Type 1 and Type 2 Diabetes.

    Science.gov (United States)

    Parkin, Christopher G; Schwenke, Stephanie; Ossege, Anna Katharina; Gruchmann, Torsten

    2017-01-01

    Manufacturers now incorporate blood glucose (bG) value interpretation tools into their monitoring systems; however, usability of these support tools has not been well studied. We evaluated the utility and perceived benefits of support tool use by individuals with type 1 (T1D) and type 2 diabetes (T2D). This 3-arm, randomized, simulation study assessed the impact of use of bG value interpretation support tools on participants' ability to correctly interpret bG values, using 1 of 3 tools: a new tool that uses colored scales with target range indicator (TRI), Colors and Smiley icons (already available). Participants assessed 50 bG values without use of any tool and repeated the assessment using 1 of the 3 tool configurations. Changes in percentage of correct responses when using a support tool and user perceptions were assessed. Data sets from 140 participants were analyzed. Increases in correct responses were seen in all study groups but most notably in the TRI group (26%, P .627). Most TRI users felt confident (94%), agreed the tool will help them identify high and low values (96%) and will help them to make correct insulin dosage decisions (80%). Use of the TRI significantly increases users' ability to correctly and confidently determine their glycemic risk when self-monitoring bG levels. This suggests the tool may offer clinical value to individuals with T1D and T2D.

  2. Implementing a screening tool for identifying patients at risk for hereditary breast and ovarian cancer: a statewide initiative.

    Science.gov (United States)

    Brannon Traxler, L; Martin, Monique L; Kerber, Alice S; Bellcross, Cecelia A; Crane, Barbara E; Green, Victoria; Matthews, Roland; Paris, Nancy M; Gabram, Sheryl G A

    2014-10-01

    The Georgia Breast Cancer Genomic Health Consortium is a partnership created with funding from the Centers for Disease Control and Prevention (CDC) to the Georgia Department of Public Health to reduce cancer disparities among high-risk minority women. The project addresses young women at increased risk for hereditary breast and ovarian cancer (HBOC) syndrome through outreach efforts. The consortium provides education and collects surveillance data using the breast cancer genetics referral screening tool (B-RST) available at www.BreastCancerGeneScreen.org . The HBOC educational protocol was presented to 73 staff in 6 public health centers. Staff used the tool during the collection of medical history. Further family history assessments and testing for mutations in the BRCA1/2 genes were facilitated if appropriate. Data was collected from November 2012 through December 2013, including 2,159 screened women. The majority of patients identified as black/African American and were 18-49 years old. Also, 6.0 % (n = 130) had positive screens, and 60.9 % (n = 67) of the 110 patients who agreed to be contacted provided a detailed family history. A total of 47 patients (42.7 %) met National Comprehensive Cancer Network guidelines when family history was clarified. Fourteen (12.7 %) underwent genetic testing; 1 patient was positive for a BRCA2 mutation, and 1 patient was found to carry a variant of uncertain significance. The introduction of genomics practice within public health departments has provided access to comprehensive cancer care for uninsured individuals. The successful implementation of the B-RST into public health centers demonstrates the opportunity for integration of HBOC screening into primary care practices.

  3. 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

  4. 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.

  5. Leveraging the benefits of storage as a risk management tool : strategies to offset price volatility

    International Nuclear Information System (INIS)

    Ledene, B.

    2002-01-01

    strong understanding of short term fundamentals, have enough manpower, and how to anticipate weekly storage estimates, weather, fuel inventories and prices. Strategies to optimize storage contracts and manage the risks were also presented for both bull and bear markets. The author suggests that in order to get the best deal, one should be prepared to take a longer-term contract and pay for some portion of the expected value. 15 figs

  6. Development of advanced risk informed asset management tool based on system dynamics approach for nuclear power plant

    International Nuclear Information System (INIS)

    Lee, Gyoung Cheol

    2007-02-01

    In the competitive circumstance of electricity industry, the economic efficiency of electricity generation facility is the most important factor to increase their competitiveness. For nuclear power plant (NPP), safety is also an essential factor. Over fast several years, efforts for development of safety concerned and financial asset maximizing method, process and tools have been continued internationally and Risk-Informed Asset Management (RIAM) methodology is suggested by Electric Power Research Institute (EPRI). This RIAM methodology is expected to provide plant operators with a project prioritization and life cycle management planning tool for making long-term maintenance plans, guiding plant budgeting, and determining the sensitivity of a plant's economic risk to the reliability and availability of system, structure, and components (SSC), as well as other technical and economic parameters. The focus of this study is to develop model that help us to resource allocation, to find what effect such allocations on the plant economic and safety performance. Detailed research process for this goal is as follow; First step for development of advanced RIAM model is to review for current RIAM model of EPRI. This part describes the overall RIAM methodology including its conceptual model, implementation process, modular approach etc. Second step is to perform feasibility study for current EPRI's RIAM model with case study. This part shows the result of feasibility study for current RIAM method by case study and discussion for result. Finally, concept of Advanced RIAM model is developed based on system dynamics approach and parameter relationship is formulated. In advanced RIAM Model, Identification of scheduled maintenance effect on other parameters and the relationship between PM Activity and failure rate is most important factor. In this study, these relationships are formulated based on system dynamics approach. Creations of these modeling tool using Vensim

  7. Dynamics of risk management tools and auctions in the second phase of the Brazilian Electricity Market reform

    International Nuclear Information System (INIS)

    De Souza, Fabio Cavaliere; Legey, Luiz Fernando Loureiro

    2010-01-01

    In 2004, the reform of the Brazilian Electricity Market underwent a thorough revision. One of its causes was the electricity rationing that began in June 2001 and lasted until February 2002. Among other measures, the 2004 revision devised new mechanisms intended to reduce risks associated to contracts settled in electricity auctions and those related to investments in new generation plants. As 4 years have passed since the onset of the reform's revision, sufficiently enough data are now available for an analysis of the post-revision dynamics of the Brazilian Electricity Market. This is the purpose of the present paper. We focus on the dynamics of the different types of electricity auctions and on the so-called Mechanism for Compensation of Surpluses and Deficits, both created in the wake of the 2004 revision. The ultimate goal is to understand the behavior of the agents involved in auctions - notably buyers and sellers of electricity - and propose remedial actions to eliminate existing loopholes in the present regulatory framework. To achieve this goal, four steps were necessary. Firstly, a data base to support the analysis was built. Then, the main drivers of the dynamics of the risk management tools were identified. Finally, consequences of the implemented changes were discussed and corrections for observed pitfalls proposed. (author)

  8. Lipid ratio as a suitable tool to identify individuals with MetS risk: A case- control study.

    Science.gov (United States)

    Abbasian, Maryam; Delvarianzadeh, Mehri; Ebrahimi, Hossein; Khosravi, Farideh

    2017-11-01

    This study aimed to compare the serum lipids ratio in staff with and without metabolic syndrome (MetS) who were working in Shahroud University of Medical Sciences. This case-control study was conducted in 2015 on 499 personnel aged 30-60 years old. ATP III criteria were used to diagnose patients with MetS. The data were analyzed by using logistic regression and ROC curve. Mean lipid ratio was higher in individuals having the MetS in both sexes compared with those without. In addition, the mean levels of lipid ratios significantly increased with increasing number of MetS components in both sexes. Also it could be concluded that TG/HDL-C ratio is the best marker for the diagnosis of MetS in men and women. Moreover, the cut-off point for the TG/HDL-C was 2.86 in women and 4.03 in men. It was found that for any unit of increases in the TG/HDL-C, the risk of developing the MetS will increase by 2.12 times. TG/HDL-C ratio is found to be the best clinical marker for the diagnosis of MetS compare with other lipid ratios, therefore it is recommended to be used as a feasible tool to identify individuals with MetS risk. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  9. Drive Cost Reduction, Increase Innovation and Mitigate Risk with Advanced Knowledge Discovery Tools Designed to Unlock and Leverage Prior Knowledge

    International Nuclear Information System (INIS)

    Mitchell, I.

    2016-01-01

    Full text: The nuclear industry is knowledge-intensive and includes a diverse number of stakeholders. Much of this knowledge is at risk as engineers, technicians and project professionals retire, leaving a widening skills and information gap. This knowledge is critical in an increasingly complex environment with information from past projects often buried in decades-old, non-integrated systems enterprise. Engineers can spend 40% or more of their time searching for answers across the enterprise instead of solving problems. The inability to access trusted industry knowledge results in increased risk and expense. Advanced knowledge discovery technologies slash research times by as much as 75% and accelerate innovation and problem solving by giving technical professionals access to the information they need, in the context of the problems they are trying to solve. Unlike traditional knowledge management approaches, knowledge discovery tools powered by semantic search technologies are adept at uncovering answers in unstructured data and require no tagging, organization or moving of data, meaning a smaller IT footprint and faster time-to-knowledge. This session will highlight best-in-class knowledge discovery technologies, content, and strategies to give nuclear industry organizations the ability to leverage the corpus of enterprise knowledge into the future. (author

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

    Science.gov (United States)

    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.

  11. Validation of a risk stratification tool for fall-related injury in a state-wide cohort.

    Science.gov (United States)

    McCoy, Thomas H; Castro, Victor M; Cagan, Andrew; Roberson, Ashlee M; Perlis, Roy H

    2017-02-06

    A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using state-wide medical claims data. Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fall-related injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. The Massachusetts health system. A total of 68 764 hospitalised individuals aged 35-65 years. Hospital readmission for fall-related injury defined by claims code. A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. This analysis of state-wide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of

  12. Primary Sclerosing Cholangitis Risk Estimate Tool (PREsTo) Predicts Outcomes in PSC: A Derivation & Validation Study Using Machine Learning.

    Science.gov (United States)

    Eaton, John E; Vesterhus, Mette; McCauley, Bryan M; Atkinson, Elizabeth J; Schlicht, Erik M; Juran, Brian D; Gossard, Andrea A; LaRusso, Nicholas F; Gores, Gregory J; Karlsen, Tom H; Lazaridis, Konstantinos N

    2018-05-09

    Improved methods are needed to risk stratify and predict outcomes in patients with primary sclerosing cholangitis (PSC). Therefore, we sought to derive and validate a new prediction model and compare its performance to existing surrogate markers. The model was derived using 509 subjects from a multicenter North American cohort and validated in an international multicenter cohort (n=278). Gradient boosting, a machine based learning technique, was used to create the model. The endpoint was hepatic decompensation (ascites, variceal hemorrhage or encephalopathy). Subjects with advanced PSC or cholangiocarcinoma at baseline were excluded. The PSC risk estimate tool (PREsTo) consists of 9 variables: bilirubin, albumin, serum alkaline phosphatase (SAP) times the upper limit of normal (ULN), platelets, AST, hemoglobin, sodium, patient age and the number of years since PSC was diagnosed. Validation in an independent cohort confirms PREsTo accurately predicts decompensation (C statistic 0.90, 95% confidence interval (CI) 0.84-0.95) and performed well compared to MELD score (C statistic 0.72, 95% CI 0.57-0.84), Mayo PSC risk score (C statistic 0.85, 95% CI 0.77-0.92) and SAP statistic 0.65, 95% CI 0.55-0.73). PREsTo continued to be accurate among individuals with a bilirubin statistic 0.90, 95% CI 0.82-0.96) and when the score was re-applied at a later course in the disease (C statistic 0.82, 95% CI 0.64-0.95). PREsTo accurately predicts hepatic decompensation in PSC and exceeds the performance among other widely available, noninvasive prognostic scoring systems. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  13. Can paramedics use FRAX (the WHO Fracture Risk Assessment Tool) to help GPs improve future fracture risk in patients who fall? Protocol for a randomised controlled feasibility study.

    Science.gov (United States)

    Clarke, Shane; Bradley, Rachel; Simmonds, Bethany; Salisbury, Chris; Benger, Jonathan; Marques, Elsa; Greenwood, Rosemary; Shepstone, Lee; Robinson, Maria; Appleby-Fleming, John; Gooberman-Hill, Rachael

    2014-09-03

    Currently identification, and therefore, management of patients at risk of osteoporotic fracture in the UK is suboptimal. As the majority of patients who fracture have fallen, it follows that people who fall can usefully be targeted in any programme that aims to reduce osteoporotic fracture. Targeting vulnerable patients who are likely to benefit from intervention may help shift the management of fracture prevention into primary care, away from emergency departments. Paramedics who attend to patients who have fallen may be well placed to assess future fracture risk, using the Fracture Risk Assessment Tool (FRAX) and communicate that information directly to general practitioners (GPs). This feasibility study takes the form of a pragmatic, randomised controlled trial aimed at exploring and refining issues of study design, recruitment, retention, sample size and acceptability preceding a large-scale study with fracture as the end point. Patients (aged >50) who fall, call an ambulance, are attended by a study paramedic and give verbal consent will be asked FRAX and fall questions. Patients who subsequently formally consent to participation will be randomised to control (usual care) or intervention groups. Intervention will constitute transmission of calculated future fracture risk to the patients' GP with suitable, evidence-based recommendations for investigation or treatment. 3 months after the index fall, data (proportion of patients in each group undergoing investigation or starting new treatment, quality of life and health economic) will be collected and analysed using descriptive statistics. A nested qualitative study will explore issues of acceptability and study design with patients, paramedics and GPs. This protocol was appro