WorldWideScience

Sample records for risk-screening environmental indicators

  1. Risk-Screening Environmental Indicators (RSEI)

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA’s Risk-Screening Environmental Indicators (RSEI) is a geographically-based model that helps policy makers and communities explore data on releases of toxic...

  2. Risk-based indicators of Canadians' exposures to environmental carcinogens.

    Science.gov (United States)

    Setton, Eleanor; Hystad, Perry; Poplawski, Karla; Cheasley, Roslyn; Cervantes-Larios, Alejandro; Keller, C Peter; Demers, Paul A

    2013-02-12

    Tools for estimating population exposures to environmental carcinogens are required to support evidence-based policies to reduce chronic exposures and associated cancers. Our objective was to develop indicators of population exposure to selected environmental carcinogens that can be easily updated over time, and allow comparisons and prioritization between different carcinogens and exposure pathways. We employed a risk assessment-based approach to produce screening-level estimates of lifetime excess cancer risk for selected substances listed as known carcinogens by the International Agency for Research on Cancer. Estimates of lifetime average daily intake were calculated using population characteristics combined with concentrations (circa 2006) in outdoor air, indoor air, dust, drinking water, and food and beverages from existing monitoring databases or comprehensive literature reviews. Intake estimates were then multiplied by cancer potency factors from Health Canada, the United States Environmental Protection Agency, and the California Office of Environmental Health Hazard Assessment to estimate lifetime excess cancer risks associated with each substance and exposure pathway. Lifetime excess cancer risks in excess of 1 per million people are identified as potential priorities for further attention. Based on data representing average conditions circa 2006, a total of 18 carcinogen-exposure pathways had potential lifetime excess cancer risks greater than 1 per million, based on varying data quality. Carcinogens with moderate to high data quality and lifetime excess cancer risk greater than 1 per million included benzene, 1,3-butadiene and radon in outdoor air; benzene and radon in indoor air; and arsenic and hexavalent chromium in drinking water. Important data gaps were identified for asbestos, hexavalent chromium and diesel exhaust in outdoor and indoor air, while little data were available to assess risk for substances in dust, food and beverages. The ability to

  3. Environmental and risk screening for prioritizing pollution prevention opportunities in the U.S. printed wiring board manufacturing industry.

    Science.gov (United States)

    Lam, Carl W; Lim, Seong-Rin; Schoenung, Julie M

    2011-05-15

    Modern manufacturing of printed wiring boards (PWBs) involves extensive use of various hazardous chemicals in different manufacturing steps such as board preparation, circuit design transfer, etching and plating processes. Two complementary environmental screening methods developed by the U.S. EPA, namely: (i) the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) and (ii) Risk-Screening Environmental Indicators (RSEI), are used to quantify geographic and chemical environmental impacts in the U.S. PWB manufacturing industry based on Toxics Release Inventory (TRI) data. Although the release weight percentages of industrial chemicals such as methanol, glycol ethers and dimethylformamide comprise the larger fraction of reported air and water emissions, results indicate that lead, copper and their compounds' releases correspond to the highest environmental impact from toxicity potentials and risk-screening scores. Combining these results with further knowledge of PWB manufacturing, select alternative chemical processes and materials for pollution prevention are discussed. Examples of effective pollution prevention options in the PWB industry include spent etchant recovery technologies, and process and material substitutions. In addition, geographic assessment of environmental burden highlights states where promotion of pollution prevention strategies and emissions regulations can have the greatest effect to curb the PWB industry's toxic release impacts. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Home Environmental and Behavioral Risk Indices for Reading Achievement.

    Science.gov (United States)

    Taylor, Jeanette; Ennis, Chelsea R; Hart, Sara A; Mikolajewski, Amy J; Schatschneider, Christopher

    2017-07-01

    The goal of this study was to identify home environmental and temperament/behavior variables that best predict standardized reading comprehension scores among school-aged children. Data from 269 children aged 9-16 ( M = 12.08; SD = 1.62) were used in discriminant function analyses to create the Home and Behavior indices. Family income was controlled in each index. The final Home and Behavior models each classified around 75% of cases correctly (reading comprehension at grade level vs. not). Each index was then used to predict other outcomes related to reading. Results showed that Home and/or Behavior accounted for 4-7% of the variance in reading fluency and spelling and 20-35% of the variance in parent-rated problems in math, social anxiety, and other dimensions. These metrics show promise as environmental and temperament/behavior risk scores that could be used to predict and potentially screen for further assessment of reading related problems.

  5. Analysis of risk indicators and issues associated with applications of screening model for hazardous and radioactive waste sites

    International Nuclear Information System (INIS)

    Buck, J.W.; Strenge, D.L.; Droppo, J.G. Jr.

    1990-12-01

    Risk indicators, such as population risk, maximum individual risk, time of arrival of contamination, and maximum water concentrations, were analyzed to determine their effect on results from a screening model for hazardous and radioactive waste sites. The analysis of risk indicators is based on calculations resulting from exposure to air and waterborne contamination predicted with Multimedia Environmental Pollutant Assessment System (MEPAS) model. The different risk indicators were analyzed, based on constituent type and transport and exposure pathways. Three of the specific comparisons that were made are (1) population-based versus maximum individual-based risk indicators, (2) time of arrival of contamination, and (3) comparison of different threshold assumptions for noncarcinogenic impacts. Comparison of indicators for population- and maximum individual-based human health risk suggests that these two parameters are highly correlated, but for a given problem, one may be more important than the other. The results indicate that the arrival distribution for different levels of contamination reaching a receptor can also be helpful in decisions regarding the use of resources for remediating short- and long-term environmental problems. The addition of information from a linear model for noncarcinogenic impacts allows interpretation of results below the reference dose (RfD) levels that might help in decisions for certain applications. The analysis of risk indicators suggests that important information may be lost by the use of a single indicator to represent public health risk and that multiple indicators should be considered. 15 refs., 8 figs., 1 tab

  6. Sound construction of risk indicators

    DEFF Research Database (Denmark)

    Sørensen, Peter Borgen; Kjær, Christian; Thomsen, Marianne

      In spite of the great effort in the area of environmental risk assessment of chemicals, a critical amount of uncertainty is still a reality due to high complexity of the governing risk problem. Unexpected adverse effects may thus take place event though the risk assessment predicts no-risk. Some...... chemicals are even lacking risk assessment due to a priori judgment based on risk screening methods that bypass further risk assessment activity. It is thus advisable to set up a safety net under the risk assessment of chemicals and this poster suggests a supporting paradigm using risk indicators...... that governs the method: HotSpot Driven Aggregation of Risk Indicators (HoSDARI) as described in Sørensen et al. (2008). The purpose of the risk assessment is to protect a defined target that has some value for protection. The target has a number of realizations each defined as a Protection Unit (PU...

  7. Screening Analysis for the Environmental Risk Evaluation System Fiscal Year 2011 Report Environmental Effects of Offshore Wind Energy

    Energy Technology Data Exchange (ETDEWEB)

    Copping, Andrea E.; Hanna, Luke A.

    2011-11-01

    Potential environmental effects of offshore wind (OSW) energy development are not well understood, and yet regulatory agencies are required to make decisions in spite of substantial uncertainty about environmental impacts and their long-term consequences. An understanding of risks associated with interactions between OSW installations and avian and aquatic receptors, including animals, habitats, and ecosystems, can help define key uncertainties and focus regulatory actions and scientific studies on interactions of most concern. During FY 2011, Pacific Northwest National Laboratory (PNNL) scientists adapted and applied the Environmental Risk Evaluation System (ERES), first developed to examine the effects of marine and hydrokinetic energy devices on aquatic environments, to offshore wind development. PNNL scientists conducted a risk screening analysis on two initial OSW cases: a wind project in Lake Erie and a wind project off the Atlantic coast of the United States near Atlantic City, New Jersey. The screening analysis revealed that top-tier stressors in the two OSW cases were the dynamic effects of the device (e.g., strike), accidents/disasters, and effects of the static physical presence of the device, such as alterations in bottom habitats. Receptor interactions with these stressors at the highest tiers of risk were dominated by threatened and endangered animals. Risk to the physical environment from changes in flow regime also ranked high. Peer review of this process and results will be conducted during FY 2012. The ERES screening analysis provides an assessment of the vulnerability of environmental receptors to stressors associated with OSW installations; a probability analysis is needed to determine specific risk levels to receptors. As more data become available that document effects of offshore wind farms on specific receptors in U.S. coastal and Great Lakes waters, probability analyses will be performed.

  8. Can data science inform environmental justice and community risk screening for type 2 diabetes?

    Science.gov (United States)

    Davis, J Allen; Burgoon, Lyle D

    2015-01-01

    Having the ability to scan the entire country for potential "hotspots" with increased risk of developing chronic diseases due to various environmental, demographic, and genetic susceptibility factors may inform risk management decisions and enable better environmental public health policies. Develop an approach for community-level risk screening focused on identifying potential genetic susceptibility hotpots. Our approach combines analyses of phenotype-genotype data, genetic prevalence of single nucleotide polymorphisms, and census/geographic information to estimate census tract-level population attributable risks among various ethnicities and total population for the state of California. We estimate that the rs13266634 single nucleotide polymorphism, a type 2 diabetes susceptibility genotype, has a genetic prevalence of 56.3%, 47.4% and 37.0% in Mexican Mestizo, Caucasian, and Asian populations. Looking at the top quintile for total population attributable risk, 16 California counties have greater than 25% of their population living in hotspots of genetic susceptibility for developing type 2 diabetes due to this single genotypic susceptibility factor. This study identified counties in California where large portions of the population may bear additional type 2 diabetes risk due to increased genetic prevalence of a susceptibility genotype. This type of screening can easily be extended to include information on environmental contaminants of interest and other related diseases, and potentially enables the rapid identification of potential environmental justice communities. Other potential uses of this approach include problem formulation in support of risk assessments, land use planning, and prioritization of site cleanup and remediation actions.

  9. Evaluation of the environmental impact of apple pest control strategies using pesticide risk indicators.

    Science.gov (United States)

    Ioriatti, Claudio; Agnello, Arthur M; Martini, Fabrizio; Kovach, Joseph

    2011-10-01

    Various pesticide risk indicators have been developed for estimating pesticide impact on human health and the environment. The present work applied a pesticide risk indicator to estimate change in pesticide risk in apple production between 2001 and 2009. The "Environmental Impact Quotient" was used, which evaluates potential impacts of pesticide active ingredients on farm workers, consumers, and nontarget organisms. A modified Environmental Impact Quotient was also tested, which accounts for all ingredients in the formulation presenting a health or environmental hazard, as identified in the Security Data Sheet. Irrespective of the rating system applied, an overall average improvement in environmental impact of apple protection strategies was indicated ranging from 23 to 24%. Hazard reduction was more significant when estimated per treatment, and was higher for acaricides and insecticides than for fungicides. Improvement appeared to be a consequence of using more selective and more effective active ingredients, applying alternative pest control techniques, compulsory periodic sprayer calibration, and wider use of dwarfing orchards. The modified Environmental Impact Quotient does not overcome all limitations regarding accuracy of pesticide risk indicators, but its ease of use in relying on official, easily accessible data, and the consistency of its results, makes it a good candidate for monitoring the success of reduced risk policies. Copyright © 2011 SETAC.

  10. III: Use of biomarkers as Risk Indicators in Environmental Risk Assessment of oil based discharges offshore.

    Science.gov (United States)

    Sanni, Steinar; Lyng, Emily; Pampanin, Daniela M

    2017-06-01

    Offshore oil and gas activities are required not to cause adverse environmental effects, and risk based management has been established to meet environmental standards. In some risk assessment schemes, Risk Indicators (RIs) are parameters to monitor the development of risk affecting factors. RIs have not yet been established in the Environmental Risk Assessment procedures for management of oil based discharges offshore. This paper evaluates the usefulness of biomarkers as RIs, based on their properties, existing laboratory biomarker data and assessment methods. Data shows several correlations between oil concentrations and biomarker responses, and assessment principles exist that qualify biomarkers for integration into risk procedures. Different ways that these existing biomarkers and methods can be applied as RIs in a probabilistic risk assessment system when linked with whole organism responses are discussed. This can be a useful approach to integrate biomarkers into probabilistic risk assessment related to oil based discharges, representing a potential supplement to information that biomarkers already provide about environmental impact and risk related to these kind of discharges. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Screening-Level Ecological Risk Assessment Methods, Revision 3

    Energy Technology Data Exchange (ETDEWEB)

    Mirenda, Richard J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2012-08-16

    This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessment is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.

  12. Digital I and C systems in nuclear power plants. Risk-screening of environmental stressors and a comparison of hardware unavailability with an existing analog system

    International Nuclear Information System (INIS)

    Hassan, M.; Vesely, W.E.

    1998-01-01

    In this report, we present a screening study to identify environmental stressors for digital instrumentation and control (I ampersand C) systems in a nuclear power plant (NPP) which can be potentially risk-significant, and compare the hardware unavailability of such a system with that of its existing analog counterpart. The stressors evaluated are temperature, humidity, vibration, radiation, electro-magnetic interference (EMI), and smoke. The results of risk-screening for an example plant, subject to some bounding assumptions and based on relative changes in plant risk (core damage frequency impacts of the stressors), indicate that humidity, EMI from lightning, and smoke can be potentially risk-significant. Risk from other sources of EMI could not be evaluated for a lack of data. Risk from temperature appears to be insignificant as that from the assumed levels of vibrations. A comparison of the hardware unavailability of the existing analog Safety Injection Actuation System (SIAS) in the example plant with that of an assumed digital upgrade of the system indicates that system unavailability may be more sensitive to the level of redundancy in elements of the digital system than to the environmental and operational variations involved. The findings of this study can be used to focus activities relating to the regulatory basis for digital I ampersand C upgrades in NPPs, including identification of dominant stressors, data-gathering, equipment qualification, and requirements to limit the effects of environmental stressors. 30 refs., 8 figs., 26 tabs

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

    Science.gov (United States)

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

    2011-12-01

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

  14. Screening Risk Evaluation methodology

    International Nuclear Information System (INIS)

    Hopper, K.M.

    1994-01-01

    The Screening Risk Evaluation (SRE) Guidance document is a set of guidelines provided for the uniform implementation of SREs performed on D ampersand D facilities. These guidelines are designed specifically for the completion of the second (semi-quantitative screening) phase of the D ampersand D Risk-Based Process. The SRE Guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the risk to human health and the environment from ongoing or probable releases within a one year time period. The Worker Exposure Index (WEI) calculates the risk to workers, occupants, and visitors in D ampersand D facilities of contaminant exposure. The Future Release Index (FRI) calculates the risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risk-to human health due to factors other than that of contaminants. The index of Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, determined on a project by project basis. The SRE is the first and most important step in the overall D ampersand D project level decision making process

  15. Do social and environmental screens influence ethical portfolio performance? Evidence from Europe

    Directory of Open Access Journals (Sweden)

    Eduardo Ortas

    2014-01-01

    Full Text Available This work aims to test whether social and environmental screening processes could determine the financial performance of ethical or Socially Responsible Investment (SRI strategies in the European context. We compare the risk-adjusted returns and systematic risk levels obtained by the two mainstream SRI equity indexes in Europe with those achieved by their official benchmarks. We find that, although these SRI indexes do not underperform their benchmarks in terms of risk-adjusted returns, they experience higher levels of risk. Additionally, the results show that higher screening intensity results in higher risk for the SRI indexes. Furthermore, the underperformance in terms of risk associated with the SRI indexes is worse in periods when there is a market downturn. This may indicate that SRI indexes are more sensitive to changes in the market cycle, because SRI indexes include companies that are more affected by market fluctuations.

  16. Screening for gestational diabetes mellitus by a model based on risk indicators

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning

    2003-01-01

    OBJECTIVE: This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators. STUDY DESIGN: In a prospective multicenter study with 5235 consecutive pregnant women, diagnostic testing with a 2-hour 75-g oral glucose...... of the results from tested women to the whole group in question, a 2.4% prevalence of gestational diabetes mellitus was calculated. Sensitivity and specificity of the model was 80.6 (73.7-87.6) and 64.8 (63.5-66.1), respectively (95% CIs). CONCLUSION: Under ideal conditions, sensitivity of the model...

  17. Reevaluation of 1999 Health-Based Environmental Screening Levels (HBESLs) for Chemical Warfare Agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Annetta Paule [ORNL; Dolislager, Fredrick G [ORNL

    2007-05-01

    This report evaluates whether new information and updated scientific models require that changes be made to previously published health-based environmental soil screening levels (HBESLs) and associated environmental fate/breakdown information for chemical warfare agents (USACHPPM 1999). Specifically, the present evaluation describes and compares changes that have been made since 1999 to U.S. Environmental Protection Agency (EPA) risk assessment models, EPA exposure assumptions, as well as to specific chemical warfare agent parameters (e.g., toxicity values). Comparison was made between screening value estimates recalculated with current assumptions and earlier health-based environmental screening levels presented in 1999. The chemical warfare agents evaluated include the G-series and VX nerve agents and the vesicants sulfur mustard (agent HD) and Lewisite (agent L). In addition, key degradation products of these agents were also evaluated. Study findings indicate that the combined effect of updates and/or changes to EPA risk models, EPA default exposure parameters, and certain chemical warfare agent toxicity criteria does not result in significant alteration to the USACHPPM (1999) health-based environmental screening level estimates for the G-series and VX nerve agents or the vesicant agents HD and L. Given that EPA's final position on separate Tier 1 screening levels for indoor and outdoor worker screening assessments has not yet been released as of May 2007, the study authors find that the 1999 screening level estimates (see Table ES.1) are still appropriate and protective for screening residential as well as nonresidential sites. As such, risk management decisions made on the basis of USACHPPM (1999) recommendations do not require reconsideration. While the 1999 HBESL values are appropriate for continued use as general screening criteria, the updated '2007' estimates (presented below) that follow the new EPA protocols currently under development

  18. Feasibility of interdisciplinary community-based fall risk screening.

    Science.gov (United States)

    Elliott, Sharon J; Ivanescu, Andrada; Leland, Natalie E; Fogo, Jennifer; Painter, Jane A; Trujillo, Leonard G

    2012-01-01

    This pilot study examined the feasibility of (1) conducting interdisciplinary fall risk screens at a communitywide adult fall prevention event and (2) collecting preliminary follow-up data from people screened at the event about balance confidence and home and activity modifications made after receiving educational information at the event. We conducted a pilot study with pre- and posttesting (4-mo follow-up) with 35 community-dwelling adults ≥55 yr old. Approximately half the participants were at risk for falls. Most participants who anticipated making environmental or activity changes to reduce fall risk initiated changes (n = 8/11; 72.7%) during the 4-mo follow-up period. We found no significant difference in participants' balance confidence between baseline (median = 62.81) and follow-up (median = 64.06) as measured by the Activities-specific Balance Confidence scale. Conducting interdisciplinary fall risk screens at an adult fall prevention event is feasible and can facilitate environmental and behavior changes to reduce fall risk. Copyright © 2012 by the American Occupational Therapy Association, Inc.

  19. Decision making with environmental indices

    Science.gov (United States)

    Hoag, Dana L.; Ascough, James C.; Keske-Handley, C.; Koontz, Lynne; Burk, A.R.

    2005-01-01

    Since Ott's seminal book on environmental indices (1978), the use of indices has expanded into several natural resource disciplines, including ecological studies, environmental policymaking, and agricultural economics. However, despite their increasing use in natural resource disciplines, researchers and public decision makers continue to express concern about validity of these instruments to capture and communicate multidimensional, and sometimes disparate, characteristics of research data and stakeholder interests. Our purpose is to demonstrate how useful indices can be for communicating environmental information to decision makers. We discuss how environmental indices have evolved over four stages: 1) simple; 2) compound multicriteria; 3) the impact matrix and 4) disparate stakeholder management. We provide examples of simple and compound indices that were used by policy decision makers. We then build a framework, called an Impact Matrix (IM), that comprehensively accounts for multiple indices but lets the user decide how to integrate them. The IM was shaped from the concept of a financial risk payoff matrix and applied to ecosystem risk. While the IM offers flexibility, it does not address stakeholder preferences about which index to use. Therefore, the last phase in our evolutionary ladder includes stakeholder indices to specifically address disparate stakeholder preferences. Finally, we assert that an environmental index has the potential to increase resource efficiency, since the number of decision making resources may be reduced, and hence improve upon resource productivity

  20. Screening Risk Assessment for Possible Radionuclides in the Amchitka Marine Environment

    Energy Technology Data Exchange (ETDEWEB)

    NNSA/NV

    2002-10-31

    As part of its environmental stewardship program the U.S. Department of Energy (DOE) is reevaluating three sites where underground nuclear tests were conducted in the deep subsurface of Amchitka Island, Alaska. The tests (i.e., Long Shot, Milrow, and Cannikin) were conducted in 1965, 1969, and 1971, respectively. Extensive investigations were conducted on these tests and their effect on the environment. Evaluations at the time of testing indicated limited release of radionuclides and absence of risk related to the testing; however, these are being reevaluated under the current DOE environmental stewardship program. A screening risk assessment of potential radionuclide release into the marine environment is an important part of this reevaluation. The risk assessment is one of three interrelated activities: a groundwater model and this screening risk assessment, both of which guide the decisions in the third activity, the site closure plan. Thus, the overall objective of the work is to understand, and subsequently manage, any risk to humans and the environment through a closure and long-term stewardship plan. The objective of this screening risk assessment is to predict whether possible releases of radionuclides at the ocean floor would represent potential risks to Native Alaskans by consumption of marine subsistence species. In addition, risks were predicted for consumers of commercial catches of marine organisms. These risks were calculated beginning with estimates of possible radionuclide release at the seafloor (from a groundwater modeling study), into the seawater, through possible uptake by marine organisms, and finally possible consumption by humans. The risk assessment model has 11 elements, progressing from potential release at the seafloor through water and food chains to human intake. Data for each of these elements were systematically found and synthesized from many sources, and represent the best available knowledge. Whenever precise data were lacking

  1. Preliminary Screening Analysis for the Environmental Risk Evaluation System: Task 2.1.1: Evaluating Effects of Stressors – Fiscal Year 2010 Progress Report: Environmental Effects of Marine and Hydrokinetic Energy

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Richard M.; Copping, Andrea E.; Van Cleve, Frances B.

    2010-11-15

    Possible environmental effects of marine and hydrokinetic (MHK) energy development are not well understood, and yet regulatory agencies are required to make decisions in spite of substantial uncertainty about environmental impacts and their long-term effects. An understanding of risk associated with likely interactions between MHK installations and aquatic receptors, including animals, habitats, and ecosystems, can help reduce the level of uncertainty and focus regulatory actions and scientific studies on interactions of most concern. As a first step in developing the Pacific Northwest National Laboratory (PNNL) Environmental Risk Evaluation System (ERES), PNNL scientists conducted a preliminary risk screening analysis on three initial MHK cases - a tidal project in Puget Sound using Open Hydro turbines, a wave project off the coast of Oregon using Ocean Power Technologies point attenuator buoys, and a riverine current project in the Mississippi River using Free Flow turbines. Through an iterative process, the screening analysis revealed that top-tier stressors in all three cases were the effects of the dynamic physical presence of the device (e.g., strike), accidents, and effects of the static physical presence of the device (e.g., habitat alteration). Receptor interactions with these stressors at the four highest tiers of risk were dominated by marine mammals (cetaceans and pinnipeds) and birds (diving and non-diving); only the riverine case (Free Flow) included different receptors in the third tier (fish) and the fourth tier (benthic invertebrates). Although this screening analysis provides a preliminary analysis of vulnerability of environmental receptors to stressors associated with MHK installations, probability analysis, especially of risk associated with chemical toxicity and accidents such as oil spills or lost gear, will be necessary to further understand high-priority risks. Subject matter expert review of this process and results is required and is

  2. Screening Analysis for the Environmental Risk Evaluation System Task 2.1.1.2: Evaluating Effects of Stressors Fiscal Year 2011 Progress Report - Environmental Effects of Marine and Hydrokinetic Energy

    Energy Technology Data Exchange (ETDEWEB)

    Copping, Andrea E.; Blake, Kara M.; Anderson, Richard M.; Zdanski, Laura C.; Gill, Gary A.; Ward, Jeffrey A.

    2011-09-01

    Potential environmental effects of marine and hydrokinetic (MHK) energy development are not well understood, and yet regulatory agencies are required to make decisions in spite of substantial uncertainty about environmental impacts and their long-term consequences. An understanding of risks associated with interactions between MHK installations and aquatic receptors, including animals, habitats, and ecosystems, can help define key uncertainties and focus regulatory actions and scientific studies on interactions of most concern. As a first step in developing the Pacific Northwest National Laboratory (PNNL) Environmental Risk Evaluation System (ERES), PNNL scientists conducted a preliminary risk screening analysis on three initial MHK cases. During FY 2011, two additional cases were added: a tidal project in the Gulf of Maine using Ocean Renewable Power Company TidGenTM turbines and a wave project planned for the coast of Oregon using Aquamarine Oyster surge devices. Through an iterative process, the screening analysis revealed that top-tier stressors in the two FY 2011 cases were the dynamic effects of the device (e.g., strike), accidents/disasters, and effects of the static physical presence of the device (e.g., habitat alteration). Receptor interactions with these stressors at the highest tiers of risk were dominated by threatened and endangered animals. Risk to the physical environment from changes in flow regime also ranked high. Peer review of this process and results will be conducted in early FY 2012. The ERES screening analysis provides an analysis of vulnerability of environmental receptors to stressors associated with MHK installations, probability analysis is needed to determine specific risk levels to receptors. “Risk” has two components: (1) The likelihood, or “probability”, of the occurrence of a given interaction or event, and (2) the potential “consequence” if that interaction or event were to occur. During FY 2011, the ERES screening

  3. Indicators for monitoring screening programs with primary HPV test.

    Science.gov (United States)

    Zorzi, Manuel; Giorgi Rossi, Paolo

    2017-01-01

    following scientific evidence produced in numerous studies, as well as national and international guidelines, organized cervical cancer screening programs in Italy have gradually introduced the HPV test as primary screening test, replacing cytology. As public health interventions, screening programs must ensure equity, improvement in quality of life, and adequate information for the population involved with regards to benefits and possible risks; therefore, it is essential for quality to be constantly checked at every phase of the project.The Italian Cervical Screening Group (Gruppo Italiano per lo Screening Cervicale, GISCi) has written a handbook for the calculation and interpretation of cervical screening program monitoring indicators that take into account the new protocol based on primary HPV test with cytology triage. based on the European guidelines and Italian recommendations on primary HPVbased screening, the working group, which includes professionals from all the fields involved in cervical screening, identified the essential points needed to monitor the screening process, the accuracy of individual tests, and early outcomes, defining a specific indicator for each aspect. The indicators were grouped as follows: baseline indicators, indicators for test repeat after one year, cumulative indicators, and waiting times. For every indicator, the source of data, calculation formula, any standards or critical thresholds, and interpretation were defined. The standards are based on the results of NTCC trials or Italian pilot studies. the main indicators proposed for the organization are the following: number of invitations, compliance with first invitation, with one-year test repeat and with colposcopy; for test and process accuracy, a cohort approach was utilised, where indicators are based on women who must be followed for at least one year, so as to integrate the results obtained after the first HPV test with the outcome of the test's repetition after one year

  4. 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.

  5. D & D screening risk evaluation guidance

    Energy Technology Data Exchange (ETDEWEB)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D&D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis.

  6. Inherent health and environmental risk assessment of nanostructured metal oxide production processes.

    Science.gov (United States)

    Torabifard, Mina; Arjmandi, Reza; Rashidi, Alimorad; Nouri, Jafar; Mohammadfam, Iraj

    2018-01-10

    The health and environmental effects of chemical processes can be assessed during the initial stage of their production. In this paper, the Chemical Screening Tool for Exposure and Environmental Release (ChemSTEER) software was used to compare the health and environmental risks of spray pyrolysis and wet chemical techniques for the fabrication of nanostructured metal oxide on a semi-industrial scale with a capacity of 300 kg/day in Iran. The pollution sources identified in each production process were pairwise compared in Expert Choice software using indicators including respiratory damage, skin damage, and environmental damages including air, water, and soil pollution. The synthesis of nanostructured zinc oxide using the wet chemical technique (with 0.523 wt%) leads to lower health and environmental risks compared to when spray pyrolysis is used (with 0.477 wt%). The health and environmental risk assessment of nanomaterial production processes can help select safer processes, modify the operation conditions, and select or modify raw materials that can help eliminate the risks.

  7. Benefit and risk in breast screening

    International Nuclear Information System (INIS)

    Law, J.; Faulkner, K.; Neilson, F.

    2001-01-01

    Justification of breast screening in radiation protection terms both for the screened population and on an individual basis is necessary. In this paper the number of cancers detected, and the number of cancers potentially induced by radiation in the UK National Health Service Breast Screening Programme (NHS BSP) are compared. Detection rates reported up to 1998 are used, with x-ray doses for 1997 and 1998 and breast cancer induction risk factors, stratified by age, recommended by the National Radiological Protection Board in 1994. Cancers detected exceed those potentially induced at all ages from 50-64. The relationship between these cancer numbers and the associated benefit and risk, in terms of breast cancer deaths avoided and induced, is then investigated. Improved values of the Nottingham Prognostic Indicator (NPI) attributed to screening provide one means of doing this. Using this strict criterion the breast-screening programme is also justified in radiation protection terms. (author)

  8. Mechanistic modeling for mammography screening risks

    International Nuclear Information System (INIS)

    Bijwaard, Harmen

    2008-01-01

    Full text: Western populations show a very high incidence of breast cancer and in many countries mammography screening programs have been set up for the early detection of these cancers. Through these programs large numbers of women (in the Netherlands, 700.000 per year) are exposed to low but not insignificant X-ray doses. ICRP based risk estimates indicate that the number of breast cancer casualties due to mammography screening can be as high as 50 in the Netherlands per year. The number of lives saved is estimated to be much higher, but for an accurate calculation of the benefits of screening a better estimate of these risks is indispensable. Here it is attempted to better quantify the radiological risks of mammography screening through the application of a biologically based model for breast tumor induction by X-rays. The model is applied to data obtained from the National Institutes of Health in the U.S. These concern epidemiological data of female TB patients who received high X-ray breast doses in the period 1930-1950 through frequent fluoroscopy of their lungs. The mechanistic model that is used to describe the increased breast cancer incidence is based on an earlier study by Moolgavkar et al. (1980), in which the natural background incidence of breast cancer was modeled. The model allows for a more sophisticated extrapolation of risks to the low dose X-ray exposures that are common in mammography screening and to the higher ages that are usually involved. Furthermore, it allows for risk transfer to other (non-western) populations. The results have implications for decisions on the frequency of screening, the number of mammograms taken at each screening, minimum and maximum ages for screening and the transfer to digital equipment. (author)

  9. Contribution o the assessment of the environmental risk associated with uranium releases in the Ritord drainage basin

    International Nuclear Information System (INIS)

    Beaugelin-Seiller, K.; Garnier-Laplace, J.; Gilbin, R.; Della-Vedova, C.

    2008-01-01

    This document reports the application to aquatic environments and more particularly to the case of a drainage basin of methods of assessment of the environmental risk presented in another report. The objective is to determine the environmental risk related to releases of uranium from ancient mining sites. The method is applied to available data to diagnose a possible chemical and/or radiological risk due to these releases. Should the occasion occurs, probabilistic approaches are used to refine the assessment of the possible risk identified by the screening. After a presentation of the context, the different screening steps are reported: methodology (exposure analysis, effect analysis, and risk characterization), deterministic characterization of the chronic radiological risk, deterministic characterization of the chronic chemical risk. The next part reports the probabilistic assessment of the chemical or radiological risk. In conclusion, the authors indicate actions to be performed to better analyse exposures, and desirable actions to better analyse effects

  10. D ampersand D screening risk evaluation guidance

    International Nuclear Information System (INIS)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D ampersand D) facilities. Although this method has been developed for D ampersand D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D ampersand D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis

  11. Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

    Science.gov (United States)

    2018-01-01

    The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481

  12. Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

    Directory of Open Access Journals (Sweden)

    Raoul S. Liévanos

    2018-04-01

    Full Text Available The California Community Environmental Health Screening Tool (CalEnviroScreen advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

  13. Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

    Science.gov (United States)

    Liévanos, Raoul S

    2018-04-16

    The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

  14. Interethnic differences in the accuracy of anthropometric indicators of obesity in screening for high risk of coronary heart disease

    Science.gov (United States)

    Herrera, VM; Casas, JP; Miranda, JJ; Perel, P; Pichardo, R; González, A; Sanchez, JR; Ferreccio, C; Aguilera, X; Silva, E; Oróstegui, M; Gómez, LF; Chirinos, JA; Medina-Lezama, J; Pérez, CM; Suárez, E; Ortiz, AP; Rosero, L; Schapochnik, N; Ortiz, Z; Ferrante, D; Diaz, M; Bautista, LE

    2009-01-01

    Background Cut points for defining obesity have been derived from mortality data among Whites from Europe and the United States and their accuracy to screen for high risk of coronary heart disease (CHD) in other ethnic groups has been questioned. Objective To compare the accuracy and to define ethnic and gender-specific optimal cut points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) when they are used in screening for high risk of CHD in the Latin-American and the US populations. Methods We estimated the accuracy and optimal cut points for BMI, WC and WHR to screen for CHD risk in Latin Americans (n=18 976), non-Hispanic Whites (Whites; n=8956), non-Hispanic Blacks (Blacks; n=5205) and Hispanics (n=5803). High risk of CHD was defined as a 10-year risk ≥20% (Framingham equation). The area under the receiver operator characteristic curve (AUC) and the misclassification-cost term were used to assess accuracy and to identify optimal cut points. Results WHR had the highest AUC in all ethnic groups (from 0.75 to 0.82) and BMI had the lowest (from 0.50 to 0.59). Optimal cut point for BMI was similar across ethnic/gender groups (27 kg/m2). In women, cut points for WC (94 cm) and WHR (0.91) were consistent by ethnicity. In men, cut points for WC and WHR varied significantly with ethnicity: from 91 cm in Latin Americans to 102 cm in Whites, and from 0.94 in Latin Americans to 0.99 in Hispanics, respectively. Conclusion WHR is the most accurate anthropometric indicator to screen for high risk of CHD, whereas BMI is almost uninformative. The same BMI cut point should be used in all men and women. Unique cut points for WC and WHR should be used in all women, but ethnic-specific cut points seem warranted among men. PMID:19238159

  15. Identification and Prioritization of Analysis Cases for Marine and Hydrokinetic Energy Risk Screening

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Richard M.; Unwin, Stephen D.; Van Cleve, Frances B.

    2010-06-16

    In this report we describe the development of the Environmental Risk Evaluation System (ERES), a risk-informed analytical process for estimating the environmental risks associated with the construction and operation of marine and hydrokinetic energy generation projects. The development process consists of two main phases of analysis. In the first phase, preliminary risk analyses will take the form of screening studies in which key environmental impacts and the uncertainties that create risk are identified, leading to a better-focused characterization of the relevant environmental effects. Existence of critical data gaps will suggest areas in which specific modeling and/or data collection activities should take place. In the second phase, more detailed quantitative risk analyses will be conducted, with residual uncertainties providing the basis for recommending risk mitigation and monitoring activities. We also describe the process used for selecting three cases for fiscal year 2010 risk screening analysis using the ERES. A case is defined as a specific technology deployed in a particular location involving certain environmental receptors specific to that location. The three cases selected satisfy a number of desirable criteria: 1) they correspond to real projects whose deployment is likely to take place in the foreseeable future; 2) the technology developers are willing to share technology and project-related data; 3) the projects represent a diversity of technology-site-receptor characteristics; 4) the projects are of national interest, and 5) environmental effects data may be available for the projects.

  16. Screening radon risks: A methodology for policymakers

    International Nuclear Information System (INIS)

    Eisinger, D.S.; Simmons, R.A.; Lammering, M.; Sotiros, R.

    1991-01-01

    This paper provides an easy-to-use screening methodology to estimate potential excess lifetime lung cancer risk resulting from indoor radon exposure. The methodology was developed under U.S. EPA Office of Policy, Planning, and Evaluation sponsorship of the agency's Integrated Environmental Management Projects (IEMP) and State/Regional Comparative Risk Projects. These projects help policymakers understand and use scientific data to develop environmental problem-solving strategies. This research presents the risk assessment methodology, discusses its basis, and identifies appropriate applications. The paper also identifies assumptions built into the methodology and qualitatively addresses methodological uncertainties, the direction in which these uncertainties could bias analyses, and their relative importance. The methodology draws from several sources, including risk assessment formulations developed by the U.S. EPA's Office of Radiation Programs, the EPA's Integrated Environmental Management Project (Denver), the International Commission on Radiological Protection, and the National Institute for Occupational Safety and Health. When constructed as a spreadsheet program, the methodology easily facilitates analyses and sensitivity studies (the paper includes several sensitivity study options). The methodology will be most helpful to those who need to make decisions concerning radon testing, public education, and exposure prevention and mitigation programs.26 references

  17. Screening situations for risk of ethical conflicts: a pilot study.

    Science.gov (United States)

    Pavlish, Carol L; Hellyer, Joan Henriksen; Brown-Saltzman, Katherine; Miers, Anne G; Squire, Karina

    2015-05-01

    Ethical conflicts, often leading to poor teamwork and moral distress, are very challenging to patients, patients' families, and health care providers. A proactive approach to ethical conflicts may improve patient care outcomes. To examine acceptability and feasibility of an ethics screening and early intervention tool for use by nurses caring for critically ill patients. Twenty-eight nurses in 2 medical centers applied the ethics screening tool to 55 patient situations. Nurses assessed situations for risk factors and early indicators of ethical conflicts and analyzed level of risk. At study completion, nurses participated in focus group discussions about the tool's benefits and challenges. Frequency counts were performed on risk factors and early indicators of ethical conflicts. Content analysis was used on written explanations regarding high-, medium-, and low-risk situations and on focus group data. Older patients with multiple comorbid conditions and aggressive treatments were frequently assessed to be at risk for ethical conflicts. Nurses who witnessed patients' suffering and deterioration were likely to initiate the screening process. The most prominent family risk factors included unrealistic expectations and adamancy about treatment. The most prominent early indicators were signs of patients' suffering, unrealistic expectations, and providers' own moral distress. High-risk situations averaged a greater number of risk factors and early indicators than did medium- and low-risk situations. Certain risk factors featured prominently in high-risk situations. A phenomenon of shared suffering emerged from the study and signifies the importance of relational strategies such as routine family conferences and ethics consultation. ©2015 American Association of Critical-Care Nurses.

  18. OBGYN screening for environmental exposures: A call for action

    Science.gov (United States)

    Allshouse, A. A.; Jungheim, E.; Powell, T. L.; Jansson, T.; Polotsky, A. J.

    2018-01-01

    Background Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. Objective Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. Study design Practicing OBGYNs were approached at the University of Colorado and by social media. The survey instrument queried demographics, environmental literacy, and screening practices. Statistical analysis was performed using Chi-square and two-sample t-test. Results We received 312 online survey responses (response rate of 12%). Responding OBGYNs were predominantly female (96%), board-certified (78%), generalists (65%) with a mean age of 37.1 years. Fewer than half of physicians screened for the following factors: occupational exposures, environmental chemicals, air pollution, pesticide use, personal care products, household cleaners, water source, use of plastics for food storage, and lead and mercury exposure. Eighty five percent of respondents reported that they did not feel comfortable obtaining an environmental history and 58% respondents reported that they performed no regular screening of environmental exposures. A higher frequency of screening was associated with > 4 years of practice (p = 0.001), and having read the environmental committee opinion (p = <0.001). Conclusion The majority of OBGYNs did not incorporate screening for known environmental exposures into routine practice. Reading the environmental committee opinions was strongly and significantly associated with a higher rate of screening. Improving physician comfort in counseling patients may enhance screening for exposures that affect reproductive health. PMID:29768418

  19. Environmental concern-based site screening of carbon dioxide geological storage in China.

    Science.gov (United States)

    Cai, Bofeng; Li, Qi; Liu, Guizhen; Liu, Lancui; Jin, Taotao; Shi, Hui

    2017-08-08

    Environmental impacts and risks related to carbon dioxide (CO 2 ) capture and storage (CCS) projects may have direct effects on the decision-making process during CCS site selection. This paper proposes a novel method of environmental optimization for CCS site selection using China's ecological red line approach. Moreover, this paper established a GIS based spatial analysis model of environmental optimization during CCS site selection by a large database. The comprehensive data coverage of environmental elements and fine 1 km spatial resolution were used in the database. The quartile method was used for value assignment for specific indicators including the prohibited index and restricted index. The screening results show that areas classified as having high environmental suitability (classes III and IV) in China account for 620,800 km 2 and 156,600 km 2 , respectively, and are mainly distributed in Inner Mongolia, Qinghai and Xinjiang. The environmental suitability class IV areas of Bayingol Mongolian Autonomous Prefecture, Hotan Prefecture, Aksu Prefecture, Hulunbuir, Xilingol League and other prefecture-level regions not only cover large land areas, but also form a continuous area in the three provincial-level administrative units. This study may benefit the national macro-strategic deployment and implementation of CCS spatial layout and environmental management in China.

  20. Assessing plant protection practices using pressure indicator and toxicity risk indicators: analysis of therelationship between these indicators for improved risk management, application in viticulture.

    Science.gov (United States)

    Oussama, Mghirbi; Kamel, Ellefi; Philippe, Le Grusse; Elisabeth, Mandart; Jacques, Fabre; Habiba, Ayadi; Jean-Paul, Bord

    2015-06-01

    The excessive use of plant protection products (PPPs) has given rise to issues of public and environmental health because of their toxicity. Reducing the use of toxic PPPs and replacing them with products that are less toxic for human health and the environment have become socially, environmentally and economically indispensable. In this article, we assess the plant protection practices of a small group of winegrowers practicing "integrated agriculture" in the south of France, in order to measure the benefit of using toxicity risk indicators as a decision-support tool for different players in land management. An analysis of plant protection practices using indicators of the risk to operator health and the environment (IRSA, IRTE), together with a frequency-of-treatment indicator (TFI), enabled us to (i) show the variability of these indicators depending on the production system and farmers' pesticide use strategies and (ii) calculate correlations between these indicators. This analysis of plant protection practices at different scales (farm, field), carried out in collaboration with the growers, enabled us to perform an initial validation of decision-support tools for determining risk management strategies regarding the use of pesticides.

  1. OBGYN screening for environmental exposures: A call for action.

    Science.gov (United States)

    Grindler, N M; Allshouse, A A; Jungheim, E; Powell, T L; Jansson, T; Polotsky, A J

    2018-01-01

    Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. Practicing OBGYNs were approached at the University of Colorado and by social media. The survey instrument queried demographics, environmental literacy, and screening practices. Statistical analysis was performed using Chi-square and two-sample t-test. We received 312 online survey responses (response rate of 12%). Responding OBGYNs were predominantly female (96%), board-certified (78%), generalists (65%) with a mean age of 37.1 years. Fewer than half of physicians screened for the following factors: occupational exposures, environmental chemicals, air pollution, pesticide use, personal care products, household cleaners, water source, use of plastics for food storage, and lead and mercury exposure. Eighty five percent of respondents reported that they did not feel comfortable obtaining an environmental history and 58% respondents reported that they performed no regular screening of environmental exposures. A higher frequency of screening was associated with > 4 years of practice (p = 0.001), and having read the environmental committee opinion (p = counseling patients may enhance screening for exposures that affect reproductive health.

  2. Screening Level Risk Assessment for the New Waste Calcining Facility

    Energy Technology Data Exchange (ETDEWEB)

    M. L. Abbott; K. N. Keck; R. E. Schindler; R. L. VanHorn; N. L. Hampton; M. B. Heiser

    1999-05-01

    This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidify (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.

  3. Children's Environmental Health Indicators in Australia.

    Science.gov (United States)

    Sly, J Leith; Moore, Sophie E; Gore, Fiona; Brune, Marie Noel; Neira, Maria; Jagals, Paul; Sly, Peter D

    2016-01-01

    Adverse environmental exposures in early life increase the risk of chronic disease but do not attract the attention nor receive the public health priority warranted. A safe and healthy environment is essential for children's health and development, yet absent in many countries. A framework that aids in understanding the link between environmental exposures and adverse health outcomes are environmental health indicators-numerical estimates of hazards and outcomes that can be applied at a population level. The World Health Organization (WHO) has developed a set of children's environmental health indicators (CEHI) for physical injuries, insect-borne disease, diarrheal diseases, perinatal diseases, and respiratory diseases; however, uptake of steps necessary to apply these indicators across the WHO regions has been incomplete. A first indication of such uptake is the management of data required to measure CEHI. The present study was undertaken to determine whether Australia has accurate up-to-date, publicly available, and readily accessible data on each CEHI for indigenous and nonindigenous Australian children. Data were not readily accessible for many of the exposure indicators, and much of the available data were not child specific or were only available for Australia's indigenous population. Readily accessible data were available for all but one of the outcome indicators and generally for both indigenous and nonindigenous children. Although Australia regularly collects data on key national indicators of child health, development, and well-being in several domains mostly thought to be of more relevance to Australians and Australian policy makers, these differ substantially from the WHO CEHI. The present study suggests that the majority of these WHO exposure and outcome indicators are relevant and important for monitoring Australian children's environmental health and establishing public health interventions at a local and national level and collection of appropriate

  4. Risks of Endometrial Cancer Screening

    Science.gov (United States)

    ... Health history and certain medicines can affect the risk of developing endometrial cancer. Anything that increases your ... have abnormal vaginal bleeding, check with your doctor. Risks of Endometrial Cancer Screening Key Points Screening tests ...

  5. Risks of Esophageal Cancer Screening

    Science.gov (United States)

    ... alcohol use, and Barrett esophagus can affect the risk of developing esophageal cancer. Anything that increases the ... tissue gives off less light than normal tissue. Risks of Esophageal Cancer Screening Key Points Screening tests ...

  6. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... women. Human papillomavirus (HPV) infection is the major risk factor for cervical cancer. Although most women with ... clinical trials is available from the NCI website . Risks of Cervical Cancer Screening Key Points Screening tests ...

  7. Risk of cancer radioinduced by mammographic screening

    International Nuclear Information System (INIS)

    Correa, Rosangela da Silveira; Peixoto, Joao Emilio; Ferreira, Rubemar de Souza; Freitas-Junior, Ruffo

    2013-01-01

    This work aims to estimate the risk benefit of mammography, in terms of the number of lives saved/number of lives lost, in the female population of the State of Goias, Brazil, depending on the age range indicated for screening and the type of technology available

  8. Environmental impact assessment screening tool

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities. 2 figs. 7 refs.

  9. Environmental impact assessment screening tool

    International Nuclear Information System (INIS)

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities

  10. Environmental Risk Profiling of the Volta Delta, Ghana

    Science.gov (United States)

    Nyarko, B. K.; Appeaning-Addo, K.; Amisigo, B.

    2017-12-01

    Volta Delta communities find it difficult to absorb or bear risk at different levels, because of the physical and economic impacts of environmental hazards. In this regards various agencies and organizations have in recent years launched initiatives to measure and identify risk areas with a set of indicators and indices. The theory underpinning this study is concepts of Modern Portfolio Theory (MPT). The Cox proportional hazards regression model will be used as the model for the risk profile. Finding the optimal level of environmental risk for activities in the Volta Delta considering the risk required, risk capacity and risk tolerance. Using data from different sources, an environmental risk profile was developed for the Volta Delta. The result indicates that risks are distributed across the Delta. However, areas that have government interventions, such as sea defense system and irrigation facilities have less threat. In addition wealthy areas do effectively reduce the threat of any form of disaster.

  11. Child Abuse and Neglect: Screening for Risks During the Perinatal Period

    Science.gov (United States)

    Besier, T.; Pillhofer, M.; Botzenhart, S.; Ziegenhain, U.; Kindler, H.; Spangler, G.; Bovenschen, I.; Gabler, S.; Künster, A. K.

    2012-01-01

    Purpose: Currently, there is a claim for earlier interventions for families in order to prevent child maltreatment. Here, a screening instrument to assess risk indicators for child abuse and neglect already in the context of maternity clinics is introduced. The present study is the first report on the psychometric properties of this instrument, the “short questionnaire for risk indices around birth” (RIAB). Material and Methods: Data were collected in the context of three different studies conducted at Ulm University Hospital. To examine interrater reliability eight case vignettes were rated by n = 90 study participants (50 students and 40 experts working at a maternity clinic). Criterion validity was examined in two studies applying the German version of the child abuse potential inventory CAPI (n = 96 families at risk and n = 160 additional families). Results: Both laymen and experts were able to understand and use the screening instrument correctly, leading to a high agreement with the sample solutions given. A high concordance was found between parentsʼ and expertsʼ ratings: In case of no reported risk factors applying the screening instrument RIAB, parents themselves reported significantly less stressors and burdens, compared to those parents with an indication for a thorough examination as pointed out in the RIAB. Conclusion: In the context of maternity clinics the RIAB is a useful, broadly applicable instrument, screening for existing risk factors at the earliest and thus allowing for the initiation of specific interventions when needed. PMID:25298543

  12. Perceptions of environmental health risks among residents in the "Toxic Doughnut": opportunities for risk screening and community mobilization.

    Science.gov (United States)

    White, Brandi M; Hall, Eric S

    2015-12-10

    Surrounded by landfills, and toxic and hazardous facilities, Altgeld Gardens is located in a "toxic doughnut". With high rates of environmentally-related conditions, residents have called for a community-based environmental health assessment to improve overall health in their community. The purpose of this study was to investigate the attitudes and beliefs of environmental health risks of Altgeld's residents which would assist community organizing efforts and provide the groundwork for a community-based environmental health assessment. A questionnaire was designed and administered to 42 Altgeld residents who also participated in focus groups to assess their perceptions of environmental health risks. All participants were Altgeld residents for at least two years and were fairly representative of the broader community. Physical and social hazards were primarily identified as posing risks to participants' family and the broader community. Physical hazards included the dumping of hazardous waste and landfills; social hazards were crime and drugs. These findings have been useful in community organizing efforts and in program planning for local community-based organizations and public health agencies. The results have also been used to prioritize health and environmental risk issues impacting the community.

  13. The association of colonoscopy quality indicators with the detection of screen-relevant lesions, adverse events, and postcolonoscopy cancers in an asymptomatic Canadian colorectal cancer screening population.

    Science.gov (United States)

    Hilsden, Robert J; Dube, Catherine; Heitman, Steven J; Bridges, Ronald; McGregor, S Elizabeth; Rostom, Alaa

    2015-11-01

    Although several quality indicators of colonoscopy have been defined, quality assurance activities should be directed at the measurement of quality indicators that are predictive of key screening colonoscopy outcomes. The goal of this study was to examine the association among established quality indicators and the detection of screen-relevant lesions (SRLs), adverse events, and postcolonoscopy cancers. Historical cohort study. Canadian colorectal cancer screening center. A total of 18,456 asymptomatic men and women ages 40 to 74, at either average risk or increased risk for colorectal cancer because of a family history, who underwent a screening colonoscopy from 2008 to 2010. Using univariate and multivariate analyses, we explored the association among procedural quality indicators and 3 colonoscopy outcomes: detection of SRLs, adverse events, and postcolonoscopy cancers. The crude rates of SRLs, adverse events, and postcolonoscopy cancers were 240, 6.44, and .54 per 1000 colonoscopies, respectively. Several indicators, including endoscopist withdrawal time (OR, 1.3; 95% CI, 1.2-1.4) and cecal intubation rate (OR, 13.9; 95% CI, 1.9-96.9), were associated with the detection of SRLs. No quality indicator was associated with the risk of adverse events. Endoscopist average withdrawal time over 6 minutes (OR, .12; 95% CI, .002-.85) and SRL detection rate over 20% (OR, .17; 95% CI, .03-.74) were associated with a reduced risk of postcolonoscopy cancers. Single-center study. Quality assurance programs should prioritize the measurement of endoscopist average withdrawal time and adenoma (SRL) detection rate. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  14. Screening for breast cancer in a high-risk series

    International Nuclear Information System (INIS)

    Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

    1982-01-01

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening

  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. Risks of Liver (Hepatocellular) Cancer Screening

    Science.gov (United States)

    ... cancer. Having hepatitis or cirrhosis can increase the risk of developing liver cancer. Anything that increases the ... clinical trials is available from the NCI website . Risks of Liver (Hepatocellular) Cancer Screening Key Points Screening ...

  17. U.S. Department of energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

    International Nuclear Information System (INIS)

    Blaylock, B.P.; Legg, J.; Travis, C.C.; Scofield, P.A.

    1995-06-01

    This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments

  18. U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

    Energy Technology Data Exchange (ETDEWEB)

    Blaylock, B.P.; Legg, J.; Travis, C.C. [Oak Ridge National Lab., TN (United States). Center for Risk Management; Simek, M.A.; Sutherland, J. [Univ. of Tennessee, Knoxville, TN (United States); Scofield, P.A. [Office of Environmental Compliance and Documentation (United States)

    1995-06-01

    This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

  19. Meeting report: development of environmental health indicators in Brazil and other countries in the americas.

    Science.gov (United States)

    Carneiro, Fernando F; Oliveira, Mara Lúcia C; Netto, Guilherme F; Galvão, Luis A C; Cancio, Jacira A; Bonini, Estela M; Corvalan, Carlos F

    2006-09-01

    This report summarizes the Brazilian experience on the design and implementation of environmental health, with contributions from Argentina, Canada, and Cuba, presented at the International Symposium on the Development of Indicators for Environmental Health Integrated Management, held in Recife, Pernambuco, Brazil, on 17-18 June 2004. The methodology for the development of environmental health indicators has been used as a reference in the implementation of environmental health surveillance in Brazil. This methodology has provided tools and processes to facilitate the understanding and to measure the determinants of risks to environmental health, to help decision makers control those risks. Key words: environmental health indicators, environmental health surveillance, integrated management.

  20. 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.

  1. Guidance Manual for Conducting Screening Level Ecological Risk Assessments at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    R. L. VanHorn; N. L. Hampton; R. C. Morris

    1995-06-01

    This document presents reference material for conducting screening level ecological risk assessments (SLERAs)for the waste area groups (WAGs) at the Idaho National Engineering Laboratory. Included in this document are discussions of the objectives of and processes for conducting SLERAs. The Environmental Protection Agency ecological risk assessment framework is closely followed. Guidance for site characterization, stressor characterization, ecological effects, pathways of contaminant migration, the conceptual site model, assessment endpoints, measurement endpoints, analysis guidance, and risk characterization are included.

  2. Establishing indices for groundwater contamination risk assessment in the vicinity of hazardous waste landfills in China

    International Nuclear Information System (INIS)

    Li Ying; Li Jinhui; Chen Shusheng; Diao Weihua

    2012-01-01

    Groundwater contamination by leachate is the most damaging environmental impact over the entire life of a hazardous waste landfill (HWL). With the number of HWL facilities in China rapidly increasing, and considering the poor status of environmental risk management, it is imperative that effective environmental risk management methods be implemented. A risk assessment indices system for HWL groundwater contamination is here proposed, which can simplify the risk assessment procedure and make it more user-friendly. The assessment framework and indices were drawn from five aspects: source term, underground media, leachate properties, risk receptors and landfill management quality, and a risk assessment indices system consisting of 38 cardinal indicators was established. Comparison with multimedia models revealed that the proposed indices system was integrated and quantitative, that input data for it could be easily collected, and that it could be widely used for environmental risk assessment (ERA) in China. - Highlights: ► No comprehensive environmental risk assessment method for hazardous waste management is proposed in China. ► An assessment indices system is established for groundwater contamination in the vicinity of hazardous waste landfill. ► All indicators are quantitative and applicable in China. - Capsule: This research identified critical indices and established a system for environmental risk assessment for groundwater contamination in the vicinity of HWLs in China.

  3. Relationship of detection rate of PET cancer screening examinees and risk factors. Analysis of background of examinees

    International Nuclear Information System (INIS)

    Shibata, Koji; Uno, Kimiichi; Arai, Masami; Matsuura, Masaaki; Yoshida, Teruhiko; Momose, Toshimitsu; Ohtomo, Kuni

    2011-01-01

    Positron emission tomography (PET) cancer screening is performed widely in Japan as opportunistic screening, but no study has focused on the correlation with various cancer risk factors and the seeking bias of examinees and cancer detection rate. Analyzing our large series of PET cancer screening data, correlations with cancer detection rates according to general cancer risk factors and PET detection survey were reviewed, and the selection bias of the medical examinees was determined. 19189 examinees who underwent PET cancer screening were enrolled. Using logistic-regression analysis, we analyzed correlations between smoking history/drinking history/cancer family history and detection rates of thyroid cancer/breast cancer/colorectal cancer/lung cancer, which are the main malignancies detected in PET cancer screening. In addition, we evaluated seeking bias of examinees, analyzing correlations between the presence of cancer risk factors and prior screening checkups at other institutions to our PET cancer screening using a matched case-control study. Cancer detection rates by FDG-PET were 1.17% (224/19189), being much higher than those of standard cancer mass screenings. In males, statistically significant correlations were seen between lung cancer and smoking, and between prostate cancer and a family history of prostate cancer, but not between the detection rates of three other types of cancer (thyroid cancer/lung cancer/colorectal cancer) and other cancer risk factors. In females, detection rates of four types of cancer (thyroid cancer/lung cancer/colorectal cancer/breast cancer) were significantly higher in the examinees without cancer risks, and subgroup analysis according to types of cancer did not indicate significant correlations either. The matched case-control study evaluating seeking bias indicated that a significant proportion of the examinees with cancer risks had undergone prior cancer screening at other institutions. Our study indicated that there was

  4. Greening the Screen: An Environmental Challenge

    OpenAIRE

    Ekin Gündüz Özdemirci

    2016-01-01

    Environmental themes and representations on screen are examined as a part of environmental social studies and can be considered a way of creating awareness of environmental issues. However, how often do we consider the environmental impact of a film or television shoot as an industrial process? In this article, I examine the sustainability practices in the motion picture industry and challenges to that by focusing on the British film and television industry as a case study. Using the intervie...

  5. The importance of retesting the hearing screening as an indicator of the real early hearing disorder

    Directory of Open Access Journals (Sweden)

    Daniela Polo Camargo da Silva

    2015-08-01

    Full Text Available INTRODUCTION: Early diagnosis of hearing loss minimizes its impact on child development. We studied factors that influence the effectiveness of screening programs.OBJECTIVE: To investigate the relationship between gender, weight at birth, gestational age, risk factors for hearing loss, venue for newborn hearing screening and "pass" and "fail" results in the retest.METHODS: Prospective cohort study was carried out in a tertiary referral hospital. The screening was performed in 565 newborns through transient evoked otoacoustic emissions in three admission units before hospital discharge and retest in the outpatient clinic. Gender, weight at birth, gestational age, presence of risk indicators for hearing loss and venue for newborn hearing screening were considered.RESULTS: Full-term infants comprised 86% of the cases, preterm 14%, and risk factors for hearing loss were identified in 11%. Considering the 165 newborns retested, only the venue for screening, Intermediate Care Unit, was related to "fail" result in the retest.CONCLUSIONS: Gender, weight at birth, gestational age and presence of risk factors for hearing loss were not related to "pass" and/or "fail" results in the retest. The screening performed in intermediate care units increases the chance of continued "fail" result in the Transient Otoacoustic Evoked Emissions test.

  6. Sequential screening for psychosocial and behavioural risk during pregnancy in a population of urban African Americans.

    Science.gov (United States)

    Kiely, M; Gantz, M G; El-Khorazaty, M N; El-Mohandes, A A E

    2013-10-01

    Screening for psychosocial and behavioural risks, such as depression, intimate partner violence, and smoking, during pregnancy is considered to be state of the art in prenatal care. This prospective longitudinal analysis examines the added benefit of repeated screening, compared with a single screening, in identifying such risks during pregnancy. Data were collected as part of a randomised controlled trial to address intimate partner violence, depression, smoking, and environmental tobacco smoke exposure in African American women. Prenatal care sites in the District of Columbia serving mainly women of minority background. A cohort of 1044 African American pregnant women in the District of Columbia. Mothers were classified by their initial response (acknowledgement of risks), and these data were updated during pregnancy. Risks were considered new if they were not previously reported. Standard hypothesis tests and logistic regression were used to predict the acknowledgment of any new risk(s) during pregnancy. New risks: psychosocial variables to understand what factors might help identify the acknowledgement of additional risk(s). Repeated screening identified more mothers acknowledging risk over time. Reported smoking increased by 11%, environmental tobacco smoke exposure increased by 19%, intimate partner violence increased by 9%, and depression increased by 20%. The psychosocial variables collected at the baseline that were entered into the logistic regression model included relationship status, education, Medicaid, illicit drug use, and alcohol use during pregnancy. Among these, only education less than high school was associated with the acknowledgement of new risk in the bivariate analyses, and significantly predicted the identification of new risks (OR 1.39, 95% CI 1.01-1.90). It is difficult to predict early on who will acknowledge new risks over the course of pregnancy, and thus all women should be screened repeatedly to allow for the identification of risks

  7. Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia

    Directory of Open Access Journals (Sweden)

    Ranjita Misra

    2016-01-01

    Full Text Available This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1 the validated 7-item diabetes risk assessment survey and (2 hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were 51.2±16.4, 31.1±7.5, and 5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents, overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221, P<0.001. In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.

  8. 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

  9. A computerized program to educate adults about environmental health risks

    International Nuclear Information System (INIS)

    Adams, M.; Dewey, J.; Schur, P.

    1993-01-01

    A computerized program called Environmental Risk Appraisal (ERA) has been developed to educate adults about environmental health risks and to motivate positive behavior change. A questionnaire addresses issues such as radon, environmental tobacco smoke, pesticides, lead, air and water pollution, and work-site risks. Responses are computer processed in seconds to produce an individualized computer printout containing a score, educational messages, and phone numbers to call for more information. A variety of audiences including environmental groups, worksites, women's organizations and health professionals were represented in this study of 269 participants. Many respondents indicated they were exposed to important environmental hazards and nearly 40 percent reported they had, or might have had, an environmental related illness at some time. Preliminary evaluation indicates the program is effective as an educational tool in raising awareness of environmental health risks

  10. Legacy Risk Measure for Environmental Waste

    International Nuclear Information System (INIS)

    Eide, S. A.; Nitschke, R. L.

    2002-01-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) is investigating the development of a comprehensive and quantitative risk model framework for environmental management activities at the site. Included are waste management programs (high-level waste, transuranic waste, low-level waste, mixed low-level waste, spent nuclear fuel, and special nuclear materials), major environmental restoration efforts, major decontamination and decommissioning projects, and planned long-term stewardship activities. Two basic types of risk estimates are included: risks from environmental management activities, and long-term legacy risks from wastes/materials. Both types of risks are estimated using the Environment, Safety, and Health Risk Assessment Program (ESHRAP) developed at the INEEL. Given these two types of risk calculations, the following evaluations can be performed: risk evaluation of an entire program (covering waste/material as it now exists through disposal or other e nd states); risk comparisons of alternative programs or activities; comparisons of risk benefit versus risk cost for activities or entire programs; ranking of programs or activities by risk; ranking of wastes/materials by risk; evaluation of site risk changes with time as activities progress; and integrated performance measurement using indicators such as injury/death and exposure rates. This paper discusses the definition and calculation of legacy risk measures and associated issues. The legacy risk measure is needed to support three of the seven types of evaluations listed above: comparisons of risk benefit versus risk cost, ranking of wastes/materials by risk, and evaluation of site risk changes with time

  11. Electromagnetic fields and health impact: measurements, monitoring and environmental indicators

    International Nuclear Information System (INIS)

    Lubritto, C.; Vetromile, C.; Petraglia, A.; Racioppoli, M.; D'Onofrio, A.

    2008-01-01

    Full text: During the last 10 years there has been a remarkable growth of the attention for problems related to the electromagnetic pollution, motivated by the alert connected to potential risk for the health of persons and due to the increasing diffusion of Bats for mobile telecommunication as EMF sources. Many projects are being realized about the environmental and health impact of electromagnetic field and an important social role is played by specific actions to minimize the risk perception of the population. This study aims to find an innovative approach to these problems through the use of a system of continuous time monitoring of the electromagnetic fields and the individuation of appropriate environmental indicators. The proposed system monitors the electromagnetic fields continuously over time, and is already operating in many southern Italian cities. It works in a very efficient way as a mean for: a) Info to the citizens, thanks to diffusion of daily collected data on Internet Web; b) Control for local administrations and Authorities, due to capability of the system itself to alert when measured values exceed the limits reported by the Italian laws; c) Planning, for the implementation of : 1) New procedures agreed among local environmental control agency, local administrations and mobile Companies for network planning and management of alarm situations; 2) New local guidelines documents concerning the installation and operation of telecommunications apparatus. Moreover, starting from the general principles of the Strategic Environmental Evaluation (VAS), the environmental impacts of EMS field is studied. Based on the model DPSIR (Drivers, Pressure, State, Impacts, Responses), 12 environmental indicators have been chosen providing an immediate and understandable tool to obtain very important information on electromagnetic pollution generated by radio-telecommunication systems. The selected environmental indicators have been applied to 11 cities of the

  12. Use of ecotoxicological screening action levels in ecological risk assessment at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Ferenbauah, R.; Ebinger, M.; Gallegos, A.; Hansen, W.; Myers, O.; Wenzel, W.

    1995-01-01

    Regulatory drivers found in several environmental statutes require that ecological risk assessment and Natural Resource Damage Assessment be performed to assess potential environmental impact from contaminated sites and from proposed remedial alternatives. At Los Alamos National Laboratory, the initial phase of the ecological risk assessment process required preliminary evaluation of contaminated sites to determine whether potential for ecological impact exists. The preliminary evaluations were made using Ecotoxicological Screening Action Levels (ESALS) calculated as a function of reference toxicity dose, body weight, food/water/air intake, and fraction of soil intake with food. Reference toxicity doses were derived from the Environmental Protection Agency Integrated Risk Information System (IRIS) and Health Effects Assessment Summary Tables (HEAST) toxicology databases. Other parameters required for ESAL calculations were derived from physiological, metabolic, and behavioral data available in the literature. The Los Alamos ESALs were derived for guilds of animals with similar behavioral patterns, which were identified from natural resource survey data collected at Los Alamos. Subsequent to development of Ecotoxicological Screening Action Levels, Hazard Quotients, which are ratios of soil concentrations to Ecotoxicological Screening Action Levels, were calculated for potential contaminants of concern. The Hazard Quotients were used to identify which potential contaminants of concern should be evaluated further for ecological impact. There is potential for ecological impact when the Hazard Quotient is equal to or greater than one

  13. Establishing indices for groundwater contamination risk assessment in the vicinity of hazardous waste landfills in China.

    Science.gov (United States)

    Li, Ying; Li, Jinhui; Chen, Shusheng; Diao, Weihua

    2012-06-01

    Groundwater contamination by leachate is the most damaging environmental impact over the entire life of a hazardous waste landfill (HWL). With the number of HWL facilities in China rapidly increasing, and considering the poor status of environmental risk management, it is imperative that effective environmental risk management methods be implemented. A risk assessment indices system for HWL groundwater contamination is here proposed, which can simplify the risk assessment procedure and make it more user-friendly. The assessment framework and indices were drawn from five aspects: source term, underground media, leachate properties, risk receptors and landfill management quality, and a risk assessment indices system consisting of 38 cardinal indicators was established. Comparison with multimedia models revealed that the proposed indices system was integrated and quantitative, that input data for it could be easily collected, and that it could be widely used for environmental risk assessment (ERA) in China. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  14. A Cross-Cultural Study on Environmental Risk Perception and Educational Strategies: Implications for Environmental Education in China

    Science.gov (United States)

    Duan, Hongxia; Fortner, Rosanne

    2010-01-01

    This cross-cultural study examined college students' environmental risk perception and their preference in terms of risk communication and educational strategies in China and the United States. The results indicated that the Chinese respondents were more concerned about environmental risk, and they perceived the environmental issues to be more…

  15. Use of environmental health-risk analysis for managing toxic substances

    International Nuclear Information System (INIS)

    McKone, T.E.

    1985-03-01

    This paper presents a set of simple models used to assess health risks based on toxicity, environmental mobility and persistence. These models use a representative landscape in order to describe the steady-state distribution of arsenic, tritiated water, and TCDD as a result of continuous additions to soil. This information is used to assess potential exposures. Application of the screening model to three chemically different carcinogens reveals that the environmental health risk does not scale with direct measures of toxicity. As estimated here, the environmental health risk of TCDD relative to tritiated water and arsenic is roughly an order of magnitude less than its cancer potency relative to these compounds. The difference is attributable in large part to the immobility of TCDD relative to tritium and the lower persistence of TCDD compared to arsenic. The purpose is to present a simple procedure for using the relative behavior of toxic species under prototype conditions as a basis for risk management. 21 refs., 4 tabs

  16. Health risks for the population living in the vicinity of an Integrated Waste Management Facility: Screening environmental pollutants

    International Nuclear Information System (INIS)

    Domingo, José L.; Rovira, Joaquim; Vilavert, Lolita; Nadal, Martí; Figueras, María J.; Schuhmacher, Marta

    2015-01-01

    We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical–biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m 3 , respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. - Highlights: • Health risks of an Integrated Waste Management Facility in Catalonia are assessed. • PCDD/F exposure near this facility is up to 10-times higher than that near others. • Environmental monitoring of incineration plants should be performed case-by-case. • Since results are very preliminary, confirmatory studies should be conducted

  17. Health risks for the population living in the vicinity of an Integrated Waste Management Facility: Screening environmental pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Domingo, José L., E-mail: joseluis.domingo@urv.cat [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Rovira, Joaquim [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Vilavert, Lolita; Nadal, Martí [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Figueras, María J. [Microbiology Unit, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Schuhmacher, Marta [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain)

    2015-06-15

    We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical–biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m{sup 3}, respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. - Highlights: • Health risks of an Integrated Waste Management Facility in Catalonia are assessed. • PCDD/F exposure near this facility is up to 10-times higher than that near others. • Environmental monitoring of incineration plants should be performed case-by-case. • Since results are very preliminary, confirmatory studies should be conducted.

  18. Environmental indicators for the nuclear area

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Cezar Braga; Mattiolo, Sandra Regina, E-mail: cezar.braga@ctmsp.mar.mil.br [Centro Tecnologico da Marinha em Sao Paujo (CTMSP), Sao Paulo, SP (Brazil)

    2013-07-01

    Environmental indicators are tools utilized for measuring the industrial environmental performance and are globally used to provide the company and other stakeholders with information concerning its effectiveness and sustainability. Furthermore, the environmental indicators are an important methodological tool used for monitoring the effectiveness of Environmental Management System goals, as well as its compliance with the established environmental policies. Currently, major companies have reported their environmental indicators based on specialized guides, such as the CDP (Carbon Disclosure Project) and the GRI (Global Reporting Initiative), enumerating the most important indicators for the company activities. However, the GRI as other bibliographies of this subject does not include specific indicators for the nuclear area, leaving a significant gap to be considered for the measurement of environmental performance of this industry. Therefore, it becomes relevant to raise the following questions. May the nuclear sector use the same indicators of the non-nuclear industry? Are these indicators effective in demonstrating environmental commitment? In this work, a discussion of the indicators for the nuclear area and the CTMSP will take place. (author)

  19. Environmental indicators for the nuclear area

    International Nuclear Information System (INIS)

    Alves, Cezar Braga; Mattiolo, Sandra Regina

    2013-01-01

    Environmental indicators are tools utilized for measuring the industrial environmental performance and are globally used to provide the company and other stakeholders with information concerning its effectiveness and sustainability. Furthermore, the environmental indicators are an important methodological tool used for monitoring the effectiveness of Environmental Management System goals, as well as its compliance with the established environmental policies. Currently, major companies have reported their environmental indicators based on specialized guides, such as the CDP (Carbon Disclosure Project) and the GRI (Global Reporting Initiative), enumerating the most important indicators for the company activities. However, the GRI as other bibliographies of this subject does not include specific indicators for the nuclear area, leaving a significant gap to be considered for the measurement of environmental performance of this industry. Therefore, it becomes relevant to raise the following questions. May the nuclear sector use the same indicators of the non-nuclear industry? Are these indicators effective in demonstrating environmental commitment? In this work, a discussion of the indicators for the nuclear area and the CTMSP will take place. (author)

  20. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  1. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    International Nuclear Information System (INIS)

    Roman, M.; Skaane, P.; Hofvind, S.

    2014-01-01

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  2. Radiation risk from CT: implications for cancer screening.

    Science.gov (United States)

    Albert, Jeffrey M

    2013-07-01

    The cancer risks associated with patient exposure to radiation from medical imaging have become a major topic of debate. The higher doses necessary for technologies such as CT and the increasing utilization of these technologies further increase medical radiation exposure to the population. Furthermore, the use of CT for population-based cancer screening continues to be explored for common malignancies such as lung cancer and colorectal cancer. Given the known carcinogenic effects of ionizing radiation, this warrants evaluation of the balance between the benefit of early cancer detection and the risk of screening-induced malignancy. This report provides a brief review of the process of radiation carcino-genesis and the literature evaluating the risk of malignancy from CT, with a focus on the risks and benefits of CT for cancer screening. The available data suggest a small but real risk of radiation-induced malignancy from CT that could become significant at the population level with widespread use of CT-based screening. However, a growing body of literature suggests that the benefits of CT screening for lung cancer in high-risk patients and CT colonography for colorectal cancer may significantly outweigh the radiation risk. Future studies evaluating the benefits of CT screening should continue to consider potential radiation risks.

  3. Analysis of risk factors associated with unilateral hearing loss in children who initially passed newborn hearing screening.

    Science.gov (United States)

    Appelbaum, Eric N; Howell, Jessica B; Chapman, Derek; Pandya, Arti; Dodson, Kelley M

    2018-03-01

    To analyze 2007 Joint Committee on Infant Hearing (JCIH) risk factors in children with confirmed unilateral hearing loss (UHL) who initially passed newborn hearing screening. Retrospective record review of 16,108 infants who passed newborn hearing screening but had one or more JCIH risk factors prompting subsequent follow-up through the universal newborn hearing screening (UNHS) program in Virginia from 2010 to 2012. The study was reviewed and qualified as exempt by the Virginia Commonwealth University Institutional Review Board (IRB) and the Virginia Department of Health. Over the 2-year study period, 14896 (4.9% of total births) children passed UNHS but had the presence of one or more JCIH risk factor. Ultimately, we identified 121 babies from this group with confirmed hearing loss (0.7%), with 48 babies (0.2%) showing UHL. The most common risk factors associated with the development of confirmed UHL after passing the initial screen were neonatal indicators, craniofacial anomalies, family history, and stigmata of syndrome associated with hearing loss. Neonatal indicators and craniofacial anomalies were the categories most often found in children with confirmed unilateral hearing loss who initially passed their newborn hearing screen. While neonatal indicators were also the most common associated risk factor in all hearing loss, craniofacial abnormalities are relatively more common in children with UHL who initially passed newborn hearing screening. Further studies assessing the etiology underlying the hearing loss and risk factor associations are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Environmental Risk Communication through Qualitative Risk Assessment

    Directory of Open Access Journals (Sweden)

    Sabre J. Coleman

    2014-06-01

    Full Text Available Environmental analysts are often hampered in communicating the risks of environmental contaminants due to the myriad of regulatory requirements that are applicable. The use of a qualitative, risk-based control banding strategy for assessment and control of potential environmental contaminants provides a standardized approach to improve risk communication. Presented is a model that provides an effective means for determining standardized responses and controls for common environmental issues based on the level of risk. The model is designed for integration within an occupational health and safety management system to provide a multidisciplinary environmental and occupational risk management approach. This environmental model, which utilizes multidisciplinary control banding strategies for delineating risk, complements the existing Risk Level Based Management System, a proven method in a highly regulated facility for occupational health and safety. A simplified environmental risk matrix is presented that is stratified over four risk levels. Examples of qualitative environmental control banding strategies are presented as they apply to United States regulations for construction, research activities, facility maintenance, and spill remediation that affect air, water, soil, and waste disposal. This approach offers a standardized risk communication language for multidisciplinary issues that will improve communications within and between environmental health and safety professionals, workers, and management.

  5. 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.

  6. New information on high risk breast screening

    International Nuclear Information System (INIS)

    Riedl, C.C.; Ponhold, L.; Gruber, R.; Pinker, K.; Helbich, T.H.

    2010-01-01

    Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized. (orig.) [de

  7. Quantum chemistry in environmental pesticide risk assessment.

    Science.gov (United States)

    Villaverde, Juan J; López-Goti, Carmen; Alcamí, Manuel; Lamsabhi, Al Mokhtar; Alonso-Prados, José L; Sandín-España, Pilar

    2017-11-01

    The scientific community and regulatory bodies worldwide, currently promote the development of non-experimental tests that produce reliable data for pesticide risk assessment. The use of standard quantum chemistry methods could allow the development of tools to perform a first screening of compounds to be considered for the experimental studies, improving the risk assessment. This fact results in a better distribution of resources and in better planning, allowing a more exhaustive study of the pesticides and their metabolic products. The current paper explores the potential of quantum chemistry in modelling toxicity and environmental behaviour of pesticides and their by-products by using electronic descriptors obtained computationally. Quantum chemistry has potential to estimate the physico-chemical properties of pesticides, including certain chemical reaction mechanisms and their degradation pathways, allowing modelling of the environmental behaviour of both pesticides and their by-products. In this sense, theoretical methods can contribute to performing a more focused risk assessment of pesticides used in the market, and may lead to higher quality and safer agricultural products. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  8. Cosmic web and environmental dependence of screening: Vainshtein vs. chameleon

    Energy Technology Data Exchange (ETDEWEB)

    Falck, Bridget; Koyama, Kazuya; Zhao, Gong-Bo, E-mail: bridget.falck@port.ac.uk, E-mail: kazuya.koyama@port.ac.uk, E-mail: gong-bo.zhao@port.ac.uk [Institute of Cosmology and Gravitation, University of Portsmouth, Burnaby Road, Portsmouth (United Kingdom)

    2015-07-01

    Theories which modify general relativity to explain the accelerated expansion of the Universe often use screening mechanisms to satisfy constraints on Solar System scales. We investigate the effects of the cosmic web and the local environmental density of dark matter halos on the screening properties of the Vainshtein and chameleon screening mechanisms. We compare the cosmic web morphology of dark matter particles, mass functions of dark matter halos, mass and radial dependence of screening, velocity dispersions and peculiar velocities, and environmental dependence of screening mechanisms in f(R) and nDGP models. Using the ORIGAMI cosmic web identification routine we find that the Vainshtein mechanism depends on the cosmic web morphology of dark matter particles, since these are defined according to the dimensionality of their collapse, while the chameleon mechanism shows no morphology dependence. The chameleon screening of halos and their velocity dispersions depend on halo mass, and small halos and subhalos can be environmentally screened in the chameleon mechanism. On the other hand, the screening of halos in the Vainshtein mechanism does not depend on mass nor environment, and their velocity dispersions are suppressed. The peculiar velocities of halos in the Vainshtein mechanism are enhanced because screened objects can still feel the fifth force generated by external fields, while peculiar velocities of chameleon halos are suppressed when the halo centers are screened.

  9. Cosmic web and environmental dependence of screening: Vainshtein vs. chameleon

    International Nuclear Information System (INIS)

    Falck, Bridget; Koyama, Kazuya; Zhao, Gong-Bo

    2015-01-01

    Theories which modify general relativity to explain the accelerated expansion of the Universe often use screening mechanisms to satisfy constraints on Solar System scales. We investigate the effects of the cosmic web and the local environmental density of dark matter halos on the screening properties of the Vainshtein and chameleon screening mechanisms. We compare the cosmic web morphology of dark matter particles, mass functions of dark matter halos, mass and radial dependence of screening, velocity dispersions and peculiar velocities, and environmental dependence of screening mechanisms in f(R) and nDGP models. Using the ORIGAMI cosmic web identification routine we find that the Vainshtein mechanism depends on the cosmic web morphology of dark matter particles, since these are defined according to the dimensionality of their collapse, while the chameleon mechanism shows no morphology dependence. The chameleon screening of halos and their velocity dispersions depend on halo mass, and small halos and subhalos can be environmentally screened in the chameleon mechanism. On the other hand, the screening of halos in the Vainshtein mechanism does not depend on mass nor environment, and their velocity dispersions are suppressed. The peculiar velocities of halos in the Vainshtein mechanism are enhanced because screened objects can still feel the fifth force generated by external fields, while peculiar velocities of chameleon halos are suppressed when the halo centers are screened

  10. Risks of Lung Cancer Screening

    Science.gov (United States)

    ... in women. Different factors increase or decrease the risk of lung cancer. Anything that increases your chance ... been studied to see if they decrease the risk of dying from lung cancer. The following screening ...

  11. Scenario-targeted toxicity assessment through multiple endpoint bioassays in a soil posing unacceptable environmental risk according to regulatory screening values.

    Science.gov (United States)

    Rodriguez-Ruiz, A; Etxebarria, J; Boatti, L; Marigómez, I

    2015-09-01

    Lanestosa is a chronically polluted site (derelict mine) where the soil (Lanestosa (LA) soil) exceeds screening values (SVs) of regulatory policies in force (Basque Country; Europe) for Zn, Pb and Cd. A scenario-targeted toxicity assessment was carried out on the basis of a multi-endpoint bioassay approach. Acute and chronic toxicity bioassays were conducted with selected test species (Vibrio fischeri, Dictyostelium discoideum, Lactuca sativa, Raphanus sativus and Eisenia fetida) in combination with chemical analysis of soils and elutriates and with bioaccumulation studies in earthworms. Besides, the toxicity profile was compared with that of the mine runoff (RO) soil and of a fresh artificially polluted soil (LAAPS) resembling LA soil pollutant profile. Extractability studies in LA soil revealed that Pb, Zn and Cd were highly available for exchange and/or release into the environment. Indeed, Pb and Zn were accumulated in earthworms and LA soil resulted to be toxic. Soil respiration, V. fischeri, vegetative and developmental cycles of D. discoideum and survival and juvenile production of E. fetida were severely affected. These results confirmed that LA soil had unacceptable environmental risk and demanded intervention. In contrast, although Pb and Zn concentrations in RO soil revealed also unacceptable risk, both metal extractability and toxicity were much lower than in LA soil. Thus, within the polluted site, the need for intervention varied between areas that posed dissimilar risk. Besides, since LAAPS, with a high exchangeable metal fraction, was the most toxic, ageing under in situ natural conditions seemingly contributed to attenuate LA soil risk. As a whole, combining multi-endpoint bioassays with scenario-targeted analysis (including leaching and ageing) provides reliable risk assessment in soils posing unacceptable environmental risk according to SVs, which is useful to optimise the required intervention measures.

  12. Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study.

    Science.gov (United States)

    Salimzadeh, Hamideh; Bishehsari, Faraz; Delavari, Alireza; Barzin, Gilda; Amani, Mohammad; Majidi, Azam; Sadjadi, Alireza; Malekzadeh, Reza

    2016-12-20

    We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer. This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm. Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Ecological risk evaluation of sediment core samples, Lake Tortum (Erzurum, NE Turkey using environmental indices

    Directory of Open Access Journals (Sweden)

    Hakan Kaya

    2017-11-01

    Full Text Available This study aimed to determine the vertical distribution of heavy metals in a 72 cm-long core sample from Lake Tortum in order to shed light on the implications of potential ecological risks. Analysis was based on the use of environmental indices such as the Integrated Pollution Load Index (PLI and Potential Ecological Risk Index (PER. Results reveal that, except for Pb, Mn and Hg, the lowest concentrations of heavy metals occur at a core depth of between 2 cm and 20 cm for Cu, Zn, Ni, Fe, As, Cd, Cr and Al. The highest concentration was found at sampling intervals of 36 cm and 50 cm, with the exception of Pb, Mn, Hg and Ni. The PLI values from bottom to top are less than 1 while the level with the nearest value to the background value lies at a depth between 24 cm and 26 cm. The PER index results suggest a low ecological risk level for Cu, Pb, Zn, Ni, Mn, Fe, As, Cr, and Al; however, Cd and Hg constitute an ecological threat to the lake ecosystem.

  14. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, S.

    Whenever we shop, the products we consider buying are labelled with the economical price we have to pay if we want to purchase them - an important parameter in our decisions as purchasers. The increrasing awareness for environmental limits and backlashes of human activities also in the building...... sector have fostered the wish to define 'the ecological price' of a building as a help for environmental conscious decision-making. In a social constructivist approach this Ph.D. thesis looks across and beyond the manifold existing approaches for environmental indicators for buildings. It acknowledges...... in the Netherlands. It identifies lines of conflict and areas of consent betweeen the relevant actors and elaborates scenarios for a possible closure of ongoing debate about environmental indicators for buildings....

  15. Benefit-risk evaluation of mammographic mass screening

    International Nuclear Information System (INIS)

    Sato, Nobuo; Ogura, Toshihiro

    1990-01-01

    This study evaluated the benefit-risk balance of mammography in mass screening by using survival rates from 3000 breast cancer patients at the Japanese Foundation for Cancer Research Institute Hospital. Because the number of participants in mammographic mass screening was small, asymptomatic patients with pathologically proven early breast cancer were categorized as the screenee group. Symptomatic patients were categorized as the patient group. Survival rates were compared in both the screenee and the patient groups. Based on the difference in areas of survival curves between screenees and patients, the ratio of person-year gain (PYG) to person-year lost (PYL) was obtained. The ratio of PYG to PYL was multiplied by the detection rate resulting from a particular screening program to obtain the benefit/risk ratio. The detection rate of nonpalpable breast cancer was 15 times higher in the screenee group than the patient group. Breast cancer was detected in 7 (0.85%) of 824 patients in the screenee group. Even when mammographic mass screening was started at the age of 30, the benefit of mammography was far superior to the risk. The number of participants in mass screening stratified by age may be required for the conclusion of the benefit-risk balance of mammography in mass screening. (N.K.)

  16. Selecting environmental indicator for use in strategic environmental assessment

    International Nuclear Information System (INIS)

    Donnelly, Alison; Jones, Mike; O'Mahony, Tadhg; Byrne, Gerry

    2007-01-01

    The primary aim of carrying out Strategic Environmental Assessment (SEA) is to provide for a high level of environmental protection and to integrate environmental considerations into the planning process. The SEA Directive (2001/42/EC) recommends monitoring to determine the environmental impact of the implementation of plans and programmes. Environmental indicators are a useful tool by which this impact may be measured. However, careful consideration must be given to developing a set of indicators in order to isolate, plan or programme specific impacts. Here, we demonstrate the effectiveness of a workshop-based approach to develop appropriate criteria for selecting environmental indicator for use in SEA. A multi-disciplinary team was used in the approach which consisted of representatives from each of four environmental fields i.e. biodiversity, water, air and climatic factors, together with SEA experts, planning experts, academics and consultants. The team reviewed various sets of criteria, already in existence, for environmental indicator development but not specifically for SEA indicators. The results of this review together with original criteria were applied to the final list agreed upon. Some of the criteria recommended includes, relevance to plan, ability to prioritise, and ability to identify conflict with other plan or SEA objectives

  17. Risk-based safety indicators

    International Nuclear Information System (INIS)

    Szikszai, T.

    1997-01-01

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

  18. 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.

  19. Body composition indices and predicted cardiovascular disease risk profile among urban dwellers in Malaysia.

    Science.gov (United States)

    Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Dahlui, Maznah; Majid, Hazreen Abdul

    2015-01-01

    This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.

  20. Body Composition Indices and Predicted Cardiovascular Disease Risk Profile among Urban Dwellers in Malaysia

    Directory of Open Access Journals (Sweden)

    Tin Tin Su

    2015-01-01

    Full Text Available Objectives. This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD risk profile in an urban population in Kuala Lumpur, Malaysia. Methods. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.

  1. Greening the Screen: An Environmental Challenge

    Directory of Open Access Journals (Sweden)

    Ekin Gündüz Özdemirci

    2016-06-01

    Full Text Available Environmental themes and representations on screen are examined as a part of environmental social studies and can be considered a way of creating awareness of environmental issues. However, how often do we consider the environmental impact of a film or television shoot as an industrial process? In this article, I examine the sustainability practices in the motion picture industry and challenges to that by focusing on the British film and television industry as a case study. Using the interviews with industry representatives and some case studies, I discuss the possibilities of creating a change in behavior in the film industry, not only in terms of embedding green measures but also reconstituting industrial mechanisms on behalf of environmental sustainability.

  2. Suitability of pesticide risk indicators for less developed countries: a comparison

    OpenAIRE

    Feola, Giuseppe; Rahn, E.; Binder, C.R.

    2011-01-01

    Pesticide risk indicators provide simple support in the assessment of environmental and health risks\\ud from pesticide use, and can therefore inform policies to foster a sustainable interaction of agriculture\\ud with the environment. For their relative simplicity, indicators may be particularly useful under conditions\\ud of limited data availability and resources, such as in Less Developed Countries (LDCs). However,\\ud indicator complexity can vary significantly, in particular between those t...

  3. Environmental and Clinical Risk Factors for Delirium in a Neurosurgical Center: A Prospective Study.

    Science.gov (United States)

    Matano, Fumihiro; Mizunari, Takayuki; Yamada, Keiko; Kobayashi, Shiro; Murai, Yasuo; Morita, Akio

    2017-07-01

    Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging fluid attenuated inversion recovery images. We prospectively enrolled 253 patients admitted to our neurosurgical center between December 2014 and June 2015 and analyzed 220 patients (100 male patients; mean age, 64.1 years; age range, 17-92 years). An Intensive Care Delirium Screening Checklist score ≥4 points indicated delirium. We evaluated patient factors consisting of baseline characteristics and related factors, such as white matter lesions (WMLs), as well as the surrounding environment. Delirium occurred in 29/220 cases (13.2%). Regarding baseline characteristics, there were significant statistical correlations between delirium and age (P = 0.0187), Hasegawa Dementia Scale-Revised score (P = 0.0022) on admission, and WMLs (P delirium and stay in a neurosurgical care unit (P = 0.0245). Multivariate logistic regression analyses showed statistically significant correlations of delirium with WMLs (P delirium (P = 0.026). WMLs in patients and the surrounding environment are risk factors for delirium in a neurosurgical center. To prevent delirium, clinicians must recognize risk factors, such as high-grade WMLs, and manage environmental factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Defining the role of risk assessment in the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) remedial investigation process at the DOE-OR

    International Nuclear Information System (INIS)

    Miller, P.D.; McGinn, C.W.; Purucker, S.T.; White, R.K.

    1994-08-01

    The risk assessment strategy that will be implemented on the Oak Ridge Reservation has been standardized to ensure consistency and technical defensibility in all risk assessment activities and is presented within this document. The strategy emphasizes using existing environmental data in screening risk analyses to aid in identifying chemicals of potential concern, operable units that could pursue a no further investigation determination, and operable units that may warrant early response actions. The screening risk analyses include a comparison of measured chemical concentrations to preliminary remediation goals, performing a most likely exposure and integration point assessment, and performing a screening ecological risk assessment. This document focuses heavily on the screening risk analyses and relies on existing U.S. Environmental Protection Agency risk assessment guidance to provide specific details on conducting baseline risk assessments. However, the document does contain a section on the baseline risk assessment process that details the exposure pathways to be evaluated on the Oak Ridge Reservation. This document will be used in conjunction with existing Martin Marietta Energy Systems, Inc. Environmental Restoration risk assessment standards, policies, procedures, and technical memoranda. The material contained herein will be periodically updated as the strategy is tried and tested and as the risk assessment methodology is revised. The primary purpose for this document is to present the proposed strategy to the Tennessee Department of Environment and Conservation and the U.S. Environmental Protection Agency, Region IV and receive concurrence or additional comments on the material presented herein

  5. Risk Profiling May Improve Lung Cancer Screening

    Science.gov (United States)

    A new modeling study suggests that individualized, risk-based selection of ever-smokers for lung cancer screening may prevent more lung cancer deaths and improve the effectiveness and efficiency of screening compared with current screening recommendations

  6. Limits to the use of environmental indices to reduce risk and/or ...

    African Journals Online (AJOL)

    Environmental indices that provide short-term predictions of recruitment have the ... Simulations, based on a 'management procedure' (sensu the International ... to be in the top or bottom third of the distribution of possible recruitment values.

  7. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, Sven

    Environmental Indicators for Buildings are studied using two different perspectives: with a technological, environmental scientific departing point and with a social scientific departing point. Different relevant groups in the building sector are identified and analysed, using the Social...

  8. 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.

  9. A Novel Environmental Justice Indicator for Managing Local Air Pollution.

    Science.gov (United States)

    Zhao, Jing; Gladson, Laura; Cromar, Kevin

    2018-06-14

    Environmental justice efforts in the United States seek to provide equal protection from environmental hazards, such as air pollution, to all groups, particularly among traditionally disadvantaged populations. To accomplish this objective, the U.S. EPA has previously required states to use an environmental justice screening tool as part of air quality planning decision-making. The generally utilized approach to assess potential areas of environmental justice concern relies on static comparisons of environmental and demographic information to identify areas where minority and low income populations experience elevated environmental exposures, but does not include any additional information that may inform the trade-offs that sub-populations of varying socio-demographic groups make when choosing where to reside in cities. In order to address this limitation, job accessibility (measured by a mobility index defining the number of jobs available within a set commuting time) was developed as a novel environmental justice indicator of environmental justice priority areas at the local level. This approach is modeled using real-world data in Allegheny County, PA (USA), and identifies areas with relatively high levels of outdoor air pollution and low access to jobs. While traditional tools tend to flag the poorest neighborhoods for environmental justice concerns, this new method offers a more refined analysis, targeting populations suffering from the highest environmental burden without the associated benefits of urban living.

  10. A Novel Environmental Justice Indicator for Managing Local Air Pollution

    Directory of Open Access Journals (Sweden)

    Jing Zhao

    2018-06-01

    Full Text Available Environmental justice efforts in the United States seek to provide equal protection from environmental hazards, such as air pollution, to all groups, particularly among traditionally disadvantaged populations. To accomplish this objective, the U.S. EPA has previously required states to use an environmental justice screening tool as part of air quality planning decision-making. The generally utilized approach to assess potential areas of environmental justice concern relies on static comparisons of environmental and demographic information to identify areas where minority and low income populations experience elevated environmental exposures, but does not include any additional information that may inform the trade-offs that sub-populations of varying socio-demographic groups make when choosing where to reside in cities. In order to address this limitation, job accessibility (measured by a mobility index defining the number of jobs available within a set commuting time was developed as a novel environmental justice indicator of environmental justice priority areas at the local level. This approach is modeled using real-world data in Allegheny County, PA (USA, and identifies areas with relatively high levels of outdoor air pollution and low access to jobs. While traditional tools tend to flag the poorest neighborhoods for environmental justice concerns, this new method offers a more refined analysis, targeting populations suffering from the highest environmental burden without the associated benefits of urban living.

  11. Ethical and affective evaluation of environmental risks

    International Nuclear Information System (INIS)

    Bohm, G.; Pfister, H.R.

    1998-01-01

    Full text of publication follows: the present paper will be concerned with environmental risk perception, with special emphasis on those environmental risks that pertain to global change phenomena, such as climate change and ozone depletion. Two determinants of risk judgments are investigated that seem particularly relevant to environmental risks: ethical and affective evaluations. It is assumed that the focus of risk evaluation can be on one of two aspects: a) on an evaluation of potential losses, or b) on ethical considerations. We assume that both, potential loss and violation of ethical principles elicit emotional evaluations, but that these two judgmental aspects are associated with different specific emotions. Following cognitive emotion theories, we distinguish loss-based emotions, such as worry and fear, from ethical emotions, e.g., guilt and anger. A study is presented that investigates the role of ethical and affective evaluations in risk judgments. Various environmental risks were presented to subjects, e.g., air pollution, ozone depletion, climate change and destruction of ecological balance. For each environmental risk, subjects indicated in free-response format as well as on rating scales the extent to which ethical principles were violated, and the intensity of both loss-based and ethical emotions. The correlational structure of the emotion ratings confirms the distinction between loss-based and ethical emotions. Risk judgments co-vary with the strength of ethical evaluation and with the intensity of loss-based emotions, but are independent of ethical emotions. The implications of these findings for the risk appraisal process are discussed. (authors)

  12. The Spatial Distributions and Variations of Water Environmental Risk in Yinma River Basin, China.

    Science.gov (United States)

    Di, Hui; Liu, Xingpeng; Zhang, Jiquan; Tong, Zhijun; Ji, Meichen

    2018-03-15

    Water environmental risk is the probability of the occurrence of events caused by human activities or the interaction of human activities and natural processes that will damage a water environment. This study proposed a water environmental risk index (WERI) model to assess the water environmental risk in the Yinma River Basin based on hazards, exposure, vulnerability, and regional management ability indicators in a water environment. The data for each indicator were gathered from 2000, 2005, 2010, and 2015 to assess the spatial and temporal variations in water environmental risk using particle swarm optimization and the analytic hierarchy process (PSO-AHP) method. The results showed that the water environmental risk in the Yinma River Basin decreased from 2000 to 2015. The risk level of the water environment was high in Changchun, while the risk levels in Yitong and Yongji were low. The research methods provide information to support future decision making by the risk managers in the Yinma River Basin, which is in a high-risk water environment. Moreover, water environment managers could reduce the risks by adjusting the indicators that affect water environmental risks.

  13. A Cross-Cultural Study on Environmental Risk Perception and Educational Strategies: Implications for Environmental Education in China

    OpenAIRE

    Duan, Hongxia; Fortner, Rosanne

    2010-01-01

    This cross-cultural study examined college students’ environmental risk perception and their preference in terms of risk communication and educational strategies in China and the U.S. The results indicated that the Chinese respondents were more concerned about environmental risk, and they perceived the environmental issues to be more harmful to health, to the environment, and to social economic development of the nation than did the American respondents. Both groups desired transpar...

  14. Playing It Safe: Assessing Cumulative Impact and Social Vulnerability through an Environmental Justice Screening Method in the South Coast Air Basin, California

    Directory of Open Access Journals (Sweden)

    Justin Scoggins

    2011-05-01

    Full Text Available Regulatory agencies, including the U.S. Environmental Protection Agency (US EPA and state authorities like the California Air Resources Board (CARB, have sought to address the concerns of environmental justice (EJ advocates who argue that chemical-by-chemical and source-specific assessments of potential health risks of environmental hazards do not reflect the multiple environmental and social stressors faced by vulnerable communities. We propose an Environmental Justice Screening Method (EJSM as a relatively simple, flexible and transparent way to examine the relative rank of cumulative impacts and social vulnerability within metropolitan regions and determine environmental justice areas based on more than simply the demographics of income and race. We specifically organize 23 indicator metrics into three categories: (1 hazard proximity and land use; (2 air pollution exposure and estimated health risk; and (3 social and health vulnerability. For hazard proximity, the EJSM uses GIS analysis to create a base map by intersecting land use data with census block polygons, and calculates hazard proximity measures based on locations within various buffer distances. These proximity metrics are then summarized to the census tract level where they are combined with tract centroid-based estimates of pollution exposure and health risk and socio-economic status (SES measures. The result is a cumulative impacts (CI score for ranking neighborhoods within regions that can inform diverse stakeholders seeking to identify local areas that might need targeted regulatory strategies to address environmental justice concerns.

  15. Delay in blood sampling for routine newborn screening is associated with increased risk of schizophrenia

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Tidselbak Larsen, Janne; Pedersen, Carsten Bøcker

    2015-01-01

    for this association. Therefore, we investigated whether the increased risk can be explained by other risk factors for schizophrenia. METHODS: A case-control design was applied. A total of 846 cases with schizophrenia were selected from the Danish Psychiatric Case Register. One control was selected for each case......BACKGROUND: The Danish Neonatal Screening Biobank, containing dried blood spot samples from all newborn in Denmark, is a unique source of data that can be utilized for analyses of genetic and environmental exposures related to schizophrenia and other mental disorders. In previous analyses, we have...... found that early and late blood sampling, compared to sampling at day 5, was associated with increased risk of schizophrenia. As delay in sampling of blood for neonatal screening cannot in itself influence the risk of schizophrenia, it must be seen as a proxy for unknown underlying causes responsible...

  16. Risk-based safety indicators

    International Nuclear Information System (INIS)

    Sedlak, J.

    2001-12-01

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

  17. Performance of the flow cytometric E-screen assay in screening estrogenicity of pure compounds and environmental samples

    Energy Technology Data Exchange (ETDEWEB)

    Vanparys, Caroline, E-mail: caroline.vanparys@ua.ac.be [Laboratory of Ecophysiology, Biochemistry and Toxicology, University of Antwerp, Antwerp (Belgium); Depiereux, Sophie; Nadzialek, Stephanie [Research Unit in Organismal Biology (URBO), University of Namur (FUNDP), Namur (Belgium); Robbens, Johan; Blust, Ronny [Laboratory of Ecophysiology, Biochemistry and Toxicology, University of Antwerp, Antwerp (Belgium); Kestemont, Patrick [Research Unit in Organismal Biology (URBO), University of Namur (FUNDP), Namur (Belgium); De Coen, Wim [Laboratory of Ecophysiology, Biochemistry and Toxicology, University of Antwerp, Antwerp (Belgium); European Chemicals Agency (ECHA), Helsinki (Finland)

    2010-09-15

    In vitro estrogenicity screens are believed to provide a first prioritization step in hazard characterization of endocrine disrupting chemicals. When applied to complex environmental matrices or mixture samples, they have been indicated valuable in estimating the overall estrogen-mimicking load. In this study, the performance of an adapted format of the classical E-screen or MCF-7 cell proliferation assay was profoundly evaluated to rank pure compounds as well as influents and effluents of sewage treatment plants (STPs) according to estrogenic activity. In this adapted format, flow cytometric cell cycle analysis was used to allow evaluation of the MCF-7 cell proliferative effects after only 24 h of exposure. With an average EC{sub 50} value of 2 pM and CV of 22%, this assay appears as a sensitive and reproducible system for evaluation of estrogenic activity. Moreover, estrogenic responses of 17 pure compounds corresponded well, qualitatively and quantitatively, with other in vitro and in vivo estrogenicity screens, such as the classical E-screen (R{sup 2} = 0.98), the estrogen receptor (ER) binding (R{sup 2} = 0.84) and the ER transcription activation assay (R{sup 2} = 0.87). To evaluate the applicability of this assay for complex samples, influents and effluents of 10 STPs covering different treatment processes, were compared and ranked according to estrogenic removal efficiencies. Activated sludge treatment with phosphorus and nitrogen removal appeared most effective in eliminating estrogenic activity, followed by activated sludge, lagoon and filter bed. This is well in agreement with previous findings based on chemical analysis or biological activity screens. Moreover, ER blocking experiments indicated that cell proliferative responses were mainly ER mediated, illustrating that the complexity of the end point, cell proliferation, compared to other ER screens, does not hamper the interpretation of the results. Therefore, this study, among other E-screen studies

  18. Performance of the flow cytometric E-screen assay in screening estrogenicity of pure compounds and environmental samples

    International Nuclear Information System (INIS)

    Vanparys, Caroline; Depiereux, Sophie; Nadzialek, Stephanie; Robbens, Johan; Blust, Ronny; Kestemont, Patrick; De Coen, Wim

    2010-01-01

    In vitro estrogenicity screens are believed to provide a first prioritization step in hazard characterization of endocrine disrupting chemicals. When applied to complex environmental matrices or mixture samples, they have been indicated valuable in estimating the overall estrogen-mimicking load. In this study, the performance of an adapted format of the classical E-screen or MCF-7 cell proliferation assay was profoundly evaluated to rank pure compounds as well as influents and effluents of sewage treatment plants (STPs) according to estrogenic activity. In this adapted format, flow cytometric cell cycle analysis was used to allow evaluation of the MCF-7 cell proliferative effects after only 24 h of exposure. With an average EC 50 value of 2 pM and CV of 22%, this assay appears as a sensitive and reproducible system for evaluation of estrogenic activity. Moreover, estrogenic responses of 17 pure compounds corresponded well, qualitatively and quantitatively, with other in vitro and in vivo estrogenicity screens, such as the classical E-screen (R 2 = 0.98), the estrogen receptor (ER) binding (R 2 = 0.84) and the ER transcription activation assay (R 2 = 0.87). To evaluate the applicability of this assay for complex samples, influents and effluents of 10 STPs covering different treatment processes, were compared and ranked according to estrogenic removal efficiencies. Activated sludge treatment with phosphorus and nitrogen removal appeared most effective in eliminating estrogenic activity, followed by activated sludge, lagoon and filter bed. This is well in agreement with previous findings based on chemical analysis or biological activity screens. Moreover, ER blocking experiments indicated that cell proliferative responses were mainly ER mediated, illustrating that the complexity of the end point, cell proliferation, compared to other ER screens, does not hamper the interpretation of the results. Therefore, this study, among other E-screen studies, supports the use of

  19. Estimating cancer risks induced by CT screening for Korea population

    International Nuclear Information System (INIS)

    Yang, Hye Jeong; Yang, Won Seok

    2016-01-01

    Computed Tomography(CT) has been used to diagnose early stages of cancer and other diseases. Since the number of CT screening has been increasing, there is now a debate about the possible benefits and risks of CT screening on asymptomatic individuals. CT screening has definite benefits, however the radiation risk of screening an asymptomatic individual is a serious problem that cannot be overlooked. Despite its potential risks, CT screening for asymptomatic individual has been gradually increased in Korea and it is attributed to increase collective effective dose. Therefore, we reported the risk level of each organ which is included in scan field for CT screening and analyzed and then evaluated the risk level of Korean population comparison to others, Hong Kong, U.S. and U.K. populations. LARs are lower with older ages for all populations of both sexes. We recommend CT screening after the age of 40 because from that age, LAR decreases and the danger of top 5 cancer increases.

  20. Are screening processes effective instruments and what are the environmental benefits?

    DEFF Research Database (Denmark)

    Nielsen, Eskild Holm; Christensen, Per; Kørnøv, Lone

    2003-01-01

    Environmental Impact Assessment (EIA)is the process by which the effects that proposed projects are likely to have with respect to a number of environmental criteria is evaluated. Screening is an activity carried out in advance of an EIA to determine whether, in fact, it is necessary to undertake...... a full assessment.The paper discuss the extent of changes due to the screening process, and ask questions like what kind of environmental considerations do the changes reflect? And are they in line with EIA's holistic environmental approach?...

  1. Risk profile of breast cancer following atypical hyperplasia detected through organized screening.

    Science.gov (United States)

    Buckley, Elizabeth; Sullivan, Tom; Farshid, Gelareh; Hiller, Janet; Roder, David

    2015-06-01

    Few population-based data are available indicating the breast cancer risk following detection of atypia within a breast screening program. Prospectively collected data from the South Australian screening program were linked with the state cancer registry. Absolute and relative breast cancer risk estimates were calculated for ADH and ALH separately, and by age at diagnosis and time since diagnosis. Post-hoc analysis was undertaken of the effect of family history on breast cancer risk. Women with ADH and ALH had an increase in relative risk for malignancy (ADH HR 2.81 [95% CI 1.72, 4.59] and (ALH HR 4.14 [95% CI 1.97, 8.69], respectively. Differences in risk profile according to time since diagnosis and age at diagnosis were not statistically significant. Estimates of the relative risk of breast cancer are necessary to inform decisions regarding clinical management and/or treatment of women with ADH and ALH. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Elite athletes experiences with risk related to cardiac screening

    DEFF Research Database (Denmark)

    Christensen, Jonas Schmidt; Thing, Lone Friis

    Society of Cardiology as well as major sports federations such as the International Olympic Committee, however, these recommendations seem to be based on an inadequate empirical foundation, just as the costs of performing cardiac screening on a larger scale seem out of proportion. Additionally, the field...... perspective on risk (Foucault 1988). For most elite athletes participation in cardiac screening is done out of a wish to obtain an acquittal from risks. Symptomatic of the risk society cardiac screening can from an athlete perspective at the same time be seen as an attempt to gain control over......Elite Athletes experiences with risks related to Cardiac Screening Jonas Schmidt Christensen1, Lone Friis Thing1 1University of Copenhagen - Department of Nutrition, Exercise and Sports (NEXS), Cardiac screening of elite athletes are recommended by both the American Heart Association & the European...

  3. Disposable Screen Printed Electrochemical Sensors: Tools for Environmental Monitoring

    Directory of Open Access Journals (Sweden)

    Akhtar Hayat

    2014-06-01

    Full Text Available Screen printing technology is a widely used technique for the fabrication of electrochemical sensors. This methodology is likely to underpin the progressive drive towards miniaturized, sensitive and portable devices, and has already established its route from “lab-to-market” for a plethora of sensors. The application of these sensors for analysis of environmental samples has been the major focus of research in this field. As a consequence, this work will focus on recent important advances in the design and fabrication of disposable screen printed sensors for the electrochemical detection of environmental contaminants. Special emphasis is given on sensor fabrication methodology, operating details and performance characteristics for environmental applications.

  4. Anticipated and experienced emotions in environmental risk perception

    Directory of Open Access Journals (Sweden)

    Gisela Bohm

    2008-01-01

    Full Text Available Affective forecasting with respect to two environmental risks (ozone depletion, air pollution was investigated by studying tourists who travelled to either Australia or Bangkok and were thus confronted with one of these risks. We measured anticipated outcome and anticipated emotions before the journey, actually experienced outcome and actually experienced emotions during the journey, and anticipated outcome and emotions concerning a future encounter with the same risk after the journey. Results indicate that tourists underestimate (air pollution or correctly predict (ozone depletion both the seriousness of the outcome and their emotional reactions. The relationship between actual outcome and actual emotions is stronger than that between anticipated outcome and anticipated emotions. Furthermore, tourists learn from their travel experience and adjust their anticipations concerning future encounters with the environmental risk. Findings suggest that the domain of environmental risks differs from personal outcomes with respect to the process of affective forecasting.

  5. Evaluation of Discrimination Indices Validity for Screening of β-Thalassemia Trait

    Directory of Open Access Journals (Sweden)

    Ahmadi A.

    2009-11-01

    Full Text Available AbstractBackground and Objectives: β-thalassemia trait (β-TT and iron deficiency anemia (IDA are the most common forms of microcytic anemia. Screening of β-thalassemia trait is important for medical counseling before marriage and preventing β-thalassemia major birth results. The most common problem in screening -TT is differentiating it from IDA. The aim of this study was to define the sensitivity, specificity, and predictive values of some discrimination indices for screening of β-TT in a sample of such patients.Methods: A total of 82 patients with microcytic anemia (MCV< 80 fl were selected from Namazi Hospital, Shiraz, Iran, and 9 discrimination indices were calculated for them. The patients were divided intotwo groups: 42 patients with β-TT and 40 patients with IDA. The sensitivity, specificity, positive and negative predictive values and Youden,s index of each discrimination index were calculated for screening β-TT.Results: None of the discrimination indices showed 100% of sensitivity and specificity. But the Shin and Lal index, RDW index and RBC count showed the highest and valuable value for screening β-TT.Conclusion: Some discrimination indices like Shin and Lal index, RDW index and RBC index are valuable indices in screening β-TT.Keywords: Beta- Thalassemia; Anemia, Iron Deficiency.

  6. Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk.

    Science.gov (United States)

    Grimm, Lars J; Saha, Ashirbani; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Yoon, Sora C; Mazurowski, Maciej A

    2018-03-27

    To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts. Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3-4.8, P = .005). There was fair interreader agreement (κ = 0.39). High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  7. Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation

    NARCIS (Netherlands)

    van Dongen, A.J.; Kremer, J.A.M.; Sluisveld, P.H. van; Verhaak, C.M.; Nelen, W.L.D.M.

    2012-01-01

    STUDY QUESTION: Is patient screening for emotional risk factors before starting IVF treatment feasible? SUMMARY ANSWER: Introduction of screening for emotional risk factors by a validated instrument (SCREENIVF) in couples treated by IVF or ICSI is feasible, indicated by a moderate to high and stable

  8. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    Directory of Open Access Journals (Sweden)

    Lauren Zeise

    2012-08-01

    Full Text Available Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure.

  9. Environmental Indicators in the Newspaper Industry

    Directory of Open Access Journals (Sweden)

    Maria Enroth

    2003-12-01

    Full Text Available Environmental indicators promote the eco-efficient development of companies, as demonstrated in earlier study. This study builds on a previously developed model and inventory tools for industryspecific environmental indicators for the graphic arts industry. This study is based on case studies from 14 newspaper companies with experience of the use of these industry-specific environmental indicators in actual production.This paper presents data on industry-specific environmental indicators for the newspaper industry. The data describes the average situation and the range of values for the indicators in 14 environmentally aware newspaper companies in Sweden in 2001. The data is also grouped so as to illustrate average values for various classes:Newspaper companies with printing facilities.Newspaper companies with no printing facilities.Newspaper printing companies.In addition, a preliminary comparison has been carried out using equivalent data for the commercial printing industry.The indicators calculated for each specific company, together with average values for these indicators, have been used to identify areas for action for the various companies and to formulate action plans. The aim of this is to promote more eco-efficient activities. The study also summarizes measures already implemented at the various companies.The use of indicators within these companies has been linked with the current and predicted future eed to communicate environmental issues. Financial and social aspects have been considered to a limited extent in the study in order to put forward the concept of sustainable development in the newspaper industry in Sweden.

  10. Environmental risk of oil spills in Northern Areas[Pollution abatement in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Hoell, Espen

    2006-07-01

    The presentation discusses consequences and risks for the environment of oil spills and other pollution factors in the northern areas particularly in the north of Norway and the Barents Sea. Various environmental risk analysis are also discussed. The main conclusions are: Environmental risk for Obelix: The environmental risk is very low. The environmental risk for Obelix is less than 21% of Hydro's acceptance criteria for minor damage. The environmental risk is acceptable. DNV: The contingency planned for Obelix (barrier 1 and 2) will reduce the environmental risk further by approx. 60%, date: 2006-01-13. Question: Hydro Oil and Energy. Does the oil industry reach other conclusions than the national research institutes does for the Management Plan of the Barents Sea. The underlying studies (of the management plan) mainly consider the consequences of worst case events. Full rate (3000 m3/d), long duration (60 days). Blowout occurring at the worst time and place. They assume that consequences experienced by shipwreck accidents in the coastal zone are relevant also for offshore discharges. They do not consider: The probability for the worst case blowout to occur. The probability for the worst case consequences to be realized. The probability for less serious impact. The probable impact distribution. Overall conclusion: Environmental Risk of oil and gas activities in Lofoten and the Barents Sea Based on: 1) 40 years of experience in the Norwegian sector. 2) World leading risk reduction technology. 3) Systematic and thorough methods for analysis of environmental risk. 4) Several environmental risk analyses for Barents Sea and Lofoten drilling operations, indicating acceptable risk levels. 5) Recent ERA for Goliath drilling indicating similar low risk levels. 6) Well functioning contingency systems. We conclude that the environmental risk of oil and gas activities in the northern areas is low and acceptable to the Norwegian society. The environmental risk due to oil

  11. Assessing the risk of pesticide environmental impact in several Argentinian cropping systems with a fuzzy expert indicator.

    Science.gov (United States)

    Arregui, María C; Sánchez, Daniel; Althaus, Rafael; Scotta, Roberto R; Bertolaccini, Isabel

    2010-07-01

    The introduction of transgenic soybean (Glycine max, L.) varieties resistant to glyphosate (GR soybeans) has rapidly expanded in Argentina, increasing pesticide use where only grasslands were previously cultivated. The authors compared an estimate of environmental risk for different crops and active ingredients using the IPEST index, which is based on a fuzzy-logic expert system. For IPEST calculations, four modules are defined, one reflecting the rate of application, the other three reflecting the risk for groundwater, surface water and air. The input variables are pesticide properties, site-specific conditions and characteristics of the pesticide application. The expert system calculates the value of modules according to the degree of membership of the input variables to the fuzzy subsets F (favourable) and U (unfavourable), and they can be aggregated following sets of decision rules. IPEST integrated values of >or= 7 reflect low environmental risk, and values of environmental contamination, and they are mainly used in maize. Groundwater was the most affected compartment. Fuzzy logic provided an easy tool combining different environmental components with pesticide properties to give a simple and accessible risk assessment. These findings provide information about active ingredients that should be replaced in order to protect water and air from pesticide contamination. Copyright (c) 2010 Society of Chemical Industry.

  12. Development of a screening tool for detecting undernutrition and dietary inadequacy among rural elderly in Malaysia: simple indices to identify individuals at high risk.

    Science.gov (United States)

    Shahar, S; Dixon, R A; Earland, J

    1999-11-01

    Undernutrition and the consumption of poor diets are prevalent among elderly people in developing countries. Recognising the importance of the early identification of individuals at high nutritional risk, this study aimed to develop a simple tool for screening. A cross-sectional study was conducted on 11 randomly selected villages among the 62 in Mersing District, Malaysia. Undernutrition was assessed using body mass index, plasma albumin and haemoglobin on 285 subjects. Dietary inadequacy (a count of nutrients falling below two-thirds of the Recommended Dietary Allowances) was examined for 337 subjects. Logistic regression analysis was performed to identify significant predictors of undernutrition and dietary inadequacy from social and health factors, and to derive appropriate indices based on these predictions. The multivariate predictors of undernutrition were 'no joint disease', 'smoker', 'no hypertension', 'depended on others for economic resource', 'respiratory disease', 'perceived weight loss' and 'chewing difficulty', with a joint sensitivity of 56% and specificity of 84%. The equivalent predictors of dietary inadequacy were 'unable to take public transport', 'loss of appetite', 'chewing difficulty', 'no regular fruit intake' and 'regularly taking less than three meals per day', with a joint sensitivity of 77% and specificity of 47%. These predictions, with minor modification to simplify operational use, led to the production of a simple screening tool. The tool can be used by public health professionals or community workers or leaders as a simple and rapid instrument to screen individual at high risk of undernutrition and/or dietary inadequacy.

  13. Environmental health research in Japan - management of environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masahisa [Lake Biwa Research Institute (Japan)

    1997-12-31

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management.

  14. Environmental health research in Japan - management of environmental risks

    International Nuclear Information System (INIS)

    Masahisa Nakamura

    1996-01-01

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management

  15. Screening mammography. A risk versus risk decision

    International Nuclear Information System (INIS)

    Ritenour, E.R.; Hendee, W.R.

    1989-01-01

    The potential risk of a radiologic procedure often is compared with the potential benefit of the procedure. While risk vs. benefit analysis has been useful as a step toward increased communication and understanding among radiologists, referring physicians, and the general public, it has the disadvantage that risk and benefit are fundamentally different quantities. Hence, their juxtaposition for purposes of comparison presents contextual difficulties. In this article, the concept is presented of comparing the risk of doing a procedure with the risk of choosing not to do the procedure. An example of risk vs. risk analysis of screening mammography for women over the age of 50 is given, with the conclusion that the risk of having yearly mammograms is less than 1/10 the risk of early death caused by failure to diagnose breast cancer by x-ray mammography. This approach to risk analysis would yield interesting data for examinations that are part of more complicated diagnostic pathways.19 references

  16. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA.

    Directory of Open Access Journals (Sweden)

    Virginia R Roth

    Full Text Available The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission.The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted.The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76.This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions.

  17. Environmental health risk assessment: Energy systems

    International Nuclear Information System (INIS)

    Krewski, D.; Somers, E.; Winthrop, S.O.

    1984-01-01

    Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

  18. 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

  19. A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants.

    Science.gov (United States)

    Park, Elyse R; Streck, Joanna M; Gareen, Ilana F; Ostroff, Jamie S; Hyland, Kelly A; Rigotti, Nancy A; Pajolek, Hannah; Nichter, Mark

    2014-02-01

    The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers' risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1-2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants' heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.

  20. A framework for techno-economic & environmental sustainability analysis by risk assessment for conceptual process evaluation

    DEFF Research Database (Denmark)

    Loureiro da Costa Lira Gargalo, Carina; Sin, Gürkan; Carvalho, Ana

    2016-01-01

    for techno-economic and environmental sustainability analysis through risk assessment is proposed for the early-stage design and screening of conceptual process alternatives. The alternatives within the design space are analyzed following the framework’s work-flow, which targets the following: (i) quantify...... the economic risk; (ii) perform the monetary valuation of environmental impact categories under uncertainty; (iii) quantify the potential environmental risk; (iv) measure the alternatives’ eco-efficiency identifying possible trade-offs; and, lastly (v) propose a joint risk assessment matrix......The need to achieve a sustainable process performance has become increasingly important in order to keep a competitive advantage in the global markets. Development of comprehensive and systematic methods to accomplish this goal is the subject of this work. To this end, a multi-level framework...

  1. A framework for techno-economic & environmental sustainability analysis by risk assessment for conceptual process evaluation

    DEFF Research Database (Denmark)

    Loureiro da Costa Lira Gargalo, Carina; Sin, Gürkan; Carvalho, Ana

    2016-01-01

    the economic risk; (ii) perform the monetary valuation of environmental impact categories under uncertainty; (iii) quantify the potential environmental risk; (iv) measure the alternatives’ eco-efficiency identifying possible trade-offs; and, lastly (v) propose a joint risk assessment matrix......The need to achieve a sustainable process performance has become increasingly important in order to keep a competitive advantage in the global markets. Development of comprehensive and systematic methods to accomplish this goal is the subject of this work. To this end, a multi-level framework...... for techno-economic and environmental sustainability analysis through risk assessment is proposed for the early-stage design and screening of conceptual process alternatives. The alternatives within the design space are analyzed following the framework’s work-flow, which targets the following: (i) quantify...

  2. EJSCREEN Environmental Indicators 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The eight EJ Index names are: Particulate Matter (PM2.5), Ozone Traffic Proximity...

  3. Radiation indicator options for environmental policy

    CERN Document Server

    Pruppers, M J M

    2002-01-01

    It has proven impossible to create an indicator capable of showing the state of the art in a single figure so as to determine the progress made in the 'radiation component' of environmental policy from the trends indicated. This is the conclusion following an investigation requested by the Ministry of Housing, Spatial Planning and the Environment in the framework of the environmental theme 'dispersion of radioactive substances and ionising radiation' to develop a radiation indicator comparable to the indicators for proprietary substances and pesticides. The most important reasons for failing to develop this indicator lie in the absence of both suitable policy targets and data for the calculations necessary for the indicator. Substituting policy targets with reference emissions, reference concentrations and reference doses would make it possible to define indicators for radiation protection. Here, environmental pressure indicators are proposed for nuclear installations and the process industry. The environment...

  4. [Study on risk assessing indicator system after schistosomiasis transmission interruption in Wuxi City].

    Science.gov (United States)

    Xiao-Jun, Meng; Sheng-Hua, Zong; Xuan, Zhang; Dong-Lin, Gao; Yan-Hua, Qian; Bing, Lu

    2017-07-27

    To establish a risk assessing indicator system after the transmission interruption of schistosomiasis in Wuxi City, so as to provide evidences for formulating strategies on schistosomiasis control and prevention. A primary risk assessing indicator system was established based on the literature review. Alternative indicators were scored and screened to establish a final indicator system through two rounds of Delphy method and the related normalized weights and combined weights were also calculated. The risk assessing indicator system was established through two rounds of expert consultation including 3 first grade indicators and 15 second grade indicators. Among the first grade indicators, the normalized weights of natural environment, key populations and social environment were 0.370 6, 0.292 9 and 0.336 5, respectively. Among the second grade indicators, the migrant population accounted for the highest combined weight of 0.125 2 compared to domestic animal of 0.037 1. The authority degree among the first grade indicators was between 0.91 and 0.93, while the authority degree among the second grade indicators was between 0.79 and 0.92. The scientific and authoritative risk assessing indicator system after the transmission interruption of schistosomiasis is established, which provides the evidences for risk assessment on schistosomiasis transmission in Wuxi City.

  5. EJSCREEN Environmental Indicators 2016 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are: Particulate Matter (PM2.5), Ozone, NATA Diesel PM, NATA...

  6. School-Based Screening to Identify At-Risk Students Not Already Known to School Professionals: The Columbia Suicide Screen

    Science.gov (United States)

    Wilcox, Holly C.; Schonfeld, Irvin Sam; Davies, Mark; Hicks, Roger C.; Turner, J. Blake; Shaffer, David

    2009-01-01

    Objectives. We sought to determine the degree of overlap between students identified through school-based suicide screening and those thought to be at risk by school administrative and clinical professionals. Methods. Students from 7 high schools in the New York metropolitan area completed the Columbia Suicide Screen; 489 of the 1729 students screened had positive results. The clinical status of 641 students (73% of those who had screened positive and 23% of those who had screened negative) was assessed with modules from the Diagnostic Interview Schedule for Children. School professionals nominated by their principal and unaware of students' screening and diagnostic status were asked to indicate whether they were concerned about the emotional well-being of each participating student. Results. Approximately 34% of students with significant mental health problems were identified only through screening, 13.0% were identified only by school professionals, 34.9% were identified both through screening and by school professionals, and 18.3% were identified neither through screening nor by school professionals. The corresponding percentages among students without mental health problems were 9.1%, 24.0%, 5.5%, and 61.3%. Conclusions. School-based screening can identify suicidal and emotionally troubled students not recognized by school professionals. PMID:19059865

  7. Raised by Depressed Parents: Is it an Environmental Risk?

    Science.gov (United States)

    Natsuaki, Misaki N.; Shaw, Daniel S.; Neiderhiser, Jenae M.; Ganiban, M. Jody; Gordon, T. Harold; Reiss, David; Leve, Leslie D.

    2014-01-01

    The mechanisms explaining how parental depression compromises healthy child development are complex and multifaceted, with genetic and environmental pathways intertwined. Reexamination of whether and how maternal and paternal depression serve as environmental risk factors is important because such an investigation can be helpful to identify modifiable mechanisms that are accessible to interventions. We review studies that have employed designs that isolate the effects of the environment from genetic influences, including adoption studies and children of twins studies. Findings indicate that maternal depression is an environmental risk factor for the emotional, behavioral, and neurobiological development of children. Although more studies are needed, preliminary findings suggest that paternal depression appears to be a weaker environmental risk as compared to maternal depression, at least during infancy and toddlerhood. Implications for theory and future research are discussed. PMID:24817170

  8. Risk-benefit analysis of 18FDG PET cancer screening

    International Nuclear Information System (INIS)

    Murano, Takeshi; Daisaki, Hiromitsu; Terauchi, Takashi; Iinuma, Takeshi; Tateno, Yukio; Tateishi, Ukihide; Kato, Kazuaki; Inoue, Tomio

    2008-01-01

    The benefits of 18 F-fluorodeoxyglucose ( 18 FDG) positron emission tomography (PET) cancer screening are expected to include a large population of examinees and are intended for a healthy group. Therefore, we attempted to determine the benefit/risk ratio, estimated risk of radiation exposure, and benefit of cancer detection. We used software that embodied the method of the International Commission on Radiological Protection (ICRP) to calculate the average duration of life of radiation exposure. We calculated the lifesaving person years of benefit to be obtained by 18 FDG PET cancer screening detection. We also calculated the benefit/risk ratio using life-shortening and lifesaving person years. According to age, the benefit/risk ratio was more than 1 at 35-39 years old for males and 30-34 years old for females. 18 FDG PET cancer screening also is effective for examinees older than this. A risk-benefit analysis of 18 FDG-PET/computed tomography (CT) cancer screening will be necessary in the future. (author)

  9. SCREENING OF ENVIRONMENTAL IMPACT OF POLLUTION WITH THE QGIS PLUGIN ENVIFATE

    Directory of Open Access Journals (Sweden)

    F. Geri

    2017-07-01

    Full Text Available Public and academic interest in environmental pollution caused by toxic substances and other sources, like noise, is constantly raising. To protect public health and ecosystems it is necessary to maintain the concentrations of pollutants below a safety threshold. In this context the development of models able to assess environmental pollution impact has been identified as a priority for future research. Scientific community has therefore produced many predictive models in the field. The vast majority of them needs to be run by specialists with a deep technical knowledge of the modeled phenomena in order to process the data and understand the results and it is not feasible to use this models for simple prescreening activities. Planners, evaluators and technical operators need reliable, usable and simple tools in order to carry out screening analysis of impact assessment. The ENVIFATE software is currently under development by the Department of Civil, environmental and mechanical engineering of the University of Trento, Italy, in the frame of a project funded by the Italian Veneto Region with the aim to make available to nonspecialists screening analysis to assess the risks of a set of possible environmental pollution sources in protected areas. The development of ENVIFATE follows these basic requirements: i Open-Source ii multiplatform iii user friendly iv GIS oriented. In order to respect these principles we have chosen to develop a plugin of QGIS, using python as a development language and creating a module for each environmental compartment analyzed: rivers, lakes, atmospheric dispersion, dispersion in groundwater and noise. The plugin architecture is composed of a series of core functions characterized by command line interfaces that can be called from third-party applications (such as Grass GIS, connectable in custom data flows and with a high level of modularity and scalability. The base of the different models are highly tested and

  10. Observational methods to assess the effectiveness of screening colonoscopy in reducing right colon cancer mortality risk: SCOLAR.

    Science.gov (United States)

    Goodman, Michael; Fletcher, Robert H; Doria-Rose, V Paul; Jensen, Christopher D; Zebrowski, Alexis M; Becerra, Tracy A; Quinn, Virginia P; Zauber, Ann G; Corley, Douglas A; Doubeni, Chyke A

    2015-11-01

    Screening colonoscopy's effectiveness in reducing risk of death from right colon cancers remains unclear. Methodological challenges of existing observational studies addressing this issue motivated the design of 'Effectiveness of Screening for Colorectal Cancer in Average-Risk Adults (SCOLAR)'. SCOLAR is a nested case-control study based on two large integrated health systems. This affords access to a large, well-defined historical cohort linked to integrated data on cancer outcomes, patient eligibility, test indications and important confounders. We found electronic data adequate for excluding ineligible patients (except family history), but not the detailed information needed for test indication assignment. The lessons of SCOLAR's design and implementation may be useful for future studies seeking to evaluate the effectiveness of screening tests in community settings.

  11. Autism – environmental risk

    Directory of Open Access Journals (Sweden)

    Henryka Langauer-Lewowicka 1

    2016-06-01

    Full Text Available The incidence of infantile autism due to developmental brain disorders has been permanently increasing in many parts of the world. Autism is characterized by impairments of communication and reciprocal social interaction and by restricted repetitive behaviours or interests. The causes of these disorders are not yet known. Experimental studies and clinical observation suggest that genetic and environmental factors could converge to result in neurotoxic mechanisms. These may lead to the development of autistic spectrum disorders (ASD. Several recent studies have indicated that perinatal exposure to environmental toxins may be the risk factor for ASD, among them: polybrominated diphenyl, esters, phthalates, bisphenol A, tetrabrombisphenol A, solvents, pesticides, and heavy metals. They can easily pass the placental and blood brain barriers and affect brain development.

  12. 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...

  13. Screening and prioritisation of chemical risks from metal mining operations, identifying exposure media of concern.

    Science.gov (United States)

    Pan, Jilang; Oates, Christopher J; Ihlenfeld, Christian; Plant, Jane A; Voulvoulis, Nikolaos

    2010-04-01

    Metals have been central to the development of human civilisation from the Bronze Age to modern times, although in the past, metal mining and smelting have been the cause of serious environmental pollution with the potential to harm human health. Despite problems from artisanal mining in some developing countries, modern mining to Western standards now uses the best available mining technology combined with environmental monitoring, mitigation and remediation measures to limit emissions to the environment. This paper develops risk screening and prioritisation methods previously used for contaminated land on military and civilian sites and engineering systems for the analysis and prioritisation of chemical risks from modern metal mining operations. It uses hierarchical holographic modelling and multi-criteria decision making to analyse and prioritise the risks from potentially hazardous inorganic chemical substances released by mining operations. A case study of an active platinum group metals mine in South Africa is used to demonstrate the potential of the method. This risk-based methodology for identifying, filtering and ranking mining-related environmental and human health risks can be used to identify exposure media of greatest concern to inform risk management. It also provides a practical decision-making tool for mine acquisition and helps to communicate risk to all members of mining operation teams.

  14. Colorectal Cancer Screening Programme in Spain: Results of Key Performance Indicators After Five Rounds (2000-2012).

    Science.gov (United States)

    Binefa, Gemma; Garcia, Montse; Milà, Núria; Fernández, Esteve; Rodríguez-Moranta, Francisco; Gonzalo, Núria; Benito, Llúcia; Clopés, Ana; Guardiola, Jordi; Moreno, Víctor

    2016-01-20

    Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000-2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.

  15. The Center for Environmental Technology Innovative Technology Screening Process

    International Nuclear Information System (INIS)

    Bertrand, C.M.

    1995-02-01

    The Center for Environmental Technology's (CET) mission is to provide a fully integrated system for accelerated evaluation, development, commercialization, and public acceptance of creative environmental solutions which match the foremost demands in today's environmentally sensitive world. In short, CET will create a means to provide quick, effective solutions for environmental needs. To meet this mission objective, CET has created a unique and innovative approach to eliminating the usual barriers in developing and testing environmental technologies. The approach paves the way for these emerging, cutting-edge technologies by coordinating environmental restoration and waste management activities of industry, universities, and the government to: efficiently and effectively transfer technology to these users, provide market-driven, cost-effective technology programs to the public and DOE, and aid in developing innovative ideas by initiating efforts between DOE facilities and private industry. The central part to this mission is selecting and evaluating specific innovative technologies for demonstration and application at United States Department of Energy (DOE) installations. The methodology and criteria used for this selection, which is called the CET Innovative Technology Screening Process, is the subject of this paper. The selection criteria used for the screening process were modeled after other DOE technology transfer programs and were further developed by CET's Technology Screening and Evaluation Board (TSEB). The process benefits both CET and the proposing vendors by providing objective selection procedures based on predefined criteria. The selection process ensures a rapid response to proposing vendors, all technologies will have the opportunity to enter the selection process, and all technologies are evaluated on the same scale and with identical criteria

  16. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

    Energy Technology Data Exchange (ETDEWEB)

    Barngkgei, Imad; Al Haffar, Iyad; Khattab, Razan [Faculty of Dentistry, Damascus University, Damascus (Syrian Arab Republic); Halboub, Esam; Almashraqi, Abeer Abdulkareem [Dept. of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan (Saudi Arabia)

    2016-09-15

    The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

  17. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices.

    Science.gov (United States)

    Barngkgei, Imad; Halboub, Esam; Almashraqi, Abeer Abdulkareem; Khattab, Razan; Al Haffar, Iyad

    2016-09-01

    The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

  18. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

    International Nuclear Information System (INIS)

    Barngkgei, Imad; Al Haffar, Iyad; Khattab, Razan; Halboub, Esam; Almashraqi, Abeer Abdulkareem

    2016-01-01

    The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices

  19. Environmental indicators for evaluating properties

    Directory of Open Access Journals (Sweden)

    Mario Grosso

    2015-06-01

    Full Text Available Property evaluation for tax purposes has traditionally relied on urban and building criteria, mostly resulting from concepts driven by the commercial attractiveness of the property under evaluation, its building and the site itself. Due to the world climate and ecological crisis, awareness has risen about the need for other indicators, which can evaluate the quality of a property, even referring to its potential environmental impact. Technical standards for the evaluation of buildings’ environmental sustainability, which have been developed since the first years of this century, both nationally and internationally, take into account the impact of the building and its relevance for the life-cycle of materials and elements, with reference to the three sectors of sustainability: environmental, economic and social. The social sector includes indicators referring to the user’s health and comfort, which also interact with the morphological and spatial characteristics of the building. However, there is a lack of methodological tools for the evaluation of said indicators and existing ones are mainly of a qualitative type. This paper suggests a methodological approach for the quantitative evaluation of sustainability indicators, relying on the accessibility of a site’s climate resources by the property, as a criterion to evaluate the potential for the reduction of negative environmental impact, as well as a criterion to improve users’ life quality.

  20. Functional Movement Screen: Pain versus composite score and injury risk.

    Science.gov (United States)

    Alemany, Joseph A; Bushman, Timothy T; Grier, Tyson; Anderson, Morgan K; Canham-Chervak, Michelle; North, William J; Jones, Bruce H

    2017-11-01

    The Functional Movement Screen (FMS™) has been used as a screening tool to determine musculoskeletal injury risk using composite scores based on movement quality and/or pain. However, no direct comparisons between movement quality and pain have been quantified. Retrospective injury data analysis. Male Soldiers (n=2154, 25.0±1.3years; 26.2±.7kg/m 2 ) completed the FMS (scored from 0 points (pain) to 3 points (no pain and perfect movement quality)) with injury data over the following six months. The FMS is seven movements. Injury data were collected six months after FMS completion. Sensitivity, specificity, receiver operator characteristics and positive and negative predictive values were calculated for pain occurrence and low (≤14 points) composite score. Risk, risk ratios (RR) and 95% confidence intervals were calculated for injury risk. Pain was associated with slightly higher injury risk (RR=1.62) than a composite score of ≤14 points (RR=1.58). When comparing injury risk between those who scored a 1, 2 or 3 on each individual movement, no differences were found (except deep squat). However, Soldiers who experienced pain on any movement had a greater injury risk than those who scored 3 points for that movement (pmovements in which pain occurrence increased, so did injury risk (p<0.01). Pain occurrence may be a stronger indicator of injury risk than a low composite score and provides a simpler method of evaluating injury risk compared to the full FMS. Published by Elsevier Ltd.

  1. Scope of environmental risk management

    Energy Technology Data Exchange (ETDEWEB)

    O' Riordan, T

    1979-01-01

    Environmental risk management embraces three techniques for project appraisal: cost/benefit analysis, environmental impact analysis and risk assessment. It also explicitly relates scientific investigations to political judgments, sometimes so closely that the two cannot be separated. Indeed it is now apparent that environmental risk management encompasses procedures both to review the relative merits and priorities of policies as well as to appraise the environmental risks of particular schemes. Until recently this relationship has not been fully appreciated, so much imagination and innovation is still required to develop the most-suitable mechanisms for review.

  2. Acceptable Risk Analysis for Abrupt Environmental Pollution Accidents in Zhangjiakou City, China.

    Science.gov (United States)

    Du, Xi; Zhang, Zhijiao; Dong, Lei; Liu, Jing; Borthwick, Alistair G L; Liu, Renzhi

    2017-04-20

    Abrupt environmental pollution accidents cause considerable damage worldwide to the ecological environment, human health, and property. The concept of acceptable risk aims to answer whether or not a given environmental pollution risk exceeds a societally determined criterion. This paper presents a case study on acceptable environmental pollution risk conducted through a questionnaire survey carried out between August and October 2014 in five representative districts and two counties of Zhangjiakou City, Hebei Province, China. Here, environmental risk primarily arises from accidental water pollution, accidental air pollution, and tailings dam failure. Based on 870 valid questionnaires, demographic and regional differences in public attitudes towards abrupt environmental pollution risks were analyzed, and risk acceptance impact factors determined. The results showed females, people between 21-40 years of age, people with higher levels of education, public servants, and people with higher income had lower risk tolerance. People with lower perceived risk, low-level risk knowledge, high-level familiarity and satisfaction with environmental management, and without experience of environmental accidents had higher risk tolerance. Multiple logistic regression analysis indicated that public satisfaction with environmental management was the most significant factor in risk acceptance, followed by perceived risk of abrupt air pollution, occupation, perceived risk of tailings dam failure, and sex. These findings should be helpful to local decision-makers concerned with environmental risk management (e.g., selecting target groups for effective risk communication) in the context of abrupt environmental accidents.

  3. Risk indices in comparative risk assessment studies

    International Nuclear Information System (INIS)

    Hubert, P.

    1984-01-01

    More than a decade ago the development of comparative risk assessment studies aroused overwhelming interest. There was no doubt that data on the health and safety aspects of energy systems would greatly benefit, or even end, the debate on nuclear energy. Although such attempts are still strongly supported, the rose-coloured expectations of the early days have faded. The high uncertainties, and the contradictory aspect, of the first results might explain this evolution. The loose connection between the range of computed risk indices and the questions on which the debate was focused is another reason for this decline in interest. Important research work is being carried out aiming at reducing the different kinds of uncertainties. Rather than the uncertainties, the paper considers the meaning of available risk indices and proposes more significant indices with respect to the goals of risk assessment. First, the indices which are of frequent use in comparative studies are listed. The stress is put on a French comparative study from which most examples are drawn. Secondly, the increase in magnitude of the indices and the decrease in the attributability of the risk to a given system is shown to be a consequence of the trend towards more comprehensive analyses. Thirdly, the ambiguity of such indices as the collective occupational risk is underlined, and a possible solution is suggested. Whenever risk assessments are related to pragmatic decision making problems it is possible to find satisfactory risk indices. The development of cost-effectiveness analyses and the proposals for quantitative safety goals clearly demonstrate this point. In the field of comparison of social impacts some proposals are made, but there remain some gaps still to be filled. (author)

  4. Cost-effectiveness and radiation risk of breast cancer screening

    International Nuclear Information System (INIS)

    Rombach, J.J.

    1987-01-01

    Base cost effectiveness risk associated with radiological screening for tuberculosis and lung tumor the Government of Netherlands advised against mass screening. However, mass screening remains an important method in the case of breast cancer

  5. Reevaluation of benefit and risk of mass screening for stomach cancer

    International Nuclear Information System (INIS)

    Iinuma, Takeshi; Tateno, Yukio

    1990-01-01

    Mass screening for stomach cancer has been performed widely because of the the most prevalent malignancy in Japan. Since X-ray diagnosis is used in stomach cancer screening, the risk of X-ray exposure must be considered by comparing the benefit of mass screening. We have reported in the previous article in 1977 that the benefit and risk of stomach cancer mass screening become equal at the age of 40 yr. Since then, various conditions of the mass screening for stomach cancer have changed so that reevaluation of the benefit and risk relationship is necessary. The risk coefficient of radiation-induced stomach cancer has been revised drastically in the report of United Nations Scientific Committee on the effects of radiation in 1988. In this report, the benefit of mass screening of stomach cancer is defined as the net elongation of average life expectancy due to the life saved, and the risk of the screening is defined as the net shortage of average life expectancy due to the radiation-induced stomach cancer and leukemia. Since the benefit increases rapidly and the risk decreases with age, an appropriate age when the benefit and risk become identical is required, and under this age the mass screening is not justified to be performed. Assuming X-ray dose equivalent to stomach of 10 mSv and risk coefficient of stomach cancer of 12.6x10 -3 Sv -1 from the United Nations report, the critical age is found to be about 35 yr. for men and women. It is strongly recommended that the dose equivalent should be lowered less than 5 mSv. In a calculation of the risk of endoscopic examination in mass screening using reported figures of fatal accident (1.6x10 -5 ) and severe injury (48x10 -5 ) of the stomach endoscopic examination, the critical ages are found to be 40 yr for men and 45 yr for women which are higher than those with X-rays. A screening test using stomach endoscopy cannot be accepted. (J.P.N.)

  6. Development of a high risk pancreatic screening clinic using 3.0 T MRI.

    Science.gov (United States)

    Barnes, Chad A; Krzywda, Elizabeth; Lahiff, Shannon; McDowell, Dena; Christians, Kathleen K; Knechtges, Paul; Tolat, Parag; Hohenwalter, Mark; Dua, Kulwinder; Khan, Abdul H; Evans, Douglas B; Geurts, Jennifer; Tsai, Susan

    2018-01-01

    Selective screening for pancreatic cancer (PC) has been proposed. We describe the establishment of a comprehensive multidisciplinary screening program using 3.0 T MRI. Criteria for screening included the presence of PC in: ≥ 2 first degree relatives (FDR), 1 FDR and 1 s degree relative (SDR), ≥ 3 any degree relatives (ADR), or any known hereditary cancer syndrome with increased PC risk. Imaging with 3.0 T MRI was performed routinely and endoscopic ultrasound was used selectively. Screening was completed in 75 patients (pts). Hereditary cancer syndromes were present in 42 (56%) of the 75 pts: BRCA2 (18), ATM (8), BRCA1 (6), CDKN2A (4), PALB2 (3), Lynch (2), and Peutz-Jeghers (1). A family history of PC was present in ≥ 2 FDR in 12 (16%) pts, 1 FDR and 1 SDR in 5 (7) pts, and ≥ 3 ADR in 16 (21%) pts. Of the 65 pts who received screening MRI, 28 (43%) pts had pancreatic cystic lesions identified, including 1 (1%) patient in whom a cholangiocarcinoma was diagnosed as well. No patient underwent surgical resection. Using a 3.0 T MRI to screen patients at high risk for developing PC identified radiographic abnormalities in 43% of patients, which were stable on subsequent surveillance. Specific guidelines for the frequency of surveillance and indications for surgery remain areas of active investigation as the global experience with high risk screening continues to mature.

  7. A quantitative screening-level approach to incorporate chemical exposure and risk into alternative assessment evaluations.

    Science.gov (United States)

    Arnold, Scott M; Greggs, Bill; Goyak, Katy O; Landenberger, Bryce D; Mason, Ann M; Howard, Brett; Zaleski, Rosemary T

    2017-11-01

    As the general public and retailers ask for disclosure of chemical ingredients in the marketplace, a number of hazard screening tools were developed to evaluate the so-called "greenness" of individual chemical ingredients and/or formulations. The majority of these tools focus only on hazard, often using chemical lists, ignoring the other part of the risk equation: exposure. Using a hazard-only focus can result in regrettable substitutions, changing 1 chemical ingredient for another that turns out to be more hazardous or shifts the toxicity burden to others. To minimize the incidents of regrettable substitutions, BizNGO describes "Common Principles" to frame a process for informed substitution. Two of these 6 principles are: "reduce hazard" and "minimize exposure." A number of frameworks have emerged to evaluate and assess alternatives. One framework developed by leading experts under the auspices of the US National Academy of Sciences recommended that hazard and exposure be specifically addressed in the same step when assessing candidate alternatives. For the alternative assessment community, this article serves as an informational resource for considering exposure in an alternatives assessment using elements of problem formulation; product identity, use, and composition; hazard analysis; exposure analysis; and risk characterization. These conceptual elements build on practices from government, academia, and industry and are exemplified through 2 hypothetical case studies demonstrating the questions asked and decisions faced in new product development. These 2 case studies-inhalation exposure to a generic paint product and environmental exposure to a shampoo rinsed down the drain-demonstrate the criteria, considerations, and methods required to combine exposure models addressing human health and environmental impacts to provide a screening level hazard and exposure (risk) analysis. This article informs practices for these elements within a comparative risk context

  8. Is mammography screening history a predictor of future breast cancer risk?

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini

    2015-01-01

    Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991......-2009) and Funen, Denmark (1993-2009), and linked to the respective cancer registries. We calculated cumulative hazard rates for breast cancer in women in cohorts defined by age at entry and number of negative screens for the maximum follow-up period in each screening centre. For all centres and cohorts...

  9. Lung Cancer Screening May Benefit Those at Highest Risk

    Science.gov (United States)

    People at the highest risk for lung cancer, based on a risk model, may be more likely to benefit from screening with low-dose CT, a new analysis suggests. The study authors believe the findings may better define who should undergo lung cancer screening, as this Cancer Currents blog post explains.

  10. Malnutrition risk questionnaire combined with body composition measurement in malnutrition screening in inflammatory bowel disease.

    Science.gov (United States)

    Csontos, Ágnes Anna; Molnár, Andrea; Piri, Zsolt; Pálfi, Erzsébet; Miheller, Pál

    2017-01-01

    The purpose of malnutrition screening is to predict the probability of a worse outcome due to nutritional factors. The Malnutrition Universal Screening Tool (MUST) can be used for screening in inflammatory bowel disease (IBD); however, it does not provide details about body composition. Our aim was to assess the body composition and combine this with the MUST method to screen risk of malnutrition and sarcopenia. A total of 173 IBD outpatients were enrolled in this cross-sectional study. The MUST scale indicated 21.4% of IBD patients to be at risk of malnutrition. A risk of sarcopenia was detected in 27.7%. However, one third of these patients were not considered to be at risk by their MUST score. Furthermore, Crohn's disease (CD) patients had a strongly unfavorable fat-free mass index (FFMI) value compared to ulcerative colitis (UC) patients, and these differences were significant among men (FFMI: 18.62 ± 2.16 vs 19.85 ± 2.22, p = 0.02, in CD and UC males, respectively). As sarcopenia is a relevant prognostic factor, the MUST method should be expanded to include body composition analysis to detect more IBD patients at risk of malnutrition and sarcopenia in order to start their nutritional therapy immediately.

  11. [Editorial] Environmental and occupational risk factors associated with different pathological conditions.

    Science.gov (United States)

    Signorelli, Salvatore Santo; Ferrante, Margherita

    2017-05-01

    A wide body of evidence indicates that environmental and occupational risk factors are associated with the development of pathological disorders. The pathogenic role of many environmental pollutants or occupational contaminants is already known and has been extensively investigated. However, the molecular mechanisms of action and the pathogenic effects of many substances remain unknown. Therefore, there is a need to better investigate the role of new environmental and occupational risk factors that may cause the development of several diseases.

  12. Environmental indicators for epidemiological studies on populations at risk after the Chernobyl accident

    International Nuclear Information System (INIS)

    Gheorghe, R.; Tulbure, R.; Barbu, R.; Dumitrescu, A.; Toro, L.; Gheorghe, D.; Ciupagea, F.; Galeriu, D.

    2006-01-01

    The dose is the basic information asked by the physician in the context of a dose effect analysis. Several studies ( in countries of former Soviet Union) on population health revealed an increase in the incidence of some diseases specific to radioactivity ( childhood thyroid cancer), which could be explained by the actual dose estimates. The present paper will focus on the assessment of the effect of 131 iodine contamination in Romania. In conclusion, deposition densities could be proportionally associated with the dose in dry deposition may be considered an adequate environmental indicator. The deposition-dose relationship in an area with a variable rainfall can only be inferred through a radioecological transfer model; such model should be able to translate the particularities of the deposition-dose relationship, and to take into account the dependence of foliar interception and retention on rainfall intensities. Even with these issues of deposition-dose relationship, the assessment of preliminary dose values from deposition patterns is financially quite effortless. Moreover, preliminary doses assessed from regional deposition patterns are very useful for detecting the possible health effects. Thus, the density of deposition should be a good environmental indicator. At the same time, we believe that in the monitoring programmes of the environmental factors much more attention should be given to the wet fraction of the deposition. (N.C.)

  13. Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

    Directory of Open Access Journals (Sweden)

    Suh Beomseok

    2012-11-01

    Full Text Available Abstract Background While knowledge and risk perception have been associated with screening for second primary cancer (SPC, there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected is associated with subsequent completion of all appropriate SPC screening in cancer survivors. Methods Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. Results Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33, after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. Conclusions The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

  14. Screening of Geomechanical Risks for Malaysian Development Field

    Directory of Open Access Journals (Sweden)

    Syed Najmuddin Syed Muhammad Syafiq

    2017-01-01

    Full Text Available Deeper drilling and exploitation of difficult reservoir is the new trend in oil and gas industry. Geomechanics study has, therefore, become a new requirement particularly for oil and gas field development. However, a complete geomechanics study is limited with the number of experts, time consuming and not a straightforward task. Therefore, there is an urgent need of a quick geomechanics screening criterion to be used as a standard guideline to evaluate the high level geomechanical risks and suitable analysis can be recommended for the identified development fields. The aim of this paper is to propose a screening criterion for geomechanical risks study based on four key parameters, drilling, depletion, injection and storage and sand production. The screening approach is designed based on Risk Assessment Matrix (RAM risk screening where the likelihood is based on a set of scores developed to specific questions. The consequence for each failure scenarios is assessed based on educated estimation of the impact towards people, asset, environment and reputation. Recommendations for geomechanical study are made based on the severity of each failure category on the RAM risk matrix. Fourteen development fields in offshore Peninsular Malaysia, offshore Sarawak and offshore Sabah are selected for the assessment. Based on results, fields in offshore Sarawak and Sabah have higher potential for geomechacnical issues mainly because of their geological settings and formation characteristics. A set of geomechanical study is proposed for each individual field for prudent management of potential geomechanics risk associated with the depletion and EOR injection scheme planned for the fields.

  15. Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

    Science.gov (United States)

    This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

  16. The ethics, the risks and the benefits of screening

    International Nuclear Information System (INIS)

    Miller, A.B.

    1989-01-01

    The ethical principles underlying screening are reviewed. It is concluded that the ethical requirements for the introduction of screening are stringent, and that screening should not be offered in the absence of unequivocal evidence of effectiveness except in a carefully conducted research study. Part of the reasons for this are the risks associated with screening, which extend beyond the risk of the test itself, to those associated with invitations for screening, false reassurance for false negatives, the diagnostic process and the problem of false positives, and the overtreatment of those with borderline abnormalities. Finally, the benefits expected from screening are considered, especially reduction in mortality from the disease, but also reduction in incidence if a precursor is detected by the test, less radical treatment for cases detected, reassurance for those who test true negative, and resource savings, though it has to be demonstrated that these exceed resource costs

  17. Association between risk factors and detection of cutaneous melanoma in the setting of a population-based skin cancer screening.

    Science.gov (United States)

    Hübner, Joachim; Waldmann, Annika; Eisemann, Nora; Noftz, Maria; Geller, Alan C; Weinstock, Martin A; Volkmer, Beate; Greinert, Rüdiger; Breitbart, Eckhard W; Katalinic, Alexander

    2017-07-07

    Early detection is considered to improve the prognosis of cutaneous melanoma. The value of population-based screening for melanoma, however, is still controversial. The aim of this study was to evaluate the predictive power of established risk factors in the setting of a population-based screening and to provide empirical evidence for potential risk stratifications. We reanalyzed data (including age, sex, risk factors, and screening results) of 354 635 participants in the Skin Cancer Research to provide Evidence for Effectiveness of Screening in Northern Germany project conducted in the German state of Schleswig-Holstein (2003-2004). In multivariable analysis, atypical nevi [odds ratio (OR): 17.4; 95% confidence interval (CI): 14.4-20.1], personal history of melanoma (OR: 5.3; 95% CI: 3.6-7.6), and multiple (≥40) common nevi (OR: 1.3; 95% CI: 1.1-1.6) were associated with an increased risk of melanoma detection. Family history and congenital nevi were not significantly associated with melanoma detection in the Skin Cancer Research to provide Evidence for Effectiveness of Screening in Northern Germany population. The effects of several risk-adapted screening strategies were evaluated. Hypothesizing a screening of individuals aged more than or equal to 35 years, irrespective of risk factors (age approach), the number needed to screen is 559 (95% CI: 514-612), whereas a screening of adults (aged ≥20) with at least one risk factor (risk approach) leads to an number needed to screen of 178 (95% CI: 163-196). Converted into one screen-detected melanoma, the number of missed melanomas is 0.15 (95% CI: 0.12-0.18) with the age approach and 0.22 (95% CI: 0.19-0.26) with the risk approach. The results indicate that focusing on individuals at high risk for melanoma may improve the cost-effectiveness and the benefit-to-harm balance of melanoma screening programs.

  18. 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

  19. 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

  20. Place attachment and natural environmental risk

    DEFF Research Database (Denmark)

    Bonaiuto, Marino; Alves, Susana; De Dominicis, Stefano

    2016-01-01

    Little is known about place attachment affecting natural environmental risk perception and coping. A systematic search of social science databases revealed 31 works (1996–2016) directly addressing place attachment in relation to different types of natural hazard risks (e.g., seismic, volcanic, etc.......). Across different contexts, the research shows: (a) positive and/or negative relationships between place attachment and natural environmental risk perception; (b) positive and/or negative relationships between place attachment and risk coping; and (c) mediating and moderating relationships. In particular......, results show that: (a) highly attached individuals perceive natural environmental risks but underestimate their potential effects; (b) highly attached individuals are unwilling to relocate when facing natural environmental risks and more likely to return to risky areas after a natural environmental...

  1. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these

  2. Risk of breast cancer after false-positive results in mammographic screening.

    Science.gov (United States)

    Román, Marta; Castells, Xavier; Hofvind, Solveig; von Euler-Chelpin, My

    2016-06-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level data from the population-based screening programs in Copenhagen and Funen in Denmark, Norway, and Spain. Overall, 150,383 screened women from Denmark (1991-2008), 612,138 from Norway (1996-2010), and 1,172,572 from Spain (1990-2006) were included. Poisson regression was used to estimate the relative risk (RR) of screen-detected cancer for women with false-positive versus negative results. We analyzed information from 1,935,093 women 50-69 years who underwent 6,094,515 screening exams. During an average 5.8 years of follow-up, 230,609 (11.9%) women received a false-positive result and 27,849 (1.4%) were diagnosed with screen-detected cancer. The adjusted RR of screen-detected cancer after a false-positive result was 2.01 (95% CI: 1.93-2.09). Women who tested false-positive at first screen had a RR of 1.86 (95% CI: 1.77-1.96), whereas those who tested false-positive at third screening had a RR of 2.42 (95% CI: 2.21-2.64). The RR of breast cancer at the screening test after the false-positive result was 3.95 (95% CI: 3.71-4.21), whereas it decreased to 1.25 (95% CI: 1.17-1.34) three or more screens after the false-positive result. Women with false-positive results had a twofold risk of screen-detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false-positive result. The increased risk should be considered when discussing stratified screening strategies. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  3. A multidisciplinary weight of evidence approach for environmental risk assessment at the Costa Concordia wreck: Integrative indices from Mussel Watch.

    Science.gov (United States)

    Regoli, Francesco; Pellegrini, David; Cicero, Anna Maria; Nigro, Marco; Benedetti, Maura; Gorbi, Stefania; Fattorini, Daniele; D'Errico, Giuseppe; Di Carlo, Marta; Nardi, Alessandro; Gaion, Andrea; Scuderi, Alice; Giuliani, Silvia; Romanelli, Giulia; Berto, Daniela; Trabucco, Benedetta; Guidi, Patrizia; Bernardeschi, Margherita; Scarcelli, Vittoria; Frenzilli, Giada

    2014-05-01

    A complex framework of chemical, biological and oceanographic activities was immediately activated after the Costa Concordia shipwreck, to assess possible contamination events and the environmental impact during both emergency and wreck removal operations. In the present paper, we describe the results obtained with caged mussels, Mytilus galloprovincialis, chosen as bioindicator organisms to detect variations of bioavailability and the early onset of molecular and cellular effects (biomarkers). Seven translocation experiments were carried out during the first year from the incident, with organisms deployed at 2 depths in 3 different sites. After 4-6 weeks, tissue concentrations were measured for the main classes of potentially released chemicals (trace metals, polycyclic aromatic hydrocarbons, volatile and aliphatic hydrocarbons, polychlorinated biphenyls, halogenated pesticides, organotin compounds, brominated flame retardants, anionic surfactants); a wide battery of biomarkers covered responses indicative of exposure, detoxification, oxidative stress, cell damage and genotoxic effects. Results excluded serious contamination events or a consistent increase of environmental pollution although some episodic spills with reversible effects were detected. Data were elaborated within a quantitative weight of evidence (WOE) model which provided synthetic hazard indices for each typology of data, before their overall integration in an environmental risk index, which generally ranged from slight to moderate. The proposed WOE model was confirmed a useful tool to summarize large datasets of complex data in integrative indices, and to simplify the interpretation for stakeholders and decision makers, thus supporting a more comprehensive process of "site-oriented" management decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. 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...

  5. Use of two indicators for the socio-environmental risk analysis of Northern Mexico under three climate change scenarios.

    Science.gov (United States)

    López-Santos, Armando; Martínez-Santiago, Santos

    The aims of this study were to (1) find critical areas susceptible to the degradation of natural resources according to local erosion rates and aridity levels, which were used as environmental quality indicators, and (2) identify areas of risk associated with the presence of natural hazards according to three climate change scenarios defined for Mexico. The focus was the municipality of Lerdo, Durango (25.166° to 25.783° N and 103.333° to 103.983° W), which has dry temperate and very dry climates (BSohw and BWhw). From the Global Circulation Models, downscaling techniques for the dynamic modeling of environmental processes using climate data, historical information, and three regionalized climate change scenarios were applied to determine the impacts from laminar wind erosion rates (LWER) and aridity indices (AI). From the historic period to scenario A2 (ScA2, 2010-2039), regarding greenhouse gas emissions, the LWER was predicted to reach 147.2 t ha -1  year -1 , representing a 0.5 m thickness over nearly 30 years and a change in the AI from 9.3 to 8.7. This trend represents an increase in drought for 70.8 % of the study area and could affect 90 % of the agricultural activities and approximately 80 % of the population living in the southeastern Lerdense territory.

  6. Delay in blood sampling for routine newborn screening is associated with increased risk of schizophrenia.

    Science.gov (United States)

    Nordentoft, Merete; Larsen, Janne Tidselbak; Pedersen, Carsten Bøcker; Sørensen, Holger Jelling; Hollegaard, Mads Villiam; Hougaard, David Michael; Mortensen, Preben Bo; Petersen, Liselotte

    2015-03-01

    The Danish Neonatal Screening Biobank, containing dried blood spot samples from all newborn in Denmark, is a unique source of data that can be utilized for analyses of genetic and environmental exposures related to schizophrenia and other mental disorders. In previous analyses, we have found that early and late blood sampling, compared to sampling at day 5, was associated with increased risk of schizophrenia. As delay in sampling of blood for neonatal screening cannot in itself influence the risk of schizophrenia, it must be seen as a proxy for unknown underlying causes responsible for this association. Therefore, we investigated whether the increased risk can be explained by other risk factors for schizophrenia. A case-control design was applied. A total of 846 cases with schizophrenia were selected from the Danish Psychiatric Case Register. One control was selected for each case, matched on sex and exact date of birth. Both early and late blood sampling was associated with increased risk for schizophrenia. Compared to blood sampling at day 5, sampling at days 0 to 4 after birth was associated with an incidence rate ratio (IRR) of 1.46 (95% CI 1.15-1.87) for development of schizophrenia, and sampling at days 6 to 9 and at days 10 to 53 was associated with an IRR of 1.5 (95% CI 1.13-1.98) and 3.00 (95% CI 1.59-5.67), respectively. After adjusting the estimates for place of birth, both parents' psychiatric illness, maternal and paternal age, parents' country of origin, child admission, and parental education and income, the estimates were slightly different. Thus, blood collection at 0-4days was associated with an IRR of 1.27 (95% CI 0.94-1.71), 6-9days 1.31 (95% CI 0.94-1.84) and 10+days 3.52 (95% CI 1.50 to 8.24). After adjusting risk estimates for well-known risk factors, delay in sampling of blood for neonatal screening was associated with unexplained increased risk of schizophrenia. Thus, a key finding is that age at test is a proxy for unobserved risk factors

  7. A time-motion study of cardiovascular disease risk factor screening integrated into HIV clinic visits in Swaziland.

    Science.gov (United States)

    Palma, Anton M; Rabkin, Miriam; Simelane, Samkelo; Gachuhi, Averie B; McNairy, Margaret L; Nuwagaba-Biribonwoha, Harriet; Bongomin, Pido; Okello, Velephi N; Bitchong, Raymond A; El-Sadr, Wafaa M

    2018-03-01

    Screening of modifiable cardiovascular disease (CVD) risk factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without screening and measured time spent on HIV and CVD risk factor screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with screening. We observed 172 patient visits (122 with CVD risk factor screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend screening to others. Provision of CVD risk factor screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD risk factor screening and counselling into HIV programmes. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  8. Limitations of Carbon Footprint as Indicator of Environmental Sustainability

    DEFF Research Database (Denmark)

    Laurent, Alexis; Olsen, Stig I.; Hauschild, Michael Z.

    2012-01-01

    change but also other environmental problems, like chemical pollution or depletion of natural resources, and the focus on CFP brings the risk of problem shifting when reductions in CFP are obtained at the expense of increase in other environmental impacts. But how real is this risk? Here, we model...... runs the risk of inadvertently shifting the problem to other environmental impacts when products are optimized to become more “green”. These findings call for the use of more broadly encompassing tools to assess and manage environmental sustainability.......Greenhouse gas accountings, commonly referred to with the popular term carbon footprints (CFP), are a widely used metric of climate change impacts and the main focus of many sustainability policies among companies and authorities. However, environmental sustainability concerns not just climate...

  9. Core damage risk indicators

    International Nuclear Information System (INIS)

    Szikszai, T.

    1994-01-01

    The purpose of this document is to show a method for the fast recalculation of the PSA. To avoid the information loose, it is necessary to simplify the PSA models, or at least reorganize them. The method, introduced in this document, require that preparation, so we try to show, how to do that. This document is an introduction. This is the starting point of the work related to the development of the risk indicators. In the future, with the application of this method, we are going to show an everyday use of the PSA results to produce the indicators of the core damage risk. There are two different indicators of the plant safety performance, related to the core damage risk. The first is the core damage frequency indicator (CDFI), and the second is the core damage probability indicator (CDPI). Of course, we cannot describe all of the possible ways to use these indicators, rather we will try to introduce the requirements to establish such an indicator system and the calculation process

  10. The use of specialisation indices to predict vulnerability of coral-feeding butterflyfishes to environmental change

    KAUST Repository

    Lawton, Rebecca J.

    2011-07-14

    In the absence of detailed assessments of extinction risk, ecological specialisation is often used as a proxy of vulnerability to environmental disturbances and extinction risk. Numerous indices can be used to estimate specialisation; however, the utility of these different indices to predict vulnerability to future environmental change is unknown. Here we compare the performance of specialisation indices using coral-feeding butterflyfishes as a model group. Our aims were to 1) quantify the dietary preferences of three butterflyfish species across habitats with differing levels of resource availability; 2) investigate how estimates of dietary specialisation vary with the use of different specialisation indices; 3) determine which specialisation indices best inform predictions of vulnerability to environmental change; and 4) assess the utility of resource selection functions to inform predictions of vulnerability to environmental change. The relative level of dietary specialisation estimated for all three species varied when different specialisation indices were used, indicating that the choice of index can have a considerable impact upon estimates of specialisation. Specialisation indices that do not consider resource abundance may fail to distinguish species that primarily use common resources from species that actively target resources disproportionately more than they are available. Resource selection functions provided the greatest insights into the potential response of species to changes in resource availability. Examination of resource selection functions, in addition to specialisation indices, indicated that Chaetodon trifascialis was the most specialised feeder, with highly conserved dietary preferences across all sites, suggesting that this species is highly vulnerable to the impacts of climate-induced coral loss on reefs. Our results indicate that vulnerability assessments based on some specialisation indices may be misleading and the best estimates of

  11. Design of environmentally friendly products using indicators

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Bey, Niki

    2001-01-01

    The paper describes the requirements of product designers towards methods for environmental evaluation; it argues that indicators can be used for rough environmental evaluations and it presents experiences made with the indicator-based Oil Point Method (OPM). This method is illustrated by means...

  12. 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.

  13. Proposed framework for the Western Area Power Administration Environmental Risk Management Program

    Energy Technology Data Exchange (ETDEWEB)

    Glantz, C.S.; DiMassa, F.V.; Pelto, P.J.; Brothers, A.J. [Pacific Northwest Lab., Richland, WA (United States); Roybal, A.L. [Western Area Power Administration, Golden, CO (United States)

    1994-12-01

    The Western Area Power Administration (Western) views environmental protection and compliance as a top priority as it manages the construction, operation, and maintenance of its vast network of transmission lines, substations, and other facilities. A recent Department of Energy audit of Western`s environmental management activities recommends that Western adopt a formal environmental risk program. To accomplish this goal, Western, in conjunction with Pacific Northwest Laboratory, is in the process of developing a centrally coordinated environmental risk program. This report presents the results of this design effort, and indicates the direction in which Western`s environmental risk program is heading. Western`s environmental risk program will consist of three main components: risk communication, risk assessment, and risk management/decision making. Risk communication is defined as an exchange of information on the potential for threats to human health, public safety, or the environment. This information exchange provides a mechanism for public involvement, and also for the participation in the risk assessment and management process by diverse groups or offices within Western. The objective of risk assessment is to evaluate and rank the relative magnitude of risks associated with specific environmental issues that are facing Western. The evaluation and ranking is based on the best available scientific information and judgment and serves as input to the risk management process. Risk management takes risk information and combines it with relevant non-risk factors (e.g., legal mandates, public opinion, costs) to generate risk management options. A risk management tool, such as decision analysis, can be used to help make risk management choices.

  14. Methodology of environmental risk assessment management

    Directory of Open Access Journals (Sweden)

    Saša T. Bakrač

    2012-04-01

    Full Text Available Successful protection of environment is mostly based on high-quality assessment of potential and present risks. Environmental risk management is a complex process which includes: identification, assessment and control of risk, namely taking measures in order to minimize the risk to an acceptable level. Environmental risk management methodology: In addition to these phases in the management of environmental risk, appropriate measures that affect the reduction of risk occurrence should be implemented: - normative and legal regulations (laws and regulations, - appropriate organizational structures in society, and - establishing quality monitoring of environment. The emphasis is placed on the application of assessment methodologies (three-model concept, as the most important aspect of successful management of environmental risk. Risk assessment methodology - European concept: The first concept of ecological risk assessment methodology is based on the so-called European model-concept. In order to better understand this ecological risk assessment methodology, two concepts - hazard and risk - are introduced. The European concept of environmental risk assessment has the following phases in its implementation: identification of hazard (danger, identification of consequences (if there is hazard, estimate of the scale of consequences, estimate of consequence probability and risk assessment (also called risk characterization. The European concept is often used to assess risk in the environment as a model for addressing the distribution of stressors along the source - path - receptor line. Risk assessment methodology - Canadian concept: The second concept of the methodology of environmental risk assessment is based on the so-called Canadian model-concept. The assessment of ecological risk includes risk arising from natural events (floods, extreme weather conditions, etc., technological processes and products, agents (chemical, biological, radiological, etc

  15. Risk-benefit analysis for mass screening of breast cancer utilizing mammography as a screening test

    International Nuclear Information System (INIS)

    Iinuma, T.A.; Tateno, Yukio

    1989-01-01

    Incidence of breast cancers in Japanese women is increasing steadily. Mass screening of breast cancer was started in Japan under auspices of Adult Health Promotion Act of the Japanese Government from 1987. As the first screening method, the palpation of breasts is employed at present, but it is expected to be replaced by the mammography. In this report, the risk-benefit analysis is presented between risk of breast carcinogenesis due to radiation and benefit of mass screening of breast cancer. The benefit of mass screening is taken as the net elongation of average life expectancy of women due to survival from breast cancers. The risk of mammography is taken as the net loss of average life expectancy of women due to breast carcinogenesis. In the latter, the latency time and plateau period of radiation carcinogenesis were taken into consideration in the calculation. The results show that the ages at which the benefit and risk become equal are between 30 and 35 years old when dose equivalent of mammography is between 10 and 20 mSv, that are conventionally used. However, the critical age will be reduced to 20 years old if the dose equivalent becomes 1 mSv. Therefore, it is strongly recommended that a low dose mammographic system should be developed in order to achieve 1 mSv for the mass screening of breast cancer of Japanese women. In author's opinion, this is quite feasible by employing a new digital radiography with imaging plate. (author)

  16. Predicting the environmental risks of radioactive discharges from Belgian nuclear power plants.

    Science.gov (United States)

    Vandenhove, H; Sweeck, L; Vives I Batlle, J; Wannijn, J; Van Hees, M; Camps, J; Olyslaegers, G; Miliche, C; Lance, B

    2013-12-01

    An environmental risk assessment (ERA) was performed to evaluate the impact on non-human biota from liquid and atmospheric radioactive discharges by the Belgian Nuclear Power Plants (NPP) of Doel and Tihange. For both sites, characterisation of the source term and wildlife population around the NPPs was provided, whereupon the selection of reference organisms and the general approach taken for the environmental risk assessment was established. A deterministic risk assessment for aquatic and terrestrial ecosystems was performed using the ERICA assessment tool and applying the ERICA screening value of 10 μGy h(-1). The study was performed for the radioactive discharge limits and for the actual releases (maxima and averages over the period 1999-2008 or 2000-2009). It is concluded that the current discharge limits for the Belgian NPPs considered do not result in significant risks to the aquatic and terrestrial environment and that the actual discharges, which are a fraction of the release limits, are unlikely to harm the environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Screening of IAEA environmental samples for fissile material content

    International Nuclear Information System (INIS)

    Hembree, Doyle M. Jr.; Carter, Joel A.; Devault, Gerald L.; Whitaker, J. Michael; Glasgow, David

    2001-01-01

    Full text: Analysis of environmental samples for the International Atomic Energy Agency (IAEA) Strengthened Safeguards Systems program requires that stringent measures be taken to control contamination. To facilitate contamination control, it is extremely useful to have some estimate of the fissile content of a given sample prior to beginning sample preparation and analysis. This is particularly true for laboratories that employ clean rooms during sample preparation. A review of the analytical results for samples submitted between January 1, 1999 and September 1, 2000 revealed that the total uranium content values ranged from 0.2 to greater than 500,000 ng/sample. Poor estimates of the uranium or plutonium content in the samples have caused some of the laboratories in the IAEA Network of Analytical Laboratories (NWAL) to experience clean laboratory contamination, sample cross contamination, and non-ideal uranium spike additions. This has led to significant increases in analysis costs (e.g., recertification of clean rooms after removing contamination, and rerunning samples) and degradation in data quality. A number of methods have been proposed for screening environmental samples for fissile material content, including gamma spectrometry, x-ray fluorescence, kinetic phosphorimetry (KPA), and inductively coupled plasma-mass spectrometry (ICP-MS). Gamma spectrometry and x-ray fluorescence are suitable for screening samples with microgram or greater quantities of uranium. ICP-MS and KPA are used successfully in some DOE NWAL laboratories to screen environmental samples. A neutron activation analysis (NAA) method that offers numerous advantages over other screening techniques for environmental samples has recently been proposed. Fissile materials such as 239 Pu and 235 U can be made to undergo fission in the intense neutron field to which they are exposed during neutron activation analysis (NAA). Some of the fission products emit neutrons referred to as 'delayed

  18. Method of assessment of the environmental risk associated with releases of radioactive substances. Adaptation to the case of mining sites in Haute-Vienne

    International Nuclear Information System (INIS)

    Beaugelin-Seiller, K.; Garnier-Laplace, J.

    2007-01-01

    This report presents methods which aim at proposing a first quantification (screening) of the potential impact and risk of releases from mining installations at the scale of a drainage basin for a given period, and at refining the characterization of the radiological and/or chemical risk when a potential risk is revealed by the screening step. The screening method allows a parallel assessment of the radio-ecological risk (for the whole set of radionuclides belonging to the uranium family) and of the chemical risk associated with uranium. The refinement is based on the use of probabilistic methods. These approaches lead to the calculation of a deterministic risk index by comparing Predicted Environmental Concentrations (PECs) with Predicted No-Effect Concentrations (PNECs) in the same media

  19. School Locations and Traffic Emissions — Environmental (InJustice Findings Using a New Screening Method

    Directory of Open Access Journals (Sweden)

    Philine Gaffron

    2015-02-01

    Full Text Available It has been shown that the location of schools near heavily trafficked roads can have detrimental effects on the health of children attending those schools. It is therefore desirable to screen both existing school locations and potential new school sites to assess either the need for remedial measures or suitability for the intended use. Current screening tools and public guidance on school siting are either too coarse in their spatial resolution for assessing individual sites or are highly resource intensive in their execution (e.g., through dispersion modeling. We propose a new method to help bridge the gap between these two approaches. Using this method, we also examine the public K-12 schools in the Sacramento Area Council of Governments Region, California (USA from an environmental justice perspective. We find that PM2.5 emissions from road traffic affecting a school site are significantly positively correlated with the following metrics: percent share of Black, Hispanic and multi-ethnic students, percent share of students eligible for subsidized meals. The emissions metric correlates negatively with the schools’ Academic Performance Index, the share of White students and average parental education levels. Our PM2.5 metric also correlates with the traffic related, census tract level screening indicators from the California Communities Environmental Health Screening Tool and the tool’s tract level rate of asthma related emergency department visits.

  20. A Risk Prediction Index for Advanced Colorectal Neoplasia at Screening Colonoscopy.

    Science.gov (United States)

    Schroy, Paul C; Wong, John B; O'Brien, Michael J; Chen, Clara A; Griffith, John L

    2015-07-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer screening. Risk stratification for advanced colorectal neoplasia (ACN) might facilitate more effective shared decision making when selecting an appropriate screening option. Our objective was to develop and validate a clinical index for estimating the probability of ACN at screening colonoscopy. We conducted a cross-sectional analysis of 3,543 asymptomatic, mostly average-risk patients 50-79 years of age undergoing screening colonoscopy at two urban safety net hospitals. Predictors of ACN were identified using multiple logistic regression. Model performance was internally validated using bootstrapping methods. The final index consisted of five independent predictors of risk (age, smoking, alcohol intake, height, and a combined sex/race/ethnicity variable). Smoking was the strongest predictor (net reclassification improvement (NRI), 8.4%) and height the weakest (NRI, 1.5%). Using a simplified weighted scoring system based on 0.5 increments of the adjusted odds ratio, the risk of ACN ranged from 3.2% (95% confidence interval (CI), 2.6-3.9) for the low-risk group (score ≤2) to 8.6% (95% CI, 7.4-9.7) for the intermediate/high-risk group (score 3-11). The model had moderate to good overall discrimination (C-statistic, 0.69; 95% CI, 0.66-0.72) and good calibration (P=0.73-0.93). A simple 5-item risk index based on readily available clinical data accurately stratifies average-risk patients into low- and intermediate/high-risk categories for ACN at screening colonoscopy. Uptake into clinical practice could facilitate more effective shared decision-making for CRC screening, particularly in situations where patient and provider test preferences differ.

  1. Suicide risk in youth with intellectual disabilities: the challenges of screening.

    Science.gov (United States)

    Ludi, Erica; Ballard, Elizabeth D; Greenbaum, Rachel; Pao, Maryland; Bridge, Jeffrey; Reynolds, William; Horowitz, Lisa

    2012-06-01

    Children and adolescents with intellectual disabilities (IDs), often diagnosed with comorbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted to (1) estimate the prevalence of suicidal thoughts, behaviors, and deaths by suicide in children and adolescents with ID; (2) describe associations between youth with ID and suicide risk; and (3) identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt, and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID.

  2. Suicide Risk in Youth with Intellectual Disability: The Challenges of Screening

    Science.gov (United States)

    Ludi, Erica; Ballard, Elizabeth D.; Greenbaum, Rachel; Pao, Maryland; Bridge, Jeffrey; Reynolds, William; Horowitz, Lisa

    2012-01-01

    Children and adolescents with intellectual disabilities (ID), often diagnosed with co-morbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted: 1) to estimate the prevalence of suicidal thoughts, behaviors and deaths by suicide in children and adolescents with ID; 2) to describe associations between youth with ID and suicide risk; 3) to identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID. PMID:22668827

  3. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Saadatmand Sepideh

    2012-10-01

    Full Text Available Abstract Background To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivity of mammography decreases. Therefore, mammography might not be the optimal method for breast cancer screening in young women. Adding MRI increases sensitivity, but also the risk of false-positive results. The limitation of all previous MRI screening studies is that they do not contain a comparison group; all participants received both MRI and mammography. Therefore, we cannot empirically assess in which stage tumours would have been detected by either test. The aim of the Familial MRI Screening Study (FaMRIsc is to compare the efficacy of MRI screening to mammography for women with a familial risk. Furthermore, we will assess the influence of breast density. Methods/Design This Dutch multicentre, randomized controlled trial, with balanced randomisation (1:1 has a parallel grouped design. Women with a cumulative lifetime risk for breast cancer due to their family history of ≥20%, aged 30–55 years are eligible. Identified BRCA1/2 mutation carriers or women with 50% risk of carrying a mutation are excluded. Group 1 receives yearly mammography and clinical breast examination (n = 1000, and group 2 yearly MRI and clinical breast examination, and mammography biennially (n = 1000. Primary endpoints are the number and stage of the detected breast cancers in each arm. Secondary endpoints are the number of false-positive results in both screening arms. Furthermore, sensitivity and positive predictive value of both screening strategies will be assessed. Cost-effectiveness of both strategies will be assessed. Analyses will also be performed with mammographic density as stratification factor. Discussion Personalized breast cancer screening

  4. Hair 2010 Documentation: Calculating risk indicators related to agricultural use of pesticides within the European Union

    NARCIS (Netherlands)

    Kruijne, R.; Deneer, J.W.; Lahr, J.; Vlaming, J.

    2011-01-01

    The HAIR instrument calculates risk indicators related to the agricultural use of pesticides in EU Member States. HAIR combines databases and models for calculating potential environmental environmental effects expressed by the exposure toxicity ratio.

  5. Self-reported screen time and cardiometabolic risk in obese Dutch adolescents.

    Directory of Open Access Journals (Sweden)

    Teatske M Altenburg

    Full Text Available BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C, high-density (HDL-C and total cholesterol (TC, triglycerides, glucose and insulin were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000] and LDL-C (B = -0.002; CI = [-0.001;0.000]. CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities.

  6. Cuticular features as indicators of environmental pollution

    Science.gov (United States)

    G. K. Sharma

    1976-01-01

    Several leaf cuticular features such as stomatal frequency, stomatal size, trichome length, type, and frequency, and subsidiary cell complex respond to environmental pollution in different ways and hence can be used as indicators of environmental pollution in an area. Several modifications in cuticular features under polluted environments seem to indicate ecotypic or...

  7. Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

    LENUS (Irish Health Repository)

    O Caoimh, Rónán

    2014-09-19

    Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC).

  8. INDICATOR OF ENVIRONMENTAL PROBLEMS OF AGRICULTURAL SECTORS UNDER THE ENVIRONMENTAL MODELING

    Directory of Open Access Journals (Sweden)

    Pruethsan Sutthichaimethee

    2016-04-01

    Full Text Available The objective of this research is to propose an indicator to deal with environmental problems for agricultural sectors caused by goods and services production. The aspects to calculate the real benefit of agricultural sectors and environmental cost for analyzing are natural resources materials, energy and transportation, fertilizer and pesticides, and sanitary and similar service. From the research it was found that the highest environmental cost of natural resources materials was 026: charcoal and fire-wood, while the lowest was 010 coconut. The highest environmental cost for energy and transportation was 024: agricultural services, while the highest environmental cost for fertilizer and pesticides was 011: palm oil. lastly, 017: other agricultural products was found as the highest environmental cost for sanitary and similar service. As a result, 010: coconut gained the highest real benefit, while 024: agricultural services presented as the lowest read benefit for the company. If Thailand using environmental problem indicator, especially with the agricultural sector, it can help to formulate efficient policies and strategies for the country in 3 development areas, which are social, economic, and environmental development.

  9. Assessment of the environmental risk perceptions and environmental attitudes of nursing students.

    Science.gov (United States)

    Sayan, Betül; Kaya, Hatice

    2016-12-01

    This is a descriptive study examining nursing students' perceptions of the environmental risks and their environmental attitudes. The study population comprised 2364 nursing students studying at universities in Istanbul in the fall semester of the 2012-2013 academic year. The sampling group was formed by 778 students which were selected by a stratified random sampling procedure. The data were collected using "The Student Personal Information Form", "The Environmental Risk Perception Scale" and "The Environmental Attitudes Scale". The students' mean score on perceptions of environmental risk was 6.04 ± 0.81(min 2.56; max 7.00) and the mean score of their environmental attitudes was 4.02 ± 0.47(min 2.28; max 5.00). It was determined that factors such as gender, interest in environmental issues, endorsement of the college course on environment as necessary, and participation in an environmental activity and awareness of non-government environmental organizations affected the environmental risk perception and environmental attitudes. A moderate positive relationship (r = 0.366, p environmental risk perceptions and their environmental attitudes. Effective environmental education should be planned at all stages of the nursing education.

  10. A method for calculating effective lifetime risk of radiation-induced cancer from screening mammography

    International Nuclear Information System (INIS)

    Ali, R.M.; England, A.; McEntee, M.F.; Hogg, P.

    2015-01-01

    Purpose: To propose a method for evaluating the effective lifetime risk of radiation-induced cancer from screening mammography and to present initial data for the UK National Breast Screening Programme. Material and methods: The imaging was undertaken using a Hologic Selenia full field digital mammographic unit. The proposed method utilises an ATOM phantom containing thermoluminescent dosimeters and a perspex-polyethylene breast phantom to measure organ doses during a standard four view screening mammogram. Effective dose was calculated and effective risk was modelled for a range of client ages. The total lifetime effective risk was then calculated for the UK national screening programme. Calculation of effective risk includes the radiation dose to examined and contralateral breasts in addition to other body organs; this is an advantage over the mean glandular dose. Results: The contralateral breast, thyroid, thymus, brain, lung, salivary glands, and bone marrow all receive more than 1 μGy radiation dose during screening mammography. A major difference exists for total effective lifetime risk of radiation-induced cancer between clients with average and high breast cancer risk. Differences are attributed to the commencement age of screening and time interval between screens. Conclusion: This study proposes a method to evaluate effective lifetime risk of radiation-induced cancer from screening mammography in order to compare different mammography screening programmes. - Highlights: • We proposed a method for the calculation of radiation-induced cancer from screening mammography. • We measured the radiation absorbed dose of different organs during screening mammography. • There are major differences between mammography screening programme categories with regard to radiation effective risk.

  11. Limitations of carbon footprint as indicator of environmental sustainability.

    Science.gov (United States)

    Laurent, Alexis; Olsen, Stig I; Hauschild, Michael Z

    2012-04-03

    Greenhouse gas accountings, commonly referred to with the popular term carbon footprints (CFP), are a widely used metric of climate change impacts and the main focus of many sustainability policies among companies and authorities. However, environmental sustainability concerns not just climate change but also other environmental problems, like chemical pollution or depletion of natural resources, and the focus on CFP brings the risk of problem shifting when reductions in CFP are obtained at the expense of increase in other environmental impacts. But how real is this risk? Here, we model and analyze the life cycle impacts from about 4000 different products, technologies, and services taken from several sectors, including energy generation, transportation, material production, infrastructure, and waste management. By investigating the correlations between the CFP and 13 other impact scores, we show that some environmental impacts, notably those related to emissions of toxic substances, often do not covary with climate change impacts. In such situations, carbon footprint is a poor representative of the environmental burden of products, and environmental management focused exclusively on CFP runs the risk of inadvertently shifting the problem to other environmental impacts when products are optimized to become more "green". These findings call for the use of more broadly encompassing tools to assess and manage environmental sustainability.

  12. Compendium of Environmental Sustainability Indicator Collections: 2005 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2005 Environmental Sustainability Index (ESI) portion of the Compendium of Environmental Sustainability Indicators Collection contains 103 variables for 146...

  13. Compendium of Environmental Sustainability Indicator Collections: 2004 Environmental Vulnerability Index (EVI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2004 Environmental Vulnerability Index (EVI) portion of the Compendium of Environmental Sustainability Indicator Collections contains 111 variables for 235...

  14. Service Use by At-Risk Youth after School-Based Suicide Screening

    Science.gov (United States)

    2009-01-01

    Objective We sought to examine follow-up service use by students identified at risk for suicidal behavior in a school-based screening program, and assess barriers to seeking services as perceived by youth and parents. Method We conducted a longitudinal study of 317 at-risk youth identified by a school-based suicide screening in six high schools in New York State. The at-risk teenagers and their parents were interviewed approximately two years after the initial screen to assess service use during the intervening period and identify barriers that may have interfered with seeking treatment. Results At the time of the screen, 72% of the at-risk students were not receiving any type of mental health service. Of these students, 51% were deemed in need of services and subsequently referred by us to a mental health professional. Nearly 70% followed through with the screening’s referral recommendations. Youth and their parents reported perceptions about mental health problems, specifically relating to the need for treatment, as the primary reasons for not seeking service. Conclusions Screening appears to be effective in enhancing the likelihood that students at risk for suicidal behavior will get into treatment. Well developed and systematic planning is needed to ensure that screening and referral services are coordinated so as to facilitate access for youth into timely treatment. PMID:19858758

  15. Environmental health indicators of climate change for the United States: findings from the State Environmental Health Indicator Collaborative.

    Science.gov (United States)

    English, Paul B; Sinclair, Amber H; Ross, Zev; Anderson, Henry; Boothe, Vicki; Davis, Christine; Ebi, Kristie; Kagey, Betsy; Malecki, Kristen; Shultz, Rebecca; Simms, Erin

    2009-11-01

    To develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions. We conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature. Sources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level. We present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change. A review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.

  16. Advantages and disadvantages of unstructured cardiovascular risk factor screening for follow-up in primary care.

    Science.gov (United States)

    de Boer, Anna W; de Mutsert, Renée; den Heijer, Martin; Rosendaal, Frits R; Jukema, Johan W; Blom, Jeanet W; Numans, Mattijs E

    2016-07-01

    In contrast to structured, integrated risk assessment in primary care, unstructured risk factor screening outside primary care and corresponding recommendations to consult a general practitioner (GP) are often based on one abnormal value of a single risk factor. This study investigates the advantages and disadvantages of unstructured screening of blood pressure and cholesterol outside primary care. After the baseline visit of the Netherlands Epidemiology of Obesity study (population-based prospective cohort study in persons aged 45-65 years, recruited 2008-2012) all participants received a letter with results of blood pressure and cholesterol, and a recommendation to consult a GP if results were abnormal. Four years after the start of the study, participants received a questionnaire about the follow-up of their results. The study population consisted of 6343 participants, 48% men, mean age 56 years, mean body mass index 30 kg/m(2). Of all participants 66% had an abnormal result and, of these, 49% had a treatment indication based on the risk estimation system SCORE-NL 2006. Of the 25% of the participants who did not consult a GP, 40% had a treatment indication. Of the participants with an abnormal result 19% were worried, of whom 60% had no treatment indication. In this population 51% of the participants with an abnormal result had unnecessarily received a recommendation to consult a GP, and 10% were unnecessarily worried. GPs should be informed about the complete risk assessment, and only participants at intermediate or high risk should receive a recommendation to consult a GP. © The European Society of Cardiology 2015.

  17. Using model-based screening to help discover unknown environmental contaminants.

    Science.gov (United States)

    McLachlan, Michael S; Kierkegaard, Amelie; Radke, Michael; Sobek, Anna; Malmvärn, Anna; Alsberg, Tomas; Arnot, Jon A; Brown, Trevor N; Wania, Frank; Breivik, Knut; Xu, Shihe

    2014-07-01

    Of the tens of thousands of chemicals in use, only a small fraction have been analyzed in environmental samples. To effectively identify environmental contaminants, methods to prioritize chemicals for analytical method development are required. We used a high-throughput model of chemical emissions, fate, and bioaccumulation to identify chemicals likely to have high concentrations in specific environmental media, and we prioritized these for target analysis. This model-based screening was applied to 215 organosilicon chemicals culled from industrial chemical production statistics. The model-based screening prioritized several recognized organosilicon contaminants and generated hypotheses leading to the selection of three chemicals that have not previously been identified as potential environmental contaminants for target analysis. Trace analytical methods were developed, and the chemicals were analyzed in air, sewage sludge, and sediment. All three substances were found to be environmental contaminants. Phenyl-tris(trimethylsiloxy)silane was present in all samples analyzed, with concentrations of ∼50 pg m(-3) in Stockholm air and ∼0.5 ng g(-1) dw in sediment from the Stockholm archipelago. Tris(trifluoropropyl)trimethyl-cyclotrisiloxane and tetrakis(trifluoropropyl)tetramethyl-cyclotetrasiloxane were found in sediments from Lake Mjøsa at ∼1 ng g(-1) dw. The discovery of three novel environmental contaminants shows that models can be useful for prioritizing chemicals for exploratory assessment.

  18. Method for environmental risk analysis (MIRA) revision 2007

    International Nuclear Information System (INIS)

    2007-04-01

    OLF's instruction manual for carrying out environmental risk analyses provides a united approach and a common framework for environmental risk assessments. This is based on the best information available. The manual implies standardizations of a series of parameters, input data and partial analyses that are included in the environmental risk analysis. Environmental risk analyses carried out according to the MIRA method will thus be comparable between fields and between companies. In this revision an update of the text in accordance with today's practice for environmental risk analyses and prevailing regulations is emphasized. Moreover, method adjustments for especially protected beach habitats have been introduced, as well as a general method for estimating environmental risk concerning fish. Emphasis has also been put on improving environmental risk analysis' possibilities to contribute to a better management of environmental risk in the companies (ml)

  19. Effect of climate change on environmental flow indicators in the narew basin, poland.

    Science.gov (United States)

    Piniewski, Mikołaj; Laizé, Cédric L R; Acreman, Michael C; Okruszko, Tomasz; Schneider, Christof

    2014-01-01

    Environmental flows-the quantity of water required to maintain a river ecosystem in its desired state-are of particular importance in areas of high natural value. Water-dependent ecosystems are exposed to the risk of climate change through altered precipitation and evaporation. Rivers in the Narew basin in northeastern Poland are known for their valuable river and wetland ecosystems, many of them in pristine or near-pristine condition. The objective of this study was to assess changes in the environmental flow regime of the Narew river system, caused by climate change, as simulated by hydrological models with different degrees of physical characterization and spatial aggregation. Two models were assessed: the river basin scale model Soil and Water Assessment Tool (SWAT) and the continental model of water availability and use WaterGAP. Future climate change scenarios were provided by two general circulation models coupled with the A2 emission scenario: IPSL-CM4 and MIROC3.2. To assess the impact of climate change on environmental flows, a method based conceptually on the "range of variability" approach was used. The results indicate that the environmental flow regime in the Narew basin is subject to climate change risk, whose magnitude and spatial variability varies with climate model and hydrological modeling scale. Most of the analyzed sites experienced moderate impacts for the Generic Environmental Flow Indicator (GEFI), the Floodplain Inundation Indicator, and the River Habitat Availability Indicator. The consistency between SWAT and WaterGAP for GEFI was medium: in 55 to 66% of analyzed sites, the models suggested the same level of impact. Hence, we suggest that state-of-the-art, high-resolution, global- or continental-scale models, such as WaterGAP, could be useful tools for water management decision-makers and wetland conservation practitioners, whereas models such as SWAT should serve as a complementary tool for more specific, smaller-scale, local

  20. The cost-effectiveness of using chronic kidney disease risk scores to screen for early-stage chronic kidney disease.

    Science.gov (United States)

    Yarnoff, Benjamin O; Hoerger, Thomas J; Simpson, Siobhan K; Leib, Alyssa; Burrows, Nilka R; Shrestha, Sundar S; Pavkov, Meda E

    2017-03-13

    Better treatment during early stages of chronic kidney disease (CKD) may slow progression to end-stage renal disease and decrease associated complications and medical costs. Achieving early treatment of CKD is challenging, however, because a large fraction of persons with CKD are unaware of having this disease. Screening for CKD is one important method for increasing awareness. We examined the cost-effectiveness of identifying persons for early-stage CKD screening (i.e., screening for moderate albuminuria) using published CKD risk scores. We used the CKD Health Policy Model, a micro-simulation model, to simulate the cost-effectiveness of using CKD two published risk scores by Bang et al. and Kshirsagar et al. to identify persons in the US for CKD screening with testing for albuminuria. Alternative risk score thresholds were tested (0.20, 0.15, 0.10, 0.05, and 0.02) above which persons were assigned to receive screening at alternative intervals (1-, 2-, and 5-year) for follow-up screening if the first screening was negative. We examined incremental cost-effectiveness ratios (ICERs), incremental lifetime costs divided by incremental lifetime QALYs, relative to the next higher screening threshold to assess cost-effectiveness. Cost-effective scenarios were determined as those with ICERs less than $50,000 per QALY. Among the cost-effective scenarios, the optimal scenario was determined as the one that resulted in the highest lifetime QALYs. ICERs ranged from $8,823 per QALY to $124,626 per QALY for the Bang et al. risk score and $6,342 per QALY to $405,861 per QALY for the Kshirsagar et al. risk score. The Bang et al. risk score with a threshold of 0.02 and 2-year follow-up screening was found to be optimal because it had an ICER less than $50,000 per QALY and resulted in the highest lifetime QALYs. This study indicates that using these CKD risk scores may allow clinicians to cost-effectively identify a broader population for CKD screening with testing for albuminuria

  1. Screening-level risk assessment for styrene-acrylonitrile (SAN) trimer detected in soil and groundwater.

    Science.gov (United States)

    Kirman, C R; Gargas, M L; Collins, J J; Rowlands, J C

    2012-01-01

    A screening-level risk assessment was conducted for styrene-acrylonitrile (SAN) Trimer detected at the Reich Farm Superfund site in Toms River, NJ. Consistent with a screening-level approach, on-site and off-site exposure scenarios were evaluated using assumptions that are expected to overestimate actual exposures and hazards at the site. Environmental sampling data collected for soil and groundwater were used to estimate exposure point concentrations. Several exposure scenarios were evaluated to assess potential on-site and off-site exposures, using parameter values for exposures to soil (oral, inhalation of particulates, and dermal contact) and groundwater (oral, dermal contact) to reflect central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. Three reference dose (RfD) values were derived for SAN Trimer for short-term, subchronic, and chronic exposures, based upon its effects on the liver in exposed rats. Benchmark (BMD) methods were used to assess the relationship between exposure and response, and to characterize appropriate points of departure (POD) for each RfD. An uncertainty factor of 300 was applied to each POD to yield RfD values of 0.1, 0.04, and 0.03 mg/kg-d for short-term, subchronic, and chronic exposures, respectively. Because a chronic cancer bioassay for SAN Trimer in rats (NTP 2011a) does not provide evidence of carcinogenicity, a cancer risk assessment is not appropriate for this chemical. Potential health hazards to human health were assessed using a hazard index (HI) approach, which considers the ratio of exposure dose (i.e., average daily dose, mg/kg-d) to toxicity dose (RfD, mg/kg-d) for each scenario. All CTE and RME HI values are well below 1 (where the average daily dose is equivalent to the RfD), indicating that there is no concern for potential noncancer effects in exposed populations even under the conservative assumptions of this screening-level assessment.

  2. Screening-Level Risk Assessment for Styrene-Acrylonitrile (SAN) Trimer Detected in Soil and Groundwater

    Science.gov (United States)

    Kirman, C. R.; Gargas, M. L.; Collins, J. J.; Rowlands, J. C.

    2012-01-01

    A screening-level risk assessment was conducted for styrene-acrylonitrile (SAN) Trimer detected at the Reich Farm Superfund site in Toms River, NJ. Consistent with a screening-level approach, on-site and off-site exposure scenarios were evaluated using assumptions that are expected to overestimate actual exposures and hazards at the site. Environmental sampling data collected for soil and groundwater were used to estimate exposure point concentrations. Several exposure scenarios were evaluated to assess potential on-site and off-site exposures, using parameter values for exposures to soil (oral, inhalation of particulates, and dermal contact) and groundwater (oral, dermal contact) to reflect central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. Three reference dose (RfD) values were derived for SAN Trimer for short-term, subchronic, and chronic exposures, based upon its effects on the liver in exposed rats. Benchmark (BMD) methods were used to assess the relationship between exposure and response, and to characterize appropriate points of departure (POD) for each RfD. An uncertainty factor of 300 was applied to each POD to yield RfD values of 0.1, 0.04, and 0.03 mg/kg-d for short-term, subchronic, and chronic exposures, respectively. Because a chronic cancer bioassay for SAN Trimer in rats (NTP 2011a) does not provide evidence of carcinogenicity, a cancer risk assessment is not appropriate for this chemical. Potential health hazards to human health were assessed using a hazard index (HI) approach, which considers the ratio of exposure dose (i.e., average daily dose, mg/kg-d) to toxicity dose (RfD, mg/kg-d) for each scenario. All CTE and RME HI values are well below 1 (where the average daily dose is equivalent to the RfD), indicating that there is no concern for potential noncancer effects in exposed populations even under the conservative assumptions of this screening-level assessment. PMID:23030654

  3. Likelihood of early detection of breast cancer in relation to false-positive risk in life-time mammographic screening: population-based cohort study.

    Science.gov (United States)

    Otten, J D M; Fracheboud, J; den Heeten, G J; Otto, S J; Holland, R; de Koning, H J; Broeders, M J M; Verbeek, A L M

    2013-10-01

    Women require balanced, high-quality information when making an informed decision on screening benefits and harms before attending biennial mammographic screening. The cumulative risk of a false-positive recall and/or (small) screen-detected or interval cancer over 13 consecutive screening examinations for women aged 50 from the start of screening were estimated using data from the Nijmegen programme, the Netherlands. Women who underwent 13 successive screens in the period 1975-1976 had a 5.3% cumulative chance of a screen-detected cancer, with a 4.2% risk of at least one false-positive recall. The risk of being diagnosed with interval cancer was 3.7%. Two decades later, these estimates were 6.9%, 7.3% and 2.9%, respectively. The chance of detection of a small, favourable invasive breast cancer, anticipating a normal life-expectancy, rose from 2.3% to 3.7%. Extrapolation to digital screening mammography indicates that the proportion of false-positive results will rise to 16%. Dutch women about to participate in the screening programme can be reassured that the chance of false-positive recall in the Netherlands is relatively low. A new screening policy and improved mammography have increased the detection of an early screening carcinoma and lowering the risk of interval carcinoma.

  4. Preparticipation Screening of Athletic Officials: SEC Football Referees at Risk.

    Science.gov (United States)

    Turner, John L; Walters, Rod; Leski, Mark J; Saywell, Robert M; Wooldridge, J Scott

    2003-03-01

    Although preparticipation screening for athletes is commonplace, few studies have addressed the issue for those officiating at games. To review current data on physiologic stress on sports officials, to obtain prevalence data on health parameters for football officials, and to determine the outcomes when screening criteria are applied in preseason exams. A protocol was established using health history questionnaires and physical exams with laboratory screening to assess the health of all football officials working in the Southeastern Conference (SEC) from 1997 to 2000. The main outcome measure was the prevalence of cardiac risk factors as determined by American College of Sports Medicine guidelines. Initial screening of 102 football officials revealed that 10.1% of SEC referees had elevated systolic blood pressure, 13.9% had elevated diastolic blood pressure, and 3.8% had resting tachycardia. Average body mass index (BMI) was 28.6 kg/m2, with 87.3% having a BMI that exceeded 25 (overweight). About one-third (31.6%) had a BMI greater than 30 (obese). Total fasting cholesterol exceeded 200 mg/dL in 44.2%, HDL levels were below 35 mg/dL in 34.3%, and LDL levels were above 120 mg/dL in 62.3%. Compared with age-adjusted national data, there were more overweight and more obese officials, but they had lower systolic and diastolic blood pressures and lower mean total cholesterol levels. Using the Framingham Study prediction model to estimate coronary heart disease (CHD) risk, analysis revealed that referees had a lower risk than the national 10-year CHD risk but a higher risk compared with that of the low-risk population. These data reveal a greater need for graded exercise testing. The higher rates of obesity among officials will promote further screening for CHD risk factors.

  5. Risk assessment and clinical decision making for colorectal cancer screening.

    Science.gov (United States)

    Schroy, Paul C; Caron, Sarah E; Sherman, Bonnie J; Heeren, Timothy C; Battaglia, Tracy A

    2015-10-01

    Shared decision making (SDM) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (PCPs) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (ACN) provides a rational strategy for reconciling these differences. To assess the importance of risk stratification in PCP decision making related to test preference for average-risk patients and receptivity to use of an electronic risk assessment tool for ACN to facilitate SDM. Mixed methods, including qualitative key informant interviews and a cross-sectional survey. PCPs at an urban, academic safety-net institution. Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool. Nine PCPs participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; P decision making, yet few providers considered risk factors other than age for average-risk patients. Providers were receptive to the use of a risk assessment tool for ACN when recommending an appropriate screening test for select patients. © 2013 John Wiley & Sons Ltd.

  6. Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

    Directory of Open Access Journals (Sweden)

    K. M. Friddle

    2017-01-01

    Full Text Available Objective. Current American retinopathy of prematurity (ROP screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP. Study Design. We performed a 13-year review from Intermountain Health Care (IHC data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP. Results. We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61% were included in the study. Overall, severe ROP occurred in 260 (9.3%, but only 11/1601 ≥ 29 weeks (0.7%. All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601 of the screened population. Conclusions. Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.

  7. Assessment of Health, Safety and Environmental Risks of Zahedan City Gasoline Stations

    Directory of Open Access Journals (Sweden)

    S. Y. Far

    2018-04-01

    Full Text Available The purpose of this study was to assess the risk and determine the health, safety and environmental status of fuel stations in Zahedan. In this study, failure mode and effects analysis (FMEA method was used for risk assessment in accordance with the HSE guidelines, national and international standards and laws. In this cross-sectional study, 2 governmental stations and 6 active private stations were evaluated after the necessary coordination with the relevant units. As a result of risk assessment, 27 health risks, 55 safety risks and 22 environmental risks were identified. From among all the identified risks, 67 risks had a Risk Priority Number (RPN of less than 91, 31 risks had an RPN ranging between 91 and 201, and 6 risks had an RPN of over 201. The findings of the study indicated that compliance with the HSE requirements was 51.85%, in the area of health, 47.57% in the area of safety and 27.45% in the environmental area. Overall compliance with the HSE requirements was 42.54%. In order to distribute fuel considering health, reducing risk and increasing compliance with the requirements for safety improvement, health and environmental conditions of fuel supplies are essential.

  8. Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

    Science.gov (United States)

    Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

    2016-11-15

    Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

  9. Risk from environmental chemicals

    Energy Technology Data Exchange (ETDEWEB)

    Somers, E [Environmental Health Directorate, Health Protection Branch, Health and Welfare Canada, Ontario

    1982-01-01

    The elements of risk assessment, namely risk identification, risk estimation, risk evaluation and risk management, are described with respect to the control of environmental chemicals. The methodology of risk estimation is outlined and examples given of its application to regulatory decision-making for a number of chemicals in Canada. Finally, the extent and limitations of the process of risk evaluation are considered together with the need to recognize the importance of the public's perception of the level of risk.

  10. Confusing Relative Risk with Absolute Risk Is Associated with More Enthusiastic Beliefs about the Value of Cancer Screening.

    Science.gov (United States)

    Caverly, Tanner J; Prochazka, Allan V; Binswanger, Ingrid A; Kutner, Jean S; Matlock, Daniel D

    2014-07-01

    Reviews of how data are presented in medical literature document that the benefit from an intervention is often exaggerated relative to the harm (e.g., relative risk for benefit and absolute risk for harm). Such mismatched presentations may create unwarranted enthusiasm, especially among those who misinterpret the statistics presented. The objective was to determine whether misinterpretation of risk data predicts enthusiasm for cancer screening. The authors administered a survey with 14 items assessing beliefs about cancer screening and 6 items measuring data interpretation ability. Multiple linear regression was used to evaluate the association between data interpretation and enthusiasm for cancer screening, with adjustment for gender and year graduated from medical school. Eighty-eight of 139 physicians at a state-wide professional meeting returned completed surveys (63% response rate). Lower data interpretation scores were associated with higher enthusiasm for cancer screening scores (P = 0.004) in the adjusted primary analysis. Confusing relative risk with absolute risk appeared to drive the overall association. Biased presentations of risk data could affect general beliefs about the value of cancer screening, especially among physicians who uncritically accept mismatched presentations of data. © The Author(s) 2014.

  11. Risk Analysis in Road Tunnels – Most Important Risk Indicators

    DEFF Research Database (Denmark)

    Berchtold, Florian; Knaust, Christian; Thöns, Sebastian

    2016-01-01

    Methodologies on fire risk analysis in road tunnels consider numerous factors affecting risks (risk indicators) and express the results by risk measures. But only few comprehensive studies on effects of risk indicators on risk measures are available. For this reason, this study quantifies...... the effects and highlights the most important risk indicators with the aim to support further developments in risk analysis. Therefore, a system model of a road tunnel was developed to determine the risk measures. The system model can be divided into three parts: the fire part connected to the fire model Fire...... Dynamics Simulator (FDS); the evacuation part connected to the evacuation model FDS+Evac; and the frequency part connected to a model to calculate the frequency of fires. This study shows that the parts of the system model (and their most important risk indicators) affect the risk measures in the following...

  12. The quality of risk factor screening during antenatal consultations in Niger.

    Science.gov (United States)

    Prual, A; Toure, A; Huguet, D; Laurent, Y

    2000-03-01

    A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health programmes over the last decade. The effectiveness of antenatal care as a tool to prevent or predict obstetric complications is being questioned more and more. In addition to the scarcity of reliable data about the predictivity of most risk factors, the quality of the screening must be questioned. The goal of this study was to assess the frequency of risk factors among a sample of pregnant women attending antenatal care in Niger and to assess the quality of the screening of those risk factors. Overall, 330 pregnant women were enrolled in the study. Each woman was examined twice: the first time by a midwife, the second time by one of the authors but without knowledge of the results of the first consultation. Fifty-five percent of pregnant women had at least one risk factor, 31% had more than one. Ninety-one percent of the risk factors were detected at interview. The following risk factors were not systematically searched for by midwives: height (48.5%), blood pressure (43.6%), glycosuria (40.6%), vaginal bleeding (38.2%), oedema (37.3%), parity (17%), age (16%), previous caesarean section (15.2%), previous stillbirth (15.2%) and previous miscarriages (14.8%). This study has shown that, in Niger, the quality of screening for risk factors during antenatal consultation is poor. In the urban settings where this study took place, lack of personnel, lack of equipment, lack of time and poor compliance by women cannot be made responsible for this situation. While screening of these risk factors continues as policy, the quality of screening must be dramatically improved.

  13. The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review.

    Science.gov (United States)

    Costigan, Sarah A; Barnett, Lisa; Plotnikoff, Ronald C; Lubans, David R

    2013-04-01

    Evidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls' sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity. A structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12-18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls. Strong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity. Screen-based sedentary

  14. Risk of breast cancer after false-positive results in mammographic screening

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

    risk (RR) of screen-detected cancer for women with false-positive versus negative results. We analyzed information from 1,935,093 women 50–69 years who underwent 6,094,515 screening exams. During an average 5.8 years of follow-up, 230,609 (11.9%) women received a false-positive result and 27,849 (1......Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level.......4%) were diagnosed with screen-detected cancer. The adjusted RR of screen-detected cancer after a false-positive result was 2.01 (95% CI: 1.93–2.09). Women who tested false-positive at first screen had a RR of 1.86 (95% CI: 1.77–1.96), whereas those who tested false-positive at third screening had a RR...

  15. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  16. Constructing Aggregate Environmental-Economic Indicators. A Comparison of 12 OECD Countries

    Energy Technology Data Exchange (ETDEWEB)

    Van den Bergh, C.J.M. [Tinbergen Institute, Labor, Region and Environment, Amsterdam/Rotterdam (Netherlands); Van Veen-Groot, D.B. [Department of Spatial Economics, Faculty of Economics and Econometrics, Vrije Universiteit Amsterdam, Amsterdam (Netherlands)

    1999-07-01

    The application of aggregate indicators in environmental-economic research has received little attention so far. An important reason is the incompleteness of environmental data. This article presents a systematic approach to construct indicators of environment and economy on a macro level. It includes a distinction into the following categories: the volume of economic activities as an indicator of potential environmental pressure; actual environmental pressure; environmental quality; and environmental policy. In each category aggregate indicators are calculated for 12 OECD countries. Subsequently, the correlation between these indicators is examined. Significant correlation is found between the economic activity indicators (or 'potential' environmental pressure), actual environmental pressure and environmental quality, whereas a very weak correlation exists with these indicators and two types of aggregate indicators of environmental policy. Due to some arbitrary choices, which are inevitable, the results are to be judged with caution. Several suggestions are offered to improve the calculation and comparison of aggregate indicators. 20 refs.

  17. Constructing Aggregate Environmental-Economic Indicators. A Comparison of 12 OECD Countries

    International Nuclear Information System (INIS)

    Van den Bergh, C.J.M.; Van Veen-Groot, D.B.

    1999-01-01

    The application of aggregate indicators in environmental-economic research has received little attention so far. An important reason is the incompleteness of environmental data. This article presents a systematic approach to construct indicators of environment and economy on a macro level. It includes a distinction into the following categories: the volume of economic activities as an indicator of potential environmental pressure; actual environmental pressure; environmental quality; and environmental policy. In each category aggregate indicators are calculated for 12 OECD countries. Subsequently, the correlation between these indicators is examined. Significant correlation is found between the economic activity indicators (or 'potential' environmental pressure), actual environmental pressure and environmental quality, whereas a very weak correlation exists with these indicators and two types of aggregate indicators of environmental policy. Due to some arbitrary choices, which are inevitable, the results are to be judged with caution. Several suggestions are offered to improve the calculation and comparison of aggregate indicators. 20 refs

  18. Environmental indicators: Establishing a common language for green building

    DEFF Research Database (Denmark)

    Dammann, Sven; Elle, Morten

    2006-01-01

    . The objective of this study was to investigate if (and to what extent) consensus on environmental indicators for buildings as ‘a common language for green building’ can be reached among core actors in the Danish building sector and what such indicators could look like. Based on an analysis of current indicator...... is unlikely. Instead, three likely scenarios are described for the future development of the indicator debate and the directions are identified into which different actors need to move in order to establish indicators that can serve as a common language for green building.......Environmental indicators for buildings have the potential to serve as a means of making the environmental impacts (and possibly benefits) of buildings visible to all relevant actors. In addition, indicators facilitate the consideration and management of an array of environmental issues...

  19. The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

    Science.gov (United States)

    Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen

    2017-08-01

    Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and

  20. Identifying environmental risk factors and mapping the risk of human West Nile virus in South Dakota.

    Science.gov (United States)

    Hess, A.; Davis, J. K.; Wimberly, M. C.

    2017-12-01

    Human West Nile virus (WNV) first arrived in the USA in 1999 and has since then spread across the country. Today, the highest incidence rates are found in the state of South Dakota. The disease occurrence depends on the complex interaction between the mosquito vector, the bird host and the dead-end human host. Understanding the spatial domain of this interaction and being able to identify disease transmission hotspots is crucial for effective disease prevention and mosquito control. In this study we use geospatial environmental information to understand what drives the spatial distribution of cases of human West Nile virus in South Dakota and to map relative infection risk across the state. To map the risk of human West Nile virus in South Dakota, we used geocoded human case data from the years 2004-2016. Satellite data from the Landsat ETM+ and MODIS for the years 2003 to 2016 were used to characterize environmental patterns. From these datasets we calculated indices, such as the normalized differenced vegetation index (NDVI) and the normalized differenced water index (NDWI). In addition, datasets such as the National Land Data Assimilation System (NLDAS), National Land Cover Dataset (NLCD), National Wetland inventory (NWI), National Elevation Dataset (NED) and Soil Survey Geographic Database (SSURGO) were utilized. Environmental variables were summarized for a buffer zone around the case and control points. We used a boosted regression tree model to identify the most important variables describing the risk of WNV infection. We generated a risk map by applying this model across the entire state. We found that the highest relative risk is present in the James River valley in northeastern South Dakota. Factors that were identified as influencing the transmission risk include inter-annual variability of vegetation cover, water availability and temperature. Land covers such as grasslands, low developed areas and wetlands were also found to be good predictors for human

  1. Identifying Relationships between High-Risk Sexual Behaviors and Screening Positive for Chlamydia and Gonorrhea in School-Wide Screening Events

    Science.gov (United States)

    Salerno, Jennifer; Darling-Fisher, Cindy; Hawkins, Nicole M.; Fraker, Elizabeth

    2013-01-01

    Background: This article describes a school-wide sexually transmitted infection (STI) screening to identify adolescent high-risk sexual behaviors, STI history/incidence, and presence of chlamydia and gonorrhea, and examines relationships between high-risk behaviors and screening positive for chlamydia and gonorrhea in an alternative high school…

  2. Environmental risk analysis

    International Nuclear Information System (INIS)

    Lima-e-Silva, Pedro Paulo de

    1996-01-01

    The conventional Risk Analysis (RA) relates usually a certain undesired event frequency with its consequences. Such technique is used nowadays in Brazil to analyze accidents and their consequences strictly under the human approach, valuing loss of human equipment, human structures and human lives, without considering the damage caused to natural resources that keep life possible on Earth. This paradigm was developed primarily because of the Homo sapiens' lack of perception upon the natural web needed to sustain his own life. In reality, the Brazilian professionals responsible today for licensing, auditing and inspecting environmental aspects of human activities face huge difficulties in making technical specifications and procedures leading to acceptable levels of impact, furthermore considering the intrinsic difficulties to define those levels. Therefore, in Brazil the RA technique is a weak tool for licensing for many reasons, and of them are its short scope (only accident considerations) and wrong a paradigm (only human direct damages). A paper from the author about the former was already proposed to the 7th International Conference on Environmetrics, past July'96, USP-SP. This one discusses the extension of the risk analysis concept to take into account environmental consequences, transforming the conventional analysis into a broader methodology named here as Environmental Risk Analysis. (author)

  3. Estimating radiation risk induced by CT screening for Korean population

    Science.gov (United States)

    Yang, Won Seok; Yang, Hye Jeong; Min, Byung In

    2017-02-01

    The purposes of this study are to estimate the radiation risks induced by chest/abdomen computed tomography (CT) screening for healthcare and to determine the cancer risk level of the Korean population compared to other populations. We used an ImPACT CT Patient Dosimetry Calculator to compute the organ effective dose induced by CT screening (chest, low-dose chest, abdomen/pelvis, and chest/abdomen/pelvis CT). A risk model was applied using principles based on the BEIR VII Report in order to estimate the lifetime attributable risk (LAR) using the Korean Life Table 2010. In addition, several countries including Hong Kong, the United States (U.S.), and the United Kingdom, were selected for comparison. Herein, each population exposed radiation dose of 100 mSv was classified according to country, gender and age. For each CT screening the total organ effective dose calculated by ImPACT was 6.2, 1.5, 5.2 and 11.4 mSv, respectively. In the case of Korean female LAR, it was similar to Hong Kong female but lower than those of U.S. and U.K. females, except for those in their twenties. The LAR of Korean males was the highest for all types of CT screening. However, the difference of the risk level was negligible because of the quite low value.

  4. Environmental indicators for industrial optimization and design

    NARCIS (Netherlands)

    Konneman, Bram

    2008-01-01

    Companies use standard financial indicators to determine their business success and optimize their business opportunities. However, sustainable development demands for an integrated approach to economic, environmental and social indicators. Although a lot of indicator initiatives are under

  5. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Schenberg, Tess [Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mitchell, Gillian [Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); Taylor, Donna [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); BreastScreen Western Australia, Adelaide Terrace, Perth, Western Australia (Australia); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of General Surgery, St John of God Hospital, Perth, Western Australia (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

    2015-09-15

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

  6. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    International Nuclear Information System (INIS)

    Schenberg, Tess; Mitchell, Gillian; Taylor, Donna; Saunders, Christobel

    2015-01-01

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening

  7. Risk modeling and screening for BRCA1 mutations among Filipino breast cancer patients

    International Nuclear Information System (INIS)

    Nato, Alejandro Q. Jr.

    2003-03-01

    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for ∼45% of families with multiple breast carcinomas and for ∼80% of breast and ovarian cancer families. In this study, we investigated 34 familial Filipino breast cancer (BC) patients to: (a) estimate breast cancer risks and BRCA1/2 mutation carrier probabilities using risk assessment and prior probability models, respectively; (b) screen for putative polymorphisms at selected smaller exons of BRCA1 by single-strand conformation polymorphism (SSCP) analysis; (c) screen for truncated mutations at BRCA1 exon 11 by radioactive protein truncation test (PTT); and (d) estimate posterior probabilities upon incorporation of screening results. SSCP analysis revealed 8 unique putative polymorphisms. Low prevalence of unique putative polymorphisms at exon 2, 5, 17, and 22 may indicate probable mutations. Contrastingly, high prevalence of unique putative polymorphisms at exons 13, 15, and 16 may suggest true polymorphisms which are biologically insignificant. PTT, DHPLC, and sequence analyses revealed a novel mutation in exon 11 involving GT insertion that resulted to a stop codon which generated a 29.7 kDa truncated protein product. This is the second documented mutation in BRCA1 exon 11 in a Filipino BC patient since 1998. Initial genotype-phenotype correlations in Filipino BC patients may be elucidated based on screening tests performed. Our results corroborate the findings of a study on unselected incident Filipino BC cases where the reported prevalence of BRCA1 mutation is low. The higher prevalence of putative polypmorphisms may be attributed to the increased stringency in patient prospecting. The Gail, Claus, and BRCAPRO models can be utilized to estimate BC risk in unaffected high-risk individuals but validation is needed. Most of the BRCAPRO and Myriad.com prior probability estimates coincide with the presence of BRCA1 mutation and/or putative polymorphisms. This pioneering

  8. Risk modeling and screening for BRCA1 mutations among Filipino breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Nato, Jr, Alejandro Q

    2003-03-01

    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for {approx}45% of families with multiple breast carcinomas and for {approx}80% of breast and ovarian cancer families. In this study, we investigated 34 familial Filipino breast cancer (BC) patients to: (a) estimate breast cancer risks and BRCA1/2 mutation carrier probabilities using risk assessment and prior probability models, respectively; (b) screen for putative polymorphisms at selected smaller exons of BRCA1 by single-strand conformation polymorphism (SSCP) analysis; (c) screen for truncated mutations at BRCA1 exon 11 by radioactive protein truncation test (PTT); and (d) estimate posterior probabilities upon incorporation of screening results. SSCP analysis revealed 8 unique putative polymorphisms. Low prevalence of unique putative polymorphisms at exon 2, 5, 17, and 22 may indicate probable mutations. Contrastingly, high prevalence of unique putative polymorphisms at exons 13, 15, and 16 may suggest true polymorphisms which are biologically insignificant. PTT, DHPLC, and sequence analyses revealed a novel mutation in exon 11 involving GT insertion that resulted to a stop codon which generated a 29.7 kDa truncated protein product. This is the second documented mutation in BRCA1 exon 11 in a Filipino BC patient since 1998. Initial genotype-phenotype correlations in Filipino BC patients may be elucidated based on screening tests performed. Our results corroborate the findings of a study on unselected incident Filipino BC cases where the reported prevalence of BRCA1 mutation is low. The higher prevalence of putative polypmorphisms may be attributed to the increased stringency in patient prospecting. The Gail, Claus, and BRCAPRO models can be utilized to estimate BC risk in unaffected high-risk individuals but validation is needed. Most of the BRCAPRO and Myriad.com prior probability estimates coincide with the presence of BRCA1 mutation and/or putative polymorphisms. This

  9. Ecological Screening Values for Surface Water, Sediment, and Soil: 2005 Update

    Energy Technology Data Exchange (ETDEWEB)

    Friday, G. P.

    2005-07-18

    One of the principal components of the environmental remediation program at the Savannah River Site (SRS) is the assessment of ecological risk. Used to support CERCLA, RCRA, and DOE orders, the ecological risk assessment (ERA) can identify environmental hazards and evaluate remedial action alternatives. Ecological risk assessment is also an essential means for achieving DOE's risk based end state vision for the disposition of nuclear material and waste hazards, the decommissioning of facilities, and the remediation of inactive waste units at SRS. The complexity of an ERA ranges from a screening level ERA (SLERA) to a full baseline ERA. A screening level ecological risk assessments, although abbreviated from a baseline risk assessment, is nonetheless considered a complete risk assessment (EPA, 2001a). One of the initial tasks of any ERA is to identify constituents that potentially or adversely affect the environment. Typically, this is accomplished by comparing a constituent's maximum concentration in surface water, sediment, or soil with an ecological screening value (ESV). The screening process can eliminate many constituents from further consideration in the risk assessment, but it also identifies those that require additional evaluation. This document is an update of a previous compilation (Friday, 1998) and provides a comprehensive listing of ecological screening values for surface water, sediment, and soil. It describes how the screening values were derived and recommends benchmarks that can be used for ecological risk assessment. The sources of these updated benchmarks include the U.S. Environmental Protection Agency (EPA), U.S. Fish and Wildlife Service (USFWS), U.S. Geological Survey (USGS), National Oceanic and Atmospheric Administration (NOAA), Oak Ridge National Laboratory (ORNL), the State of Florida, the Canadian Council of Ministers of the Environment (CCME), the Dutch Ministry of the Environment (RIVM), and the scientific literature. It

  10. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    International Nuclear Information System (INIS)

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

    2005-01-01

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 x 10 -6 , 6 x 10 -4 ] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10 -3 . The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs

  11. Impact of socioeconomic deprivation on screening for cardiovascular disease risk in a primary prevention population: a cross-sectional study.

    Science.gov (United States)

    Lang, Sarah-Jane; Abel, Gary A; Mant, Jonathan; Mullis, Ricky

    2016-03-21

    Investigate the association between socioeconomic deprivation and completeness of cardiovascular disease (CVD) risk factor recording in primary care, uptake of screening in people with incomplete risk factor recording and with actual CVD risk within the screened subgroup. Cross-sectional study. Nine UK general practices. 7987 people aged 50-74 years with no CVD diagnosis. CVD risk was estimated using the Framingham equation from data extracted from primary care electronic health records. Where there was insufficient information to calculate risk, patients were invited to attend a screening assessment. Proportion of patients for whom clinical data were sufficiently complete to enable CVD risk to be calculated; proportion of patients invited to screening who attended; proportion of patients who attended screening whose 10-year risk of a cardiovascular event was high (>20%). For each outcome, a set of logistic regression models were run. Crude and adjusted ORs were estimated for person-level deprivation, age, gender and smoking status. We included practice-level deprivation as a continuous variable and practice as a random effect to account for clustering. People who had lower Indices of Multiple Deprivation (IMD) scores (less deprived) had significantly worse routine CVD risk factor recording (adjusted OR 0.97 (0.95 to 1.00) per IMD decile; p=0.042). Screening attendance was poorer in those with more deprivation (adjusted OR 0.89 (0.86 to 0.91) per IMD decile; p20% (OR 1.09 (1.03 to 1.15) per IMD decile; p=0.004). Our data suggest that those who had the most to gain from screening were least likely to attend, potentially exacerbating existing health inequalities. Future research should focus on tailoring the delivery of CVD screening to ensure engagement of socioeconomically deprived groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Screening youth for suicide risk in medical settings: time to ask questions.

    Science.gov (United States)

    Horowitz, Lisa M; Bridge, Jeffrey A; Pao, Maryland; Boudreaux, Edwin D

    2014-09-01

    This paper focuses on the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's Aspirational Goal 2 (screening for suicide risk) as it pertains specifically to children, adolescents, and young adults. Two assumptions are forwarded: (1) strategies for screening youth for suicide risk need to be tailored developmentally; and (2) we must use instruments that were created and tested specifically for suicide risk detection and developed specifically for youth. Recommendations for shifting the current paradigm include universal suicide screening for youth in medical settings with validated instruments. Published by Elsevier Inc.

  13. Lipoprotein metabolism indicators improve cardiovascular risk prediction.

    Directory of Open Access Journals (Sweden)

    Daniël B van Schalkwijk

    Full Text Available BACKGROUND: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to investigate whether lipoprotein metabolism indicators can improve cardiovascular risk prediction and therapy management. METHODS AND RESULTS: We calculated lipoprotein metabolism indicators for 1981 subjects (145 cases, 1836 controls from the Framingham Heart Study offspring cohort in which NMR lipoprotein profiles were measured. We applied a statistical learning algorithm using a support vector machine to select conventional risk factors and lipoprotein metabolism indicators that contributed to predicting risk for general cardiovascular disease. Risk prediction was quantified by the change in the Area-Under-the-ROC-Curve (ΔAUC and by risk reclassification (Net Reclassification Improvement (NRI and Integrated Discrimination Improvement (IDI. Two VLDL lipoprotein metabolism indicators (VLDLE and VLDLH improved cardiovascular risk prediction. We added these indicators to a multivariate model with the best performing conventional risk markers. Our method significantly improved both CVD prediction and risk reclassification. CONCLUSIONS: Two calculated VLDL metabolism indicators significantly improved cardiovascular risk prediction. These indicators may help to reduce prescription of unnecessary cholesterol-lowering medication, reducing costs and possible side-effects. For clinical application, further validation is required.

  14. Environmental noise pollution and risk of preeclampsia.

    Science.gov (United States)

    Auger, Nathalie; Duplaix, Mathilde; Bilodeau-Bertrand, Marianne; Lo, Ernest; Smargiassi, Audrey

    2018-08-01

    Environmental noise exposure is associated with a greater risk of hypertension, but the link with preeclampsia, a hypertensive disorder of pregnancy, is unclear. We sought to determine the relationship between environmental noise pollution and risk of preeclampsia during pregnancy. We analyzed a population-based cohort comprising 269,263 deliveries on the island of Montreal, Canada between 2000 and 2013. We obtained total environmental noise pollution measurements (LA eq24 , L den , L night ) from land use regression models, and assigned noise levels to each woman based on the residential postal code. We computed odds ratios (OR) and 95% confidence intervals (CI) for the association of noise with preeclampsia in mixed logistic regression models with participants as a random effect, and adjusted for air pollution, neighbourhood walkability, maternal age, parity, multiple pregnancy, comorbidity, socioeconomic deprivation, and year of delivery. We assessed whether noise exposure was more strongly associated with severe or early onset preeclampsia than mild or late onset preeclampsia. Prevalence of preeclampsia was higher for women exposed to elevated environmental noise pollution levels (LA eq24h  ≥ 65 dB(A) = 37.9 per 1000 vs. <50 dB(A) = 27.9 per 1000). Compared with 50 dB(A), an LA eq24h of 65.0 dB(A) was not significantly associated the risk of preeclampsia (OR 1.09, 95% CI 0.99-1.20). Associations were however present with severe (OR 1.29, 95% CI 1.09-1.54) and early onset (OR 1.71, 95% CI 1.20-2.43) preeclampsia, with results consistent across all noise indicators. The associations were much weaker or absent for mild and late preeclampsia. Environmental noise pollution may be a novel risk factor for pregnancy-related hypertension, particularly more severe variants of preeclampsia. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Science.gov (United States)

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  16. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Directory of Open Access Journals (Sweden)

    Davina Fevery

    Full Text Available Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq is used in environmental policy in Flanders (Belgium. The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN. The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  17. Predicting the environmental risks of radioactive discharges from Belgian nuclear power plants

    International Nuclear Information System (INIS)

    Vandenhove, H.; Sweeck, L.; Vives i Batlle, J.; Wannijn, J.; Van Hees, M.; Camps, J.; Olyslaegers, G.; Miliche, C.; Lance, B.

    2013-01-01

    An environmental risk assessment (ERA) was performed to evaluate the impact on non-human biota from liquid and atmospheric radioactive discharges by the Belgian Nuclear Power Plants (NPP) of Doel and Tihange. For both sites, characterisation of the source term and wildlife population around the NPPs was provided, whereupon the selection of reference organisms and the general approach taken for the environmental risk assessment was established. A deterministic risk assessment for aquatic and terrestrial ecosystems was performed using the ERICA assessment tool and applying the ERICA screening value of 10 μGy h −1 . The study was performed for the radioactive discharge limits and for the actual releases (maxima and averages over the period 1999–2008 or 2000–2009). It is concluded that the current discharge limits for the Belgian NPPs considered do not result in significant risks to the aquatic and terrestrial environment and that the actual discharges, which are a fraction of the release limits, are unlikely to harm the environment. -- Highlights: • Impact of radioactive discharges by the Belgian NPPs of Doel and Tihange on wildlife was evaluated. • Deterministic risk assessment for aquatic and terrestrial ecosystems performed with the ERICA tool. • NPP discharge limits do not result in significant risks to the aquatic and terrestrial environment. • Actual discharges, a fraction of the release limits, are unlikely to harm the environment

  18. Environmental screening report : Harrow Wind Farm

    International Nuclear Information System (INIS)

    2008-04-01

    AIM PowerGen Corporation is proposing to develop a wind energy project located on the northern shores of Lake Erie, Ontario called the Harrow Wind Farm. The wind energy project would consist of 24 wind turbines having a total capacity of 39.6 megawatts and comprise four small projects of six wind turbines each to be submitted to the standard offer program. The purpose of the project is to supply clean energy to the Ontario energy system using state-of-the-art wind energy technology. This report presented an environmental screening of the Harrow Wind Farm, as required by the Canadian Environmental Assessment Act and the Ontario Environmental Assessment Act. The report provided a detailed description of the Harrow Wind Farm location, optimization process and schedule as well as a detailed characterization of the natural and socio-economic environment. The report also provided a description of the regulatory agencies, as well as public and First Nations consultation activities. The effects on natural and socio-economic components were evaluated and an accidents and malfunction plan was also presented. Last, the report included a discussion of the effects of the environment on the Harrow Wind Farm; a summary of mitigation, impact management, and monitoring commitments of AIM PowerGen; and an overview of environmental advantages and disadvantages. It was concluded that the project design has benefited from several consultations with local authorities, lot owners and local residents, as well as federal and provincial agencies to ensure that environmental and social impacts are minimized while maximizing energy generation. refs., tabs., figs

  19. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

    Science.gov (United States)

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Risk of Malnutrition and Pressure Ulcer in a mixed hospital population. Nutritional risk screening predicting pressure ulcer.

    OpenAIRE

    Alhaug, Johanne

    2016-01-01

    Abstract Background and aim Malnutrition and pressure ulcer represent significant health problems for hospital inpatients, in addition to having a considerable impact on local and national health care cost. Sufficient nutritional status is crucial for proper wound healing, and malnutrition is a prominent risk factor for pressure ulcer development. Risk of malnutrition can be identified using standardized screening tools, such as the Nutritional Risk Screening (NRS) 2002. The objective of this...

  1. Multi-indicator assessment of water environment in government environmental auditing

    Institute of Scientific and Technical Information of China (English)

    HE Gui-zhen; LU Yong-long; MA Hua; WANG Xiao-long

    2007-01-01

    This study focuses on a multi-indicator assessment methodology for governmental environmental auditing of water protection programs. The environmental status of Wuli Lake in China was assessed using the global indicators (driver-status-response) developed by the CSD, and four additional indicators proposed by the author- water quality, pollution load, aquatic ecosystem status and lake sediment deposition. Various hydrological, chemical, biological and environmental parameters were used to estimate the values of the indicators for assessment of environmental status of the lake based on time series data sets for twenty years. The indicators proposed can be customized to meeting the needs for particular assessment of water protection programs. This method can be used to evaluate the performance of national environmental protection programs and provide technical support for environmental auditors.

  2. A DPSIR model for ecological security assessment through indicator screening: a case study at Dianchi Lake in China.

    Directory of Open Access Journals (Sweden)

    Zhen Wang

    Full Text Available Given the important role of lake ecosystems in social and economic development, and the current severe environmental degradation in China, a systematic diagnosis of the ecological security of lakes is essential for sustainable development. A Driving-force, Pressure, Status, Impact, and Risk (DPSIR model, combined with data screening for lake ecological security assessment was developed to overcome the disadvantages of data selection in existing assessment methods. Correlation and principal component analysis were used to select independent and representative data. The DPSIR model was then applied to evaluate the ecological security of Dianchi Lake in China during 1988-2007 using an ecological security index. The results revealed a V-shaped trend. The application of the DPSIR model with data screening provided useful information regarding the status of the lake's ecosystem, while ensuring information efficiency and eliminating multicollinearity. The modeling approach described here is practical and operationally efficient, and provides an attractive alternative approach to assess the ecological security of lakes.

  3. Environmental Indicator Principium with Case References to Agricultural Soil, Water, and Air Quality and Model-Derived Indicators.

    Science.gov (United States)

    Zhang, T Q; Zheng, Z M; Lal, R; Lin, Z Q; Sharpley, A N; Shober, A L; Smith, D; Tan, C S; Van Cappellen, P

    2018-03-01

    Environmental indicators are powerful tools for tracking environmental changes, measuring environmental performance, and informing policymakers. Many diverse environmental indicators, including agricultural environmental indicators, are currently in use or being developed. This special collection of technical papers expands on the peer-reviewed literature on environmental indicators and their application to important current issues in the following areas: (i) model-derived indicators to indicate phosphorus losses from arable land to surface runoff and subsurface drainage, (ii) glutathione-ascorbate cycle-related antioxidants as early-warning bioindicators of polybrominated diphenyl ether toxicity in mangroves, and (iii) assessing the effectiveness of using organic matrix biobeds to limit herbicide dissipation from agricultural fields, thereby controlling on-farm point-source pollution. This introductory review also provides an overview of environmental indicators, mainly for agriculture, with examples related to the quality of the agricultural soil-water-air continuum and the application of model-derived indicators. Current knowledge gaps and future lines of investigation are also discussed. It appears that environmental indicators, particularly those for agriculture, work efficiently at the field, catchment, and local scales and serve as valuable metrics of system functioning and response; however, these indicators need to be refined or further developed to comprehensively meet community expectations in terms of providing a consistent picture of relevant issues and/or allowing comparisons to be made nationally or internationally. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  4. Opportunities for web-based indicators in environmental sciences.

    Directory of Open Access Journals (Sweden)

    Sergio Malcevschi

    Full Text Available This paper proposes a set of web-based indicators for quantifying and ranking the relevance of terms related to key-issues in Ecology and Sustainability Science. Search engines that operate in different contexts (e.g. global, social, scientific are considered as web information carriers (WICs and are able to analyse; (i relevance on different levels: global web, individual/personal sphere, on-line news, and culture/science; (ii time trends of relevance; (iii relevance of keywords for environmental governance. For the purposes of this study, several indicators and specific indices (relational indices and dynamic indices were applied to a test-set of 24 keywords. Outputs consistently show that traditional study topics in environmental sciences such as water and air have remained the most quantitatively relevant keywords, while interest in systemic issues (i.e. ecosystem and landscape has grown over the last 20 years. Nowadays, the relevance of new concepts such as resilience and ecosystem services is increasing, but the actual ability of these concepts to influence environmental governance needs to be further studied and understood. The proposed approach, which is based on intuitive and easily replicable procedures, can support the decision-making processes related to environmental governance.

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

    Directory of Open Access Journals (Sweden)

    Ester Vilaprinyo

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

  6. Perceptions of risk and barriers to cervical cancer screening at Moi ...

    African Journals Online (AJOL)

    Background: Affordable screening cervical cancer methods using visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) are being developed. Scaling up of screening services requires an understanding of the user perceptions about screening. Objectives: Determine the perceptions of risk and barriers to ...

  7. Mammographic casting-type calcification associated with small screen-detected invasive breast cancers: is this a reliable prognostic indicator?

    International Nuclear Information System (INIS)

    Peacock, C.; Given-Wilson, R.M.; Duffy, S.W.

    2004-01-01

    AIM: The aim of the present study was to establish whether mammographic casting-type calcification associated with small screen-detected invasive breast cancers is a reliable prognostic indicator. METHODS AND MATERIALS: We retrospectively identified 50 consecutive women diagnosed with an invasive cancer less than 15 mm who showed associated casting calcification on their screening mammograms. Controls were identified that showed no microcalcification and were matched for tumour size, histological type and lymph node status. A minimum of 5 years follow-up was obtained, noting recurrence and outcome. Conditional and unconditional logistic regression, depending on the outcome variable, were used to analyse the data, taking the matched design into account in both cases. Where small numbers prohibited the use of logistic regression, Fisher's exact test was used. RESULTS: Five deaths from breast cancer occurred out of the 50 cases, of which three were lymph node positive, two were lymph node negative and none were grade 3. None of the 78 control cases died from breast cancer. The difference in breast cancer death rates was significant by Fisher's exact test (p=0.02). Risk of recurrence was also significantly increased in the casting cases (OR=3.55, 95% CI 1.02-12.33, p=0.046). CONCLUSION: Although the overall outcome for small screen-detected breast cancers is good, our study suggests that casting calcification is a poorer prognostic factor. The advantage of a mammographic feature as an independent prognostic indicator lies in early identification of high-risk patients, allowing optimization of management

  8. Decision support for utility environmental risk management

    International Nuclear Information System (INIS)

    Balson, W.E.; Wilson, D.S.

    1991-01-01

    This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment

  9. 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

  10. Risk communication considerations to facilitate the screening of mass populations for potential contamination with radioactive material.

    Science.gov (United States)

    Emery, R J; Sprau, D D; Morecook, R C

    2008-11-01

    Experience gained during a field training exercise with a Medical Reserve Corps unit on the screening of large groups of individuals for possible contamination with radioactive material revealed that while exercise participants were generally attentive to the proper use of protective equipment and detectors, they tended to overlook important basic risk communications aspects. For example, drill participants did not actively communicate with the persons waiting in line for screening, a step which would provide re-assurance, possibly minimize apprehension, and would clarify expectations. When questioned on this issue of risk communication, drill participants were often able to craft ad hoc messages, but the messages were inconsistent and likely would not have significantly helped diminish anxiety and maintain crowd control. Similar difficulties were encountered regarding messaging for persons determined to be contaminated, those departing the screening center, and those to be delivered to the media. Based on these experiences, the need for a suggested list of risk communication points was identified. To address this need, a set of risk communication templates were developed that focused on the issues likely to be encountered in a mass screening event. The points include issues such as the importance of remaining calm, steps for minimizing possible intake or uptake, considerations for those exhibiting acute injuries, expected screening wait times, the process to be followed and the information to be collected, the process to be undertaken for those exhibiting contamination, and symptoms to watch for after departure. Drill participants indicated in follow-up discussions that such pre-established risk communication templates would serve to enhance their ability to assist in times of emergency and noted the potential broader applicably of the approach for use in responses for other disasters types as well.

  11. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    Science.gov (United States)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  12. Gaps in Addressing Cardiovascular Risk in Rheumatoid Arthritis: Assessing Performance Using Cardiovascular Quality Indicators.

    Science.gov (United States)

    Barber, Claire E H; Esdaile, John M; Martin, Liam O; Faris, Peter; Barnabe, Cheryl; Guo, Selynne; Lopatina, Elena; Marshall, Deborah A

    2016-11-01

    Cardiovascular disease (CVD) is a major comorbidity for patients with rheumatoid arthritis (RA). This study sought to determine the performance of 11 recently developed CVD quality indicators (QI) for RA in clinical practice. Medical charts for patients with RA (early disease or biologic-treated) followed at 1 center were retrospectively reviewed. A systematic assessment of adherence to 11 QI over a 2-year period was completed. Performance on the QI was reported as a percentage pass rate. There were 170 charts reviewed (107 early disease and 63 biologic-treated). The most frequent CVD risk factors present at diagnosis (early disease) and biologic start (biologic-treated) included hypertension (26%), obesity (25%), smoking (21%), and dyslipidemia (15%). Performance on the CVD QI was highly variable. Areas of low performance (risk assessment, communication to the primary care physician (PCP) that patients with RA were at increased risk of CVD, body mass index documentation and counseling if overweight, communication to a PCP about an elevated blood pressure, and discussion of risks and benefits of antiinflammatories in patients at CVD risk. Rates of diabetes screening and lipid screening were 67% and 69%, respectively. The area of highest performance was observed for documentation of intent to taper corticosteroids (98%-100% for yrs 1 and 2, respectively). Gaps in CVD risk management were found and highlight the need for quality improvements. Key targets for improvement include coordination of CVD care between rheumatology and primary care, and communication of increased CVD risk in RA.

  13. An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

    Science.gov (United States)

    Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

    2008-01-01

    BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

  14. Screening women at high risk of breast cancer on the basis of evidence

    International Nuclear Information System (INIS)

    Warren, Ruth

    2001-01-01

    Geneticists are able to identify the risk of breast cancer. Strategies on offer include prevention, early diagnosis by screening, and prophylactic surgery. This paper analyses the evidence for offering screening. The radiation dose of mammography has been measured, but the risk is not fully known. Mammography screening of women of 40-50 years in the normal population has known effect. Little evidence is available for women under 40 years or for women with genetic susceptibility to breast cancer. Dense parenchymal pattern is associated with high grade cancers, and is both a risk factor and a reason for impaired screening sensitivity. Whether this applies to younger women or women at high risk is speculative. The pathological features of the cancers in gene carriers show differences from those occurring in normal women. This work should be correlated with imaging features. There is no literature to support the use of newer imaging methods in these women. Ultrasound and MRI avoid radiation and may be useful in dense breasts. SestaMIBI and PET scanning are not yet mature enough for screening, and may never have such a role. Any newer modality must be subjected to a formal randomised trial before being offered to screen women at high risk

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

    Science.gov (United States)

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

    2017-10-20

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

  16. An Effective Community?Academic Partnership to Extend the Reach of Screenings for Fall Risk

    OpenAIRE

    Schrodt, Lori A.; Garbe, Kathie C.; Chaplin, Rebecca; Busby-Whitehead, Jan; Shubert, Tiffany E.

    2013-01-01

    Older adults should be screened for fall risk annually. Community providers (people without formal medical training who work with older adults in senior centers or aging services) may be a viable group to expand the reach of screenings. Our community–academic partnership developed a program to increase and assess fall risk screenings by community providers. Community sites hosted training workshops and screening events. Community screenings were well attended and received by providers and old...

  17. Compendium of Environmental Sustainability Indicator Collections: Rio to Johannesburg Dashboard of Sustainable Indicators

    Data.gov (United States)

    National Aeronautics and Space Administration — The Rio to Johannesburg Dashboard of Sustainable Development Indicators portion of the Compendium of Environmental Sustainability Indicator Collections contains 35...

  18. Wind turbine environmental assessment -- Vol 1: Screening document

    International Nuclear Information System (INIS)

    2000-04-01

    The environmental effects of the proposed construction and operation of up to three wind turbines on the Toronto waterfront are evaluated in accordance with the requirements of the Canadian Environmental Assessment Act (CEAA) and Regulations. The nine sections of the report provide background on the environmental assessment and the wind turbine project; provide justification for the project and describes alternative sites and wind turbine technologies; outlines the scope of the project; sketches the biophysical and socio-economic environment; presents an evaluation of the environmental impacts and proposed mitigating measures; describes the public consultation program that was carried out; summarizes the comments received from interested parties; presents the conclusion of the environmental impact assessment; and responds to the public comments received on the draft screening document. Most of the concerns raised involved avoidance reactions by birds, disruption or fragmentation of wildlife, the potential for high kill rate of small nocturnal migrants and young birds, and the effect of noise on breeding birds. The overall recommendation of the consultants is that the project is not likely to cause significant adverse environmental effects and its construction and operations should be authorized. 115 refs., 8 tabs., 2 figs. (14 appendices are in volume 2)

  19. Environmental risk assessment system for phosphogypsum tailing dams.

    Science.gov (United States)

    Sun, Xin; Ning, Ping; Tang, Xiaolong; Yi, Honghong; Li, Kai; Zhou, Lianbi; Xu, Xianmang

    2013-01-01

    This paper may be of particular interest to the readers as it provides a new environmental risk assessment system for phosphogypsum tailing dams. In this paper, we studied the phosphogypsum tailing dams which include characteristics of the pollution source, environmental risk characteristics and evaluation requirements to identify the applicable environmental risk assessment methods. Two analytical methods, that is, the analytic hierarchy process (AHP) and fuzzy logic, were used to handle the complexity of the environmental and nonquantitative data. Using our assessment method, different risk factors can be ranked according to their contributions to the environmental risk, thereby allowing the calculation of their relative priorities during decision making. Thus, environmental decision-makers can use this approach to develop alternative management strategies for proposed, ongoing, and completed PG tailing dams.

  20. DEVELOPMENT OF A RISK SCREENING METHOD FOR CREDITED OPERATOR ACTIONS

    International Nuclear Information System (INIS)

    HIGGINS, J.C.; O'HARA, J.M.; LEWIS, P.M.; PERSENSKY, J.; BONGARRA, J.

    2002-01-01

    DEVELOPMENT OF A RISK SCREENING METHOD FOR CREDITED OPERATOR ACTIONS. THE U.S. NUCLEAR REGULATORY COMMISSION (NRC) REVIEWS THE HUMAN FACTORS ASPECTS OF PROPOSED LICENSE AMENDMENTS THAT IMPACT HUMAN ACTIONS THAT ARE CREDITED IN A PLANTS SAFETY ANALYSIS. THE STAFF IS COMMITTED TO A GRADED APPROACH TO THESE REVIEWS THAT FOCUS RESOURCES ON THE MOST RISK IMPORTANT CHANGES. THEREFORE, A RISK INFORMED SCREENING METHOD WAS DEVELOPED BASED ON AN ADAPTATION OF EXISTING GUIDANCE FOR RISK INFORMED REGULATION AND HUMAN FACTORS. THE METHOD USES BOTH QUANTITATIVE AND QUALITATIVE INFORMATION TO DIVIDE THE AMENDMENT REQUESTS INTO DIFFERENT LEVELS OF REVIEW. THE METHOD WAS EVALUATED USING A VARIETY OF TESTS. THIS PAPER WILL SUMMARIZE THE DEVELOPMENT OF THE METHODOLOGY AND THE EVALUATIONS THAT WERE PERFORMED TO VERIFY ITS USEFULNESS

  1. Comparison of cumulative false-positive risk of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp

    2015-01-01

    INTRODUCTION: In the United States (US), about one-half of women screened with annual mammography have at least one false-positive test after ten screens. The estimate for European women screened ten times biennially is much lower. We evaluate to what extent screening interval, mammogram type......=400,204), between 1991-2012 and 1993-2013, respectively. Model-based cumulative false-positive risks were computed for the entire sample, using two statistical methods (Hubbard Njor) previously used to estimate false-positive risks in the US and Europe. RESULTS: Empirical cumulative risk of at least...... one false-positive test after eight (annual or biennial) screens was 41.9% in BCSC, 16.1% in Copenhagen, and 7.4% in Funen. Variation in screening interval and mammogram type did not explain the differences by country. Using the Hubbard method, the model-based cumulative risks after eight screens...

  2. The role of age, ethnicity and environmental factors in modulating malaria risk in Rajasthali, Bangladesh

    Directory of Open Access Journals (Sweden)

    Haque Ubydul

    2011-12-01

    Full Text Available Abstract Background Malaria is endemic in the Rajasthali region of the Chittagong Hill Tracts in Bangladesh and the Rajasthali region is the most endemic area of Bangladesh. Quantifying the role of environmental and socio-economic factors in the local spatial patterns of malaria endemicity can contribute to successful malaria control and elimination. This study aimed to investigate the role of environmental factors on malaria risk in Rajasthali and to quantify the geographical clustering in malaria risk unaccounted by these factors. Method A total of 4,200 (78.9%; N = 5,322 households were targeted in Rajasthali in July, 2009, and 1,400 individuals were screened using a rapid diagnostic test (Falci-vax. These data were linked to environmental and socio-economic data in a geographical information system. To describe the association between environmental factors and malaria risk, a generalized linear mixed model approach was utilized. The study investigated the role of environmental factors on malaria risk by calculating their population-attributable fractions (PAF, and used residual semivariograms to quantify the geographical clustering in malaria risk unaccounted by these factors. Results Overall malaria prevalence was 11.7%. Out of 5,322 households, 44.12% households were living in areas with malaria prevalence of ≥ 10%. The results from statistical analysis showed that age, ethnicity, proximity to forest, household density, and elevation were significantly and positively correlated with the malaria risk and PAF estimation. The highest PAF of malaria prevalence was 47.7% for third tertile (n = 467 of forest cover, 17.6% for second tertile (n = 467 of forest cover and 19.9% for household density >1,000. Conclusion Targeting of malaria health interventions at small spatial scales in Bangladesh should consider the social and socio-economic risk factors identified as well as alternative methods for improving equity of access to interventions

  3. An evaluation of a risk-based environmental regulation in Brazil: Limitations to risk management of hazardous installations

    International Nuclear Information System (INIS)

    Naime, Andre

    2017-01-01

    The environmental regulation of hazardous projects with risk-based decision-making processes can lead to a deficient management of human exposure to technological hazards. Such an approach for regulation is criticized for simplifying the complexity of decisions involving the economic, social, and environmental aspects of the installation and operation of hazardous facilities in urban areas. Results of a Brazilian case study indicate that oil and gas transmission pipelines may represent a threat to diverse communities if the relationship between such linear projects and human populations is overlooked by regulatory bodies. Results also corroborate known challenges to the implementation of EIA processes and outline limitations to an effective environmental and risk management. Two preliminary topics are discussed to strengthen similar regulatory practices. Firstly, an effective integration between social impact assessment and risk assessment in EIA processes to have a more comprehensive understanding of the social fabric. Secondly, the advancement of traditional management practices for hazardous installations to pursue a strong transition from assessment and evaluation to management and control and to promote an effective interaction between land-use planning and environmental regulation.

  4. An evaluation of a risk-based environmental regulation in Brazil: Limitations to risk management of hazardous installations

    Energy Technology Data Exchange (ETDEWEB)

    Naime, Andre, E-mail: andre.naime.ibama@gmail.com

    2017-03-15

    The environmental regulation of hazardous projects with risk-based decision-making processes can lead to a deficient management of human exposure to technological hazards. Such an approach for regulation is criticized for simplifying the complexity of decisions involving the economic, social, and environmental aspects of the installation and operation of hazardous facilities in urban areas. Results of a Brazilian case study indicate that oil and gas transmission pipelines may represent a threat to diverse communities if the relationship between such linear projects and human populations is overlooked by regulatory bodies. Results also corroborate known challenges to the implementation of EIA processes and outline limitations to an effective environmental and risk management. Two preliminary topics are discussed to strengthen similar regulatory practices. Firstly, an effective integration between social impact assessment and risk assessment in EIA processes to have a more comprehensive understanding of the social fabric. Secondly, the advancement of traditional management practices for hazardous installations to pursue a strong transition from assessment and evaluation to management and control and to promote an effective interaction between land-use planning and environmental regulation.

  5. Risk factors & screening modalities for oral cancer.

    Science.gov (United States)

    Chau, Steven

    2008-01-01

    Dentists are at the forefront for screening oral cancer. In addition to the well known carcinogenic potential of tobacco and alcohol, betel nut chewing and human papilloma virus are important risk factors in the development of oral cancer. To aid in screening and decreasing morbidity and mortality from oral cancer, a variety of techniques have been developed. These techniques show promise but they require additional investigations to determine their usefulness in oral cancer detection. Dentists need to be well educated and vigilant when dealing with all patients they encounter. Early detection, diagnosis and treatment are critical for the effective management of oral cancers.

  6. Uniform Transnational Assessment of the Environmental Indices from the Romanian Catchment Area of the Tisa River

    Directory of Open Access Journals (Sweden)

    SILVIU-FLORIN FONOGEA

    2010-01-01

    Full Text Available The uniform transnational assessment of the environmental indices in the catchment area of the Tisa river aims at rehabilitating, protecting and conserving the environmental systems, as well as creating a commonly strategic demarche concerning a sustainable spatial development, based on integrated intersectorial approaches of environmental issues, viewed in their territorial dimension. The information necessary in underlining the current situation in the Romanian catchment area of the Tisa has been structured according to the following categories of analysed indices: sources of surface waters, resources of drinkable water and water supply resources, the risk of not reaching the environmental objectives, significant sources of water pollution (punctual sources of pollution, diffuse sources of pollution, significant hydromorphic pressure, the quality of water, significant sources of air pollution, soils affected by agricultural and industrial activities, nature protection and waste management.

  7. Network television news coverage of environmental risks

    International Nuclear Information System (INIS)

    Greenberg, M.R.; Sandman, P.M.; Sachsman, D.V.; Salomone, K.L.

    1989-01-01

    Despite the criticisms that surround television coverage of environmental risk, there have been relatively few attempts to measure what and whom television shows. Most research has focused analysis on a few weeks of coverage of major stories like the gas leak at Bhopal, the Three Mile Island nuclear accident, or the Mount St. Helen's eruption. To advance the research into television coverage of environmental risk, an analysis has been made of all environmental risk coverage by the network nightly news broadcasts for a period of more than two years. Researchers have analyzed all environmental risk coverage-564 stories in 26 months-presented on ABC, CBS, and NBC's evening news broadcasts from January 1984 through February 1986. The quantitative information from the 564 stories was balanced by a more qualitative analysis of the television coverage of two case studies-the dioxin contamination in Times Beach, Missouri, and the suspected methyl isocyanate emissions from the Union Carbide plant in Institute, West Virginia. Both qualitative and quantitative data contributed to the analysis of the role played by experts and environmental advocacy sources in coverage of environmental risk and to the suggestions for increasing that role

  8. Benefit-risk analysis for mass screening of stomach cancer in Japan, 2

    International Nuclear Information System (INIS)

    Iinuma, Takeshi; Tateno, Yukio; Umegaki, Yoichiro; Hashizume, Tadashi; Kitabatake, Takashi.

    1978-01-01

    Mass screening of stomach cancer is one of the largest screening systems in Japan. In the previous paper, we have described the benefit-risk analysis in terms of life-saving due to early detection of stomach cancer and loss of life due to late induction of cancer by radiation. In this paper, we report the genetic effect of x-ray diagnosis used in the mass screening and cost-effectiveness for the screening program. The former is calculated by the product of genetically significant dose and rate of induction for genetic effects. Since the genetically significant dose in woman is about 10 times larger than that in man, the genetic risk is greater in woman accordingly. It is also found that the genetic risk over 40 years old is only 3% of the risk in the whole population and that it is almost neglected if the screening is performed only over age of 40. Cost of the screening is estimated to be yen 3,000/person which includes that of photofluorography and a part of other detailed examinations. Since total population screened is about 4 million in 1975, the total amount of cost is 1.2 x 10 10 yen/year. Cost per person-year is mainly dependent upon the age of the person: for one person-year in man or woman of 15 - 19 years old, the cost is about 20 million yen, but it is about 150,000 yen for man of 70 - 74 years old. These information is useful in the decision on the mass screening policy for stomach cancer in Japan. (auth.)

  9. A nutritional risk screening model for patients with liver cirrhosis established using discriminant analysis

    Directory of Open Access Journals (Sweden)

    ZHU Binghua

    2017-06-01

    Full Text Available ObjectiveTo establish a nutritional risk screening model for patients with liver cirrhosis using discriminant analysis. MethodsThe clinical data of 273 patients with liver cirrhosis who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2015 to March 2016 were collected. Body height, body weight, upper arm circumference, triceps skinfold thickness, subscapular skinfold thickness, and hand grip strength were measured and recorded, and then body mass index (BMI and upper arm muscle circumference were calculated. Laboratory markers including liver function parameters, renal function parameters, and vitamins were measured. The patients were asked to complete Nutritional Risk Screening 2002 and Malnutrition Universal Screening Tool (MUST, and a self-developed nutritional risk screening pathway was used for nutritional risk classification. Observation scales of the four diagnostic methods in traditional Chinese medicine were used to collect patients′ symptoms and signs. Continuous data were expressed as mean±SD (x±s; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. Discriminant analysis was used for model establishment, and cross validation was used for model verification. ResultsThe nutritional risk screening pathway for patients with liver cirrhosis was used for the screening of respondents, and there were 49 patients (17.95% in non-risk group, 49 (17.95% in possible-risk group, and 175 (64.10% in risk group. The distance criterion function was used to establish the nutritional risk screening model for patients with liver cirrhosis: D1=-11.885+0.310×BMI+0150×MAC+0.005×P-Alb-0.001×Vit B12+0.103×Vit D-0.89×ascites-0.404×weakness-0.560×hypochondriac pain+0035×dysphoria with feverish sensation (note: if a patient has ascites, weakness, hypochondriac pain

  10. [Comparison of screening performance between primary high-risk HPV screening and high-risk HPV screening plus liquid-based cytology cotesting in diagnosis of cervical precancerous or cancerous lesions].

    Science.gov (United States)

    Zhao, X L; Remila, Rezhake; Hu, S Y; Zhang, L; Xu, X Q; Chen, F; Pan, Q J; Zhang, X; Zhao, F H

    2018-05-06

    Objective: To evaluate and compare the screening performance of primary high-risk HPV(HR-HPV) screening and HR-HPV screening plus liquid-based cytology (LBC) cotesting in diagnosis of cervical cancer and precancerous lesions (CIN2+). Methods: We pooled 17 population-based cross-sectional studies which were conducted across China from 1999 to 2008. After obtaining informed consent, all women received liquid-based cytology(LBC)testing, HR-HPV DNA testing. Totally 28 777 women with complete LBC, HPV and biopsy results were included in the final analysis. Screening performance of primary HR-HPV DNA screening and HPV screening plus LBC co-testing in diagnosis of CIN2+ were calculated and compared among different age groups. Results: Among the whole population, the detection rates of primary HR-HPV screening and HR-HPV screening plus LBC co-testing are 3.05% (879 CIN2+) and 3.13%(900 CIN2+), respectively. The sensitivity were 96.4% and 98.7% (χ(2)=19.00, PHPV screening performed better than co-testing (AUC were 0.913 and 0.888; Z= 6.16, PHPV screening, co-testing showed significantly higher colposcopy referral rates (16.5% and 23.6%, respectively, χ(2)=132.00, PHPV screening in diagnosis of CIN2+, and was 12.5 (15.7%(288 cases) vs 1.3%(23 cases)) times as much as the detection rate of HR-HPV screening plus cytology contesting. Conclusion: Compared with primary HR-HPV screening, HR-HPV screening plus cytology co-testing does not show better results in the screening performance for CIN2+ detection, and the cost-effectiveness is not good enough, especially in younger age group.

  11. The case for indicator condition-guided HIV screening

    DEFF Research Database (Denmark)

    Lazarus, J V; Hoekstra, M; Raben, D

    2013-01-01

    One-half of the estimated 2.5 million people who now live with HIV in the World Health Organization (WHO) European Region are still diagnosed late. A central question is which clinical scenarios should trigger an HIV test recommendation in order to avoid late presentation. Drawing on the work...... of the HIV Indicator Diseases across Europe Study (HIDES), new guidance brings together in one place a list of the conditions that should result in an HIV screening recommendation....

  12. 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.

  13. Effect of providing risk information on undergoing cervical cancer screening: a randomized controlled trial.

    Science.gov (United States)

    Fujiwara, Hiroyuki; Shimoda, Akihiro; Ishikawa, Yoshiki; Taneichi, Akiyo; Ohashi, Mai; Takahashi, Yoshifumi; Koyanagi, Takahiro; Morisawa, Hiroyuki; Takahashi, Suzuyo; Sato, Naoto; Machida, Shizuo; Takei, Yuji; Saga, Yasushi; Suzuki, Mitsuaki

    2015-01-01

    In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.

  14. Development of organ-specific donor risk indices.

    Science.gov (United States)

    Akkina, Sanjeev K; Asrani, Sumeet K; Peng, Yi; Stock, Peter; Kim, W Ray; Israni, Ajay K

    2012-04-01

    Because of the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival with various combinations of donor and recipient characteristics. Here we review the kidney donor risk index (KDRI) and the liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The KDRI has a potential role in developing new kidney allocation algorithms. The LDRI allows a greater appreciation of the importance of donor factors, particularly for hepatitis C virus-positive recipients; as the donor risk index increases, the rates of allograft and patient survival among these recipients decrease disproportionately. The use of livers with high donor risk indices is associated with increased hospital costs that are independent of recipient risk factors, and the transplantation of livers with high donor risk indices into patients with Model for End-Stage Liver Disease scores indices for liver transplantation, including donor-recipient matching and the retransplant donor risk index. Although substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. Copyright © 2012 American Association for the Study of Liver Diseases.

  15. Canadian environmental sustainability indicators: highlights 2005

    International Nuclear Information System (INIS)

    2005-12-01

    Canadians' health and their social and economic well-being are fundamentally linked to the quality of their environment. Recognizing this, in 2004 the Government of Canada committed to establishing national indicators of freshwater quality, air quality and greenhouse gas emissions. The goal of these new indicators is to provide Canadians with more regular and reliable information on the state of their environment and how it is linked with human activity. Canadians need clearly defined environmental indicators - measuring sticks that can track the results that have been achieved through the efforts of governments, industries and individuals to protect and improve the environment. Environment Canada, Statistics Canada and Health Canada are working together to further develop and communicate these indicators. Reflecting the joint responsibility for environmental management in Canada, this effort has benefited from the cooperation and input of the provinces and territories. The indicators are: air quality; greenhouse gas emissions; and, freshwater quality. Air quality tracks Canadians' exposure to ground-level ozone - a key component of smog. The indicator measures one of the most common, harmful air pollutants to which people are exposed. The use of the seasonal average of ozone concentrations reflects the potential for long-term health effects. Greenhouse gas emissions tracks the annual releases of the six greenhouse gases that are the major contributors to climate change. The indicator comes directly from the greenhouse gas inventory report prepared by Environment Canada for the United Nations Framework Convention on Climate Change (UNFCCC) and the Kyoto Protocol. The data are widely used to report on progress toward Canada's Kyoto target for reduced emissions. Freshwater quality reports the status of surface water quality at selected monitoring sites across the country. For this first report, the focus of the indicator is on the protection of aquatic life, such as

  16. 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

  17. Cost-effectiveness and radiological risk associated with mass chest screening

    International Nuclear Information System (INIS)

    Stieve, F.E.

    1987-01-01

    This report presents in summary the cost effectiveness and radiological risks associated with mass chest tuberculosis screening in major European countries. The state of tuberculosis in west Europe, the cost effectiveness of mass screening, international standards regarding radiation doses as well as the need for quality control are addressed

  18. Mitigating the Risk of Environmental Hazards in Mexico

    Science.gov (United States)

    2011-10-28

    wildfires.9 Infectious hazards in Mexico pose an intermediate risk of disease and include food or waterborne illness, hepatitis, dengue fever , Valley Fever ...the type of health threat that is posed. 12 Nanotechnology: Within the Latin American region , Brazil , Argentina and Mexico are leaders in...07/25/ dengue -on-the-loose/ (accessed 11 October 2011). 41. Environmental Protection Agency, State of the Border Region Indicators Report 2005, EPA

  19. Breast cancer screening in Italy: evaluating key performance indicators for time trends and activity volumes.

    Science.gov (United States)

    Giordano, Livia; Castagno, Roberta; Giorgi, Daniela; Piccinelli, Cristiano; Ventura, Leonardo; Segnan, Nereo; Zappa, Marco

    2015-01-01

    Together with the National centre for screening monitoring (ONS), GISMa supports annual collection of data on national breast screening activities. Aggregated data on implementation and performance are gathered through a standardized form to calculate process and impact indicators. Analyzed data belong to 153 local programmes in the period 2006-2011 (2006-2012 for participation rate only). During the whole period, Italian crude participation rate exceeded GISMa's acceptable standard (50%), even though a higher participation in northern and central Italy compared to southern Italy and Islands was observed. Time trend analysis of diagnostic indicators confirmed in 2011 an adequate quality of breast screening performance, especially at subsequent screening. Recall rate at initial screening did not reach the acceptable standard (performance was achieved at subsequent screening. The same trend was followed by the overall detection rate and positive predictive value. They both showed a progressive reduction (from 6.2‰ in 2006 to 4.5‰ in 2011 for DR and from 8.0% in 2006 to 5.2% in 2011 for PPV, respectively) at initial screening and a good, stable trend at subsequent screening. Activity volume analysis shows that in programmes with greater activity (test/year ≥10,000) RR at both initial and subsequent screening has a better performance. This is also true for DR and PPV where programmes with high volumes of activity do better, especially when compared with those that interpret fewer than 5,000 mammograms per year. In spite of a few limits, these results are reassuring, and they reward the efforts made by screening professionals. It is therefore important to continue to monitor screening indicators and suggest, test, and evaluate new strategies for continuous improvement.

  20. Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: findings from two representative community surveys.

    Science.gov (United States)

    Fuller-Thomson, E; Sawyer, J-L

    2014-01-01

    Screening strategies for childhood physical abuse (CPA) need to be improved in order to identify those most at risk. This study uses two regionally representative community samples to examine whether a cluster or cumulative model of risk indicators (i.e. parental divorce, parental unemployment, and parental addictions) explains a larger proportion of the variation in CPA. Data were drawn from Statistics Canada's National Population Health Survey (1994-1995) and Canadian Community Health Survey 3.1 (2005). Response rates were greater than 80% in both samples. Each survey had approximately 13,000 respondents aged 18 and over who answered questions about the above adverse childhood experiences. A gradient was shown with similar outcomes in each data set. Only 3.4% of adults who experienced none of the three risk indicators reported they had been physically abused during childhood or adolescence. The prevalence of CPA was greater among those who experienced parental divorce alone (8.3%-10.7%), parental unemployment alone (8.9%-9.7%) or parental addictions alone (18.0%-19.5%). When all three risk indicators were present, the prevalence of CPA ranged from 36.0%-41.0% and the age-sex-race adjusted odds were greater than 15 times that of individuals with none of the three risk indicators. The cluster model explained a statistically significantly larger proportion of the variation than the cumulative model although the difference between the two models was modest. For the purposes of parsimony, the cumulative model may be the better alternative. Adults who were exposed to two or more childhood risk indicators were much more likely to report that they were physically abused during their childhood than those with only one or no risk factors. Medical professionals may use this information on cumulative risk factors to more effectively target screening for potential CPA. Future research should include prospective studies. © 2012 John Wiley & Sons Ltd.

  1. Environmental proxies of antigen exposure explain variation in immune investment better than indices of pace of life.

    Science.gov (United States)

    Horrocks, Nicholas P C; Hegemann, Arne; Ostrowski, Stéphane; Ndithia, Henry; Shobrak, Mohammed; Williams, Joseph B; Matson, Kevin D; Tieleman, B I

    2015-01-01

    Investment in immune defences is predicted to covary with a variety of ecologically and evolutionarily relevant axes, with pace of life and environmental antigen exposure being two examples. These axes may themselves covary directly or inversely, and such relationships can lead to conflicting predictions regarding immune investment. If pace of life shapes immune investment then, following life history theory, slow-living, arid zone and tropical species should invest more in immunity than fast-living temperate species. Alternatively, if antigen exposure drives immune investment, then species in antigen-rich tropical and temperate environments are predicted to exhibit higher immune indices than species from antigen-poor arid locations. To test these contrasting predictions we investigated how variation in pace of life and antigen exposure influence immune investment in related lark species (Alaudidae) with differing life histories and predicted risks of exposure to environmental microbes and parasites. We used clutch size and total number of eggs laid per year as indicators of pace of life, and aridity, and the climatic variables that influence aridity, as correlates of antigen abundance. We quantified immune investment by measuring four indices of innate immunity. Pace of life explained little of the variation in immune investment, and only one immune measure correlated significantly with pace of life, but not in the predicted direction. Conversely, aridity, our proxy for environmental antigen exposure, was predictive of immune investment, and larks in more mesic environments had higher immune indices than those living in arid, low-risk locations. Our study suggests that abiotic environmental variables with strong ties to environmental antigen exposure can be important correlates of immunological variation.

  2. Cancer risk assessments and environmental regulation

    International Nuclear Information System (INIS)

    Scroggin, D.G.

    1990-01-01

    Governmental regulation of toxic substances, such as carcinogens and radiation, prompts both legal and scientific controversies. Industry, environmental activist groups, government regulators, and the general public are all concerned with the question of how environmental risk to public health is to be measured and what level of risk warrants government action under the environmental laws. Several recent events shed light on the fundamental scientific and legal problems inherent in such regulation, and these events may affect the direction of future developments. These events include implementation of generic Risk Assessment Guidelines by the US EPA, litigation challenging EPA's regulation of carcinogenic substances, new scientific understanding of the relative risks from human exposure to natural and man-made sources, and the continuing growth of toxic tort litigation in which victims of cancer seek large damages from industrial emitters of pollution

  3. Profiling the environmental risk management of Chinese local environmental agencies

    NARCIS (Netherlands)

    He, G.; Zhang, L.; Mol, A.P.J.; Lu, Y.

    2013-01-01

    The increasing frequency and impact of environmental accidents have pushed the issue of environmental risk management (ERM) to the top of the Chinese governments’ agendas and popularized the term ‘emergency response.’ Although the boundary between environmental accidents and other types of accidents

  4. Colorectal cancer screening for average-risk North Americans: an economic evaluation.

    Directory of Open Access Journals (Sweden)

    Steven J Heitman

    Full Text Available BACKGROUND: Colorectal cancer (CRC fulfills the World Health Organization criteria for mass screening, but screening uptake is low in most countries. CRC screening is resource intensive, and it is unclear if an optimal strategy exists. The objective of this study was to perform an economic evaluation of CRC screening in average risk North American individuals considering all relevant screening modalities and current CRC treatment costs. METHODS AND FINDINGS: An incremental cost-utility analysis using a Markov model was performed comparing guaiac-based fecal occult blood test (FOBT or fecal immunochemical test (FIT annually, fecal DNA every 3 years, flexible sigmoidoscopy or computed tomographic colonography every 5 years, and colonoscopy every 10 years. All strategies were also compared to a no screening natural history arm. Given that different FIT assays and collection methods have been previously tested, three distinct FIT testing strategies were considered, on the basis of studies that have reported "low," "mid," and "high" test performance characteristics for detecting adenomas and CRC. Adenoma and CRC prevalence rates were based on a recent systematic review whereas screening adherence, test performance, and CRC treatment costs were based on publicly available data. The outcome measures included lifetime costs, number of cancers, cancer-related deaths, quality-adjusted life-years gained, and incremental cost-utility ratios. Sensitivity and scenario analyses were performed. Annual FIT, assuming mid-range testing characteristics, was more effective and less costly compared to all strategies (including no screening except FIT-high. Among the lifetimes of 100,000 average-risk patients, the number of cancers could be reduced from 4,857 to 1,393 [corrected] and the number of CRC deaths from 1,782 [corrected] to 457, while saving CAN$68 per person. Although screening patients with FIT became more expensive than a strategy of no screening when the

  5. Risk-based performance indicators

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  6. Building better environmental risk assessments

    Directory of Open Access Journals (Sweden)

    Raymond eLayton

    2015-08-01

    Full Text Available Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERA for genetically modified (GM crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data, and adapting advances in risk analysis from other relevant disciplines.

  7. Building Better Environmental Risk Assessments

    Science.gov (United States)

    Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

    2015-01-01

    Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines. PMID:26301217

  8. Building Better Environmental Risk Assessments.

    Science.gov (United States)

    Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

    2015-01-01

    Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems - examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines.

  9. Risk Stratification and Shared Decision Making for Colorectal Cancer Screening: A Randomized Controlled Trial.

    Science.gov (United States)

    Schroy, Paul C; Duhovic, Emir; Chen, Clara A; Heeren, Timothy C; Lopez, William; Apodaca, Danielle L; Wong, John B

    2016-05-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer (CRC) screening, yet providers often fail to comply with patient preferences that differ from their own. To determine whether risk stratification for advanced colorectal neoplasia (ACN) influences provider willingness to comply with patient preferences when selecting a desired CRC screening option. Randomized controlled trial. Asymptomatic, average-risk patients due for CRC screening in an urban safety net health care setting. Patients were randomized 1:1 to a decision aid alone (n= 168) or decision aid plus risk assessment (n= 173) arm between September 2012 and September 2014. The primary outcome was concordance between patient preference and test ordered; secondary outcomes included patient satisfaction with the decision-making process, screening intentions, test completion rates, and provider satisfaction. Although providers perceived risk stratification to be useful in selecting an appropriate screening test for their average-risk patients, no significant differences in concordance were observed between the decision aid alone and decision aid plus risk assessment groups (88.1% v. 85.0%,P= 0.40) or high- and low-risk groups (84.5% v. 87.1%,P= 0.51). Concordance was highest for colonoscopy and relatively low for tests other than colonoscopy, regardless of study arm or risk group. Failure to comply with patient preferences was negatively associated with satisfaction with the decision-making process, screening intentions, and test completion rates. Single-institution setting; lack of provider education about the utility of risk stratification into their decision making. Providers perceived risk stratification to be useful in their decision making but often failed to comply with patient preferences for tests other than colonoscopy, even among those deemed to be at low risk of ACN. © The Author(s) 2016.

  10. An assessment of community health workers' ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study.

    Science.gov (United States)

    Gaziano, Thomas A; Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Khanam, Masuma; Puoane, Thandi; Levitt, Naomi S

    2015-09-01

    Cardiovascular disease contributes substantially to the non-communicable disease (NCD) burden in low-income and middle-income countries, which also often have substantial health personnel shortages. In this observational study we investigated whether community health workers could do community-based screenings to predict cardiovascular disease risk as effectively as could physicians or nurses, with a simple, non-invasive risk prediction indicator in low-income and middle-income countries. This observation study was done in Bangladesh, Guatemala, Mexico, and South Africa. Each site recruited at least ten to 15 community health workers based on usual site-specific norms for required levels of education and language competency. Community health workers had to reside in the community where the screenings were done and had to be fluent in that community's predominant language. These workers were trained to calculate an absolute cardiovascular disease risk score with a previously validated simple, non-invasive screening indicator. Community health workers who successfully finished the training screened community residents aged 35-74 years without a previous diagnosis of hypertension, diabetes, or heart disease. Health professionals independently generated a second risk score with the same instrument and the two sets of scores were compared for agreement. The primary endpoint of this study was the level of direct agreement between risk scores assigned by the community health workers and the health professionals. Of 68 community health worker trainees recruited between June 4, 2012, and Feb 8, 2013, 42 were deemed qualified to do fieldwork (15 in Bangladesh, eight in Guatemala, nine in Mexico, and ten in South Africa). Across all sites, 4383 community members were approached for participation and 4049 completed screening. The mean level of agreement between the two sets of risk scores was 96·8% (weighted κ=0·948, 95% CI 0·936-0·961) and community health workers showed

  11. Integrated approach of environmental impact and risk assessment of Rosia Montana Mining Area, Romania.

    Science.gov (United States)

    Stefănescu, Lucrina; Robu, Brînduşa Mihaela; Ozunu, Alexandru

    2013-11-01

    The environmental impact assessment of mining sites represents nowadays a large interest topic in Romania. Historical pollution in the Rosia Montana mining area of Romania caused extensive damage to environmental media. This paper has two goals: to investigate the environmental pollution induced by mining activities in the Rosia Montana area and to quantify the environmental impacts and associated risks by means of an integrated approach. Thus, a new method was developed and applied for quantifying the impact of mining activities, taking account of the quality of environmental media in the mining area, and used as case study in the present paper. The associated risks are a function of the environmental impacts and the probability of their occurrence. The results show that the environmental impacts and quantified risks, based on quality indicators to characterize the environmental quality, are of a higher order, and thus measures for pollution remediation and control need to be considered in the investigated area. The conclusion drawn is that an integrated approach for the assessment of environmental impact and associated risks is a valuable and more objective method, and is an important tool that can be applied in the decision-making process for national authorities in the prioritization of emergency action.

  12. Identification of risk factors for enteral feeding intolerance screening in critically ill patients

    Science.gov (United States)

    Xu, Lei; Wang, Ting; Chen, Ting; Yang, Wen-Qun; Liang, Ze-Ping; Zhu, Jing-Ci

    2017-01-01

    Objectives: To identify risk factors for enteral feeding intolerance screening in critically ill patients, thereby, provide some reference for healthcare staff to assess the risk of feeding intolerance, and lay the foundation for future scale development. Methods: This study used a mixed methodology, including a literature review, semi-structured interviews, the Delphi technique, and the analytic hierarchy process. We used the literature review and semi-structured interviews (n=22) to draft a preliminarily item pool for feeding intolerance, Delphi technique (n=30) to screen and determine the items, and the analytic hierarchy process to calculate the weight of each item. The study was conducted between June 2014 and September 2015 in Daping Hospital, Third Military Medical University, Chongqing, China. Results: Twenty-three risk factors were selected for the scale, including 5 dimensions. We assigned a weight to each item according to their impact on the feeding intolerance, with a higher score indicating a greater impact. The weight of each dimension was decreasing as follows: patient conditions, weight score equals 42; general conditions, weight score equals 23; gastrointestinal functions, weight score equals 15; biochemical indexes, weight score equals 14; and treatment measures, weight score equals 6. Conclusion: Developed list of risk factors based on literature review, survey among health care professionals and expert consensus should provide a basis for future studies assessing the risk of feeding intolerance in critically ill patients. PMID:28762434

  13. Use of biological indicators for evaluating environmental stress

    International Nuclear Information System (INIS)

    Letourneau, C.; Castonguay, J.

    1988-09-01

    This report examines the usefulness of biological analyses for evaluating environmental stress. All forms of stress are addressed; particular attention, however, is paid to the use of biological analyses to evaluate the impact on the environment from radioactive releases of the nuclear industry. First, we will review different biological analyses which are grouped into two approaches: the holistic approach (biotic and diversity indices) and the reductionist approach ('biological indicators' per se). Secondly, we will compare the usefulness of plants and animals as indicators based on the established criteria. This report ends with a compilation of letters received from different organizations which outline the present use in Canada of biological indicators for evaluating environmental stress

  14. Use of biological indicators to evaluate environmental stress

    International Nuclear Information System (INIS)

    Letourneau, C.; Castonguay, J.

    1987-09-01

    This report examines the usefulness of biological analyses for evaluating environmental stress. All forms of stress are addressed; particular attention, however, is paid to the use of biological analyses to evaluate the impact on the environment from radioactive releases of the nuclear industry. First, we will review different biological analyses which are grouped into two approaches: the holistic approach (biotic and diversity indices) and the reductionist approach ('biological indicators' per se). Secondly, we will compare the usefulness of plants and animals as indicators based on the established criteria. This report ends with a compilation of letters received from different organizations which outline the present usage in Canada of biological indicators for evaluating environmental stress

  15. Racial Differences in Perceptions of Air Pollution Health Risk: Does Environmental Exposure Matter?

    Directory of Open Access Journals (Sweden)

    Jayajit Chakraborty

    2017-01-01

    Full Text Available This article extends environmental risk perception research by exploring how potential health risk from exposure to industrial and vehicular air pollutants, as well as other contextual and socio-demographic factors, influence racial/ethnic differences in air pollution health risk perception. Our study site is the Greater Houston metropolitan area, Texas, USA—a racially/ethnically diverse area facing high levels of exposure to pollutants from both industrial and transportation sources. We integrate primary household-level survey data with estimates of excess cancer risk from ambient exposure to industrial and on-road mobile source emissions of air toxics obtained from the U.S. Environmental Protection Agency. Statistical analysis is based on multivariate generalized estimation equation models which account for geographic clustering of surveyed households. Our results reveal significantly higher risk perceptions for non-Hispanic Black residents and those exposed to greater cancer risk from industrial pollutants, and also indicate that gender influences the relationship between race/ethnicity and air pollution risk perception. These findings highlight the need to incorporate measures of environmental health risk exposure in future analysis of social disparities in risk perception.

  16. Accuracy of Referring Provider and Endoscopist Impressions of Colonoscopy Indication.

    Science.gov (United States)

    Naveed, Mariam; Clary, Meredith; Ahn, Chul; Kubiliun, Nisa; Agrawal, Deepak; Cryer, Byron; Murphy, Caitlin; Singal, Amit G

    2017-07-01

    Background: Referring provider and endoscopist impressions of colonoscopy indication are used for clinical care, reimbursement, and quality reporting decisions; however, the accuracy of these impressions is unknown. This study assessed the sensitivity, specificity, positive and negative predictive value, and overall accuracy of methods to classify colonoscopy indication, including referring provider impression, endoscopist impression, and administrative algorithm compared with gold standard chart review. Methods: We randomly sampled 400 patients undergoing a colonoscopy at a Veterans Affairs health system between January 2010 and December 2010. Referring provider and endoscopist impressions of colonoscopy indication were compared with gold-standard chart review. Indications were classified into 4 mutually exclusive categories: diagnostic, surveillance, high-risk screening, or average-risk screening. Results: Of 400 colonoscopies, 26% were performed for average-risk screening, 7% for high-risk screening, 26% for surveillance, and 41% for diagnostic indications. Accuracy of referring provider and endoscopist impressions of colonoscopy indication were 87% and 84%, respectively, which were significantly higher than that of the administrative algorithm (45%; P 90%) for determining screening (vs nonscreening) indication, but specificity of the administrative algorithm was lower (40.3%) compared with referring provider (93.7%) and endoscopist (84.0%) impressions. Accuracy of endoscopist, but not referring provider, impression was lower in patients with a family history of colon cancer than in those without (65% vs 84%; P =.001). Conclusions: Referring provider and endoscopist impressions of colonoscopy indication are both accurate and may be useful data to incorporate into algorithms classifying colonoscopy indication. Copyright © 2017 by the National Comprehensive Cancer Network.

  17. Environmental risk analysis of hazardous material rail transportation

    Energy Technology Data Exchange (ETDEWEB)

    Saat, Mohd Rapik, E-mail: mohdsaat@illinois.edu [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States); Werth, Charles J.; Schaeffer, David [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States); Yoon, Hongkyu [Sandia National Laboratories, Albuquerque, NM 87123 (United States); Barkan, Christopher P.L. [Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, 1243 Newmark Civil Engineering Laboratory, 205 North Mathews Avenue, Urbana, IL 61801 (United States)

    2014-01-15

    Highlights: • Comprehensive, nationwide risk assessment of hazardous material rail transportation. • Application of a novel environmental (i.e. soil and groundwater) consequence model. • Cleanup cost and total shipment distance are the most significant risk factors. • Annual risk varies from $20,000 to $560,000 for different products. • Provides information on the risk cost associated with specific product shipments. -- Abstract: An important aspect of railroad environmental risk management involves tank car transportation of hazardous materials. This paper describes a quantitative, environmental risk analysis of rail transportation of a group of light, non-aqueous-phase liquid (LNAPL) chemicals commonly transported by rail in North America. The Hazardous Materials Transportation Environmental Consequence Model (HMTECM) was used in conjunction with a geographic information system (GIS) analysis of environmental characteristics to develop probabilistic estimates of exposure to different spill scenarios along the North American rail network. The risk analysis incorporated the estimated clean-up cost developed using the HMTECM, route-specific probability distributions of soil type and depth to groundwater, annual traffic volume, railcar accident rate, and tank car safety features, to estimate the nationwide annual risk of transporting each product. The annual risk per car-mile (car-km) and per ton-mile (ton-km) was also calculated to enable comparison between chemicals and to provide information on the risk cost associated with shipments of these products. The analysis and the methodology provide a quantitative approach that will enable more effective management of the environmental risk of transporting hazardous materials.

  18. Environmental risk analysis of hazardous material rail transportation

    International Nuclear Information System (INIS)

    Saat, Mohd Rapik; Werth, Charles J.; Schaeffer, David; Yoon, Hongkyu; Barkan, Christopher P.L.

    2014-01-01

    Highlights: • Comprehensive, nationwide risk assessment of hazardous material rail transportation. • Application of a novel environmental (i.e. soil and groundwater) consequence model. • Cleanup cost and total shipment distance are the most significant risk factors. • Annual risk varies from $20,000 to $560,000 for different products. • Provides information on the risk cost associated with specific product shipments. -- Abstract: An important aspect of railroad environmental risk management involves tank car transportation of hazardous materials. This paper describes a quantitative, environmental risk analysis of rail transportation of a group of light, non-aqueous-phase liquid (LNAPL) chemicals commonly transported by rail in North America. The Hazardous Materials Transportation Environmental Consequence Model (HMTECM) was used in conjunction with a geographic information system (GIS) analysis of environmental characteristics to develop probabilistic estimates of exposure to different spill scenarios along the North American rail network. The risk analysis incorporated the estimated clean-up cost developed using the HMTECM, route-specific probability distributions of soil type and depth to groundwater, annual traffic volume, railcar accident rate, and tank car safety features, to estimate the nationwide annual risk of transporting each product. The annual risk per car-mile (car-km) and per ton-mile (ton-km) was also calculated to enable comparison between chemicals and to provide information on the risk cost associated with shipments of these products. The analysis and the methodology provide a quantitative approach that will enable more effective management of the environmental risk of transporting hazardous materials

  19. Analysis of the environmental and economic indicators of the industrial enterprise

    Science.gov (United States)

    Mikhailov, V. G.; Kiseleva, T. V.

    2018-05-01

    In the paper the features of the analysis of the environmental and economic indicators of the industrial enterprise are considered. The purpose of the study is to improve the system of environmental and economic analysis at the enterprise for more accurate forecasting of its main environmental and economic indicators. The study of the main approaches to the implementation of environmental and economic analysis based on the corresponding systems of indicators with identification of the most significant factors was carried out. The main result of the study is the choice of a system for analyzing the environmental and economic indicators, maximally oriented to a specific enterprise, taking into account its production specific features. The practical significance of the study consists in the selection of an adequate system of indicators at enterprises to improve the effectiveness from preparation of an environmentally safe management decision.

  20. Assessing the Environmental Risks of Nanomaterials

    DEFF Research Database (Denmark)

    Grieger, Khara Deanne; Hansen, Steffen Foss; Baun, Anders

    to a wide range of technical limitations. For instance, serious knowledge gaps remain within e.g. the detection of NM in the environment, developing adequate testing equipment and protocols, and toxicity endpoints (Grieger et al., 2009). In the past few years, many scientists and organizations have...... considered. Furthermore, we recommend the use of biomonitoring in some environmental ‘hot spots’ to serve as early warning detectors while the field of NM environmental risk assessment matures, as recommended in our previous work. Ultimately, this analysis may aid the advancement of environmental risk...

  1. Mute swans: Natural (?) environmental indicators

    Science.gov (United States)

    Day, D.; Perry, Matthew C.

    2004-01-01

    The rapid expansion of the Chesapeake Bay's population of feral mute swans (Cygnus olar), coupled with a dramatic Bay-wide decline in submerged aquatic vegetation (SAV), has fueled much of the current debate surrounding the need for a management plan to protect the aquatic food resources that are critical to many species native to the Bay. Crucial to this decision process is a sound understanding of the ecological ramifications of having the year-round presence of a large, nonnative, aquatic herbivore on the Bay. Ultimately, this will require a quantitative assessment of the ecological harm currently posed by mute swans before a biologically defensible management strategy can be developed. Unfortunately, very little new information specific to the Bay's mute swan population has been gathered since Reese first studied them in the late 1960s and 1970s. While the debate over what to do about the rapidly expanding mute swan population continues, there is much that can be gained from study of this beautiful intruder. Several recent studies of the feeding habits of mute swans have shown that mutes can provide a unique barometer, or indicator, of environmental conditions. Because of their reliance on SAV as a primary food source, monitoring the density of swans utilizing a particular area can give some indication of the status of the area's grass beds. This phenomenon was clearly demonstrated during the summer of 1999 when there was a dramatic decline in the number of swans observed around the Eastern Neck NWR, a traditional population stronghold. The shift in bird use was precipitated by a rapid, large-scale collapse of the area's aquatic grass beds, possibly the result of a prolonged drought. During the winter of 2000/2001, a similar ecological assessment was conducted by comparing body weights of swans collected from Tangier Sound, an area with relatively abundant grass beds, and swans from the waters adjacent to Eastern Neck Island. Swans weights tended to reflect the

  2. Psychological consequences of screening for cardiovascular risk factors in an un-selected general population

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; S. Andersen, John; K. Jacobsen, Rikke

    2015-01-01

    Background: Concerns that general health checks, including screening for risk factors to ischemic heart disease (IHD),have negative psychological consequences seem widely unfounded; however, previous studies are only based on selfreports from participants. Aim: To investigate if risk factor...... screening in healthy adults leads to mental distress in the study population, independent of participation. Methods: The Inter99 study (1999 – 2006) was a randomised intervention in the general population, aiming to prevent IHD by a healthier lifestyle. We included the whole study population, independent......-screening of psychological status did not influence the psychological impact of screening. Conclusions: This large, randomised intervention study supports that screening for risk factors to IHD does not increase mental distress, not even in the mentally or socioeconomically most vulnerable persons.This study included...

  3. Screening for nutritional risk in hospitalized children: comparison of two instruments

    Directory of Open Access Journals (Sweden)

    Dwi Novianti

    2017-06-01

    Full Text Available Background Malnutrition in hospitalized children has negative impact on morbidity, mortality, length of stay, and health-care cost. A simple screening tool is needed to detect hospital malnutrition risk in children. Objective To compare the level of agreement of the Screening Tool for Malnutrition in Pediatrics (STAMP and Pediatric Nutritional Risk Score (PNRS with anthropometric measurements, as screening tools for hospital malnutrition in children. Methods A cross-sectional study was conducted from February to July 2014 in the Pediatric and Surgery Wards at H. Adam Malik Hospital, Medan, North Sumatera. Inclusion criteria were children aged 2 to 18 years who were hospitalized for more than 72 hours. Subjects were screened using STAMP and PNRS, and underwent anthropometric measurement on admission. The weight measurements were repeated on the 3rd and 7th days, and just before discharge. The STAMP and PNRS results were compared in terms of level of agreement with anthropometric measurements. Data were analyzed by Kappa value and Spearman’s correlation test. Results A total of 127 children were screened with both instruments. The PNRS had slight agreement with hospital malnutrition prevalence (κ=0.175; P=0.028, while STAMP had not  (κ=0.080; P=0.193. Both screening tools had weak positive correlations with length of stay, but the correlation was stronger for PNRS than for STAMP (r=0.218; P=0.014 vs. r=0.188; P=0.034, respectively. The prevalence of hospital malnutrition was 40.9%.  Conclusions The PNRS screening tool has slight agreement with anthropometric measurement for identifying hospital malnutrition risk in children.

  4. Randomized controlled trial of storytelling compared to a personal risk tool intervention on colorectal cancer screening in low-income patients.

    Science.gov (United States)

    Larkey, Linda K; McClain, Darya; Roe, Denise J; Hector, Richard D; Lopez, Ana Maria; Sillanpaa, Brian; Gonzalez, Julie

    2015-01-01

    Screening rates for colorectal cancer (CRC) lag for low-income, minority populations, contributing to poorer survival rates. A model of storytelling as culture-centric health promotion was tested for promoting CRC screening. A two-group parallel randomized controlled trial. Primary care, safety-net clinics. Low-income patients due for CRC screening, ages 50 to 75 years, speaking English or Spanish. Patients were exposed to either a video created from personal stories composited into a drama about "Papa" receiving CRC screening, or an instrument estimating level of personal cancer risk. Patients received a health care provider referral for CRC screening and were followed up for 3 months to document adherence. Behavioral factors related to the narrative model (identification and engagement) and theory of planned behavior. Main effects of the interventions on screening were tested, controlling for attrition factors, and demographic factor associations were assessed. Path analysis with model variables was used to test the direct effects and multiple mediator models. Main effects on CRC screening (roughly half stool-based tests, half colonoscopy) did not indicate significant differences (37% and 42% screened for storytelling and risk-based messages, respectively; n = 539; 33.6% male; 62% Hispanic). Factors positively associated with CRC screening included being female, Hispanic, married or living with a partner, speaking Spanish, having a primary care provider, lower income, and no health insurance. Engagement, working through positive attitudes toward the behavior, predicted CRC screening. A storytelling and a personalized risk-tool intervention achieved similar levels of screening among unscreened/underscreened, low-income patients. Factors usually associated with lower rates of screening (e.g., no insurance, being Hispanic) were related to more adherence. Both interventions' engagement factor facilitated positive attitudes about CRC screening associated with behavior

  5. Environmental screening of dark matter haloes in f(R) gravity

    Science.gov (United States)

    Shi, Difu; Li, Baojiu; Han, Jiaxin

    2017-07-01

    In certain theories of modified gravity, Solar system constraints on deviations from general relativity (GR) are satisfied by virtue of a so-called screening mechanism, which enables the theory to revert to GR in regions where the matter density is high or the gravitational potential is deep. In the case of chameleon theories, the screening has two contributions - self-screening, which is due to the mass of an object itself, and environmental screening, which is caused by the surrounding matter - which are often entangled, with the second contribution being more crucial for less massive objects. A quantitative understanding of the effect of the environment on the screening can prove critical in observational tests of such theories using systems such as the Local Group and dwarf galaxies, for which the environment may be inferred in various ways. We use the high-resolution liminality simulation of Shi et al. to test the fidelity of different definitions of environment. We find that, although the different ways to define environment in practice do not agree with one another perfectly, they can provide useful guidance, and cross checks about how well a dark matter halo is screened. In addition, the screening of subhaloes in dark matter haloes is primarily determined by the environment, with the subhalo mass playing a minor role, which means that lower resolution simulations where subhaloes are not well resolved can still be useful for understanding the modification of gravity inside subhaloes.

  6. Design of an environmental site assessment template for open radioactive site contamination : a radioecological risk approach and case study

    International Nuclear Information System (INIS)

    Nguyen, T.

    2004-01-01

    To reduce redundancy, cost, and time, while at the same time ultimately increasing the effectiveness of the radioactive risk management process, a logical framework incorporating risk assessments (human cancer and environmental risks) into the environmental site assessment process was designed for radioactive open site contamination. Risk-based corrective action is becoming an increasingly more acceptable approach for the remediation of contaminated sites. In the past, cleanup goals were usually established without any regard to the risk involved, by mandating remediation goals based solely on maximum contamination levels. Now, a multi-stage environmental site assessment template has been developed on a radioecological approach. The template gives a framework for making environmentally sound decisions based on relevant regulations and guidelines. The first stage involves the comparison of the background screening activity level to the regulated activity level, the second stage involves the use of site-specific information to determine the risk involved with the contamination, and the third stage provides a remediation decision matrix based on results from the first two stages. This environmental site assessment template is unique because it incorporates the modified Canadian National Classification System for radioactive contaminated sites and two different types of risk assessments (human cancer risks and the newly designed ecological risk) into the decision making process. The template was used to assess a radiologically contaminated site at the Canadian Forces Base at Suffield (Alberta) as a case study, and it reaffirms the Department of National Defence's action as appropriate. This particular site is a Class 3, has an overall insignificant human cancer risk ( -6 ) and a low environmental risk, and conforms to all regulated guidelines. Currently, it is restricted and should be left as is, provided that the subsurface is not disturbed. (author)

  7. Role of emotion in public information on environmental risk and pre-environmental behaviour

    NARCIS (Netherlands)

    Meijnders, A.L.; Midden, C.J.H.; Wilke, H.A.M.

    1996-01-01

    What role does emotion play in the provision of public information about· the risks of environmental pollution? This is a question that is asked in the research project on the 'Role of emotion in public information on environmental risks and pro-environmental behaviour'. This article describes the

  8. Risk assessment calculations using MEPAS, an accepted screening methodology, and an uncertainty analysis for the reranking of Waste Area Groupings at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    Shevenell, L.; Hoffman, F.O.; MacIntosh, D.

    1992-03-01

    The Waste Area Groupings (WAGs) at the Oak Ridge National Laboratory (ORNL) were reranked with respect to on- and off-site human health risks using two different methods. Risks associated with selected contaminants from each WAG for occupants of WAG 2 or an off-site area were calculated using a modified formulation of the Multimedia Environmental Pollutant Assessment System (MEPAS) and a method suitable for screening, referred to as the ORNL/ESD method (the method developed by the Environmental Sciences Division at ORNL) in this report. Each method resulted in a different ranking of the WAGs. The rankings from the two methods are compared in this report. All risk assessment calculations, except the original MEPAS calculations, indicated that WAGs 1; 2, 6, 7 (WAGs 2, 6 and 7 as one combined WAG); and 4 pose the greatest potential threat to human health. However, the overall rankings of the WAGs using constant parameter values in the different methods were inconclusive because uncertainty in parameter values can change the calculated risk associated with particular pathways, and hence, the final rankings. Uncertainty analysis using uncertainties about all model parameters were used to reduce biases associated with parameter selection and to more reliably rank waste sites according to potential risks associated with site contaminants. Uncertainty analysis indicates that the WAGs should be considered for further investigation, or remediation, in the following order: (1) WAG 1; (2) WAGs 2, 6, and 7 (combined); and 4; (3) WAGs 3, 5, and 9; and, (4) WAG 8

  9. An environmental generalised Luenberger-Hicks-Moorsteen productivity indicator and an environmental generalised Hicks-Moorsteen productivity index.

    Science.gov (United States)

    Abad, A

    2015-09-15

    The purpose of this paper is to introduce an environmental generalised productivity indicator and its ratio-based counterpart. The innovative environmental generalised total factor productivity measures inherit the basic structure of both Hicks-Moorsteen productivity index and Luenberger-Hicks-Moorsteen productivity indicator. This methodological contribution shows that these new environmental generalised total factor productivity measures yield the earlier standard Hicks-Moorsteen index and Luenberger-Hicks-Moorsteen indicator, as well as environmental performance index, as special cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. A simple method to identify areas of environmental risk due to manure application.

    Science.gov (United States)

    Flores, Héctor; Arumí, José Luis; Rivera, Diego; Lagos, L Octavio

    2012-06-01

    The management of swine manure is becoming an important environmental issue in Chile. One option for the final disposal of manure is to use it as a biofertilizer, but this practice could impact the surrounding environment. To assess the potential environmental impacts of the use of swine manure as a biofertilizer, we propose a method to identify zones of environmental risk through indices. The method considers two processes: nutrient runoff and solute leaching, and uses available information about soils, crops and management practices (irrigation, fertilization, and rotation). We applied the method to qualitatively assess the environmental risk associated with the use of swine manure as a biofertilizer in an 8,000-pig farm located in Central Chile. Results showed that the farm has a moderate environmental risk, but some specific locations have high environmental risks, especially those associated with impacts on areas surrounding water resources. This information could assist the definition of better farm-level management practices, as well as the preservation of riparian vegetation acting as buffer strips. The main advantage of our approach is that it combines qualitative and quantitative information, including particular situations or field features based on expert knowledge. The method is flexible, simple, and can be easily extended or adapted to other processes.

  11. An integrated risk assessment approach: Risk assessment in the programmatic environmental impact statement

    International Nuclear Information System (INIS)

    Morris, J.M.

    1994-01-01

    The following paper is an informal summary of salient points made in the presentation entitled open-quotes An Integrated Risk Assessment Approach: Risk Assessment in the Programmatic Environmental Impact Statement (PEIS).close quotes. This presentation was given at the U.S. DOE Integrated Planning Workshop in Denver, Colorado on June 2, 1994. Integrated decision analysis is very important in environmental restoration and waste management in the evaluation of such things as land use planning, waste load forecasting, cost analyses, and technology development activities. Integrated risk assessment is an approach that addresses multiple components of risk, including: risks from surplus facilities as well as typical environmental restoration sites, risks to the public, risks to workers, ecological risk, risks before, during and after remediation activities, and others

  12. Canadian environmental sustainability indicators 2006

    International Nuclear Information System (INIS)

    2006-01-01

    In 2004, the Canadian government committed to reporting annual national indicators of air quality, greenhouse gas (GHG) emissions and freshwater quality in order to provide Canadians with more regular and consistent information on the state of the environment and how it is linked with human activities. The national air quality indicators in this report focused on human exposure to ground-level ozone and fine particulate matter (PM 2.5 ). The report showed that from 1990 to 2004, the ozone indicator showed year-to-year variability, with an averaged increase of 0.9 per cent per year. Stations in southern Ontario reported the highest levels of ozone and PM 2.5 in the country in 2004. There was no discernible upward or downward trend in PM 2.5 levels at the national level for the 2000 to 2004 period, and GHG emissions rose 27 per cent from 1990 to 2004. In 2004, emissions were 35 per cent above the target to which Canada committed under the Kyoto Protocol. However, while total emissions rose, emissions per unit of gross domestic product (GDP) fell by 14 per cent from 1990 to 2004. GHG emissions also grew faster than the Canadian population, resulting in a 10 per cent rise in emissions per person. The freshwater quality indicator presented in this report covered the period from 2002 to 2004, and focused on the ability of Canada's surface waters to support aquatic life. For the 340 sites selected across southern Canada, water quality was rated as good or excellent at 44 per cent of sites, fair at 34 per cent of sites, and marginal or poor at 22 per cent of sites. The report included a chapter which attempted to integrate the indicators with other environmental impacts, measures of economic performance, and indices of social progress to improve the ability of the report to influence decision-making that fully accounts for environmental sustainability. 63 refs., 18 figs

  13. Selecting Environmental Performance Indicators : The Case of Numico

    NARCIS (Netherlands)

    Scherpereel, C.; Koppen, van C.S.A.; Heering, G.B.F.

    2001-01-01

    In order to achieve both efficient and reliable external communication adapted to the company's specific conditions, it is desirable to establish a clear relation between the environmental performance indicators (EPIs) used internally for environmental management and the EPIs used externally for

  14. Patient doses and radiation risks in film-screen mammography in Finland

    International Nuclear Information System (INIS)

    Servomaa, A.; Parviainen, T.; Komppa, T.

    1995-01-01

    Screen-film mamography is the most sensitive method for the early detection of breast cancer. Breast doses in mamography should be measured for several reasons, especially for the evaluation of patient risk in a screening programme, but also for the assessment and comparison of imaging techniques and equipment performance. In this study, the factors affecting patient doses were assessed by making performance and patient dose measurements; about 50 mammographic units used for screening were included in the study. The lifetime risk as a function of age at exposure was calculated using the average glandular dose, the relative risk model shown in the BEIR V report, and the breast cancer mortality in Finland. The mean surface dose of a 4.5 cm thick phantom was 6.3 mGy, and the mean glandular dose 1.0 mGy. Analysis of the surface dose with respect to film optical density, relative speed of film processing, sensitivity of image receptors, and antiscatter grid showed that the mean surface dose could be decreased by more than 50%. For the screened age group of 50 to 59 years, the risk of exposure-induced death (REID) of breast cancer is about 1.4 x 10 -6 mSv -1 , and the average loss of life expectancy due to the radiation-induced breast cancer deaths (LLE/REID) is about 9.5 years. (Author)

  15. Environmental risk assessment: an Australian perspective. Supervising Scientist Report 102

    International Nuclear Information System (INIS)

    Beer, T.; Ziolkowski, F.

    1995-01-01

    Environmental risk assessment can be used as a strategic tool to set environmental priorities and as a tactical tool to set environmental standards. This report is designed to inform Australian environmental managers about the techniques and applications of environmental risk assessment and to familiarize risk analysts with some of the issues that are of concern to environmental managers. The use of risk assessment is illustrated by applying its techniques to five case studies which include: risk from chemicals and from contaminated sites; risk to people and to the natural environment from development, such as uranium mining; climate change; and risk associated with political decision-making. Then, by considering Australian and overseas practice, a generic framework is presented within which environmental risk assessment in Australia can be undertaken, and possible methods of implementation are discussed. refs., 38 figs

  16. Evaluation of a clinical risk index for advanced colorectal neoplasia among a North American population of screening age.

    Science.gov (United States)

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-11-19

    A clinical risk index employing age, sex, family history of colorectal cancer (CRC), smoking history and body mass index (BMI) may be useful for prioritizing screening with colonoscopy. The aim of this study was to conduct an external evaluation of a previously published risk index for advanced neoplasia (AN) in a large, well-characterized cohort. Five thousand one hundred thirty-seven asymptomatic persons aged 50 to 74 (54.9 % women) with a mean age (SD) of 58.3 (6.2) years were recruited for the study from a teaching hospital and colorectal cancer screening centre between 2003 and 2011. All participants underwent a complete screening colonoscopy and removal of all polyps. AN was defined as cancer or a tubular adenoma, traditional serrated adenoma (TSA), or sessile serrated adenoma (SSA) with villous characteristics (≥25% villous component), and/or high-grade dysplasia and/or diameter ≥10 mm. Risk scores for each participant were summed to derive an overall score (0-8). The c-statistic was used to measure discriminating ability of the risk index. The prevalence of AN in the study cohort was 6.8 %. The likelihood of detecting AN increased from 3.6 to 13.1 % for those with a risk score of 1 to 6 respectively. The c-statistic for the multivariable logistic model in our cohort was 0.64 (95 % CI = 0.61-067) indicating modest overlap between risk scores. The risk index for AN using age, sex, family history, smoking history and BMI was found to be of limited discriminating ability upon external validation. The index requires further refinement to better predict AN in average risk persons of screening age.

  17. Urbanization, housing and environmental quality indicators ...

    African Journals Online (AJOL)

    Urbanization, housing and environmental quality indicators. ... Journal of Agriculture, Forestry and the Social Sciences ... Urbanization ideally should also imply an enhancement of housing quality and other components of human settlements such as power supply, portable water, good roads, proper refuse and sewage ...

  18. EJSCREEN Demographic Indicators 2015 Public

    Science.gov (United States)

    EJSCREEN uses demographic factors as very general indicators of a community's potential susceptibility to the types of environmental factors included in this screening tool. There are six demographic indicators: Demographic Index, Supplementary Demographic Index, Individuals under Age 5, Individuals over Age 64, Percent Low-Income, Linguistic Isolation, Percent Minority, and Less than High School Education.

  19. 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.

  20. Development of Organ-Specific Donor Risk Indices

    Science.gov (United States)

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores Donor Risk Index has limited this practice. Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036

  1. Screening report : Municipality of Leamington : Leamington Pollution Control Centre stand-by emergency power class environmental assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-03-15

    The Leamington Pollution Control Centre (PCC) is located in Ontario and treats residential and commercial wastewater collected from the Municipality of Leamington. The Leamington PCC currently has one standby diesel generator with a rated capacity of 545 kW. This generator provides power to the plant's disinfection facilities to reduce the risk of back-up into the collection system during power failures. The Municipality of Leamington plans to provide treatment in addition to disinfection during power outages. In order to achieve this, additional standby power is required to run the primary clarifiers, the aeration system and the secondary clarifiers. This document presented a screening report for the new standby generator, whose installation is considered a Schedule B under the Municipal Class Environmental Assessment process. The report reviewed background information on the proposed project; Ontario's Environmental Assessment Act; and the Class Environmental Assessment Act. It outlined the problem statement; identification of solutions; existing conditions; impacts and mitigation during construction and operation; and public consultation procedures. 2 refs., 4 figs., 1 appendix.

  2. The Autism Parent Screen for Infants: Predicting risk of autism spectrum disorder based on parent-reported behavior observed at 6-24 months of age.

    Science.gov (United States)

    Sacrey, Lori-Ann R; Bryson, Susan; Zwaigenbaum, Lonnie; Brian, Jessica; Smith, Isabel M; Roberts, Wendy; Szatmari, Peter; Vaillancourt, Tracy; Roncadin, Caroline; Garon, Nancy

    2018-04-01

    This study examined whether a novel parent-report questionnaire, the Autism Parent Screen for Infants, could differentiate infants subsequently diagnosed with autism spectrum disorder from a high-risk cohort (siblings of children diagnosed with autism spectrum disorder (n = 66)) from high-risk and low-risk comparison infants (no family history of autism spectrum disorder) who did not develop autism spectrum disorder (n = 138 and 79, respectively). Participants were assessed prospectively at 6, 9, 12, 15, 18, and 24 months of age. At 36 months, a blind independent diagnostic assessment for autism spectrum disorder was completed. Parent report on the Autism Parent Screen for Infants was examined in relation to diagnostic outcome and risk status (i.e. high-risk sibling with autism spectrum disorder, high-risk sibling without autism spectrum disorder, and low-risk control). The results indicated that from 6 months of age, total score on the Autism Parent Screen for Infants differentiated between the siblings with autism spectrum disorder and the other two groups. The sensitivity, specificity, and positive and negative predictive validity of the Autism Parent Screen for Infants highlight its potential for the early screening of autism spectrum disorder in high-risk cohorts.

  3. Implications of Nine Risk Prediction Models for Selecting Ever-Smokers for Computed Tomography Lung Cancer Screening.

    Science.gov (United States)

    Katki, Hormuzd A; Kovalchik, Stephanie A; Petito, Lucia C; Cheung, Li C; Jacobs, Eric; Jemal, Ahmedin; Berg, Christine D; Chaturvedi, Anil K

    2018-05-15

    Lung cancer screening guidelines recommend using individualized risk models to refer ever-smokers for screening. However, different models select different screening populations. The performance of each model in selecting ever-smokers for screening is unknown. To compare the U.S. screening populations selected by 9 lung cancer risk models (the Bach model; the Spitz model; the Liverpool Lung Project [LLP] model; the LLP Incidence Risk Model [LLPi]; the Hoggart model; the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Model 2012 [PLCOM2012]; the Pittsburgh Predictor; the Lung Cancer Risk Assessment Tool [LCRAT]; and the Lung Cancer Death Risk Assessment Tool [LCDRAT]) and to examine their predictive performance in 2 cohorts. Population-based prospective studies. United States. Models selected U.S. screening populations by using data from the National Health Interview Survey from 2010 to 2012. Model performance was evaluated using data from 337 388 ever-smokers in the National Institutes of Health-AARP Diet and Health Study and 72 338 ever-smokers in the CPS-II (Cancer Prevention Study II) Nutrition Survey cohort. Model calibration (ratio of model-predicted to observed cases [expected-observed ratio]) and discrimination (area under the curve [AUC]). At a 5-year risk threshold of 2.0%, the models chose U.S. screening populations ranging from 7.6 million to 26 million ever-smokers. These disagreements occurred because, in both validation cohorts, 4 models (the Bach model, PLCOM2012, LCRAT, and LCDRAT) were well-calibrated (expected-observed ratio range, 0.92 to 1.12) and had higher AUCs (range, 0.75 to 0.79) than 5 models that generally overestimated risk (expected-observed ratio range, 0.83 to 3.69) and had lower AUCs (range, 0.62 to 0.75). The 4 best-performing models also had the highest sensitivity at a fixed specificity (and vice versa) and similar discrimination at a fixed risk threshold. These models showed better agreement on size of the

  4. Participatory Risk Assessment for Environmental Decision-Making

    International Nuclear Information System (INIS)

    Homan, Jacqueline; Petts, Judith

    2001-01-01

    Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in practice, decision

  5. Participatory Risk Assessment for Environmental Decision-Making

    Energy Technology Data Exchange (ETDEWEB)

    Homan, Jacqueline; Petts, Judith [Univ. of Birmingham (United Kingdom). Centre for Environmental Research and Training; Pollard, Simon; Twigger-Ross, Clare [National Centre for Risk Analysis and Options Appraisal, London (United Kingdom)

    2001-07-01

    Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in

  6. Managing Complex Environmental Risks

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Mikael [Karlstad Univ. (Sweden). Dept. of Environmental Sciences

    2006-09-15

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  7. Managing Complex Environmental Risks

    International Nuclear Information System (INIS)

    Karlsson, Mikael

    2006-01-01

    Environmental and public health risks are often handled in a process in which experts, and sometimes policy makers, try their best to quantitatively assess, evaluate and manage risks. This approach harmonises with mainstream interpretations of sustainable development, which aim at defining a desirable relationship between human and natural systems, for instance by policies that define limit values of different forms of disturbances. However, under conditions of high scientific incertitude, diverging values and distrust, this approach is far from satisfactory. The use of cell phones, hazardous chemicals, nuclear or fossil energy systems, and modern biotechnology are examples of activities causing such risks with high complexity. Against this background, a complementary interpretation of the concept of sustainable development is suggested. This interpretation is operationalised through new formulations of three common principles for public risk management; the precautionary principle, the polluter pays principle and the principle of public participation. Implementation of these reformulated principles would challenge some foundations of present mainstream views on environmental decision-making, but would on the other hand contribute to improved practices for long-term human welfare and planetary survival (full text of contribution)

  8. 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

  9. Validity of a method for the self-screening of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Barroso M

    2018-05-01

    Full Text Available María Barroso,1–3 Silvia Pérez-Fernández,1,4 M Mar Vila,1,4,5 M Dolors Zomeño,6,7 Ruth Martí-Lluch,8 Ferran Cordon,9 Rafel Ramos,8,10,11 Roberto Elosua,1,4 Irene R Degano,1,4 Montse Fitó,5,12 Carmen Cabezas,13 Gemma Salvador,13 Conxa Castell,13 María Grau1,4,14 1Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, 2Centre d’Atenció Primària La Marina, Direcció d’Atenció Primària Barcelona, Institut Català de la Salut, 3Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, School of Medicine, Autonomous University of Barcelona, 4Consortium for Biomedical Research in Cardiovascular Disease (CIBERCV, 5Department of Mathematics and Computer Science, University of Barcelona, 6Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Research Institute, 7School of Health Sciences, Blanquerna-Ramon Llull University, Barcelona, Spain; 8Unitat de Suport a la Recerca de Girona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 9Centre d’Atenció Primària Montilivi, Direcció d’Atenció Primària Girona, Institut Català de la Salut, 10Department of Medical Sciences, School of Medicine, University of Girona, 11Girona Biomedical Research Institute, Girona, Spain; 12Consortium for Biomedical Research in Obesity and Nutrition (CIBEROBN, 13Catalan Agency of Public Health, 14Department of Medicine, University of Barcelona, Barcelona, Spain Background: The validity of a cardiovascular risk self-screening method was assessed. The results obtained for self-measurement of blood pressure, a point-of-care system’s assessment of lipid profile and glycated hemoglobin, and a self-administered questionnaire (sex, age, diabetes, tobacco consumption were compared with the standard screening (gold standard conducted by a health professional. Methods: Crossover clinical trial on a population-based sample from Girona (north-eastern Spain, aged 35–74, with no

  10. Environmental Risk Assessment System for Phosphogypsum Tailing Dams

    OpenAIRE

    Xin Sun; Ping Ning; Xiaolong Tang; Honghong Yi; Kai Li; Lianbi Zhou; Xianmang Xu

    2013-01-01

    This paper may be of particular interest to the readers as it provides a new environmental risk assessment system for phosphogypsum tailing dams. In this paper, we studied the phosphogypsum tailing dams which include characteristics of the pollution source, environmental risk characteristics and evaluation requirements to identify the applicable environmental risk assessment methods. Two analytical methods, that is, the analytic hierarchy process (AHP) and fuzzy logic, were used to handle the...

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  12. Integrated environmental risk assessment for petroleum-contaminated sites - a North American case study

    International Nuclear Information System (INIS)

    Chen, Z.; Huang, G.H.; Chakma, A.

    1998-01-01

    In this study, an integrated risk assessment approach is proposed for evaluating environmental risks derived from petroleum-contaminated sites. The proposed approach is composed of (i) a hydrocarbon spill screening model (HSSM) which is used for simulating immiscible flow of released hydrocarbons in vadose zone, formation of lens in capillary fringe, dissolution of pollutants at water table, and transport of the pollutants to receptors, and (ii) a fuzzy relation analysis (FRA) model which is developed for comprehensively evaluating risks caused by a number of pollutants with different impact characteristics, based on the HSSM results. This hybrid HSSM-FRA approach was applied to a case study for a petroleum-contaminated site in western Canada, where soil and groundwater was contaminated by industrial wastes containing benzene, toluene, ethylbenzene and xylenes (BTEXs). The results suggest that the HSSM-FRA can provide insight into the potential risk to the receptor of concern downward the aquifer and can serve as a basis for further remediation-related decision analysis. (author)

  13. Environmental risk analysis for offshore oil and gas activities

    Energy Technology Data Exchange (ETDEWEB)

    Brude, Odd Willy; Aspholm, Ole O.; Rudberg, Anders [Det Norske Veritas (Brazil)

    2008-07-01

    Offshore oil and gas activities always have a risk for environmental impact due to potential accidental releases of oil and gas. The environmental risk can be calculated as a combination of the frequency of such accidents to occur and their environmental consequences in terms of environmental damage to habitats or populations. A method for conducting environmental risk analysis has been in use in Norwegian offshore waters for a decade, with a continuously refinement of methodology over the past years. This paper outlines the principles in the MIRA method and gives examples and discussions regarding use in different environmental compartments. The risk assessment starts with identification of oil spill scenarios with frequencies of potential release rates and spill durations. The next step is to model the oil drift for each accidental oil spill scenario. Drift and fate of oil is modeled probabilistic. Based on the oil spill scenarios and their probability of oil pollution, the potential environmental damage is quantified for each scenario. The endpoint of environmental damage is reduction of a population and the resulting recovery time (in years) for various species and habitats. Environmental risk levels are then evaluated against the operating companies' environmental acceptance criteria. (author)

  14. Developing a Screening Model to Establish Human Risk from Glacial Meltwater Release of Legacy Organochlorine Pollutants at the Silvretta Glacier in the Swiss Alps

    Science.gov (United States)

    Miner, K. R.

    2017-12-01

    Organochlorine pollutants (OCPs) banned globally by the Stockholm Convention in 2004 are reemerging from melting glaciers in numerous alpine ecosystems. Despite the known OCP influx from glaciers, a study of human risk from uptake of pesticides in glacial meltwater has never been attempted. Our study qualifies human uptake routes and quantifies risk utilizing published meltwater data from the Silvretta Glacier in the Swiss Alps in combination with methodology established by the US Environmental Protection Agency (EPA). Relatively high concentrations of OCPs in Silvretta glacier meltwater reflect proximity to use near high density populations and provide the best estimate of a 95th percentile human risk scenario. This screening level model assesses direct PCB risk to humans through consumption of fish tissue and meltwater. Our model shows a risk for both cancer and non-cancer disease impacts to children with lifetime exposure to glacial meltwater and an average local fish consumption. For adults with an abbreviated 30 year exposure timeframe, the risk for non-cancer effects is negligible and cancer effects are only barely above screening level. Populations that consume higher quantities of local fish are at greater risk, with additional challenges borne by children. Further direct study into the individual level risk to Swiss residents from glacial meltwater pollution is deemed necessary by our screening study.

  15. 78 FR 77153 - Environmental Action Statement Screening Form and Proposed Amendment to the Candidate...

    Science.gov (United States)

    2013-12-20

    ... the information necessary to determine impacts in the environmental action statement screening form... authorized for 25 years in Alfalfa, Beaver, Beckham, Cimarron, Custer, Dewey, Ellis, Harper, Major, Roger... discussion of the impacts, both positive and negative, can be found in the Final Environmental Assessment and...

  16. Knowledge and Health Belief Attitudes of Oral Cancer and Its Screening Among At-Risk Southern Thai Muslims.

    Science.gov (United States)

    Khwankong, Srisuk; Sriplung, Hutcha; Kerdpon, Duangporn

    2018-06-01

    Oral cancer is one of the leading cancers in Thailand; southern Thai Muslims seem to have a longer delay in attending treatment for oral cancer than Buddhists in the same area. Visual screenings of high-risk populations have been suggested to be an effective prevention method. This study assessed oral cancer knowledge and belief attitudes influencing oral cancer screening in Thai Muslim high-risk groups. Twelve semi-structured in-depth interviews and the focus group discussion were conducted based on the health belief model. Stratified purposeful sampling was used to recruit the participants. Inclusion criteria were those who practiced the risk habits for oral cancer and were 40 years of age or older, smokers (20+ cigarettes per day for at least 20 years) and/or betel quid chewers (10+ times per day for at least 10 years). Participants lacked knowledge about oral cancer in terms of signs and symptoms and predisposing factors. This influenced misleading belief attitudes concerning susceptibility of oral cancer, barriers, and their self-efficacy to have oral cancer screening examinations. Betel quid chewing was not regarded as a risk habit but as having a protective role against the disease. Perceived susceptibility was also seen by some to be dependent upon Allah's will. Traditional medication was mentioned as a preferred alternative to modern treatment. The latter was believed by some to be the cause of death for cancer patients. Interventions to promote oral cancer knowledge and right belief attitudes for oral cancer screening are clearly indicated.

  17. A framework for the establishment of organizational risk indicators

    International Nuclear Information System (INIS)

    Oien, K.

    2001-01-01

    Organizational risk indicators are proposed as a tool for risk control during operation of offshore installations, as a complement to QRA-based indicators. An organizational factor framework is developed based on a review of existing organizational factor frameworks, research on safety performance indicators, and previous work on QRA-based indicators. The results comprise a qualitative organizational model, proposed organizational risk indicators, and a quantification methodology for assessing the impact of the organization on risk. The risk indicators, when validated, will aid in a frequent control of the risk in the periods between the updating of the quantitative risk assessments

  18. Environmental Risk Assessment Strategy for Nanomaterials

    Directory of Open Access Journals (Sweden)

    Janeck J. Scott‐Fordsmand

    2017-10-01

    Full Text Available An Environmental Risk Assessment (ERA for nanomaterials (NMs is outlined in this paper. Contrary to other recent papers on the subject, the main data requirements, models and advancement within each of the four risk assessment domains are described, i.e., in the: (i materials, (ii release, fate and exposure, (iii hazard and (iv risk characterisation domains. The material, which is obviously the foundation for any risk assessment, should be described according to the legislatively required characterisation data. Characterisation data will also be used at various levels within the ERA, e.g., exposure modelling. The release, fate and exposure data and models cover the input for environmental distribution models in order to identify the potential (PES and relevant exposure scenarios (RES and, subsequently, the possible release routes, both with regard to which compartment(s NMs are distributed in line with the factors determining the fate within environmental compartment. The initial outcome in the risk characterisation will be a generic Predicted Environmental Concentration (PEC, but a refined PEC can be obtained by applying specific exposure models for relevant media. The hazard information covers a variety of representative, relevant and reliable organisms and/or functions, relevant for the RES and enabling a hazard characterisation. The initial outcome will be hazard characterisation in test systems allowing estimating a Predicted No-Effect concentration (PNEC, either based on uncertainty factors or on a NM adapted version of the Species Sensitivity Distributions approach. The risk characterisation will either be based on a deterministic risk ratio approach (i.e., PEC/PNEC or an overlay of probability distributions, i.e., exposure and hazard distributions, using the nano relevant models.

  19. Environmental Risk Assessment Strategy for Nanomaterials.

    Science.gov (United States)

    Scott-Fordsmand, Janeck J; Peijnenburg, Willie J G M; Semenzin, Elena; Nowack, Bernd; Hunt, Neil; Hristozov, Danail; Marcomini, Antonio; Irfan, Muhammad-Adeel; Jiménez, Araceli Sánchez; Landsiedel, Robert; Tran, Lang; Oomen, Agnes G; Bos, Peter M J; Hund-Rinke, Kerstin

    2017-10-19

    An Environmental Risk Assessment (ERA) for nanomaterials (NMs) is outlined in this paper. Contrary to other recent papers on the subject, the main data requirements, models and advancement within each of the four risk assessment domains are described, i.e., in the: (i) materials, (ii) release, fate and exposure, (iii) hazard and (iv) risk characterisation domains. The material, which is obviously the foundation for any risk assessment, should be described according to the legislatively required characterisation data. Characterisation data will also be used at various levels within the ERA, e.g., exposure modelling. The release, fate and exposure data and models cover the input for environmental distribution models in order to identify the potential (PES) and relevant exposure scenarios (RES) and, subsequently, the possible release routes, both with regard to which compartment(s) NMs are distributed in line with the factors determining the fate within environmental compartment. The initial outcome in the risk characterisation will be a generic Predicted Environmental Concentration (PEC), but a refined PEC can be obtained by applying specific exposure models for relevant media. The hazard information covers a variety of representative, relevant and reliable organisms and/or functions, relevant for the RES and enabling a hazard characterisation. The initial outcome will be hazard characterisation in test systems allowing estimating a Predicted No-Effect concentration (PNEC), either based on uncertainty factors or on a NM adapted version of the Species Sensitivity Distributions approach. The risk characterisation will either be based on a deterministic risk ratio approach (i.e., PEC/PNEC) or an overlay of probability distributions, i.e., exposure and hazard distributions, using the nano relevant models.

  20. Screening for nutritional risk in hospitalized children with liver disease.

    Science.gov (United States)

    Song, Tiantian; Mu, Ying; Gong, Xue; Ma, Wenyan; Li, Li

    2017-01-01

    Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support. A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMI- for-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups. The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (pnutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (pnutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.

  1. In-hospital fall-risk screening in 4,735 geriatric patients from the LUCAS project.

    Science.gov (United States)

    Neumann, L; Hoffmann, V S; Golgert, S; Hasford, J; Von Renteln-Kruse, W

    2013-03-01

    In-hospital falls in older patients are frequent, but the identification of patients at risk of falling is challenging. Aim of this study was to improve the identification of high-risk patients. Therefore, a simplified screening-tool was developed, validated, and compared to the STRATIFY predictive accuracy. Retrospective analysis of 4,735 patients; evaluation of predictive accuracy of STRATIFY and its single risk factors, as well as age, gender and psychotropic medication; splitting the dataset into a learning and a validation sample for modelling fall-risk screening and independent, temporal validation. Geriatric clinic at an academic teaching hospital in Hamburg, Germany. 4,735 hospitalised patients ≥65 years. Sensitivity, specificity, positive and negative predictive value, Odds Ratios, Youden-Index and the rates of falls and fallers were calculated. There were 10.7% fallers, and the fall rate was 7.9/1,000 hospital days. In the learning sample, mental alteration (OR 2.9), fall history (OR 2.1), and insecure mobility (Barthel-Index items 'transfer' + 'walking' score = 5, 10 or 15) (OR 2.3) had the most strongest association to falls. The LUCAS Fall-Risk Screening uses these risk factors, and patients with ≥2 risk factors contributed to the high-risk group (30.9%). In the validation sample, STRATIFY SENS was 56.8, SPEC 59.6, PPV 13.5 and NPV 92.6 vs. LUCAS Fall-Risk Screening was SENS 46.0, SPEC 71.1, PPV 14.9 and NPV 92.3. Both the STRATIFY and the LUCAS Fall-Risk Screening showed comparable results in defining a high-risk group. Impaired mobility and cognitive status were closely associated to falls. The results do underscore the importance of functional status as essential fall-risk factor in older hospitalised patients.

  2. Risk screening of pharmaceutical compounds in Romanian aquatic environment.

    Science.gov (United States)

    Gheorghe, Stefania; Petre, Jana; Lucaciu, Irina; Stoica, Catalina; Nita-Lazar, Mihai

    2016-06-01

    The aquatic environment is under increased pressure by pharmaceutically active compounds (PhACs) due to anthropogenic activities. In spite of being found at very low concentrations (ng/L to μg/L) in the environment, PhACs represent a real danger to aquatic ecosystems due to their bioaccumulation and long-term effects. In this study, the presence in the aquatic environment of six non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac, acetaminophen, naproxen, indomethacin, and ketoprofen), caffeine, and carbamazepine were monitored. Moreover, their aquatic risk and ecotoxicity by three biological models were evaluated. The monitoring studies performed in Romania showed that all studied PhACs were naturally present at concentrations >0.01 μg/L, pointing out the necessity to perform further toxicity tests for environmental risk assessment. The toxicity studies were carried out on aquatic organisms or bacteria and they indicated, for most of the tested PhACs, an insignificant or low toxicity effects: lethal concentrations (LC50) on fish Cyprinus carpio ranged from 42.60 mg/L to more than 100 mg/L; effective concentrations (EC50) on planktonic crustacean Daphnia magna ranged from 11.02 mg/L to more than 100 mg/L; inhibitory concentrations (IC50)/microbial toxic concentrations (MTC) on Vibrio fischeri and other bacterial strains ranged from 7.02 mg/L to more than 100 mg/L. The PhAC aquatic risk was assessed by using the ratio between measured environmental concentration (MEC) and predicted no effect concentration (PNEC) calculated for each type of organism. The average of quotient risks (RQs) revealed that the presence of these compounds in Romania's aquatic environment induced a lower or moderate aquatic risk.

  3. Initial Screening of Environmentally Sustainable Surface Pretreatments for Adhesive Bonding Applications

    Science.gov (United States)

    2017-05-17

    13. SUPPLEMENTARY NOTES 14. ABSTRACT A methacrylate adhesive marketed for high-temperature applications was screened in combination with...conditioning = RT. Mode-of-failure = mixed - mode (MM). ........................................................................................ 26 Fig. B-3...moisture exposure conditions. Additionally, as environmental regulations force various chemicals from the commercial market , the pretreatments and

  4. Environmental program with operational cases to reduce risk to the marine environment significantly

    International Nuclear Information System (INIS)

    Cline, J.T.; Forde, R.

    1991-01-01

    In this paper Amoco Norway Oil Company's environmental program is detailed, followed by example operational programs and achievements aimed to minimize environmental risks to the marine environment at Valhall platform. With a corporate goal to be a leader in protecting the environment, the appropriate strategies and policies that form the basis of the environmental management system are incorporated in the quality assurance programs. Also, included in the program are necessary organizational structures, responsibilities of environmental affairs and line organization personnel, compliance procedures and a waste task force obliged to implement operations improvements. An internal environmental audit system has been initiated, in addition to corporate level audits, which, when communicated to the line organization closes the environmental management loop through experience feed back. Environmental projects underway are significantly decreasing the extent and/or risk of pollution from offshore activities. The cradle to grave responsibility is assumed with waste separated offshore and onshore followed by disposal in audited sites. A $5 MM program is underway to control produced oily solids and reduce oil in produced water aiming to less than 20 ppm. When oil-based mud is used in deeper hole sections, drill solids disposed at sea average less than 60 g oil/kg dry cuttings using appropriate shaker screens, and a washing/centrifuge system to remove fines. Certain oily liquid wastes are being injected down hole whereas previously they were burned using a mud burner. Finally, a program is underway with a goal to eliminate sea discharge of oil on cuttings through injection disposal of oily wastes, drilling with alternative muds such as a cationic water base mud, and/or proper onshore disposal of oily wastes

  5. Implementation of a fall screening program in a high risk of fracture population.

    Science.gov (United States)

    Ritchey, Katherine; Olney, Amanda; Shofer, Jane; Phelan, Elizabeth A; Matsumoto, Alvin M

    2017-10-31

    Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling. Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people

  6. Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

    Science.gov (United States)

    Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

    2015-10-01

    To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Colorectal cancer screening of high-risk populations: A national survey of physicians

    Directory of Open Access Journals (Sweden)

    White Pascale M

    2012-01-01

    Full Text Available Abstract Background The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009. Results The average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement." Conclusions There is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.

  8. Designing environmental performance indicators (EPIs) for eco-efficiency

    International Nuclear Information System (INIS)

    Campbell, B.

    1997-01-01

    Environmental performance indicators (EPI) were discussed and a method by which companies can design indicators to help measure their progress toward greater eco-efficiency was presented. EPIs are quantitative measures of environmental performance. EPIs can measure one attribute, such as effluent released to water, or they can be a complex index. EPIs track impacts on the environment and provide information for decision making. The need for more eco-efficient companies, i.e. companies that produce useful goods and services while reducing their consumption of resources and while making efforts to reduce pollution, was emphasized

  9. Urban Air Environmental Health Indicators for Kuala Lumpur City

    International Nuclear Information System (INIS)

    Leh, O.L.H.; Shaharuddin Ahmad; Kadaruddin Aiyub; Yaakob Mohd Jani; Hwa, T.K.

    2012-01-01

    Air environmental health indicators were defined operationally as a combination of air quality and air-related health indicators. Clean air is a basic precondition of human health. Air pollutants had been identified with potential negative impact on health especially on respiratory and cardiovascular diseases. Thus, studies are necessary to identify and understand the state of environmental health. This study was aimed to examine and analyses the air environmental health condition in city of Kuala Lumpur by using a set of indicators. House to house questionnaire survey was carried out to collect air-related health data, and air quality sampling was carried out to identify ambient air quality level of the city. In general, city of Kuala Lumpur was found to have a moderate level of air quality. Air-related illnesses indicated by acute respiratory infection and asthma were found to be higher in more developed or higher density zones, as compared to other zones. Besides, air-related illnesses were significantly correlated to respondents exposure to air pollution. The findings imply that human health can be improved by managing the urban development and its environmental quality properly. (author)

  10. Leading product-related environmental performance indicators: a selection guide and database

    DEFF Research Database (Denmark)

    Issa, Isabela I.; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

    2015-01-01

    Ecodesign is a proactive environmental management and improvement approach employed in the product development process, which aims to minimize the environmental impacts caused during a product's life cycle and thus improve its environmental performance. The establishment of measurable environmental...... in the selection and application of environmental performance indicators - a more structured approach is still lacking. This paper presents the efforts made to identify and systematize existing leading product-related environmental performance indicators, based on a systematic literature review, and to develop...

  11. [Screening for atherosclerosis to prevent cardiovascular risk : a pro-contra debate].

    Science.gov (United States)

    Nanchen, David; Genest, Jacques

    2018-02-28

    Detecting atherosclerosis using imaging techniques is the subject of intense debate in the scientific community. Among the arguments in favor of screening, a better identification or better stratification of cardiovascular risk is mentioned, compared to cardiovascular risk scores based solely on traditional risk factors, such as blood pressure or cholesterol levels. Imaging techniques are also used to monitor the progression of atherosclerosis among patients using lipid-lowering or antihypertensive drugs in primary prevention. However, several experts in recent years have challenged the clinical utility of these imaging techniques in asymptomatic adults. This article proposes a debate « for or against » to describe the main arguments for or against the use of imaging for screening for atherosclerosis.

  12. Screening for chronic kidney disease and its risk factors in Oghara ...

    African Journals Online (AJOL)

    Background: The risk factors associated with CKD such as hypertension, diabetes and obesity remain prevalent globally, resulting in a high prevalence of CKD especially in developing countries. Screening for CKD and its' risk factors is recommended for high-risk population. This study aimed to determine the prevalence ...

  13. Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

    Science.gov (United States)

    Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

    2016-04-01

    Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups. © 2015 UICC.

  14. Environmental indices for common Michigan trees and shrubs.

    Science.gov (United States)

    Gary J. Brand

    1985-01-01

    Plants are indicators of environmental factors like moisture, nutrients, heat, and light. Semi-quantitative indices for these four factors were developed for 90 Michigan trees and shrubs. The indices and a tally of species present provide a simple evaluation of the environment of a forest stand and a useful management aid.

  15. Systematic assessment of environmental risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos

    2017-01-01

    factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD......Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD...

  16. The SOBANE risk management strategy and the Déparis method for the participatory screening of the risks.

    Science.gov (United States)

    Malchaire, J B

    2004-08-01

    The first section of the document describes a risk-prevention strategy, called SOBANE, in four levels: screening, observation, analysis and expertise. The aim is to make risk prevention faster, more cost effective, and more effective in coordinating the contributions of the workers themselves, their management, the internal and external occupational health (OH) practitioners and the experts. These four levels are: screening, where the risk factors are detected by the workers and their management, and obvious solutions are implemented; observation, where the remaining problems are studied in more detail, one by one, and the reasons and the solutions are discussed in detail; analysis, where, when necessary, an OH practitioner is called upon to carry out appropriate measurements to develop specific solutions; expertise, where, in very sophisticated and rare cases, the assistance of an expert is called upon to solve a particular problem. The method for the participatory screening of the risks (in French: Dépistage Participatif des Risques), Déparis, is proposed for the first level screening of the SOBANE strategy. The work situation is systematically reviewed and all the aspects conditioning the easiness, the effectiveness and the satisfaction at work are discussed, in search of practical prevention measures. The points to be studied more in detail at level 2, observation, are identified. The method is carried out during a meeting of key workers and technical staff. The method proves to be simple, sparing in time and means and playing a significant role in the development of a dynamic plan of risk management and of a culture of dialogue in the company.

  17. The importance of retesting the hearing screening as an indicator of the real early hearing disorder

    OpenAIRE

    Silva,Daniela Polo Camargo da; Lopez,Priscila Suman; Ribeiro,Georgea Espíndola; Luna,Marcos Otávio de Mesquita; Lyra,João César; Montovani,Jair Cortez

    2015-01-01

    INTRODUCTION: Early diagnosis of hearing loss minimizes its impact on child development. We studied factors that influence the effectiveness of screening programs.OBJECTIVE: To investigate the relationship between gender, weight at birth, gestational age, risk factors for hearing loss, venue for newborn hearing screening and "pass" and "fail" results in the retest.METHODS: Prospective cohort study was carried out in a tertiary referral hospital. The screening was performed in 565 newborns thr...

  18. Environmental radiation standards and risk limitation

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1987-01-01

    The Environmental Protection Agency and Nuclear Regulatory Commission have established environmental radiation standards for specific practices which correspond to limits on risk to the public that vary by several orders of magnitude and often are much less than radiation risks that are essentially unregulated, e.g., risks from radon in homes. This paper discusses a proposed framework for environmental radiation standards that would improve the correspondence with limitation of risk. This framework includes the use of limits on annual effective dose equivalent averaged over a lifetime, rather than limits on dose equivalent to whole body or any organ for each year of exposure, and consideration of exposures of younger age groups as well as adults; limits on annual effective dose equivalent averaged over a lifetime no lower than 0.25 mSv (25 mrem) per practice; maintenance of all exposures as low as reasonably achievable (ALARA); and establishment of a generally applicable de minimis dose for public exposures. Implications of the proposed regulatory framework for the current system of standards for limiting public exposures are discussed. 20 refs

  19. Anthropometric indicators as screening instrument for falls in the elderly

    Directory of Open Access Journals (Sweden)

    Drielly Soares Freitas

    2016-12-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n5p530   Anthropometric indicators enable professionals for predicting risk of falls in the elderly; however, there is a gap in literature on reference values. This study analyzes anthropometric indicators such as screening tests for falls in the elderly. Cross-sectional population-based systematic sampling was conducted through a household survey and body composition assessment. Anthropometric measurements were performed using portable electronic scale and stadiometer. Bioimpedance device was used to measure body mass index, body fat and lean body mass. Falls were evaluated in the 12 months preceding the interview as a dependent variable. Discriminatory analysis was performed for falls through the ROC curve, sensitivity, specificity, positive and negative predictive values. Overall, 275 older adults participated in this study, whose prevalence of falls was 23.6%. The average body mass index was 27.8kg/cm2 and 52.1% of individuals were overweight. Among older men, height (ROC=0.68; 95%CI 0.54-0.78 and lean body mass (ROC=0.63, 95%CI 0.58- 0.76 were associated to the occurrence of falls. When considering cutoff of 52.2kg and 166cm, sensitivity was obtained in 75% and high negative predictive values (88.1% and 89.1% respectively. For women, lean body mass (ROC=0.61, 95%CI 0.30-0.49 and body mass (ROC=0.60, 95%CI 0.53-0.72 were relevant from the optimal cutoff point of 28.9% and 57.2kg/m2. Lean body mass was more sensitive (63.2% and body mass little more specific (64.3%, both with high negative predictive values (82.0% and 83.0%. The indicators used were able to discriminate older adults who have suffered from falls.

  20. Methodology for development of risk indicators for offshore platforms

    International Nuclear Information System (INIS)

    Oeien, K.; Sklet, S.

    1999-01-01

    This paper presents a generic methodology for development of risk indicators for petroleum installations and a specific set of risk indicators established for one offshore platform. The risk indicators should be used to control the risk during operation of platforms. The methodology is purely risk-based and the basis for development of risk indicators is the platform specific quantitative risk analysis (QRA). In order to identify high risk contributing factors, platform personnel are asked to assess whether and how much the risk influencing factors will change. A brief comparison of probabilistic safety assessment (PSA) for nuclear power plants and quantitative risk analysis (QRA) for petroleum platforms is also given. (au)

  1. Significance of metabolites in the environmental risk assessment of pharmaceuticals consumed by human.

    Science.gov (United States)

    Han, Eun Jeong; Lee, Dong Soo

    2017-08-15

    The purpose of this study is to demonstrate the significance of metabolites to the ERA of human pharmaceuticals. The predicted exposure concentrations (PECs) in surface water were estimated for a total of 24 selected active pharmaceutical ingredients (APIs) and their metabolites using a life cycle based emission estimation model combined with a multimedia fate model with Monte-Carlo calculations. With the eco-toxicity data, the hazard quotients (HQs) of the metabolites were compared with those of individual parents alone. The results showed that PEC or toxicity or both of the metabolites was predicted to be higher than that of their parent APIs, which resulted in a total of 18 metabolites (from 12 parents) that have greater HQs than their parents. This result clearly demonstrated that some metabolites may potentially pose greater risk than their parent APIs in the water environment. Therefore, significance of metabolites should be carefully evaluated for monitoring strategy, priority setting, and scoping of the environmental risk assessment of APIs. The method used in the present work may serve as a pragmatic approach for the purpose of preliminary screening or priority setting of environmental risk posed by both APIs and their metabolites. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. 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.

  3. [Environmental health and inequalities: building indicators for sustainable development].

    Science.gov (United States)

    Carneiro, Fernando Ferreira; Franco Netto, Guilherme; Corvalan, Carlos; de Freitas, Carlos Machado; Sales, Luiz Belino Ferreira

    2012-06-01

    Despite its progress in terms of socio-economic indicators, Brazil is still unequal, which is due to an unequal and exclusionary historical process. In this paper we selected the Human Development Index - HDI and other social, economic, environmental and health indicators to exemplify this situation. We selected the municipalities that had the lowest HDI in the country in 2000 comparing their evolution over time between 2000 and 2010 by means of indicators linked to the economic, environmental and social pillars of sustainable development. These municipalities have an HDI classified as low (sustainable development with quality of life, the improvement of sanitation and education indicators should be a priority for Brazil.

  4. Pain on Functional Movement Screen Tests and Injury Risk.

    Science.gov (United States)

    Bushman, Timothy T; Grier, Tyson L; Canham-Chervak, Michelle C; Anderson, Morgan K; North, William J; Jones, Bruce H

    2015-11-01

    The Functional Movement Screen (FMS) is a tool intended to evaluate limitations or asymmetries of movement to detect individuals at risk for exercise- and sports-related injury. The purpose was to determine the association and predictive value of specific FMS tests with injury risk in physically active men. Soldiers aged 18-57 years completed the FMS (n = 2,476). Demographic and fitness data were collected by survey. Medical record data for any, overuse, and traumatic injury 6 months after the assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated along with receiver operator characteristics to determine area under the curve (AUC). Risks, risk ratios, odds ratios (ORs), and 95% confidence intervals were calculated to assess injury risks. Multivariate logistic regression identified that pain on 5 of the 7 tests was associated with greater risk for any injury (OR = 1.50-3.51): deep squat, hurdle step, in-line lunge, trunk stability push-up, and rotary stability. However, FMS registered low sensitivity, PPV, and AUC for all 7 tests for the 3 injury types (2-24% sensitivity, 16-74% PPV, and 50-58% AUC). Although the presence of pain was associated with a higher risk of injury on 5 tests, a low sensitivity, PPV, and AUC were displayed. Therefore, caution is advised when implementing the FMS as a screening tool in an Army or similarly active population as it could lead to prevention and treatment resources being directed toward individuals who are not at greater risk for injury.

  5. The economics of screening infants at risk of hearing impairment: an international analysis.

    Science.gov (United States)

    Burke, Martyn J; Shenton, Ruth C; Taylor, Matthew J

    2012-02-01

    Hearing impairment in children across the world constitutes a particularly serious obstacle to their optimal development and education, including language acquisition. Around 0.5-6 in every 1000 neonates and infants have congenital or early childhood onset sensorineural deafness or severe-to-profound hearing impairment, with significant consequences. Therefore, early detection is a vitally important element in providing appropriate support for deaf and hearing-impaired babies that will help them enjoy equal opportunities in society alongside all other children. This analysis estimates the costs and effectiveness of various interventions to screen infants at risk of hearing impairment. The economic analysis used a decision tree approach to determine the cost-effectiveness of newborn hearing screening strategies. Two unique models were built to capture different strategic screening decisions. Firstly, the cost-effectiveness of universal newborn hearing screening (UNHS) was compared to selective screening of newborns with risk factors. Secondly, the cost-effectiveness of providing a one-stage screening process vs. a two-stage screening process was investigated. Two countries, the United Kingdom and India, were used as case studies to illustrate the likely cost outcomes associated with the various strategies to diagnose hearing loss in infants. In the UK, the universal strategy incurs a further cost of approximately £2.3 million but detected an extra 63 cases. An incremental cost per case detected of £36,181 was estimated. The estimated economic burden was substantially higher in India when adopting a universal strategy due to the higher baseline prevalence of hearing loss. The one-stage screening strategy accumulated an additional 13,480 and 13,432 extra cases of false-positives, in the UK and India respectively when compared to a two-stage screening strategy. This represented increased costs by approximately £1.3 million and INR 34.6 million. The cost

  6. Poor environmental tracking can make extinction risk insensitive to the colour of environmental noise

    Science.gov (United States)

    van de Pol, Martijn; Vindenes, Yngvild; Sæther, Bernt-Erik; Engen, Steinar; Ens, Bruno J.; Oosterbeek, Kees; Tinbergen, Joost M.

    2011-01-01

    The relative importance of environmental colour for extinction risk compared with other aspects of environmental noise (mean and interannual variability) is poorly understood. Such knowledge is currently relevant, as climate change can cause the mean, variability and temporal autocorrelation of environmental variables to change. Here, we predict that the extinction risk of a shorebird population increases with the colour of a key environmental variable: winter temperature. However, the effect is weak compared with the impact of changes in the mean and interannual variability of temperature. Extinction risk was largely insensitive to noise colour, because demographic rates are poor in tracking the colour of the environment. We show that three mechanisms—which probably act in many species—can cause poor environmental tracking: (i) demographic rates that depend nonlinearly on environmental variables filter the noise colour, (ii) demographic rates typically depend on several environmental signals that do not change colour synchronously, and (iii) demographic stochasticity whitens the colour of demographic rates at low population size. We argue that the common practice of assuming perfect environmental tracking may result in overemphasizing the importance of noise colour for extinction risk. Consequently, ignoring environmental autocorrelation in population viability analysis could be less problematic than generally thought. PMID:21561978

  7. Compendium of Environmental Sustainability Indicator Collections: Complete Collection, Version 1.1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Compendium of Environmental Sustainability Indicator Collections, Version 1.1 contains 426 indicators for 239 countries from five major environmental...

  8. Risk of Breast Cancer among Young Women and Importance of Early Screening.

    Science.gov (United States)

    Memon, Zahid Ali; Kanwal, Noureen; Sami, Munam; Larik, Parsa Azam; Farooq, Mohammad Zain

    2015-01-01

    Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. We conducted a cross-sectional study among women aged 18 to 25 using a self- administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized

  9. Trends in the quality assurance process indicators for Japanese colorectal cancer screening during 2003-13.

    Science.gov (United States)

    Machii, Ryoko; Saika, Kumiko; Kasuya, Kayoko; Takahashi, Hirokazu; Saito, Hiroshi

    2018-04-01

    Recently, the importance of quality assurance (QA) for cancer screening has gained increasing attention in Japan. This study aimed to evaluate QA process indicators for population-based colorectal cancer screening during 2003-13. A national cancer screening database was used to evaluate the following process indicators: the positivity rate, diagnostic follow-up rate, unidentified results rate, non-compliance with diagnostic follow-up rate, cancer detection rate and positive predictive value (PPV). The positivity rate remained constant at 6.5% until 2011, and then increased slightly thereafter. During 2003-13, the cancer detection rate increased from 0.15% to 0.21%, and the PPV increased from 2.2% to 3.1%. Although the diagnostic follow-up rate increased from 58% to 67%, the non-compliance with diagnostic follow-up rate decreased from 24% to 16% and the unidentified results rate decreased from 18% to 17%. During the study period, the QA process indicators for colorectal cancer screening in Japan generally improved. However, the recent increase in the positivity rate requires careful observation. Innovative solutions are needed to increase the diagnostic follow-up rate.

  10. Postmenopausal osteoporosis: early screening of risk patients by spinal biphotonic absorptiometry

    International Nuclear Information System (INIS)

    Sabatier, J.P.; Guaydier-Souquieres, G.; Loyau, G.

    1990-01-01

    With quantification techniques of the spinal bone condition, especially with spinal biphotonic absorptiometry, early screening of patients risking subsequent development of osteoporosis complicated with vertebral compression is possible. An investigation was conducted in Lower Normandy, in 386 women who had undergone menopause or an ovariectomy, with ages ranging between 40 and 56 years; 274 were in a peri-menopausal state. A curve of the bone mineral content according to age was previously established. From this curve, in semilogarithmic representation, each patient risk was assessed. This risk is considered as high in 30 p. cent of the patients, non existent in 52 p. cent and 18 p. cent are borderline. The percentage of high risk patients increases with the number of years since menopause. It is hoped that the incidence of osteoporosis will decrease with early screening and preventive therapeutic measures [fr

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

    Science.gov (United States)

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

    2013-04-01

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

  12. Generalized indices for radiation risk analysis

    International Nuclear Information System (INIS)

    Bykov, A.A.; Demin, V.F.

    1989-01-01

    A new approach to ensuring nuclear safety has begun forming since the early eighties. The approach based on the probabilistic safety analysis, the principles of acceptable risk, the optimization of safety measures, etc. has forced a complex of adequate quantitative methods of assessment, safety analysis and risk management to be developed. The method of radiation risk assessment and analysis hold a prominent place in the complex. National and international research and regulatory organizations ICRP, IAEA, WHO, UNSCEAR, OECD/NEA have given much attention to the development of the conceptual and methodological basis of those methods. Some resolutions of the National Commission of Radiological Protection (NCRP) and the Problem Commission on Radiation Hygiene of the USSR Ministry of Health should be also noted. Both CBA (cost benefit analysis) and other methods of radiation risk analysis and safety management use a system of natural and socio-economic indices characterizing the radiation risk or damage. There exist a number of problems associated with the introduction, justification and use of these indices. For example, the price, a, of radiation damage, or collective dose unit, is a noteworthy index. The difficulties in its qualitative and quantitative determination are still an obstacle for a wide application of CBA to the radiation risk analysis and management. During recent 10-15 years these problems have been a subject of consideration for many authors. The present paper also considers the issues of the qualitative and quantitative justification of the indices of radiation risk analysis

  13. The inventory of sources, environmental releases and risk assessment for perfluorooctane sulfonate in China

    International Nuclear Information System (INIS)

    Zhang Lai; Liu Jianguo; Hu Jianxin; Liu Chao; Guo Weiguang; Wang Qiang; Wang Hong

    2012-01-01

    With about 100 t/y of the production volume, perfluorootane sulfonates (PFOS) are mainly used for metal plating, aqueous fire-fighting foams (AFFFs) and sulfluramidin China, and the use amount is about 30–40 t/y, 25–35 t/y and 4–8 t/y respectively. Based on the inventory of PFOS production and uses with geographic distribution educed from statistics, environmental risk assessment of PFOS was taken by using EUSES model, as well as its environmental releases were estimated both in local and regional levels in China. While the environmental release from manufacture is significant in Central China region, metal plating was identified as the major PFOS release source in regional level. The East China region shows the most strong emission strength of PFOS. Though the predicted environmental concentrations (PECs) were not exceed current relevant predicted no effect concentrations (PNECs) of the risk characterization for PFOS, higher PECs was estimated around major PFOS release sources showing undesirable environmental risk at local level. - Highlights: ► Inventory of production and uses of perfluorooctane sulfonate (PFOS) in China with geographical distribution. ► Characteristics of PFOS release sources and distribution consistent with social-economic situation in China. ► Effective model predicted results of PFOS environmental risk assessment in local and regional scales compared with relevant environmental monitoring data. - Inventory of PFOS production and use of with sectoral and regional distribution of China, environmental releases and risk status were indicated both in the local and regional level of the country.

  14. Fall risk screening protocol for older hearing clinic patients.

    Science.gov (United States)

    Criter, Robin E; Honaker, Julie A

    2017-10-01

    The primary purposes of this study were (1) to describe measures that may contrast audiology patients who fall from those who do not fall and (2) to evaluate the clinical performance of measures that could be easily used for fall risk screening in a mainstream audiology hearing clinic. Cross-sectional study Study sample: Thirty-six community-dwelling audiology patient participants and 27 community-dwelling non-audiology patients over 60 years of age. The Hearing Handicap Inventory for the Elderly (HHIE) most accurately identified patients with a recent fall (sensitivity: 76.0%), while the Dizziness Handicap Inventory (DHI) most accurately identified patients without a recent fall (specificity: 90.9%). A combination of measures used in a protocol-including HHIE, DHI, number of medications, and the Timed Up and Go test-resulted in good, accurate identification of patients with or without a recent history of falls (92.0% sensitivity, 100% specificity). This study reports good sensitivity and excellent specificity for identifying patients with and without a recent history of falls when measures were combined into a screening protocol. Despite previously reported barriers, effective fall risk screenings may be performed in hearing clinic settings with measures often readily accessible to audiologists.

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

    Science.gov (United States)

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

    2015-09-15

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

  16. Identification of At-Risk Youth by Suicide Screening in a Pediatric Emergency Department.

    Science.gov (United States)

    Ballard, Elizabeth D; Cwik, Mary; Van Eck, Kathryn; Goldstein, Mitchell; Alfes, Clarissa; Wilson, Mary Ellen; Virden, Jane M; Horowitz, Lisa M; Wilcox, Holly C

    2017-02-01

    The pediatric emergency department (ED) is a critical location for the identification of children and adolescents at risk for suicide. Screening instruments that can be easily incorporated into clinical practice in EDs to identify and intervene with patients at increased suicide risk is a promising suicide prevention strategy and patient safety objective. This study is a retrospective review of the implementation of a brief suicide screen for pediatric psychiatric ED patients as standard of care. The Ask Suicide Screening Questions (ASQ) was implemented in an urban pediatric ED for patients with psychiatric presenting complaints. Nursing compliance rates, identification of at-risk patients, and sensitivity for repeated ED visits were evaluated using medical records from 970 patients. The ASQ was implemented with a compliance rate of 79 %. Fifty-three percent of the patients who screened positive (237/448) did not present to the ED with suicide-related complaints. These identified patients were more likely to be male, African American, and have externalizing behavior diagnoses. The ASQ demonstrated a sensitivity of 93 % and specificity of 43 % to predict return ED visits with suicide-related presenting complaints within 6 months of the index visit. Brief suicide screening instruments can be incorporated into standard of care in pediatric ED settings. Such screens can identify patients who do not directly report suicide-related presenting complaints at triage and who may be at particular risk for future suicidal behavior. Results have the potential to inform suicide prevention strategies in pediatric EDs.

  17. Environmental pollution risk and insurance

    OpenAIRE

    Fragnelli, Vito; Marina, Maria Erminia

    2002-01-01

    We consider environmental risks that are evaluated too much heavy for a single insurance company, but they can be insured by n companies which a premium is assigned to.This is precisely the Italian scenario where a pool of companies co-insures these risks.Under a game theoretic approach we start by analyzing how they should split the risk and the premium in order to be better off. Under suitable hypotheses, there exists an optimal decomposition of the risk, that allow us to define a cooperati...

  18. Cardiovascular risk factors and incident albuminuria in screen-detected type 2 diabetes

    NARCIS (Netherlands)

    Webb, D. R.; Zaccardi, F.; Davies, M. J.; Griffin, S. J.; Wareham, N. J.; Simmons, R. K.; Rutten, G. E.; Sandbaek, A.; Lauritzen, T.; Borch-Johnsen, K.; Khunti, K.

    2017-01-01

    Background: It is unclear whether cardiovascular risk factor modification influences the development of renal disease in people with type 2 diabetes identified through screening. We determined predictors of albuminuria 5 years after a diagnosis of screen-detected diabetes within the ADDITION-Europe

  19. Assessing Environmental Impact Indicators in Road Construction Projects in Developing Countries

    Directory of Open Access Journals (Sweden)

    Mohamed Marzouk

    2017-05-01

    Full Text Available Environmental pollution is considered to be one of the main concerns in the construction industry. Environmental pollution has become a major challenge to construction projects due to the huge amount of pollution caused by construction projects. There are different types of environmental impact indicators, such as the greenhouse gas (GHG footprint, eutrophication potential (EP, acidification potential (AP, human health (HH particulate, ozone depletion, and smog. Each of these environmental impact indicators can be linked to different phases of the construction projects. The overall environmental impact indicators can be divided into direct, indirect, and operational emissions. This paper presents a Building Information Modeling (BIM-based methodology for the assessment of environmental impacts in road construction projects. The model takes into account the overall life cycle of the road construction project, which is divided into: manufacturing phase, transportation phase, construction phase, maintenance phase, operational phase, recycling phase, and deconstruction phase. A case study is presented to demonstrate the applicability of the proposed model. The proposed model solves a major problem for road construction project teams who want to assess the environmental impact indicators associated with their project prior to the start of the execution of their projects.

  20. Modern biogeochemistry environmental risk assessment

    CERN Document Server

    Bashkin, Vladimir N

    2006-01-01

    Most books deal mainly with various technical aspects of ERA description and calculationsAims at generalizing the modern ideas of both biogeochemical and environmental risk assessment during recent yearsAims at supplementing the existing books by providing a modern understanding of mechanisms that are responsible for the ecological risk for human beings and ecosystem

  1. Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer.

    Science.gov (United States)

    Takeda, Takashi; Tsuji, Kosuke; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Tominaga, Eiichiro; Aoki, Daisuke

    2018-05-01

    Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM₅ were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM₅, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  2. Risk-based environmental assessment for uranium mines – Some Canadian and Australian experience

    International Nuclear Information System (INIS)

    Phaneuf, M.; McKee, M.; Woods, P.

    2014-01-01

    The Risk-Based Approach to Environmental Assessment in Australia: • This has emerged over the last 2 decades; • Currently usually based around the Australian and New Zealand standard (AS4360:1999) for risk assessment: • Potential impact events; • Inherent risk levels (e.g. low, moderate) using a matrix approach; • Design and operational control measures; • Residual risk levels; • Outcomes to be achieved; • Outcomes measurement criteria - • Leading to ‘compliance’ monitoring; • Leading indicator criteria - • Leading to ‘early warning’ monitoring

  3. Risk and environmental impact assessment: nuclear and environmental licensing interface

    International Nuclear Information System (INIS)

    Costa, Eduardo M.; Monteiro, Iara A.

    1997-01-01

    The main aims of this paper are the identification and discussion of interfaces and application of common concepts in the existing nuclear and environmental licensing procedures. Risk and impact assessment of nuclear electricity generation are two of these concepts which are discussed detail. The risk concept, which had initially focused on engineering projects, has been extended to many other areas of human activity. Risk resulting from the use of ionization radiation has been associated to the dose for the critical members of the public. Therefore, radiation protection applies basic dose limits which are established in national and international recommendations. These recommendations are increasing the emphasis to keep all the exposures to ionizing radiation as low as reasonable achievable, economical and social factors being taken into account. On the other hand, environmental impact assessment has been used as a tool in planning and decision-making processes, thus including environmental concern in the discussion of social and economical development strategies. This paper aims to discuss the association of these two concepts by presenting the procedures of control of radiological impact during normal operation of a nuclear power plant and the various forms of risk communication to the public in the case of events occurrence. (author). 13 refs

  4. Full Implementation of Screening for Nutritional Risk and Dysphagia in an Acute Stroke Unit: A Clinical Audit.

    Science.gov (United States)

    Kampman, Margitta T; Eltoft, Agnethe; Karaliute, Migle; Børvik, Margrethe T; Nilssen, Hugo; Rasmussen, Ida; Johnsen, Stein H

    2015-10-01

    In patients with acute stroke, undernutrition and aspiration pneumonia are associated with increased mortality and length of hospital stay. Formal screening for nutritional risk and dysphagia helps to ensure optimal nutritional management in all patients with stroke and to reduce the risk of aspiration in patients with dysphagia. We developed a national guideline for nutritional and dysphagia screening in acute stroke, which was introduced in our stroke unit on June 1, 2012. The primary objective was to audit adherence to the guideline and to achieve full implementation. Second, we assessed the prevalence of nutritional risk and dysphagia. We performed a chart review to assess performance of screening for nutritional risk and dysphagia in all patients with stroke hospitalized for ≥48 hours between June 1, 2012, and May 31, 2013. Next we applied a "clinical microsystems approach" with rapid improvement cycles and audits over a 6-month period to achieve full implementation. The chart review showed that nutritional risk screening was performed in 65% and swallow testing in 91% of eligible patients (n = 185). Proactive implementation resulted in >95% patients screened (n = 79). The overall prevalence of nutritional risk was 29%, and 23% of the patients failed the initial swallow test. Proactive implementation is required to obtain high screening rates for nutritional risk and swallowing difficulties using validated screening tools. The proportion of patients at nutritional risk and the prevalence of dysphagia at initial swallow test were in the lower range of previous reports.

  5. Environmental viral contamination in a pediatric hospital outpatient waiting area: implications for infection control.

    Science.gov (United States)

    D'Arcy, Nikki; Cloutman-Green, Elaine; Klein, Nigel; Spratt, David A

    2014-08-01

    Nosocomial outbreaks of viral etiology are costly and can have a major impact on patient care. Many viruses are known to persist in the inanimate environment and may pose a risk to patients and health care workers. We investigate the frequency of environmental contamination with common health care-associated viruses and explore the use of torque-teno virus as a marker of environmental contamination. Environmental screening for a variety of clinically relevant viruses was carried out over 3 months in a UK pediatric hospital using air sampling and surface swabbing. Swabs were tested for the presence of virus nucleic acid by quantitative polymerase chain reactions. Viral nucleic acid was found on surfaces and in the air throughout the screening period, with adenovirus DNA being the most frequent. Door handles were frequently contaminated. Torque-teno virus was also found at numerous sites. Evidence of environmental contamination with viral pathogens is present in health care environments and may be indicative of an infectious virus being present. Screening for viruses should be included in infection control strategies. Torque-teno virus may provide a better marker of contamination and reduce time and cost of screening for individual viruses. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Landfill waste and recycling: Use of a screening-level risk assessment tool for end-of-life cadmium telluride (CdTe) thin-film photovoltaic (PV) panels

    International Nuclear Information System (INIS)

    Cyrs, William D.; Avens, Heather J.; Capshaw, Zachary A.; Kingsbury, Robert A.; Sahmel, Jennifer; Tvermoes, Brooke E.

    2014-01-01

    Grid-connected solar photovoltaic (PV) power is currently one of the fastest growing power-generation technologies in the world. While PV technologies provide the environmental benefit of zero emissions during use, the use of heavy metals in thin-film PV cells raises important health and environmental concerns regarding the end-of-life disposal of PV panels. To date, there is no published quantitative assessment of the potential human health risk due to cadmium leaching from cadmium telluride (CdTe) PV panels disposed in a landfill. Thus, we used a screening-level risk assessment tool to estimate possible human health risk associated with disposal of CdTe panels into landfills. In addition, we conducted a literature review of potential cadmium release from the recycling process in order to contrast the potential health risks from PV panel disposal in landfills to those from PV panel recycling. Based on the results of our literature review, a meaningful risk comparison cannot be performed at this time. Based on the human health risk estimates generated for PV panel disposal, our assessment indicated that landfill disposal of CdTe panels does not pose a human health hazard at current production volumes, although our results pointed to the importance of CdTe PV panel end-of-life management. - Highlights: • Analysis of possible human health risk posed by disposal of CdTe panels into landfills. • Qualitative comparison of risks associated with landfill disposal and recycling of CdTe panels. • Landfill disposal of CdTe panels does not pose a human health hazard at current production volumes. • There could be potential risks associated with recycling if not properly managed. • Factors other than concerns over toxic substances will likely drive the decisions of how to manage end-of-life PV panels

  7. The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

    Science.gov (United States)

    Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

    2017-03-01

    Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Risk communication in environmental assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rahm-Crites, L. [Lawrence Livermore National Lab., Germantown, MD (United States). Washington Operations Office

    1996-08-26

    Since the enactment of NEPA and other environmental legislation, the concept of `risk communication` has expanded from simply providing citizens with scientific information about risk to exploring ways of making risk information genuinely meaningful to the public and facilitating public involvement in the very processes whereby risk is analyzed and managed. Contemporary risk communication efforts attempt to find more effective ways of conveying increasingly complex risk information and to develop more democratic and proactive approaches to community involvement, in particular to ensuring the participation of diverse populations in risk decisions. Although considerable progress has been made in a relatively short time, risk communication researchers and practitioners currently face a number of challenges in a time of high expectations, low trust, and low budgets.

  9. Screening for colorectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Hans J.; Jakobsen, Karen V.; Christensen, Ib J.

    2011-01-01

    Emerging results indicate that screening improves survival of patients with colorectal cancer. Therefore, screening programs are already implemented or are being considered for implementation in Asia, Europe and North America. At present, a great variety of screening methods are available including...... into improvements of screening for colorectal cancer includes blood-based biological markers, such as proteins, DNA and RNA in combination with various demographically and clinically parameters into a "risk assessment evaluation" (RAE) test. It is assumed that such a test may lead to higher acceptance among...... procedures for colorectal cancer. Therefore, results of present research, validating RAE tests, are awaited with interest....

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Integrating economic and environmental indicators in the assessment of desertification risk: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Salvati, L. [Piazza F. Morosini 12, Rome (Italy); Zitti, M.; Ceccarelli, T. [Ufficio Centrale di Ecologia Agraria, Rome (Italy)

    2008-09-30

    Desertification is a complex phenomenon which reduces the soil fertility involving ecological and economic processes that characterize the environment at different geographic scales. The most widely accepted definition of desertification is the one given by the United Nations Convention. It defines desertification as 'land degradation in arid, semi-arid and dry sub-humid areas resulting from various factors, including climatic variations and human actities'.Desertification involves many countries featuring different ecological, economic, and social conditions. In Mediterranean Europe, high human pressure, economic development, and climatic changes combine to produce land consumption, soil erosion, salinization, and fire risk, all considered as key factors to start desertification processes. For many years the term desertification has been strictly associated to geo-physical conditions, but in very complex ecosystems the study of the interaction of physical patterns with population and social characteristics is necessary to better delineate areas at risk. The aims of this paper are therefore (i) to review recent findings in term of desertification processes and risk assessment in the Mediterranean basin, (ii) to illustrate a simplified model in which social and economic variables may significantly accelerate land degradation leading to desertification, (iii) to suggest a set of demographic, economic, and institutional indicators suitable to contribute to the assessment of desertification risk in the Mediterranean basin, (iv) to built a synthetic index based on a multivariate approach and, finally, (v) to compare such index with a standard index of desertification risk only referring to geo-physical conditions. As a conclusion, new findings to be achieved in the context of human impact on environment as an original contribution to the study of desertification were delineated.

  12. Empirical applications of an environmental stress indicator and the environmental efficiency revolution in Taiwan

    Directory of Open Access Journals (Sweden)

    Han-Shen Chen

    2013-09-01

    Full Text Available In this essay, the first aim is to apply the structure of material flow analysis (MFA and ecological footprint model to construct an environmental stress indicator. Secondly, an impact, population, affluence and technology (IPAT analysis is used to resolve indicators related to MFA and resource yield productivity. The research indicates following results: (1 The 2007 per capita ecological deficit in Taiwan is 6.3441 square hm.The figures reflect that productivity and life intensity of residents have exceeded the carrying capacity of Taiwan's ecological economic system. (2 Wealth becomes the most important factor in material needs and pollution discharge. (3 Environmental efficiency and ecological efficiency slowed down dramatically, demonstrating that use of resources and total amount of environmental stress stay at a developmental stage. Therefore, if proper measures are not adopted, the current weak sustainability will lead into the vicious circle which departs from sustainable development.

  13. Women’s perspectives and experiences on screening for osteoporosis (Risk-stratified Osteoporosis Strategy Evaluation, ROSE)

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Huniche, Lotte; Ammentorp, Jette

    2014-01-01

    main themes: knowledge about osteoporosis, psychological aspects of screening, and moral duty. The women viewed the program in the context of their everyday life and life trajectories. Age, lifestyle, and knowledge about osteoporosis were important to how women ascribed meaning to the program, how......This study aimed to investigate women's perspectives and experiences with screening for osteoporosis. Focus groups and individual interviews were conducted. Three main themes emerged: knowledge about osteoporosis, psychological aspects of screening, and moral duty. Generally, screening was accepted...... due to life experiences, self-perceived risk, and the preventive nature of screening. PURPOSE: The risk-stratified osteoporosis strategy evaluation (ROSE) study is a randomized prospective population-based trial investigating the efficacy of a screening program to prevent fractures in women aged 65...

  14. Vested interest and environmental risk communication

    DEFF Research Database (Denmark)

    De Dominicis, Stefano; Crano, William D.; Ganucci Cancellieri, Uberta

    2014-01-01

    Vested interest theory (VIT), first investigated on environmental risk, suggests that the hedonic relevance of an attitude object moderates relations between attitudes, intentions, and responses to danger. Emphasizing vested interest may maximize impacts of risk communications. Study 1 (N=215...... method of developing effective risk announcements.......) assessed differences between inhabitants of two flood-risk areas in Italy on past experience, risk perceptions, concerns, attitudes, and behavioral intentions. Objectively, higher risk areas' residents reported more experience, and greater perceived risk and concern, while no preparedness differences were...

  15. Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

    Directory of Open Access Journals (Sweden)

    Shan Liu

    Full Text Available No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments.A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy. Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars and quality adjusted life-years (QALYs. Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY.The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds

  16. Risk Control of Offshore Installations. A Framework for the Establishment of Risk Indicators

    Energy Technology Data Exchange (ETDEWEB)

    Oeien, Knut

    2001-07-01

    Currently quantitative risk assessments are carried out to analyze the risk level of offshore installations and to evaluate whether or not the risk level is acceptable. By way of the quantitative risk analysis the risk status of a given installation is obtained. However, the risk status is obtained so infrequently that it is inadequate for risk control. It can be compared to economic control having the economic status presented about each fifth year, which is obviously inadequate. It is important to know the risk status because this may provide an early warning about the need for remedial actions. Without frequent information about the risk status, control of risk cannot be claimed. The main objective of this thesis has been the development of a framework for the establishment of risk indicators. These risk indicators provide a status of the risk level through measuring of changes in technical, operational and organizational factors important to risk, and is thus a means to control risk during operation of offshore petroleum installations. The framework consists of a technical methodology using the quantitative risk assessment as a basis, an organizational model, and an organizational quantification methodology. Technical risk indicators are established from the technical methodology covering the risk factors explicitly included in the quantitative risk assessment. Organizational risk indicators measure changes in the organizational risk factors included in the organizational model, but not included in the quantitative risk assessment. The organizational model is an extension to the risk model in the quantitative risk assessment. The organizational quantification methodology calculates the effect of the changes measured by the organizational risk indicators. The organizational model may also be applied as a qualitative tool for root cause analysis of incidents (process leaks). Other results are an intermediate-level expert judgment procedure applicable for

  17. Assessment of Uncertainty-Based Screening Volumes for NASA Robotic LEO and GEO Conjunction Risk Assessment

    Science.gov (United States)

    Narvet, Steven W.; Frigm, Ryan C.; Hejduk, Matthew D.

    2011-01-01

    Conjunction Assessment operations require screening assets against the space object catalog by placing a pre-determined spatial volume around each asset and predicting when another object will violate that volume. The selection of the screening volume used for each spacecraft is a trade-off between observing all conjunction events that may pose a potential risk to the primary spacecraft and the ability to analyze those predicted events. If the screening volumes are larger, then more conjunctions can be observed and therefore the probability of a missed detection of a high risk conjunction event is small; however, the amount of data which needs to be analyzed increases. This paper characterizes the sensitivity of screening volume size to capturing typical orbit uncertainties and the expected number of conjunction events observed. These sensitivities are quantified in the form of a trade space that allows for selection of appropriate screen-ing volumes to fit the desired concept of operations, system limitations, and tolerable analyst workloads. This analysis will specifically highlight the screening volume determination and selection process for use in the NASA Conjunction Assessment Risk Analysis process but will also provide a general framework for other Owner / Operators faced with similar decisions.

  18. Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program.

    Science.gov (United States)

    Huded, Jill M; Dresden, Scott M; Gravenor, Stephanie J; Rowe, Theresa; Lindquist, Lee A

    2015-12-01

    Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs) annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT), a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL) model. Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT), social work or home health as determined by the GNL. Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%), outpatient PT referrals (n=56, 12.2%) and social work consultation (n=162, 44%). The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

  19. Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program

    Directory of Open Access Journals (Sweden)

    Jill M. Huded

    2015-12-01

    Full Text Available Introduction: Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT, a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL model. Methods: Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT, social work or home health as determined by the GNL. Results: Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%, outpatient PT referrals (n=56, 12.2% and social work consultation (n=162, 44%. Conclusion: The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

  20. How does HPV vaccination status relate to risk perceptions and intention to participate in cervical screening?

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob

    2016-01-01

    will not attend screening because they falsely think that the vaccine has eliminated their cervical cancer risk. The aim of this study was to investigate the association between HPV vaccination status and perceptions of cervical cancer risk; perceptions of vaccine effect; and intention to participate in cervical...... and intentions to participate in cervical screening. Main outcomes were: perceived lifetime-risk of cervical cancer; perceived HPV vaccine effect; and intention to participate in cervical screening. Results: HPV vaccinated women more often than unvaccinated women intended to participate in screening: adjusted...... odds ratio (OR) for being HPV vaccinated when intending to participate in screening of 3.89 (95 % CI: 2.50–6.06). HPV vaccinated women perceived cervical cancer risk to be higher than unvaccinated women did: adjusted OR of 0.11 (95 % CI: 0.03–0.39) and 0.51 (95 % CI: 0.33–0.78) for being HPV vaccinated...

  1. [Screening of the risk of functional decline performed by an inpatient geriatric consultation team in a general hospital].

    Science.gov (United States)

    Benoît, F; Bertiaux, M; Schouterden, R; Huard, E; Segers, K; Decorte, L; Robberecht, J; Simonetti, C; Surquin, M

    2013-01-01

    The Mobile Geriatric Team (MGT) is part of the Geriatric Care Program and aims to provide interdisciplinary geriatric expertise to other professionals for old patients hospitalized outside geriatric department. Our hospital has a MGT since 2008. Our objective is to retrospectively describe the population of patients of 75 years and older hospitalized outside the geriatric ward and screened for the risk of functional decline by the MGT between 1 October 2009 and 30 September 2011. We recorded the risk of functional decline, as indicated by the Identification of Senior At Risk score (ISAR) performed within 48 h after admission, place of living, discharge destination, Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) scores. In two years, 1.568 patients > or = 75 Y were screened with the ISAR score (mean age 82.5 Y, 60.7% of women). We identified 833 patients with a high-risk of functional decline (ISAR > or = 3). The majority of high-risk subjects (78%) were living at home before hospitalization and 58.7% returned home after discharge. Depression and cognitive impairment were identified among respectively 41% and 59% of high-risk subjects. Only 128 patients were admitted for fall. Most of the faller patients were living at home prior hospitalization and had an ISAR score > or = 3. The MGT allowed identifying many patients > or = 75 Y living at home and presenting with high-risk of functional decline and geriatric syndromes, confirming that good screening procedures are necessary to optimize management of hospitalized olders. Most of faller patients have an ISAR score > or = 3 and should benefit a comprehensive geriatric assessment.

  2. Decision making concept of risk control: integration of decision criteria, top level risk indices and plant performance indices

    International Nuclear Information System (INIS)

    Vojnovic, D.; Mavko, B.; Kozuh, M.

    1993-01-01

    A support system for risk monitoring and control is suggested. The following concepts of system elements are briefly discussed: risk curve partitioning, the reliability cost function, the multi-objective optimization model, preference assessment, safety/risk indicators, and knowledge based systems. (Z.S.) 2 figs

  3. Environmental risk allocation in the asset rationalization process

    International Nuclear Information System (INIS)

    Kruhlak, R.M.; Miller, S.R.

    1999-01-01

    Public concern regarding the state of the environment has resulted in improved enforcement of existing laws related to protection of the environment. This has had an impact on oil and gas transactions. One of the factors which affects the nature of oil and gas acquisitions and dispositions is the risk associated with environmental conditions. For example, the purchaser of an oil or gas asset may acquire threats of prosecution under existing legislation, or may acquire significant costs associated with remediation or clean-up. Vendors may also be affected by environmental risks resulting from divestiture. Risks include increased liability, continuing liability, and a growing uncertainty over the potential extent and nature of environmental problems. These problems mean that lawyers must find adequate methods of allocating risk. The best approach is to place more emphasis on rigorous due diligence, disclosure and contractual accommodation of identifiable environmental problems at the time of the acquisition or disposition. 2 figs

  4. 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...

  5. Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study.

    Directory of Open Access Journals (Sweden)

    Kevin Ten Haaf

    2017-04-01

    Full Text Available Selection of candidates for lung cancer screening based on individual risk has been proposed as an alternative to criteria based on age and cumulative smoking exposure (pack-years. Nine previously established risk models were assessed for their ability to identify those most likely to develop or die from lung cancer. All models considered age and various aspects of smoking exposure (smoking status, smoking duration, cigarettes per day, pack-years smoked, time since smoking cessation as risk predictors. In addition, some models considered factors such as gender, race, ethnicity, education, body mass index, chronic obstructive pulmonary disease, emphysema, personal history of cancer, personal history of pneumonia, and family history of lung cancer.Retrospective analyses were performed on 53,452 National Lung Screening Trial (NLST participants (1,925 lung cancer cases and 884 lung cancer deaths and 80,672 Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO ever-smoking participants (1,463 lung cancer cases and 915 lung cancer deaths. Six-year lung cancer incidence and mortality risk predictions were assessed for (1 calibration (graphically by comparing the agreement between the predicted and the observed risks, (2 discrimination (area under the receiver operating characteristic curve [AUC] between individuals with and without lung cancer (death, and (3 clinical usefulness (net benefit in decision curve analysis by identifying risk thresholds at which applying risk-based eligibility would improve lung cancer screening efficacy. To further assess performance, risk model sensitivities and specificities in the PLCO were compared to those based on the NLST eligibility criteria. Calibration was satisfactory, but discrimination ranged widely (AUCs from 0.61 to 0.81. The models outperformed the NLST eligibility criteria over a substantial range of risk thresholds in decision curve analysis, with a higher sensitivity for all models and a

  6. Risk-based priority scoring for Brookhaven National Laboratory environmental restoration programs

    International Nuclear Information System (INIS)

    Morris, S.C.; Meinhold, A.F.

    1995-05-01

    This report describes the process of estimating the risk associated with environmental restoration programs under the Brookhaven National Laboratory Office of Environmental Restoration. The process was part of an effort across all Department of Energy facilities to provide a consistent framework to communicate risk information about the facilities to senior managers in the DOE Office of Environmental Management to foster understanding of risk activities across programs. the risk evaluation was a qualitative exercise. Categories considered included: Public health and safety; site personnel safety and health; compliance; mission impact; cost-effective risk management; environmental protection; inherent worker risk; environmental effects of clean-up; and social, cultural, political, and economic impacts

  7. Integrated environmental risk assessment and whole-process management system in chemical industry parks.

    Science.gov (United States)

    Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

    2013-04-19

    Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on.

  8. Integrated Environmental Risk Assessment and Whole-Process Management System in Chemical Industry Parks

    Science.gov (United States)

    Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

    2013-01-01

    Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on. PMID:23603866

  9. Integrated Environmental Risk Assessment and Whole-Process Management System in Chemical Industry Parks

    Directory of Open Access Journals (Sweden)

    Lei Huang

    2013-04-01

    Full Text Available Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on.

  10. The occurrence of high-risk factors for hearing loss in very-low-birth-weight neonates: a retrospective exploratory study of targeted hearing screening.

    Science.gov (United States)

    Kanji, Amisha; Khoza-Shangase, Katijah

    2012-12-01

    The current study aimed at determining the type and frequency of high-risk factors for hearing loss in a group of very-low-birth-weight (VLBW) neonates in a tertiary hospital in South Africa with the objective of collating evidence that could be used in arguing for or against revisiting targeted hearing screening in developing countries. Furthermore, the study aimed at investigating the relationship between the identified high-risk factors and hearing screening results. In a retrospective data review design, data were collated from files from the VLBW project; this included hearing screening records, as well as records from participant medical and audiology files. Records of 86 neonates with birth weights ranging between 680 g and 1500 g were reviewed. Findings indicated that neonatal jaundice, exposure to human immunodeficiency virus (HIV), mechanical or assisted ventilation, and neonatal intensive care unit stay greater than 48 hours were the most frequently occurring high-risk factors for hearing loss in the current sample. These factors are consistent with those listed in the high-risk register of the Health Professions Council of South Africa for the South African context. Findings confirm the complexity of risk factors, and the influence that a variety of factors such as poor follow-up or return rate might have on the implementation of early hearing detection and intervention. The importance of establishing context-specific risk factors for effective implementation of targeted screening protocols where niversal newborn hearing screening is not yet a reality was highlighted by the current study.

  11. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  12. How strategic environmental assessment can inform lenders about potential environmental risks

    DEFF Research Database (Denmark)

    Banhalmi-Zakar, Zsuzsa; Larsen, Sanne Vammen

    2015-01-01

    at a time when it can be used as an input to bank lending decisions, which can assist banks in making lending decisions with better environmental outcomes. For these reasons, we argue that in some circumstances, and particularly for project finance transactions, SEA may be a more useful environmental......In this paper, we explore the potential for strategic environmental assessment (SEA) to be a useful tool for banks to manage environmental risks and inform lending decisions. SEA is an environmental assessment tool that was developed to assist strategic-level decision-makers, such as policy...

  13. Simplified risk model support for environmental management integration

    International Nuclear Information System (INIS)

    Eide, S.A.; Jones, J.L.; Wierman, T.E.

    1998-01-01

    This paper summarizes the process and results of human health risk assessments of the US Department of Energy (DOE) complex-wide programs for high-level waste, transuranic waste, low-level, mixed low-level waste, and spent nuclear fuel. The DOE baseline programs and alternatives for these five material types were characterized by disposition maps (material flow diagrams) and supporting information in the May 1997 report 'A Contractor Report to the Department of Energy on Environmental Baseline Programs and Integration Opportunities' (Discussion Draft). Risk analyses were performed using the Simplified Risk Model (SRM), developed to support DOE Environmental Management Integration studies. The SRM risk analyses consistently and comprehensively cover the life cycle programs for the five material types, from initial storage through final disposition. Risk results are presented at several levels: DOE complex-wide, material type program, individual DOE sites, and DOE site activities. The detailed risk results are documented in the February 1998 report 'Human Health Risk Comparisons for Environmental Management Baseline Programs and Integration Opportunities' (Discussion Draft)

  14. [Quantitative assessment of fungal risk in the case of construction works in healthcare establishments: Proposed indicators for the determination of the impact of management precautions on the risk of fungal infection].

    Science.gov (United States)

    Gangneux, J-P; Adjidé, C-C; Bernard, L; Botterel, F; Carel, A; Castel, O; Derouin, F; Hoarau, G; Labussière, H; Lafaurie, M; Millon, L; Pottecher, B; Thiebaut, A; Turco, M; Baron, R

    2012-03-01

    Construction works in healthcare establishments produce airborne fungal spores and considerably increase the risk of exposure of immunosuppressed patients. It is necessary to reinforce protective measures, or even to implement specific precautions, during this critical phase. The aim of these precautions is to protect both those areas, which are susceptible to dust, and patients at risk of a fungal infection particularly invasive aspergillosis. When construction works are planned in healthcare establishments, the first step consists in the characterisation of the environmental fungal risk and the second one in proposing risk management methods. It is then essential to establish impact indicators in order to evaluate the risk management precautions applied. The working group promoted by the French societies of medical mycology and hospital hygiene (SFMM & SF2H) details here both environmental and epidemiological impact indicators that can be used. Copyright © 2012. Published by Elsevier SAS.

  15. EPR Spectroscopy in Environmental Lichen-Indication

    Science.gov (United States)

    Bondarenko, P. V.; Nguyet, Le Thi Bich; Zhuravleva, S. E.; Trukhan, E. M.

    2017-09-01

    The paramagnetic properties of lichens were investigated using EPR spectroscopy and Xanthoria parietina (L.) Th. Fr. as a case study. It was found that the concentration of paramagnetic centers in lichen thalli increased as the air-pollution level increased. Possible formation mechanisms of the paramagnetic centers in lichens were discussed. The efficiency of using EPR spectroscopy to study lichens as environmental quality indicators was demonstrated.

  16. The influence of knowledge and perception of the risk of cervical cancer on screening behavior in mainland Chinese women.

    Science.gov (United States)

    Gu, Can; Chan, Carmen W H; Twinn, Sheila; Choi, Kai Chow

    2012-12-01

    Theories of health behavior and empirical research highlight the risk perception as a significant factor for people adopting cancer screening. However, screening uptakes and risk perception of cervical cancer in mainland Chinese women remains unknown. This paper adopted the protection motivation theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing utilization of cervical screening. A self-administered questionnaire was completed by 167 participants in mainland China (79 nonscreened and 88 screened women) in 2007 which consisted of four sections: background information, women's attendance pattern for cervical screening, perceptions related to body health and knowledge about cervical cancer and screening, and PMT measures. All women considered themselves at low risk of cervical cancer. No significant association was observed between previous screening uptake and PMT variables. Using multivariate analysis, having children, a perception that visiting doctors regularly is important to health, average and high levels of knowledge about cervical screening were significantly associated with having been received screening. Chinese women demonstrated an unrealistic optimism about their personal risk of cervical cancer. The findings do not support an association between risk perception and screening uptake. In spite of this, current findings revealed some possible factors influencing women's screening behavior. This study highlights the significance of knowledge and culturally-relevant health behavior and beliefs about cervical screening for Chinese women in determining whether or not they receive screening. The promotion of cervical cancer prevention and early detection should be integrated into public education about women's health. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Indicator system for the environmental assessment of energy transport systems

    International Nuclear Information System (INIS)

    Knoepfel, I.

    1995-01-01

    The aim of this dissertation is to define a consistent set of indicators for the environmental assessment of different energy transport systems: high-voltage alternating and direct current transmission lines, electric cables, pipelines for gas and oil, inland waterway, road and rail transportation, according to state-of-the-art technologies. The indicator system is used for comparative analysis and identification of environmental hot-spots of the different systems. The environmental performance of power plants close to production or unloading terminals with subsequent power transmission and the transport of fossil fuels with power production close to the end-users is compared. Quantitative indicators are defined for different impact categories: fossil energy depletion, impacts from emissions, land use, noise impacts and visibility. A further aggregation of the different indicators to obtain a universal environmental score was not envisaged. It was not possible to define a quantitative indicator for possible electric and magnetic field effects because of insufficient knowledge of the involved dose-response metrics. The proposed indicators quantify dose-response relationships also below emission or immission limits imposed by law, which was one of the main requirements in this work. By reducing all information to an equivalent impacted area, a high level of consistency was achieved for land use, noise impacts and visibility indicators. Other indicators refer to the energy content of fossil resources and to equivalent emissions of reference substances. The calculation of an equivalent impacted area was not considered an efficient approach in these cases. The performance of the proposed indicator system and its applicability to infrastructure and regional planning is tested in two practical examples. (author) figs., tabs., refs

  18. 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.

  19. Risk Analysis for Environmental Health Triage

    International Nuclear Information System (INIS)

    Bogen, K T

    2005-01-01

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage

  20. Risk-benefit analysis and cost-effectiveness analysis of lung cancer screening by spiral CT

    International Nuclear Information System (INIS)

    Iinuma, Takeshi

    1999-01-01

    Mass screening of lung cancer has been widely performed using indirect chest X-ray method in Japan. However reduction of the mortality for lung cancer is questioned. We have proposed that recently developed spiral CT should be adopted for the screening of lung cancer, since CT has an excellent detectability for small nodule. Lung Cancer Screening CT (LSCT) has been developed by author's group using spiral CT with low dose and light weight in order to make a mobile unit. In this paper risk-benefit analysis and cost-effectiveness analysis are described for the LSCT screening of lung cancer. As a risk, radiation carcinogenesis due to exposure from LSCT are compared with gain of life-expectancy by screening and men of 40 years or more and women of 45 years or more are justified. The cost per person-year is estimated for LSCT screening which is better than that of present method, although total cost is higher. The LSCT screening could be recommended if total cost is affordable. (author)

  1. Comparing yield and relative costs of WHO TB screening algorithms in selected risk groups among people aged 65 years and over in China, 2013.

    Directory of Open Access Journals (Sweden)

    Canyou Zhang

    Full Text Available To calculate the yield and cost per diagnosed tuberculosis (TB case for three World Health Organization screening algorithms and one using the Chinese National TB program (NTP TB suspect definitions, using data from a TB prevalence survey of people aged 65 years and over in China, 2013.This was an analytic study using data from the above survey. Risk groups were defined and the prevalence of new TB cases in each group calculated. Costs of each screening component were used to give indicative costs per case detected. Yield, number needed to screen (NNS and cost per case were used to assess the algorithms.The prevalence survey identified 172 new TB cases in 34,250 participants. Prevalence varied greatly in different groups, from 131/100,000 to 4651/ 100,000. Two groups were chosen to compare the algorithms. The medium-risk group (living in a rural area: men, or previous TB case, or close contact or a BMI <18.5, or tobacco user had appreciably higher cost per case (USD 221, 298 and 963 in the three algorithms than the high-risk group (all previous TB cases, all close contacts. (USD 72, 108 and 309 but detected two to four times more TB cases in the population. Using a Chest x-ray as the initial screening tool in the medium risk group cost the most (USD 963, and detected 67% of all the new cases. Using the NTP definition of TB suspects made little difference.To "End TB", many more TB cases have to be identified. Screening only the highest risk groups identified under 14% of the undetected cases,. To "End TB", medium risk groups will need to be screened. Using a CXR for initial screening results in a much higher yield, at what should be an acceptable cost.

  2. Developing pipeline risk methodology for environmental license permit; Metodologia para avaliacao do risco em dutos, no licenciamento ambiental

    Energy Technology Data Exchange (ETDEWEB)

    Arruda, Paulo; Naime, Andre [Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renovaveis (IBAMA), Brasilia, DF (Brazil). Diretoria de Licenciamento e Qualidade Ambiental; Serpa, Ricardo [Companhia de Tecnologia de Saneamento Ambiental (CETESB), Sao Paulo, SP (Brazil). Setor de Analise de Riscos; Mendes, Renato F. [PETROBRAS Engenharia, RJ (Brazil); Ventura, Gilmar [TRANSPETRO - PETROBRAS Transportes, Rio de Janeiro, RJ (Brazil)

    2005-07-01

    Some new pipelines undertakings aim to establish connection between gas provinces in the Southeast and consumers in the Northeast of Brazil, in order to supply medium consuming centers and regions with minor potential of development. Consulting companies are carrying out Environmental Assessments studies and among them is the Risk Analyses of these pipeline transmission systems, in order to receive environmental permits by IBAMA, the Federal Brazilian Environmental Agency. In addition, existing interstate pipeline systems which are under IBAMA regulation will also require the same attention. For the purpose of defining a Pipeline Risk Analysis Protocol with methodology and risk criteria, with minimum risk analysis information on a comprehensive process, it has been decided for a 'tour de force' formed by experts from IBAMA and PETROBRAS engineers. The risk assessment protocol is focus on the risk to communities in the neighborhood of these pipelines and on the potential damage to the environment near and far from the ROW. The joined work ended up in two protocols, which attempt to provide environmental license permits for oil pipeline and gas pipelines with minimum contents for risk analysis studies. Another aspect is the environmental risk that has been focused on the contingency plan approach, since there are no consolidated environmental risk criteria for application as a common worldwide sense. The environmental risk mapping - MARA methodology will indicate areas with potential to be affected by leakages along a pipeline system. (author)

  3. 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.

  4. Patients' Experiences of Nurse-Led Screening for Cardiovascular Risk in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Frølund, Jannie Christina; Primdahl, Jette

    2015-01-01

    organization of screening programmes. METHODS: Three qualitative focus group interviews were carried out with 14 outpatients diagnosed with RA. The participants were stratified into groups, depending on whether they had a low-to-moderate or high ten-year risk of cardiovascular death according to the European...... screening programmes for CVD for patients with RA, it is important that the screening consultation is individualized and tailored to patients' needs and their RA. Copyright © 2015 John Wiley & Sons, Ltd....

  5. Risks of mammograms

    International Nuclear Information System (INIS)

    Swartz, H.M.; Reichling, B.A.

    1977-01-01

    In summary, the following practical guidelines for mammography are offered: 1. Any woman, regardless of age, with signs or symptoms that indicate breast cancer should have a mammogram. 2. A woman who has a high risk for breast cancer (e.g., strong family history, no pregnancy before 30 years of age, or a previous breast cancer) should receive periodic screening examinations, including mammography. 3. Periodic screening for asymptomatic women over the age of 50 is indicated. 4. The value of periodic screening for asymptomatic women who are not considered to be at high risk and are under the age of 50 years is not established. Such screening should be carried out only when useful data can be collected on the benefits and risks of this procedure. 5. For any individual woman, the risk of inducing breast cancer by mammography is very low. 6. Mammograms should be made only with modern equipment and techniques designed to provide optimum information with minimal dose

  6. Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme.

    Science.gov (United States)

    Steele, R J C; Kostourou, I; McClements, P; Watling, C; Libby, G; Weller, D; Brewster, D H; Black, R; Carey, F A; Fraser, C

    2010-01-01

    To assess the effect of gender, age and deprivation on key performance indicators in a colorectal cancer screening programme. Between March 2000 and May 2006 a demonstration pilot of biennial guaiac faecal occult blood test (gFOBT) colorectal screening was carried out in North-East Scotland for all individuals aged 50-69 years. The relevant populations were subdivided, by gender, into four age groups and into five deprivation categories according to the Scottish Index of Multiple Deprivation (SIMD), and key performance indicators analysed within these groups. In all rounds, uptake of the gFOBT increased with age (P key performance indicators, and this has implications both for the evaluation of screening programmes and for strategies designed to reduce inequalities.

  7. Environmental risk management for pharmaceutical compounds

    Energy Technology Data Exchange (ETDEWEB)

    Voulvoulis, N [Imperial College London (United Kingdom)

    2004-09-15

    Pharmaceuticals are a highly variable group of organic compounds with the potential to cause harm to aquatic ecosystems and human health. Thousands of tones of pharmacologically active substances are used annually but surprisingly little is known about their ultimate fate in the environment. The data collected to date, rarely provide information on the processes that determine their environmental fate and although they receive considerable pharmacological and clinical testing during development, knowledge of their ecotoxicity is poor. One major concern is that antibiotics found in sewage effluent may cause increased resistance amongst natural bacterial populations. The debate over risks associated with chemicals in the environment represents more than just another disagreement in the scientific community. It has opened the door to a new way of thinking about the onset of uninherited diseases, the nature of scientific investigation, and the role of scientific knowledge in the policymaking process. For example, research evidence on endocrine disruption collected over the last few years has changed dramatically the way we think about chemical risks. In part, this change has also been attributed to the precautionary principle, as a new approach to environmental policy forged in Europe. The term ''precautionary approach'' declares an obligation to control the dangerous substances even before a definitive causal link had been established between the chemicals and health or environmental effects, and represents a radical departure from traditional approaches to risk assessment and particularly risk management, which includes an integration of the assessment, communication and mitigation of risks.

  8. Observed and Predicted Risk of Breast Cancer Death in Randomized Trials on Breast Cancer Screening.

    Science.gov (United States)

    Autier, Philippe; Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

    2016-01-01

    The role of breast screening in breast cancer mortality declines is debated. Screening impacts cancer mortality through decreasing the number of advanced cancers with poor diagnosis, while cancer treatment works through decreasing the case-fatality rate. Hence, reductions in cancer death rates thanks to screening should directly reflect reductions in advanced cancer rates. We verified whether in breast screening trials, the observed reductions in the risk of breast cancer death could be predicted from reductions of advanced breast cancer rates. The Greater New York Health Insurance Plan trial (HIP) is the only breast screening trial that reported stage-specific cancer fatality for the screening and for the control group separately. The Swedish Two-County trial (TCT)) reported size-specific fatalities for cancer patients in both screening and control groups. We computed predicted numbers of breast cancer deaths, from which we calculated predicted relative risks (RR) and (95% confidence intervals). The Age trial in England performed its own calculations of predicted relative risk. The observed and predicted RR of breast cancer death were 0.72 (0.56-0.94) and 0.98 (0.77-1.24) in the HIP trial, and 0.79 (0.78-1.01) and 0.90 (0.80-1.01) in the Age trial. In the TCT, the observed RR was 0.73 (0.62-0.87), while the predicted RR was 0.89 (0.75-1.05) if overdiagnosis was assumed to be negligible and 0.83 (0.70-0.97) if extra cancers were excluded. In breast screening trials, factors other than screening have contributed to reductions in the risk of breast cancer death most probably by reducing the fatality of advanced cancers in screening groups. These factors were the better management of breast cancer patients and the underreporting of breast cancer as the underlying cause of death. Breast screening trials should publish stage-specific fatalities observed in each group.

  9. [Screening for the risk of allergy and prevention in French maternity units: A survey].

    Science.gov (United States)

    Chouraqui, J-P; Simeoni, U; Tohier, C; Nguyen, F; Kempf, C; Beck, L; Lachambre, E

    2015-09-01

    Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Identifying and Reconciling Risk Across Sectors: The implications of differing views of risk in climate policy, environmental conservation, and the finance sector

    Science.gov (United States)

    Johns, T.; Henderson, I.; Thoumi, G.

    2014-12-01

    The presence and valuation of risk are commonalities that link the diverse fields of climate change science and policy, environmental conservation, and the financial/investment sector. However, the definition and perception of risks vary widely across these critically linked fields. The "Stranded Asset" concept developed by organizations like the Carbon Tracker Initiative begins to elucidate the links between climate change risk and financial risk. Stranded assets are those that may lose some or all value from climate disruption, changes in demand-side dynamics and/or a more stringent regulatory environment. In order to shift financial flows toward climate change mitigation, emissions-heavy activities that present finance and investment opportunities must also be assessed for their GHG-asset risk attributes in terms of their contribution and vulnerability to climate disruption, as well as other environmental externalities. Until the concept of GHG-asset risk in investment is reconciled with the risks of climate change and environmental conservation, it will not be possible to shift business and financial practices, and unlock private sector resources to address the climate change and conservation challenge. UNEP-FI is researching the application of the concept of Value-atRisk (VaR) to explore links between the financial sector and deforestation/REDD+. The research will test the hypothesis that climate risk is a financial risk, and propose tools to identify and quantify risks associated with unsustainable land-use investments. The tools developed in this research will help investors, managers and governments assess their exposures to the material REDD-related risks in their portfolios. This will inform the development of 'zero net deforestation' investment indices to allow investors to lower the 'deforestation' exposure of 'benchmark' financial indices used by many of the largest money managers. A VaR analysis will be performed, combining the notion of externality

  11. An electronic screen for triaging adolescent substance use by risk levels.

    Science.gov (United States)

    Levy, Sharon; Weiss, Roger; Sherritt, Lon; Ziemnik, Rosemary; Spalding, Allegra; Van Hook, Shari; Shrier, Lydia A

    2014-09-01

    Screening adolescents for substance use and intervening immediately can reduce the burden of addiction and substance-related morbidity. Several screening tools have been developed to identify problem substance use for adolescents, but none have been calibrated to triage adolescents into clinically relevant risk categories to guide interventions. To describe the psychometric properties of an electronic screen and brief assessment tool that triages adolescents into 4 actionable categories regarding their experience with nontobacco substance use. Adolescent patients (age range, 12-17 years) arriving for routine medical care at 2 outpatient primary care centers and 1 outpatient center for substance use treatment at a pediatric hospital completed an electronic screening tool from June 1, 2012, through March 31, 2013, that consisted of a question on the frequency of using 8 types of drugs in the past year (Screening to Brief Intervention). Additional questions assessed severity of any past-year substance use. Patients completed a structured diagnostic interview (Composite International Diagnostic Interview-Substance Abuse Module), yielding Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) substance use diagnoses. For the entire screen and the Screening to Brief Intervention, sensitivity and specificity for identifying nontobacco substance use, substance use disorders, severe substance use disorders, and tobacco dependence were calculated using the Composite International Diagnostic Interview-Substance Abuse Module as the criterion standard. Of 340 patients invited to participate, 216 (63.5%) enrolled in the study. Sensitivity and specificity were 100% and 84% (95% CI, 76%-89%) for identifying nontobacco substance use, 90% (95% CI, 77%-96%) and 94% (95% CI, 89%-96%) for substance use disorders, 100% and 94% (95% CI, 90%-96%) for severe substance use disorders, and 75% (95% CI, 52%-89%) and 98% (95% CI, 95%-100%) for nicotine dependence. No significant

  12. A Danish diabetes risk score for targeted screening: the Inter99 study.

    Science.gov (United States)

    Glümer, Charlotte; Carstensen, Bendix; Sandbaek, Annelli; Lauritzen, Torsten; Jørgensen, Torben; Borch-Johnsen, Knut

    2004-03-01

    To develop a simple self-administered questionnaire identifying individuals with undiagnosed diabetes with a sensitivity of 75% and minimizing the high-risk group needing subsequent testing. A population-based sample (Inter99 study) of 6,784 individuals aged 30-60 years completed a questionnaire on diabetes-related symptoms and risk factors. The participants underwent an oral glucose tolerance test. The risk score was derived from the first half and validated on the second half of the study population. External validation was performed based on the Danish Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION) pilot study. The risk score was developed by stepwise backward multiple logistic regression. The final risk score included age, sex, BMI, known hypertension, physical activity at leisure time, and family history of diabetes, items independently and significantly (Pscreening strategy for type 2 diabetes, decreasing the numbers of subsequent tests and thereby possibly minimizing the economical and personal costs of the screening strategy.

  13. Is the Population Detected by Screening in China Truly at High Risk of Stroke?

    Science.gov (United States)

    Wang, Yuan; Wang, Jing; Cheng, Juan; Liang, Xuan; Li, Xin; Lu, Wenli

    2018-04-09

    The Chinese Stroke Screening and Prevention Project (CSSPP) considers patients with 3 or more risk factors to be at high risk of stroke, and does not quantitatively assess the risk for stroke. However, to detect high-risk groups more efficiently, a health risk appraisal (HRA) model should be used to assess individual risk of stroke. The odds ratios for the 8 risk factors for stroke were pooled and the data were used to develop an HRA model to predict individuals' risks of developing stroke in the next 5 years. The Chinese screening project and HRA screening strategies were then compared. We assessed 4196 Chinese individuals who received checkups in 2015. The average 5-year risk of stroke was 5.81‰, with men being at higher risk of stroke than women over that period. The average 5-year risk of stroke also increased with the number of risk factors. 932 individuals (22.2%) were identified as being at high risk of stroke according to CSSPP, whereas 318 individuals with fewer than 3 risk factors were considered being at low risk despite having a 5-year risk of stroke greater than 4.0% by our assessment. Notably, among patients with hypertension and diabetes who were classified as being at low risk of stroke by the CSSPP, the HRA recognized 15.9% and 14.3% as being at high risk of stroke, respectively. All 8 major risk factors affect stroke risk differently, and the efficiency of clustering these risk factors might be improved by considering the relative risk of each factor with an HRA model. Copyright © 2018. Published by Elsevier Inc.

  14. Breast cancer risk is increased in the years following false-positive breast cancer screening.

    Science.gov (United States)

    Goossens, Mathijs C; De Brabander, Isabel; De Greve, Jacques; Vaes, Evelien; Van Ongeval, Chantal; Van Herck, Koen; Kellen, Eliane

    2017-09-01

    A small number of studies have investigated breast cancer (BC) risk among women with a history of false-positive recall (FPR) in BC screening, but none of them has used time-to-event analysis while at the same time quantifying the effect of false-negative diagnostic assessment (FNDA). FNDA occurs when screening detects BC, but this BC is missed on diagnostic assessment (DA). As a result of FNDA, screenings that detected cancer are incorrectly classified as FPR. Our study linked data recorded in the Flemish BC screening program (women aged 50-69 years) to data from the national cancer registry. We used Cox proportional hazards models on a retrospective cohort of 298 738 women to assess the association between FPR and subsequent BC, while adjusting for potential confounders. The mean follow-up was 6.9 years. Compared with women without recall, women with a history of FPR were at an increased risk of developing BC [hazard ratio=2.10 (95% confidence interval: 1.92-2.31)]. However, 22% of BC after FPR was due to FNDA. The hazard ratio dropped to 1.69 (95% confidence interval: 1.52-1.87) when FNDA was excluded. Women with FPR have a subsequently increased BC risk compared with women without recall. The risk is higher for women who have a FPR BI-RADS 4 or 5 compared with FPR BI-RADS 3. There is room for improvement of diagnostic assessment: 41% of the excess risk is explained by FNDA after baseline screening.

  15. 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

  16. Sustainable Environmental Management Indicators in South African Primary Schools

    Directory of Open Access Journals (Sweden)

    Luiza O. de Sousa

    2017-05-01

    Full Text Available This research explores sustainable environmental management indicators in South African primary schools. Of key interest is the comparison of a township, farm and urban primary school that identify indicators that promote education for sustainable development in schools that implement an environmental management system. Data are drawn from one-on-one interviews, focus group interviews, observations and document analysis from 35 participants in three schools. A comparison of the three schools was done by content and thematic analysis of a within-case analysis. Data from the township school revealed that socioeconomic factors and organisational structure promote education for sustainable development. The farm school data revealed that health promotion can be managed within an environmental management system within a hierarchical school structure. The urban school data revealed that an economic inducement brings a school to realise that it can reduce its carbon footprint, gain financially and utilize its resources with innovation. A case is made that the four pillars of sustainable development (environment, society, economy, and governance endorse education for sustainable development. Furthermore, the objectives of environmental education ought to remain nested in an environmental management system to ensure that the global goal of quality education is achieved.

  17. Urinary tract cancer and hereditary nonpolyposis colorectal cancer : Risks and screening options

    NARCIS (Netherlands)

    Sijmons, RH; Kiemeney, LALM; Witjes, JA; Vasen, HFA

    Purpose: We investigate the risk of the different types of urinary tract cancer in hereditary nonpolyposis colorectal cancer families and review screening options. Materials and Methods: We retrospectively calculated the relative and cumulative risks of developing urinary tract cancer by comparing

  18. Needs for Risk Informing Environmental Cleanup Decision Making - 13613

    International Nuclear Information System (INIS)

    Zhu, Ming; Moorer, Richard

    2013-01-01

    This paper discusses the needs for risk informing decision making by the U.S. Department of Energy (DOE) Office of Environmental Management (EM). The mission of the DOE EM is to complete the safe cleanup of the environmental legacy brought about from the nation's five decades of nuclear weapons development and production and nuclear energy research. This work represents some of the most technically challenging and complex cleanup efforts in the world and is projected to require the investment of billions of dollars and several decades to complete. Quantitative assessments of health and environmental risks play an important role in work prioritization and cleanup decisions of these challenging environmental cleanup and closure projects. The risk assessments often involve evaluation of performance of integrated engineered barriers and natural systems over a period of hundreds to thousands of years, when subject to complex geo-environmental transformation processes resulting from remediation and disposal actions. The requirement of resource investments for the cleanup efforts and the associated technical challenges have subjected the EM program to continuous scrutiny by oversight entities. Recent DOE reviews recommended application of a risk-informed approach throughout the EM complex for improved targeting of resources. The idea behind this recommendation is that by using risk-informed approaches to prioritize work scope, the available resources can be best utilized to reduce environmental and health risks across the EM complex, while maintaining the momentum of the overall EM cleanup program at a sustainable level. In response to these recommendations, EM is re-examining its work portfolio and key decision making with risk insights for the major sites. This paper summarizes the review findings and recommendations from the DOE internal reviews, discusses the needs for risk informing the EM portfolio and makes an attempt to identify topics for R and D in integrated

  19. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  20. Screening for Behavioral Risk: Identification of High Risk Cut Scores within the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

    Science.gov (United States)

    Kilgus, Stephen P.; Taylor, Crystal N.; von der Embse, Nathaniel P.

    2018-01-01

    The purpose of this study was to support the identification of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) cut scores that could be used to detect high-risk students. Teachers rated students across two time points (Time 1 n = 1,242 students; Time 2 n = 704) using the SAEBRS and the Behavioral and Emotional Screening System…

  1. Toxicological benchmarks for screening contaminants of potential concern for effects on sediment-associated biota: 1994 Revision. Environmental Restoration Program

    International Nuclear Information System (INIS)

    Hull, R.N.; Suter, G.W. II

    1994-06-01

    Because a hazardous waste site may contain hundreds of chemicals, it is important to screen contaminants of potential concern for the ecological risk assessment. Often this screening is done as part of a Screening Assessment, the purpose of which is to evaluate the available data, identify data gaps, and screen contaminants of potential concern. Screening may be accomplished by using a set of toxicological benchmarks. These benchmarks are helpful in determining whether contaminants warrant further assessment or are at a level that requires no further attention. If a chemical concentration or the reported detection limit exceeds a proposed lower benchmark, more analysis is needed to determine the hazards posed by that chemical. If, however, the chemical concentration falls below the lower benchmark value, the chemical may be eliminated from further study. This report briefly describes three categories of approaches to the development of sediment quality benchmarks. These approaches are based on analytical chemistry, toxicity test and field survey data. A fourth integrative approach incorporates all three types of data. The equilibrium partitioning approach is recommended for screening nonpolar organic contaminants of concern in sediments. For inorganics, the National Oceanic and Atmospheric Administration has developed benchmarks that may be used for screening. There are supplemental benchmarks from the province of Ontario, the state of Wisconsin, and US Environmental Protection Agency Region V. Pore water analysis is recommended for polar organic compounds; comparisons are then made against water quality benchmarks. This report is an update of a prior report. It contains revised ER-L and ER-M values, the five EPA proposed sediment quality criteria, and benchmarks calculated for several nonionic organic chemicals using equilibrium partitioning

  2. Validation of the alcohol use module from a multidimensional prenatal psychosocial risk screening instrument.

    Science.gov (United States)

    Harrison, Patricia A; Godecker, Amy; Sidebottom, Abbey C

    2012-12-01

    The purpose of the study was to validate the Prenatal Risk Overview (PRO) Alcohol use domain against a structured diagnostic interview. The PRO was developed to screen for 13 psychosocial risk factors associated with poor birth outcomes. After clinic staff administered the PRO to prenatal patients, they asked for consent to administration of selected modules of the structured clinical interview for DSM-IV (SCID) by a research assistant. To assess the criterion validity of the PRO, low and moderate/high risk classifications from the alcohol use domain were cross-tabulated with SCID Alcohol Use Disorder variables. The study sample included 744 women. Based on PRO responses, 48.7% reported alcohol use during the 12 months before they learned they were pregnant; 5.4% reported use post pregnancy awareness. The typical quantity consumed pre-pregnancy was four or more drinks per occasion. Based on the SCID, 7.4% met DSM-IV criteria for either Alcohol Abuse or Dependence. Sensitivity and specificity of the PRO for Alcohol Use Disorders were 83.6 and 80.3%, respectively. Negative predictive value was 98.4% and positive predictive value was 25.3%. The results indicate the PRO effectively identified pregnant women with Alcohol Use Disorders. However, prenatal screening must also detect consumption patterns that do not meet diagnostic thresholds but may endanger fetal development. The PRO also identified women who continued to drink after they knew they were pregnant, as well as those whose previous drinking habits put them at risk for resumption of hazardous use.

  3. Screening older adults at risk of falling with the Tinetti balance scale.

    Science.gov (United States)

    Raîche, M; Hébert, R; Prince, F; Corriveau, H

    2000-09-16

    In a prospective study of 225 community dwelling people 75 years and older, we tested the validity of the Tinetti balance scale to predict individuals who will fall at least once during the following year. A score of 36 or less identified 7 of 10 fallers with 70% sensitivity and 52% specificity. With this cut-off score, 53% of the individuals were screened positive and presented a two-fold risk of falling. These characteristics support the use of this test to screen older people at risk of falling in order to include them in a preventive intervention.

  4. Framework for Assessing Indicators of Environmental Impacts in the Transport Sector

    DEFF Research Database (Denmark)

    Joumard, Robert; Gudmundsson, Henrik; Folkeson, Lennart

    2011-01-01

    The following questions were addressed in this study: How can environmental impacts of transport be identified? How can the impacts be represented by operational indicators? How can several indicators be considered jointly? How can indicators be used in planning and decision making? First......, a definition of the phrase “indicator of environmental impacts in the transport sector” was derived. The concept of a chain of causality between a source and a final target was developed as a common reference for indicators and their assessment. Criteria and methods for the assessment and selection...

  5. 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.

  6. Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Lewalter, Thorsten; Bongiorni, Maria Grazia

    2013-01-01

    The purpose of this EHRA survey was to examine the current clinical practice of screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy with a focus on selection of candidates for implantable cardioverter-defibrillator (ICD) therapy, timing of ICD...... implantation, and use of non-invasive and invasive diagnostic tests across Europe. A systematic screening programme for sudden cardiac death existed in 19 out of 31 centres (61.3%). Implantation of ICDs according to the inclusion criteria of MADIT-II and SCD-HeFT trials was reported in 30 and 29% of centres......, respectively, followed by MADIT-CRT (18%), COMPANION (16%), and combined MADIT and MUSTT (7%) indications. In patients with severe renal impairment, ICD implantation for primary prevention of sudden death was always avoided in 8 centres (33.3%), was not used only if creatinine level was >2.5 mg/dL in 10...

  7. [Hypertriglyceridemic waist phenotype: associated factors and comparison with other cardiovascular and metabolic risk indicators in the ELSA-Brasil study].

    Science.gov (United States)

    Freitas, Roberta Souza; Fonseca, Maria de Jesus Mendes da; Schmidt, Maria Inês; Molina, Maria Del Carmen Bisi; Almeida, Maria da Conceição Chagas de

    2018-03-29

    This study's objectives were to estimate the prevalence of hypertriglyceridemic waist (HTW) phenotype in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), identify associated risk factors, and compare with other cardiovascular and metabolic risk indicators. This was a cross-sectional study with baseline data from a cohort of public employees. HTW is defined as the simultaneous presence of increased waist circumference (WC) (≥ 80cm for women, ≥ 90cm for men according to the International Diabetes Federation - IDF; and ≥ 88cm for women, ≥ 102cm for men according to the U.S. National Cholesterol Education Program - NCEP) and hypertriglyceridemia. Associations between independent variables and HTW were tested with multivariate logistic regression models. HTW was also compared to other cardiovascular and metabolic risk indicators by means of correlation tests, kappa index, sensitivity, and specificity. After exclusions, 12,811 participants were analyzed. Prevalence of HTW ranged from 24.7% (IDF) to 13.3% (NCEP). HTW was associated with age, excessive alcohol consumption, former smoking, low HDL, non-high HDL, and increased C-reactive protein, independently of gender or the criterion used to define HTW. HTW was associated with cardiovascular risk indicators, especially metabolic syndrome. The high prevalence of HTW and its association with cardiovascular risk indicators, especially metabolic syndrome, supports its use as a cardiometabolic risk screening tool in clinical practice.

  8. 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.

  9. Environmental Indicators. A Preliminary Set = Indicateurs d'environnement. Une etude pilote.

    Science.gov (United States)

    Organisation for Economic Cooperation and Development, Paris (France).

    This document provides a preliminary set of environmental indicators by which to measure environmental performance. The indicators are patterned on the outline of the Organisation for Economic Cooperation and Development (OECD) "Report on the State of the Environment," a companion volume published in the same year. This volume is…

  10. Approach on environmental risk assessment of nanosilver released from textiles

    Energy Technology Data Exchange (ETDEWEB)

    Voelker, Doris, E-mail: doris.voelker@uba.de [Federal Environment Agency Germany, Section IV 2.2, Wörlitzer Platz 1, 06844 Dessau-Rosslau (Germany); Schlich, Karsten [Fraunhofer Institute for Molecular Biology and Applied Ecology, Department of Ecotoxicology, Auf dem Aberg 1, 57392 Schmallenberg (Germany); Hohndorf, Lars; Koch, Wolfgang; Kuehnen, Ute [Federal Environment Agency Germany, Section IV 2.2, Wörlitzer Platz 1, 06844 Dessau-Rosslau (Germany); Polleichtner, Christian; Kussatz, Carola [Federal Environment Agency Germany, Section IV 2.4, Schichauweg 58, 12307 Berlin (Germany); Hund-Rinke, Kerstin [Fraunhofer Institute for Molecular Biology and Applied Ecology, Department of Ecotoxicology, Auf dem Aberg 1, 57392 Schmallenberg (Germany)

    2015-07-15

    Based on the increased utilization of nanosilver (silver nanomaterials=AgNM) as antibacterial agent, there is the strong need to assess the potential environmental implication associated with its new application areas. In this study an exemplary environmental risk assessment (ERA) of AgNM applied in textiles was performed. Environmental exposure scenarios (via municipal sewage treatment plant (STP)) with wastewater supply from domestic homes) were developed for three different types of textiles equipped with AgNM. Based on these scenarios predicted environmental concentrations (PECs) were deduced for STPs and for the environmental compartments surface water, sediment as well as soil. These PECs were related to PNECs (predicted no effect concentrations). PNECs were deduced from results of ecotoxicity tests of a selected AgNM (NM-300K). Data on ecotoxicology were derived from various tests with activated sludge, cyanobacteria, algae, daphnids, fish, duckweed, macrophytes, chironomids, earthworms, terrestrial plants as well as soil microorganisms. Emission data for the AgNM NM-300K from textiles were derived from washing experiments. The performed ERA was based on the specifications defined in the ECHA Guidances on information requirements and chemical safety assessment. Based on the chosen scenarios and preconditions, no environmental risk of the AgNM NM-300K released from textiles was detected. Under conservative assumptions a risk quotient for surface water close to 1 indicated that the aquatic compartment may be affected by an increased emission of AgNM to the environment due to the high sensitivity of aquatic organisms to silver. Based on the successful retention of AgNM in the sewage sludge and the still ongoing continual application of sewage sludge on farmland it is recommended to introduce a threshold for total silver content in sewage sludge into the respective regulations. Regarding potential risk mitigation measures, it is emphasized to preferably directly

  11. Approach on environmental risk assessment of nanosilver released from textiles

    International Nuclear Information System (INIS)

    Voelker, Doris; Schlich, Karsten; Hohndorf, Lars; Koch, Wolfgang; Kuehnen, Ute; Polleichtner, Christian; Kussatz, Carola; Hund-Rinke, Kerstin

    2015-01-01

    Based on the increased utilization of nanosilver (silver nanomaterials=AgNM) as antibacterial agent, there is the strong need to assess the potential environmental implication associated with its new application areas. In this study an exemplary environmental risk assessment (ERA) of AgNM applied in textiles was performed. Environmental exposure scenarios (via municipal sewage treatment plant (STP)) with wastewater supply from domestic homes) were developed for three different types of textiles equipped with AgNM. Based on these scenarios predicted environmental concentrations (PECs) were deduced for STPs and for the environmental compartments surface water, sediment as well as soil. These PECs were related to PNECs (predicted no effect concentrations). PNECs were deduced from results of ecotoxicity tests of a selected AgNM (NM-300K). Data on ecotoxicology were derived from various tests with activated sludge, cyanobacteria, algae, daphnids, fish, duckweed, macrophytes, chironomids, earthworms, terrestrial plants as well as soil microorganisms. Emission data for the AgNM NM-300K from textiles were derived from washing experiments. The performed ERA was based on the specifications defined in the ECHA Guidances on information requirements and chemical safety assessment. Based on the chosen scenarios and preconditions, no environmental risk of the AgNM NM-300K released from textiles was detected. Under conservative assumptions a risk quotient for surface water close to 1 indicated that the aquatic compartment may be affected by an increased emission of AgNM to the environment due to the high sensitivity of aquatic organisms to silver. Based on the successful retention of AgNM in the sewage sludge and the still ongoing continual application of sewage sludge on farmland it is recommended to introduce a threshold for total silver content in sewage sludge into the respective regulations. Regarding potential risk mitigation measures, it is emphasized to preferably directly

  12. Screen Exposure During Daily Routines and a Young Child's Risk for Having Social-Emotional Delay.

    Science.gov (United States)

    Raman, Sajani; Guerrero-Duby, Sara; McCullough, Jennifer L; Brown, Miraides; Ostrowski-Delahanty, Sarah; Langkamp, Diane; Duby, John C

    2017-11-01

    This cross-sectional study assessed associations between social-emotional development in young children and their number of daily routines involving an electronic screen. We hypothesized children with poor social-emotional development have a significant portion of daily routines occurring with a screen. Two hundred and ten female caregivers of typically developing children 12 to 36 months old completed the Ages and Stages Questionnaire: Social-Emotional (ASQ: SE) and a media diary. Caregivers completed the diary for 1 day around 10 daily routines (Waking Up, Diapering/Toileting, Dressing, Breakfast, Lunch, Naptime, Playtime, Dinner, Bath, and Bedtime). Median number of daily routines occurring with a screen for children at risk and not at risk for social-emotional delay (as defined by the ASQ: SE) was 7 versus 5. Children at risk for social-emotional delay were 5.8 times more likely to have ≥5 routines occurring with a screen as compared to children not at risk for delay (χ 1 2 = 9.28, N = 210, P = .002; 95% confidence interval = 1.66-20.39).

  13. Pre-operative Screening and Manual Drilling Strategies to Reduce the Risk of Thermal Injury During Minimally Invasive Cochlear Implantation Surgery.

    Science.gov (United States)

    Dillon, Neal P; Fichera, Loris; Kesler, Kyle; Zuniga, M Geraldine; Mitchell, Jason E; Webster, Robert J; Labadie, Robert F

    2017-09-01

    This article presents the development and experimental validation of a methodology to reduce the risk of thermal injury to the facial nerve during minimally invasive cochlear implantation surgery. The first step in this methodology is a pre-operative screening process, in which medical imaging is used to identify those patients that present a significant risk of developing high temperatures at the facial nerve during the drilling phase of the procedure. Such a risk is calculated based on the density of the bone along the drilling path and the thermal conductance between the drilling path and the nerve, and provides a criterion to exclude high-risk patients from receiving the minimally invasive procedure. The second component of the methodology is a drilling strategy for manually-guided drilling near the facial nerve. The strategy utilizes interval drilling and mechanical constraints to enable better control over the procedure and the resulting generation of heat. The approach is tested in fresh cadaver temporal bones using a thermal camera to monitor temperature near the facial nerve. Results indicate that pre-operative screening may successfully exclude high-risk patients and that the proposed drilling strategy enables safe drilling for low-to-moderate risk patients.

  14. The Functional Movement Screen and Injury Risk: Association and Predictive Value in Active Men.

    Science.gov (United States)

    Bushman, Timothy T; Grier, Tyson L; Canham-Chervak, Michelle; Anderson, Morgan K; North, William J; Jones, Bruce H

    2016-02-01

    The Functional Movement Screen (FMS) is a series of 7 tests used to assess the injury risk in active populations. To determine the association of the FMS with the injury risk, assess predictive values, and identify optimal cut points using 3 injury types. Cohort study; Level of evidence, 2. Physically active male soldiers aged 18 to 57 years (N = 2476) completed the FMS. Demographic and fitness data were collected by survey. Medical record data for overuse injuries, traumatic injuries, and any injury 6 months after the FMS assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated along with the receiver operating characteristic (ROC) to determine the area under the curve (AUC) and identify optimal cut points for the risk assessment. Risks, risk ratios (RRs), odds ratios (ORs), and 95% CIs were calculated to assess injury risks. Soldiers who scored ≤14 were at a greater risk for injuries compared with those who scored >14 using the composite score for overuse injuries (RR, 1.84; 95% CI, 1.63-2.09), traumatic injuries (RR, 1.26; 95% CI, 1.03-1.54), and any injury (RR, 1.60; 95% CI, 1.45-1.77). When controlling for other known injury risk factors, multivariate logistic regression analysis identified poor FMS performance (OR [score ≤14/19-21], 2.00; 95% CI, 1.42-2.81) as an independent risk factor for injuries. A cut point of ≤14 registered low measures of predictive value for all 3 injury types (sensitivity, 28%-37%; PPV, 19%-52%; AUC, 54%-61%). Shifting the injury risk cut point of ≤14 to the optimal cut points indicated by the ROC did not appreciably improve sensitivity or the PPV. Although poor FMS performance was associated with a higher risk of injuries, it displayed low sensitivity, PPV, and AUC. On the basis of these findings, the use of the FMS to screen for the injury risk is not recommended in this population because of the low predictive value and misclassification of the

  15. [Status Quo, Uncertainties and Trends Analysis of Environmental Risk Assessment for PFASs].

    Science.gov (United States)

    Hao, Xue-wen; Li, Li; Wang, Jie; Cao, Yan; Liu, Jian-guo

    2015-08-01

    This study systematically combed the definition and change of terms, category and application of perfluoroalkyl and polyfluoroalkyl substances (PFASs) in international academic, focusing on the environmental risk and exposure assessment of PFASs, to comprehensively analyze the current status, uncertainties and trends of PFASs' environmental risk assessment. Overall, the risk assessment of PFASs is facing a complicated situation involving complex substance pedigrees, various types, complex derivative relations, confidential business information and risk uncertainties. Although the environmental risk of long-chain PFASs has been widely recognized, the short-chain PFASs and short-chain fluorotelomers as their alternatives still have many research gaps and uncertainties in environmental hazards, environmental fate and exposure risk. The scope of risk control of PFASs in the international community is still worth discussing. Due to trade secrets and market competition, the chemical structure and risk information of PFASs' alternatives are generally lack of openness and transparency. The environmental risk of most fluorinated and non-fluorinated alternatives is not clear. In total, the international research on PFASs risk assessment gradually transfer from long-chain perfluoroalkyl acids (PFAAs) represented by perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) to short-chain PFAAs, and then extends to other PFASs. The main problems to be solved urgently and researched continuously are: the environmental hazardous assessment indexes, such as bioaccumulation and environmental migration, optimization method, the environmental release and multimedia environmental fate of short-chain PFASs; the environmental fate of neutral PFASs and the transformation and contribution as precursors of short-chain PFASs; the risk identification and assessment of fluorinated and non-fluorinated alternatives of PFASs.

  16. Technology Evaluation for Environmental Risk Mitigation Compendium

    Science.gov (United States)

    Meinhold, A.; Greene, B.; Dussich, J.; Sorkin, A.; Olsen, W.

    2017-01-01

    The Technology Evaluation for Environmental Risk Mitigation (TEERM) Principal Center and its predecessor organization the Acquisition Pollution Prevention Program (AP2) supported the National Aeronautics and Space Administration (NASA) in identifying technology solutions to risks and costs to NASA programs driven by environmental regulations and requirements. TEERM researched the commercial and government marketplace to locate viable and available technologies that met NASAs needs. TEERM focused on addressing environmentally-driven risks of direct concern to NASA programs and facilities, including hazardous materials in NASA operations and materials that became obsolescent because of environmental regulations. TEERM projects aimed to reduce cost; ensure the health and safety of people, assets, and the environment; promote efficiency; and minimize duplication. Major TEERM and AP2 projects focused on waste minimization and hazardous waste treatment, recycling, corrosion prevention and control, solvent and ozone depleting substances substitution, and aqueous based cleaners. In 2017, NASA made the decision to terminate the TEERM Principal Center. This Compendium Report documents TEERM and AP2 project successes. The Compendium Report traces the evolution of TEERM based on evolving risks and requirements for NASA and its relationship to the Space Shuttle Program, the United States Department of Defense, the European Space Agency, and other public and private stakeholders. This Compendium Report also documents project details from Project Summaries and Joint Test Plans and describes project stakeholders and collaborative effort results.

  17. Systematic Review of Studies of Workplace Exposure to Environmental Tobacco Smoke and Lung Cancer Risk

    Directory of Open Access Journals (Sweden)

    Xinzhuo WANG

    2011-04-01

    Full Text Available Background and objective It has been reported that there was a close relationship between lung cancer risk and environmental tobacco smoke at workplace. The aim of this study is to explore the relationship between workplace environmental tobacco smoke exposure and lung cancer risk among non-smoking subjects. Methods By searching Medline, CENTRAL (the Cochrane central register of controlledtrials, EMBASE, CBM, CNKI and VIP et al, we collected both domestic and overseas published documents on workplace environmental tobacco smoke exposure and lung cancer risk. Random or fixed effect models were applied to conduct systematic review on the study results, the combined odds ratio (OR and the 95% confidence interval (CI were calculated as well. Results 22 reports were included into the combined analysis, which indicated that 25% lung cancer risk was increased by exposing to workplace environment tobacco smoke (OR=1.25, 95%CI: 1.13-1.39, P < 0.001. For female the increased risk was 22% (OR=1.22, 95%CI: 1.05-1.42, P=0.011. For male the increased risk was 54%, but it does not reach the statistical significance (OR=1.54, 95%CI: 0.74-3.18, P=0.247. Conclusion Workplace environmental tobacco smoke exposure is an important risk factor of lung cancer risk among non-smoking subjects. Especially for non-smoking women who expose to workplace environment tobacco smoke have a close relationship with lung cancer.

  18. Are we ready for the challenge of implementing risk-based breast cancer screening and primary prevention?

    NARCIS (Netherlands)

    Rainey, L.; Waal, D. van der; Jervaeus, A.; Wengstrom, Y.; Evans, D.G.; Donnelly, L.S.; Broeders, M.J.M.

    2018-01-01

    BACKGROUND: Increased knowledge of breast cancer risk factors provides opportunities to shift from a one-size-fits-all screening programme to a personalised approach, where screening and prevention is based on a woman's risk of developing breast cancer. However, potential implementation of this new

  19. Newborn hearing screening protocol in tuscany region.

    Science.gov (United States)

    Berrettini, Stefano; Ghirri, Paolo; Lazzerini, Francesco; Lenzi, Giovanni; Forli, Francesca

    2017-09-20

    Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment. In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines. In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are

  20. Carbon footprint as environmental performance indicator for the manufacturing industry

    DEFF Research Database (Denmark)

    Laurent, Alexis; Olsen, Stig Irving; Hauschild, Michael Zwicky

    2010-01-01

    With the current focus on our climate change impacts, the embodied CO2 emission or "Carbon footprint" is often used as an environmental performance indicator for our products or production activities. The ability of carbon footprint to represent other types of impact like human toxicity, and hence...... the overall environmental impact is investigated based on life cycle assessments of several materials of major relevance to manufacturing industries. The dependence of the carbon footprint on the assumed scenarios for generation of thermal and electrical energy in the life cycle of the materials is analyzed......, and the appropriateness of carbon footprint as an overall indicator of the environmental performance is discussed....

  1. The results of an ecological risk assessment screening at the Idaho National Engineering's waste area group 2

    International Nuclear Information System (INIS)

    VanHorn, R.

    1995-01-01

    The Idaho National Engineering Laboratory (INEL) is a Department of Energy (DOE) facility located in southeastern Idaho and occupies approximately 890 square miles on the northwestern portion of the eastern Snake River Plain. INEL has been devoted to nuclear energy research and related activities since its establishment in 1949. In the process of fulfilling this mission, wastes were generated, including radioactive and hazardous materials. Most materials were effectively stored or disposed of, however, some release of contaminants to the environment has occurred. For this reason, the INEL was listed by the US environmental Protection Agency on the National Priorities List (NPL), in November, 1989. This report describes the results of an ecological risk assessment performed for the Waste Area Groups 2 (WAG 2) at the INEL. It also summarizes the performance of screening level ecological risk assessments (SLERA)

  2. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans.

    Science.gov (United States)

    Ma, Grace X; Fang, Carolyn Y; Seals, Brenda; Feng, Ziding; Tan, Yin; Siu, Philip; Yeh, Ming Chin; Golub, Sarit A; Nguyen, Minhhuyen T; Tran, Tam; Wang, Minqi

    2017-03-01

    To evaluate the effectiveness of a community-based liver cancer prevention program on hepatitis B virus (HBV) screening among low-income, underserved Vietnamese Americans at high risk. We conducted a cluster randomized trial involving 36 Vietnamese community-based organizations and 2337 participants in Pennsylvania, New Jersey, and New York City between 2009 and 2014. We randomly assigned 18 community-based organizations to a community-based multilevel HBV screening intervention (n = 1131). We randomly assigned the remaining 18 community-based organizations to a general cancer education program (n = 1206), which included information about HBV-related liver cancer prevention. We assessed HBV screening rates at 6-month follow-up. Intervention participants were significantly more likely to have undergone HBV screening (88.1%) than were control group participants (4.6%). In a Cochran-Mantel-Haenszel analysis, the intervention effect on screening outcomes remained statistically significant after adjustment for demographic and health care access variables, including income, having health insurance, having a regular health provider, and English proficiency. A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

  3. Screening adherence and cancer risk perceptions in colorectal cancer survivors with Lynch-like syndrome.

    Science.gov (United States)

    Katz, L H; Burton-Chase, A M; Advani, S; Fellman, B; Polivka, K M; Yuan, Y; Lynch, P M; Peterson, S K

    2016-03-01

    Cancer screening recommendations for patients with Lynch-like syndrome (LLS) are not well defined. We evaluated adherence to Lynch syndrome (LS) screening recommendations, cancer risk perceptions, and communication within the families among colorectal cancer (CRC) survivors with LLS. Thirty-four participants with LLS completed a questionnaire about risk perception, adherence to LS screening recommendations, and communication with relatives. Clinical data were obtained from medical records. Most participants (76%) believed they should undergo colonoscopy every 1-2 years. Only 41% correctly interpreted their genetic tests as uninformative negative or as variant of unknown significance for LS. Less than half had had an upper gastrointestinal endoscopy for screening purpose. Among female participants, 86% had been screened for endometrial cancer (EC) and 71% for ovarian cancer. Most participants had informed relatives about the CRC diagnosis and advised them to undergo CRC screening, but only 50% advised female relatives to be screened for EC and only one-third advised relatives to have genetic counseling. Most CRC survivors with LLS follow the same cancer screening recommended for LS patients but do not understand the meaning of LLS. Greater care must be devoted to communicating the implications of nondiagnostic germline mutation testing among patients with LLS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Environmental risk management for pharmaceutical compounds

    Energy Technology Data Exchange (ETDEWEB)

    Voulvoulis, N. [Imperial College London (United Kingdom)

    2004-09-15

    Pharmaceuticals are a highly variable group of organic compounds with the potential to cause harm to aquatic ecosystems and human health. Thousands of tones of pharmacologically active substances are used annually but surprisingly little is known about their ultimate fate in the environment. The data collected to date, rarely provide information on the processes that determine their environmental fate and although they receive considerable pharmacological and clinical testing during development, knowledge of their ecotoxicity is poor. One major concern is that antibiotics found in sewage effluent may cause increased resistance amongst natural bacterial populations. The debate over risks associated with chemicals in the environment represents more than just another disagreement in the scientific community. It has opened the door to a new way of thinking about the onset of uninherited diseases, the nature of scientific investigation, and the role of scientific knowledge in the policymaking process. For example, research evidence on endocrine disruption collected over the last few years has changed dramatically the way we think about chemical risks. In part, this change has also been attributed to the precautionary principle, as a new approach to environmental policy forged in Europe. The term ''precautionary approach'' declares an obligation to control the dangerous substances even before a definitive causal link had been established between the chemicals and health or environmental effects, and represents a radical departure from traditional approaches to risk assessment and particularly risk management, which includes an integration of the assessment, communication and mitigation of risks.

  5. Environmental screening tools for assessment of infrastructure plans based on biodiversity preservation and global warming (PEIT, Spain)

    International Nuclear Information System (INIS)

    Garcia-Montero, Luis G.; Lopez, Elena; Monzon, Andres; Otero Pastor, Isabel

    2010-01-01

    Most Strategic Environmental Assessment (SEA) research has been concerned with SEA as a procedure, and there have been relatively few developments and tests of analytical methodologies. The first stage of the SEA is the 'screening', which is the process whereby a decision is taken on whether or not SEA is required for a particular programme or plan. The effectiveness of screening and SEA procedures will depend on how well the assessment fits into the planning from the early stages of the decision-making process. However, it is difficult to prepare the environmental screening for an infrastructure plan involving a whole country. To be useful, such methodologies must be fast and simple. We have developed two screening tools which would make it possible to estimate promptly the overall impact an infrastructure plan might have on biodiversity and global warming for a whole country, in order to generate planning alternatives, and to determine whether or not SEA is required for a particular infrastructure plan.

  6. Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer

    NARCIS (Netherlands)

    Ripping, Theodora Maria; Hubbard, Rebecca A.; Otten, Johannes D. M.; den Heeten, Gerard J.; Verbeek, André L. M.; Broeders, Mireille J. M.

    2016-01-01

    Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected

  7. Which part of a short, global risk assessment, the Risk Instrument for Screening in the Community, predicts adverse healthcare outcomes?

    LENUS (Irish Health Repository)

    O’Caoimh, Rónán

    2015-01-01

    The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (\

  8. Certain Actions from the Functional Movement Screen Do Not Provide an Indication of Dynamic Stability

    Science.gov (United States)

    Lockie, Robert G.; Callaghan, Samuel J.; Jordan, Corrin A.; Luczo, Tawni M.; Jeffriess, Matthew D.; Jalilvand, Farzad; Schultz, Adrian B.

    2015-01-01

    Dynamic stability is an essential physical component for team sport athletes. Certain Functional Movement Screen (FMS) exercises (deep squat; left- and right-leg hurdle step; left- and right-leg in-line lunge [ILL]; left- and right-leg active straight-leg raise; and trunk stability push-up [TSPU]) have been suggested as providing an indication of dynamic stability. No research has investigated relationships between these screens and an established test of dynamic stability such as the modified Star Excursion Balance Test (mSEBT), which measures lower-limb reach distance in posteromedial, medial, and anteromedial directions, in team sport athletes. Forty-one male and female team sport athletes completed the screens and the mSEBT. Participants were split into high-, intermediate-, and low-performing groups according to the mean of the excursions when both the left and right legs were used for the mSEBT stance. Any between-group differences in the screens and mSEBT were determined via a one-way analysis of variance with Bonferroni post hoc adjustment (p in any of the screens, and only two positive correlations between the screens and the mSEBT (TSPU and right stance leg posteromedial excursion, r = 0.37; left-leg ILL and left stance leg posteromedial excursion, r = 0.46). The mSEBT clearly indicated participants with different dynamic stability capabilities. In contrast to the mSEBT, the selected FMS exercises investigated in this study have a limited capacity to identify dynamic stability in team sport athletes. PMID:26557187

  9. The assessment of sediment screening risk in Venice Lagoon and other coastal areas using international sediment quality guidelines

    International Nuclear Information System (INIS)

    Apitz, S.A.; Barbanti, A.; Bocci, M.; Delaney, E.; Bernstein, A.G.; Montobbio, L.

    2007-01-01

    A number of studies carried out in recent years have shown the presence of a wide range of contaminants in the Venice Lagoon. It is important to have a good understanding of the ecological quality of Venice Lagoon sediments, in order to: i) define and locate areas where a threat to the environment is present and therefore an intervention is needed (i.e. in situ assessment and management); and ii) define sustainable and environmentally correct ways of managing sediments which are to be dredged for navigational purposes or in relation to other interventions (i.e., ex situ management). Materials and Methods: To examine how various regional and international SQGs 'classed' screening risk in Venice Lagoon sediments, data on median contaminant levels in surface sediments in Venice Lagoon resulting from a literature review were compared to a range of local and international sediment quality guidelines (SQGs). Then data on sediment contaminant levels in various areas and sub-basins of Venice Lagoon (main Lagoon, Porto Marghera and Venice City Canals) and in other regional and international transitional and coastal ecosystems with various levels of human impact (urbanization and industrialization) were evaluated based upon a selected consensus-based SQG. Finally, screening sediment quality for all of Venice Lagoon was mapped and contoured, relative to this consensus-based SQG and briefly compared with direct toxicity measurement through a battery of bioassays. Results: SQGs allow the sediment areas to be put in terms of potential, or screening, risk. Although there were some differences depending upon which specific SQGs were applied, the Venice SQGs and other international SQGs provided the same general picture of screening risk in Venice Lagoon despite geographic differences. Venice Lagoon South has the lowest screening risk levels, Venice Lagoon Central/North has the highest (and is nearest to the Porto Marghera and Venice City Canals sites). Discussion: The Venice

  10. Internet-based screening for dementia risk.

    Science.gov (United States)

    Brandt, Jason; Sullivan, Campbell; Burrell, Larry E; Rogerson, Mark; Anderson, Allan

    2013-01-01

    The Dementia Risk Assessment (DRA) is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person. Advanced age, lower education, male sex, complaints of severe memory impairment, and histories of cerebrovascular disease, Parkinson's disease, and brain tumor all contributed significantly to poor memory performance. A high correlation was obtained between proxy-reported decline and actual memory test performance. In Study 2, 52 persons seeking first-time evaluation at dementia clinics completed the DRA prior to their visits. Their responses (and those of their proxy informants) were compared to the results of independent evaluation by geriatric neuropsychiatrists. The 30 patients found to meet criteria for probable Alzheimer's disease, vascular dementia, or frontotemporal dementia differed on the DRA from the 22 patients without dementia (most other neuropsychiatric conditions). Scoring below criterion on the DRA's memory test had moderately high predictive validity for clinically diagnosed dementia. Although additional studies of larger clinical samples are needed, the DRA holds promise for wide-scale screening for dementia risk.

  11. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Sasa Nie

    2017-10-01

    Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

  12. [Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department].

    Science.gov (United States)

    Peng, Lu-Ting; Li, Rong; Zhao, Wei-Hua; Chen, Yin-Hua; Li, Xiao-Mei; Chen, Meng-Ying; Cao, Jia; Li, Xiao-Nan

    2013-10-01

    To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management. Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded. Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (Pnutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (Pnutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (Pnutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.

  13. A streamlined risk screening method for managing reutilization of abandoned factories in Taiwan

    Directory of Open Access Journals (Sweden)

    I-Chun Chen

    2017-05-01

    Full Text Available An integrated management strategy that considers the competing relationships between land values and associated risks in the process of land-use conversion is needed to assess and manage the reutilization of brownfields. However, the often large number of individual brownfields renders it difficult to conduct a completed risk assessment for all sites, and a streamlined risk screening method would facilitate prioritization of the redevelopment of those factories. This methodology takes into account the spatial heterogeneity of contaminated lands and produces risk mapping that compiles complex risk-related information. Using abandoned factories in Taiwan as a case study, the method considers 40 points (50% accumulated probability as the threshold of acceptable risk. Emergency risk should be over 90% of accumulated probability. For the sustainability of brownfield reutilization in Taiwan, this research uses a risk matrix to identify the low, middle, and high risk for brownfield reutilization. It can indicate zones with a high risk level or low economic incentive as areas of concern for future decision making. In Taiwan, high-risk sites with high incentive account for only 21.3% of the sites. In contrast, the sites with the lowest incentive and low risk account for 57.6% of the sites. To avoid failure in the brownfield market, three strategies are suggested: (1 flexible land management with urban planning is a feasible option for protecting the receptor's health; (2 the government could provide the tool or brownfield funds to reduce the uncertainty of investment risk; and (3 risk monitoring and management can reduce the possible pitfalls associated with brownfield reutilization.

  14. Beachfront screening for skin cancer in Texas Gulf coast surfers.

    Science.gov (United States)

    Dozier, S; Wagner, R F; Black, S A; Terracina, J

    1997-01-01

    Skin cancer screening programs may attract the "worried well," while those at greatest risk for skin cancer are less likely to attend. Our purpose was to compare the results of skin cancer screening examinations between persons participating in the 1992 American Academy of Dermatology-sponsored free skin cancer screening and surfers participating in a free beachfront skin cancer screening held in conjunction with a regional surfing competition. The hypothesis was that screening an at-risk population (ie, surfers) would be more productive in terms of incidence of clinically diagnosed malignant skin lesions. Surfers were significantly younger and predominantly male. The incidence of basal cell carcinoma was significantly greater in the surfing population than in the self-selected population with similar ages. This study indicates that directed skin cancer screening of an at-risk population was more productive in finding skin cancer than screening of a self-selected population. Future efforts to identify individuals with skin cancer should be broadened to include high-risk populations such as daytime outdoor athletes and high-risk occupational groups, since they may not be reached by current screening efforts.

  15. Contrast-enhanced spectral mammography (CESM) versus MRI in the high-risk screening setting: patient preferences and attitudes.

    Science.gov (United States)

    Phillips, Jordana; Miller, Matthew M; Mehta, Tejas S; Fein-Zachary, Valerie; Nathanson, Audrey; Hori, Wendy; Monahan-Earley, Rita; Slanetz, Priscilla J

    Our study evaluates patient preferences toward screening CESM versus MRI. As part of a prospective study, high-risk patients had breast MRI and CESM. Patients completed an anonymous survey to evaluate preferences regarding the two modalities. 88% of participants completed the survey. 79% preferred CESM over MRI if the exams had equal sensitivity. 89% would be comfortable receiving contrast as part of an annual screening test. High-risk populations may accept CESM as a screening exam and may prefer it over screening MRI if ongoing trials demonstrate screening CESM to be clinically non-inferior MRI. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cost-effectiveness and radiological risk associated with mammography screening in Italy

    International Nuclear Information System (INIS)

    Toma, S.; Pino, G.; Brighetti, S.

    1987-01-01

    The available evidence, including biological evidence, supports the notion of a non-linear relationship between dosage and effect, especially when comparing small and average cumulative dosage. There is, however, no specific experimental evidence to demonstrate this, as far as we know. Nor is there any evidence of risk from mammography. Nevertheless, this type of examination in young asymptomatic women should be evaluated in terms of risk/benefit, given the essential role played by latency time in tumour development. The cost-effectiveness of mass screening must be evaluated by simulation of models before the screening itself is begun. The use of mathematical methods in the evaluation of the costs and the benefits is, today, necessary to attain to optimizing decisions, for improving social and medical aspects of a mass screening program. This approach needs tools such as: Markov analysis, Queues theory, Monte Carlo method, Decision theory, Linear programming ect., but its advantages are manifest. It permits to choose the best acts for our needs, satisfying at the same time medical and financial aspects

  17. A Randomized Trial of Genetic and Environmental Risk Assessment (GERA) for Colorectal Cancer Risk in Primary Care: Trial Design and Baseline Findings

    Science.gov (United States)

    Myers, Ronald E.; Manne, Sharon L.; Wilfond, Benjamin; Sifri, Randa; Ziring, Barry; Wolf, Thomas A.; Cocroft, James; Ueland, Amy; Petrich, Anett; Swan, Heidi; DiCarlo, Melissa; Weinberg, David S.

    2010-01-01

    Purpose This paper describes an ongoing randomized controlled trial designed to assess the impact of genetic and environmental risk assessment (GERA) on colorectal cancer (CRC) screening. Methods The trial includes asymptomatic patients who are 50-79 years and are not up-to-date with CRC screening guidelines. Patients who responded to a baseline telephone survey are randomized to a GERA or Control group. GERA Group participants meet with a nurse, decide whether to have a GERA blood test (a combination of genetic polymorphism and folate), and, if tested, receive GERA feedback. Follow-up telephone surveys are conducted at one and six months. A chart audit is performed at six months. Results Of 2,223 eligible patients, 562 (25%) have enrolled. Patients who enrolled in the study were significantly younger than those who did not (p<0.001). Participants tended to be 50-59 years (64%), female (58%), white (52%), married (51%), and have more than a high school education (67%). At baseline, most participants had some knowledge of CRC screening and GERA, viewed CRC screening favorably, and reported that they had decided to do screening. Almost half had worries and concerns about CRC. Conclusions One in four eligible primary care patients enrolled in the study. Age was negatively associated with enrollment. Prospective analyses using data for all participants will provide more definitive information on GERA uptake and the impact of GERA feedback. PMID:20828635

  18. 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.

  19. Reaching Graduate Students at Risk for Suicidal Behavior through the Interactive Screening Program

    Science.gov (United States)

    Moffitt, Lauren B.; Garcia-Williams, Amanda; Berg, John P.; Calderon, Michelle E.; Haas, Ann P.; Kaslow, Nadine J.

    2014-01-01

    Suicidal behavior is a significant concern among graduate students. Because many suicidal graduate students do not access mental health services, programs to connect them to resources are essential. This article describes the Interactive Screening Program (ISP), an anonymous, Web-based tool for screening and engaging at-risk graduate school…

  20. Breast cancer screening in BRCA1 and BRCA2 mutation carriers after risk reducing salpingo-oophorectomy

    NARCIS (Netherlands)

    Fakkert, I.E.; Jansen, L.; Meijer, K.; Kok, Theo; Oosterwijk, J.C.; Mourits, M.J.E.; de Bock, G.H.

    Breast cancer screening is offered to BRCA1 and BRCA2 mutation carriers from the age of 25 years because of their increased risk of breast cancer. As ovarian cancer screening is not effective, risk-reducing salpingho-oophorectomy (RRSO) is offered after child bearing age. RRSO before menopause